HIV was once considered unstoppable, but the annual figures released today by the Kirby Institute at the University of New South Wales show that overall, Australia has made huge strides in reducing new cases.

Key points: 963 new cases of HIV infection in Australia in 2017, compared to 2,412 at peak of epidemic in 1987

963 new cases of HIV infection in Australia in 2017, compared to 2,412 at peak of epidemic in 1987 7 per cent decline in HIV rates in Australia over past 5 years

7 per cent decline in HIV rates in Australia over past 5 years 41 per cent increase in HIV rates among Aboriginal and Torres Strait Islander people over past 5 years

New figures released today show Australia has made significant progress in reducing rates of HIV, but in some populations rates are increasing, and health authorities say there is much more work to do to make sure prevention measures and treatments reach everyone.

There were 963 new cases of HIV infection in Australia in 2017, compared to 2,412 at the peak of the epidemic in 1987.

"In the past five years, we've seen a 7 per cent decline in HIV in Australia, which is the lowest number on record since 2010," said Professor Rebecca Guy, an epidemiologist and head of the Kirby Institute's Surveillance, Evaluation and Research Program.

"We haven't seen declines like this in a very long time."

It is a success she attributes to more testing, treatment, and preventative measures.

"Australia has really made a strong commitment to try to end HIV, like many countries across the world, and in the past five years there's been a lot of strategies which have been implemented to try and reduce HIV in the community," Professor Guy told RN Breakfast.

Why the decline?

"Men are testing twice as much as they did five years ago," Professor Guy said.

For those living with HIV, treatment improves their health but also suppresses the virus to an undetectable level, meaning it is not transmittable.

Professor Guy said the introduction of pre-exposure prophylaxis, or PrEP, over the past few years had played a role in the reduction of HIV.

PrEP is a similar concept to oral contraception, where a pill is taken as a precaution, rather than as a treatment after infection has occurred.

Recently it has been available through state-funded programs, with the Government putting it on the PBS from April 1, 2018.

The greatest decline in rates was among gay and bisexual men.

Heterosexuals make up 200 of the 1,000 cases every year, and they are diagnosed quite late, according to Professor Guy.

"Half of heterosexuals diagnosed with HIV get their first test more than four years after they have acquired HIV," she said.

The number of diagnoses in Australia has remained stable over the past two decades. ( Kirby Health: HIV in Australia surveillance short report 2018 )

"That's a long time they were unaware they had acquired HIV; they may unknowingly pass it onto someone else.

"[That] suggests the need for greater awareness and strategies to increase testing."

HIV on the rise in some populations

The results are "a mixed story," said associate professor James Ward, who is the head of the Infectious Diseases Research Program, Aboriginal Health at the South Australian Health and Medical Research Institute.

"In 2017, we sustained another increase in HIV notifications, and in fact over the last five years, there's been a 41 per cent increase in notification rate of HIV among Aboriginal and Torres Strait Islander people, compared to a 12 per cent decrease among non-Aboriginal populations," he said.

The report shows Indigenous Australians are two times more likely to be diagnosed with HIV than non-Indigenous Australians, a rate which has been increasingly steadily since 2008 in regional and remote areas of Australia.

Mr Ward said the reasons for the disparity were complex.

"I think we have to go back to point one, which is really about addressing some of these underlying determinants of health that impact on Aboriginal people's health overall," he told The World Today.

"So, education, employment, housing, poverty — they all play into it, and that's part of the reason why HIV and other STIs are increasing in Aboriginal populations."

He said biomedical prevention methods were not working as well for Aboriginal and Torres Strait Islander people as they were for the non-Aboriginal population.

And he said limited access to suitable preventive and diagnostic health care outside of urban settings was also playing a part.

"Where we've seen the increases are in regional and remote areas and they happen to be the areas where there is the least HIV expertise, they happen to be the areas where there are the least gay men, and so efforts are not directed at these areas for gay men," Mr Ward said.

In addition, the limited needle-exchange programs outside urban areas affected the prevention of HIV through injecting drug use.

Professor Guy is advocating a multifaceted approach to any prevention program.

"It needs to address all those different exposure groups and make sure that it's always led by Indigenous people," Professor Guy said.

Australia can continue to lead the way

Professor Darryl O'Donnell, the chief executive of the Australian Federation of AIDS Organisations, said it would take a lot more work, but he said Australia was capable of eliminating HIV.

"Australia is one of the few places in the world that really has the potential to drive HIV to incredibly low levels — what we call virtual elimination of HIV," Professor O'Donnell said.

The Joint United Nations Program on HIV and AIDS has set global targets.

By 2020 it would like to see 90 per cent of people living with HIV diagnosed and treated, and for 90 per cent of people receiving antiretroviral therapy to have viral suppression.

"Australia has for the first time reached targets set by UN aids, so this is a really important moment for Australia," Professor Guy told AM.

"It's a great achievement, there's only very few countries in the world who have achieved those levels of testing and treatment.

"There's new targets being set globally for 2030 and that's our next step … to make sure we keep up the momentum and also enhance the response so we can meet those global targets."