HIV the developing world

Bruce Boman Dr Joel Wiseman general practitioner June 1981 CDC Bulletin “ five young men, all active homosexuals, were treated for biopsy-proven pneumocystis carinii pneumonia at three different hospitals in Los Angeles, California Two of the patients died.” 23 million people living with HIV 5% prevalence  1.3 million  222,000  21,000 prevalence 0.6% prevalence 0.5% prevalence 0.1%  First reported case AIDS in Australia October 1982  First reported case in Vietnam 1990  Acute seroconversion illness first described by Professor David Cooper from Sydney in the Lancet in 1985  These two photographs summarise the difference between our epidemics In Australia the gay community  Relapse rates of up to 95% when measured by drug testing  Cost per resident US$225 (rural centre) US$641(urban centre)  Cost of NSP over same period US$15-$21  Estimated total cost of mandatory detention centres between 2005 & 2015 US$146.9 million B93 Clubs Cactus Blossom Club for female IDUs & FSWs  The NSW Drug Court  People charged with a drug offence likely to lead to prison  Could plead guilty & be placed in a 12 month closely supervised program in the community  Expected to remain drug & crime free & develop life & job skills  Noncompliance resulted in imprisonment  38% less likely to be reconvicted for a drug offence  30% less likely to be reconvicted for a violent offence  Over follow up period of 1,250 days Of the nightclub strip in Kings Cross in Sydney an experiment to reduce deaths from heroin overdose  While antiretroviral drugs are important in preventing spread from mother to child, prolonging life & improving the quality of life  The only way our two countries can reduce the prevalence of infection is by preventing transmission  Vietnam by reducing unsafe IV drug use & Australia by reducing unprotected sex among gay men ... the world where HIV transmission rates have remained stable over a substantial period of time.”  How has Australia prevented spread of HIV from the gay community into IVDUs & from IVDUs to the. .. Sydney in the Lancet in 1985  These two photographs summarise the difference between our epidemics In Australia the gay community In Vietnam IV drug users  Australia: 64% people living with HIV are... with an HIV infected person 0.5% (RAS)  Insertive anal sex with an HIV infected person 0.065% (IAS) People living with HIV are considerably older in Australia than Vietnam NSW is one of the few