This booklet was prepared by the Aboriginal Health Equity—Sexual Health and Wellbeing team at the South Australian Health and Medical Research Institute (SAHMRI). The booklet is produced for Aboriginal and Torres Strait Islander Awareness Week (ATSIHAW) each year, to highlight human immunodeficiency virus (HIV) rates among Aboriginal and Torres Strait Islander people and inform development of policies and actions to bring rates down. The booklet profiles ATSIHAW and the role played by Aboriginal Community Controlled Health Services and communities in making it such a success.
- In 2018, the HIV notification rate among Aboriginal and Torres Strait Islander people was 4.7 per 100,000, more than twice as high as in the Australian-born non-Indigenous population
- The report recommends that there is enhanced access to NSPs (services providing disposable syringes) for Aboriginal and Torres Strat Islander injecting drug users. Develop culturally appropriate and accessible education and health promotion resources on harm reduction for Aboriginal and Torres Strait Islander injecting drug users, addressing fear and stigma associated with disclosing injecting drug use
- Although there is no data on pre-exposure prophylaxis (PrEP) prescribing for Aboriginal and Torres Strait Islander people since PBS listing, a recent study of inclusion of Aboriginal and Torres Strait Islander participants in PrEP trials undertaken prior to the April 2018 listing of PrEP under the PBS, estimated that trial participation for the population of Aboriginal gay men at high-risk of HIV was significantly less than for non-Indigenous gay men. It was also found that Aboriginal participants were more likely to be lost to follow-up than other trial participants.
- The level of health literacy among Aboriginal communities is low, and there is very poor understanding of HIV exposure risks in communities where HIV rates are increasing. Myths regarding modes of HIV transmission persist, fuelling HIV-related stigma and shame. This complicates efforts to address cultural taboos regarding discussion of sex, sexuality and illicit drug use; undermines efforts to enhance HIV testing rates, including via rollout of point-of-care testing; and limits the reach of mainstream health promotion aiming to enhance understanding of biomedical prevention—PrEP, PEP and treatment as prevention.
- There need to be PrEP campaigns developed that specifically target and engage Aboriginal and Torres Strait Islander people at risk of HIV—gay and bisexual men, transgender people, and people in sero-discordant relationships.