Conceptual medical abstract, rainbow coloured. Binary code and wave lengths. Credit: AdobeStock

Identifying the predictors and consequences of disparities in the uptake of HIV prevention and treatment programs in Australia

The challenge

Australia has set the ambitious target of eliminating HIV transmission, reflecting global strategies “to end the AIDS epidemic” by 2030. We have seen reductions in HIV transmission among Australia-born gay and bisexual men, but not in other sub-populations at higher risk of HIV. To achieve elimination, we need to understand the reasons for gaps in access to prevention technologies among subpopulations. We also need to know whether there were other factors, such as disabilities, financial stress, contact with the justice system and co-morbidities that may have contributed to reduced access to prevention and limited their access to the prevention technologies.

The project

We will develop and implement an innovative data linkage platform that allows us to create a national e-cohort of people with HIV, linking HIV diagnoses from 1997–2025 with eight other national datasets. This comprehensive dataset will enable us to achieve our aims of tracking and analysing (i) missed clinical opportunities for HIV testing; (ii) PrEP uptake and usage; (iii) HIV treatment initiation, adherence, and care; and (iv) HIV-related morbidity and mortality. We will conduct analyses at regular time points to measure the uptake of prevention and treatment technologies in all priority populations. We will identify characteristics associated with lower uptake of the technologies across a broad range of demographic, social, cultural, economic, and health domains.

The method

We will establish a national retrospective e-cohort of all people diagnosed with HIV in Australia between 1997 and 2025, linked with a total of eight national administrative datasets. Membership of the cohort will be defined by a record of a new HIV diagnosis recorded in the National HIV Registry. For each HIV record, from 1997-2025, we will aim to link with records on the same individual from eight other datasets.

The impact

Our research will produce a novel national data linkage platform which provides the comprehensive information needed to inform and evaluate equitable HIV responses in Australia. Findings from the research on the factors associated with gaps in access will support the development of HIV prevention and treatment programs appropriately tailored to ensure equitable outcomes.

Project collaborators

Australian Federation of AIDS Organisations; Western Health Department of Health NSW; Department of Health WA; National Association of People with HIV Australia; Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine; Positive Life NSW; National Aboriginal Community Controlled Health Organisation Department of Health Victoria; Department of Health Queensland; Federation of Ethnic Communities' Councils of Australia.

Project funding

National Health and Medical Research Council Partnership Project