HIV self-test funds ‘a vital step in eradication’

January 25 2023

An article from The Australian titled HIV self-test funds ‘a vital step in eradication’


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Epidemiologists, AIDS organisations and Australia’s only manufacturer of HIV self-testing kits are calling on the federal government to publicly fund the technology, saying it is essential to eradicating the potentially fatal virus.


Despite a fall in HIV infections – from 1082 new diagnoses in 2014 to a record low 552 in 2022 – health experts are concerned decreased testing over the course of the Covid pandemic may have resulted in infections going undetected, particularly among at-risk groups.


In 2020, the number of HIV tests in publicly funded sexual health clinics in NSW decreased by 38 per cent compared with 2019.


Program head of the Kirby Institute’s HIV epidemiology and prevention program Andrew Grulich said HIV testing was critical to prevention, enabling positive cases to be immediately linked to treatment, which rapidly reduced their viral load and capacity to transmit the virus.


Australia has a target of diagnosing at least 90 per cent of all those living with HIV, based on World Health Organisation recommendations.

“We’re close to 90 per cent, but we certainly can do better, and we have some populations where we’re a lot less than 90 per cent,”

Professor Grulich said.

“The most important of those groups is overseas-born gay and bisexual men. These men often live in communities where the stigma associated with both HIV and simply being gay is very high.

“In these communities, HIV testing is not as high as it should be, and this is where self-testing comes in. Having ready access to testing would be a real step forward for those people who … don’t want to get tested by a doctor.

“Public funding of home-based tests would absolutely make a ­difference. There is strong evidence cost is a barrier to testing.

“We are targeting HIV elimination, and we won’t get (that) unless we can increase testing rates.”

In October 2021, the Therapeutic Goods Administration ­approved HIV self tests made by Sydney-headquartered Atomo Diag­nostics for sale in pharmacies, where it retails for about $25. The TGA found the Atomo tests to have a sensitivity of 99.6 per cent.


Last year, the US Centres for Disease Control announced $US41.5m ($59m) over five years to supply home testing kits – putting pressure on Australia to follow suit. The number of people living in Australia with HIV in 2021 was estimated to be 29,460, compared with almost 1.2 million aged 13 and older in the US.


Professor Grulich said although home tests were slightly less accurate than blood tests at a doctor’s surgery or sexual health clinic and processed in a laboratory, the boost in testing rates more than compensated for any risk of incorrect results.


Atomo Diagnostics chief executive John Kelly said Australia had historically been very slow at adopting point-of-care and community-based testing, and likened the failure so far to publicly fund HIV self-testing to the pace with which rapid antigen tests were rolled out amid the Covid pandemic.

“As an Australia-headquartered and listed company, it’s frustrating we sell this test to governments all over the world and we struggle to have a conversation with the government here about public health support,”

he said.

“We’re way behind the OECD average in terms of moving away from laboratory testing, and the dogma around insisting on lab testing in Covid, for PCR rather than more cost-effective antigen programs, is a clear example of that bias in the system,”

Mr Kelly said.


Australian Federation of AIDS Organisations chief executive Darryl O’Donnell said HIV self-testing was a “critical piece of the puzzle” in the push to end transmission of the virus in Australia.


A Health Department spokeswoman said Health Minister Mark Butler “has announced the establishment of an expert advisory group that will drive Australia’s HIV response and the implementation of the 9th National HIV Strategy”.


Much of the recent fall in new HIV cases has been attributed to pre-exposure prophylaxis, or PrEP, a medication 100 per cent effective at preventing HIV transmission and which has been available through the PBS since 2018.

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