UNSW Annual Surveillance Report 2013

2013
HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report
The Kirby Institute for infection and immunity in society 2013

ISSN 1838 5559
This publication is available at Internet address http://www.kirby.unsw.edu.au Suggested citation: The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013. The Kirby Institute, The University of New South Wales, Sydney NSW 2052 The Kirby Institute for infection and immunity in society The University of New South Wales, Sydney NSW 2052 Telephone: 02 9385 0900 Facsimile: 02 9385 0920 International prefix: 61 2 Email: recept@kirby.unsw.edu.au
2013
Prepared by Melanie Middleton, Megan Tapia, David Wilson, Ann McDonald
The Kirby Institute

in collaboration with Australian Gonococcal Surveillance Programme Communicable Diseases Network Australia Centre in Social Research in Health National Serology Reference Laboratory, Australia and collaborating networks in surveillance for HIV, viral hepatitis and sexually transmissible infections
The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine, The University of New South Wales. The Surveillance and Evaluation Program at The Kirby Institute is responsible for the public health monitoring and evaluation of patterns of transmission of bloodborne viral and sexually transmissible infections and is a research associate of the Australian Institute of Health and Welfare. Its work is overseen by the Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis.
2013
Contents
Preface 1 Acknowledgments 3 Summary 7 Main Findings
HIV infection Viral hepatitis Sexually transmissible infections other than HIV HIV, viral hepatitis and sexually transmissible infections in selected populations Men who have sex with men Aboriginal and Torres Strait Islander people People who inject drugs Heterosexual transmission of HIV infection Monitoring genital warts Illness and treatment in people with HIV infection and viral hepatitis
9
9 12 16 18 18 20 23 25 27 29
Tables 33 Methodological notes 125
References 133
Tables
1 National surveillance for newly diagnosed HIV infection 1.1 National HIV Registry 1.2 Monitoring incident HIV infection 1.3 National surveillance for newly diagnosed HIV infection in Aboriginal and Torres Strait Islander people 1.4 National surveillance for perinatal exposure to HIV 1.5 Global comparisons for HIV 2 National surveillance for viral hepatitis 2.1 Notification of viral hepatitis to the National Notifiable Diseases Surveillance System 2.2 National surveillance for viral hepatitis in Aboriginal and Torres Strait Islander people 2.3 Long term outcomes among people with chronic viral hepatitis 2.4 Global comparisons of hepatitisB virus prevalence 3 National surveillance for sexually transmissible infections 35 35 42 44 46 49 53 53 62 66 67 71
3.1 Notification of specific sexually transmissible infections to the National Notifiable Diseases Surveillance System 71 3.2 National surveillance for sexually transmissible infections in Aboriginal and Torres Strait Islander people 3.3 Gonococcal isolates 4 HIV, viral hepatitis and sexually transmissible infections in selected populations 4.1 HIV seroprevalence among people seen at sexual health clinics 4.2 HIV and hepatitisC seroprevalence among people who inject drugs 4.3 Incidence of hepatitisC infection among people who inject drugs 4.4 HIV, hepatitisB surface antigen and hepatitisC antibody in blood donors 4.5 Genital Warts Surveillance Network 5 Risk behaviour 5.1 Sexual, injecting and HIV antibody testing behaviour among men who have sex with men 5.2 Sexual and injecting behaviour among people who inject drugs 6 Estimates of the number of people living with HIV infection and viral hepatitis 6.1 Estimates of the number of people living with diagnosed HIV infection 6.2 Estimates of the number of people living with viral hepatitis 7 Uptake of treatment for HIV infection and viral hepatitis 7.1 Uptake of antiretroviral treatment for HIV infection 7.2 Monitoring prescriptions for HIV treatment 7.3 Monitoring prescriptions for viral hepatitis 75 84 86 86 92 100 102 106 110 110 111 118 118 118 120 120 122 123
2013
Preface
This report is the seventeenth annual review of available surveillance data pertaining to the occurrence of HIV, viral hepatitis and sexually transmissible infections in Australia. It is intended to be a reference document for organisations and individuals interested in the occurrence of these infectious diseases in Australia, drawing together relevant data from many sources into a single comprehensive report. The report is available at Internet address http://www.kirby.unsw.edu.au . The Australian HIV Public Access Dataset, holding records of cases of HIV infection, diagnosed in Australia by 31 December 2012 and reported by 31 March 2013, is also available through the website http://www.kirby.unsw.edu.au The main findings of the report are presented as text, supported by figures. The underlying data are presented as tables and follow the main report. The tables are provided with no commentary, except for brief explanatory footnotes. A methodological summary follows the tables, along with references to other documents and reports which provide further information. The accompanying report Bloodborne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander people: Surveillance and Evaluation Report 2013 presents a detailed analysis of the occurrence of bloodborne viral and sexually transmitted infections in a format designed to be accessible for Aboriginal and Torres Strait Islander health services and communities. The report is available at Internet address http://www.kirby.unsw.edu.au Some of the information regarding risk behaviour which appears in this report is also published, along with further behavioural data, in the report HIV/AIDS, HepatitisC and Sexually Transmissible Infections in Australia Annual Report of Trends in Behaviour 2013, edited by the Centre for Social Research in Health. Specifically, data reported in Tables 5.1.1 and 7.1.2 of HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013 also appears in the report on behavioural data. Unless specifically stated otherwise, all data provided in the report are to the end of 2012, as reported by 31 March 2013. All data in this report are provisional and subject to future revision. This report could not have been prepared without the collaboration of a large number of organisations involved in health services throughout Australia. The ongoing contribution of all collaborating organisations, listed in the following section, to national surveillance for HIV, viral hepatitis and sexually transmissible infections is gratefully acknowledged.
HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013
2013
Acknowledgments
National organisations
Association for Prevention and Harm Reduction Programs, VIC Australasian Society for HIV Medicine, Sydney, NSW Australia and New Zealand Liver Transplant Registry, Sydney, NSW Australian Federation of AIDS Organisations, Sydney, NSW Australian Government Department of Health and Ageing, Canberra, ACT Australian Injecting and Illicit Drug Users League, ACT Australian Institute of Health and Welfare, Canberra, ACT Australian Paediatric Surveillance Unit and its contributors, Westmead, NSW Australian Red Cross Blood Service, Melbourne, VIC Centre for Social Research in Health, The University of New South Wales, NSW Communicable Diseases Network Australia, Canberra, ACT Hepatitis Australia, Canberra, ACT National Aboriginal Community Controlled Health Organisation, ACT National Association of People Living with HIV/AIDS, Sydney, NSW National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, NSW National Serology Reference Laboratory, Australia, Fitzroy, VIC
State/Territory health departments

