A HIV diagnosis and treatment cascade for Aboriginal and Torres Strait Islander peoples of Australia

ABSTRACT

Aboriginal and Torres Strait Islander (hereafter Aboriginal) people are a priority population for HIV care in Australia; however, no HIV cascade exists for this population. We developed annual HIV cascades for 2010–2017 specific to Aboriginal peoples. By 2017, an estimated 595 Aboriginal people were living with HIV (PLWH); however, 14% remained undiagnosed. Cascade steps below global targets were: PLWH aware of their diagnosis (86%), and retention in care (81% of those who had received any care in previous two years in a sentinel network of clinics). For people retained in care, treatment outcomes surpassed global targets (92% receiving treatment, 93% viral suppression). Increases occurred across all HIV cascade steps over time; however, the least improvement was for retention in care, while the greatest improvement was achieving viral suppression. The HIV cascade for Aboriginal peoples highlights both gaps and strengths in the Australian HIV care system, and importantly highlights where potential interventions may be required to achieve the global UNAIDS targets.

KEYWORDS:

• Australia [MeSH]
• HIV [MeSH]
• Aboriginal and Torres Strait Islander
• treatment cascade
• diagnosis cascade

Acknowledgements

The authors wish to thank the Australian HIV Diagnosis and Care Reference Group for their input. JW is supported by a Sylvia and Charles Viertel Senior Medical Research Fellowship. ACCESS receives Australian Commonwealth Government funding. The Kirby Institute is funded by the Australian Government Department of Health and is affiliated with the Faculty of Medicine, UNSW Sydney, Australia. All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Richard Gray, Jacqueline Stephens and Tobias Vickers. The first draft of the manuscript was written by Jacqueline Stephens. All authors commented on previous versions of the manuscript, and all authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of this study are available on request from the Kirby Institute. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.