Communicable Disease Control, Health Directorate, ACT Government, Canberra, ACT Centre for Health Protection, NSW Ministry of Health, North Sydney, NSW Sexual Health and Blood Borne Virus Unit, CDC, Department of Health and Families, Darwin, NT Queensland Health, Brisbane, QLD STI and BBV Section, Communicable Disease Control Branch, SA Health, Adelaide, SA Department of Health and Human Services, Hobart, TAS Communicable Disease Epidemiology and Surveillance, Health Protection Branch, Victorian Government Department of Health, Melbourne, VIC; The Macfarlane Burnet Institute for Medical Research and Public Health Limited, Prahran; HepatitisB Program, Epidemiology Unit, Victorian Infectious Diseases Reference Laboratory, VIC Communicable Diseases Control Branch, Department of Health, Perth, WA
Australian Gonococcal Surveillance Programme

Reference Laboratories:
Microbiology Department, Canberra Hospital, Woden, ACT Department of Microbiology, The Prince of Wales Hospital, Randwick, NSW Microbiology Laboratory, Royal Darwin Hospital, Casuarina, NT Queensland Health Scientific Services, Coopers Plains, QLD SA Pathology at Womens and Childrens Hospital, North Adelaide, SA Department of Microbiology and Infectious Diseases, Royal Hobart Hospital, Hobart, TAS The Microbiological Diagnostic Unit (PHL), Department of Microbiology and Immunology, University of Melbourne, Parkville, VIC Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, WA
Collaborative group on sentinel surveillance in sexual health clinics

Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW Royal Prince Alfred Hospital Sexual Health Clinic, Camperdown, NSW Brisbane Sexual Health Clinic, Brisbane, QLD Gold Coast Sexual Health Clinic, Miami, QLD Clinic 275, Adelaide, SA Melbourne Sexual Health Centre, Melbourne, VIC
Genital Warts Surveillance Network

Contributing organisations
Northern Sydney Sexual Health Service, St Leonards; Royal Prince Alfred Hospital Sexual Health Clinic, NSW NT Sexual Health and BBV Unit, NT Cairns Sexual Health Services, Cairns Base Hospital, Cairns; Gold Coast Sexual Health Clinic, Miami, QLD Hobart, Devonport and Launceston Sexual Health Service, TAS Melbourne Sexual Health Centre, Carlton, VIC Fremantle Hospital, Fremantle, WA
Australian HIV Observational Database

Tamworth Sexual Health Service, Tamworth; Blue Mountains Sexual Health Clinic, Katoomba; Holdsworth House Medical Practice, Darlinghurst; Illawarra Sexual Health, Wollongong; Royal Prince Alfred Hospital Sexual Health Clinic, Camperdown; Macquarie Sexual Health Centre, Dubbo; Nepean Sexual Health and HIV Clinic, Penrith; Holden Street Clinic, Gosford; Lismore Sexual Health & AIDS Services, Lismore; St Vincents Hospital, Darlinghurst; Sydney Sexual Health Centre, Sydney, Dr Ellis General Medical Practice, Coffs Harbour; Taylor Square Private Clinic, Darlinghurst; East Sydney Doctors, Surry Hills; Parramatta Sexual Health Clinic, Parramatta; Albion Street Centre, Sydney; Clinic 16, St Leonards, NSW Communicable Disease Centre, Royal Darwin Hospital, Darwin, NT AIDS Medical Unit, North Quay; Clinic 87, Sunshine Coast & Cooloola HIV Sexual Health Service, Nambour; Gladstone Road Medical Centre, Highgate Hill; Gold Coast Sexual Health Clinic, Miami; Cairns Sexual Health Services, Cairns Base Hospital, Cairns, QLD The Care and Prevention Program, Adelaide University, Adelaide, SA The Alfred Hospital, Prahran; Melbourne Sexual Health Centre, Carlton; Monash Medical Centre, Clayton; Prahran Market Clinic, South Yarra; The Centre Clinic, St Kilda; The Carlton Clinic, Carlton; Northside Clinic, Fitzroy North, VIC Department of Clinical Immunology, Royal Perth Hospital, Perth, WA
Collaboration of Australian Needle and Syringe Programs

Directions, ACT. ACON Hunter; Central Coast NSP Services, Gosford, Long Jetty and Woy Woy; First Step Program, Port Kembla and Nowra; Health ConneXions, Liverpool; Hunter Harm Reduction Services, Newcastle; Kirketon Road Centre and Clinic 180, Kings Cross; Mid North Coast Harm Reduction, Coffs Harbour; Murrumbidgee Harm Reduction, Albury and Wagga Wagga; NSW Users and AIDS Association (NUAA), Surry Hills; Northern NSW Harm Reduction, Ballina, Byron Bay, Grafton, Lismore, Murwillumbah, Nimbin, and Tweed Heads; Resource and Education Program for IDUs, Redfern; Central Access Service, Kogarah and Sutherland; South Court Primary Care NSP, Nepean; Western Sydney HIV/HepatitisC Prevention Service, Blacktown, Mt Druitt and Parramatta. Northern Territory AIDS and HepatitisC Council, Alice Springs, Darwin and Palmerston, NT. Biala Community Alcohol and Drug Services, Brisbane; Cairns ATODS NSP, Cairns; Queensland Injectors Health Network (QuIHN), Brisbane, Gold Coast and Sunshine Coast; Kobi House, Toowoomba; West Moreton Sexual Health Service, Ipswich; Townsville ATODS NSP. Drug and Alcohol Services South Australia, Adelaide; Hindmarsh Centre, Hindmarsh; Nunkuwarrin Yunti Community Health Centre, Adelaide; South Australia Voice for Intravenous Education (SAVIVE): AIDS Council South Australia, Norwood; Parks Community Health Service, Adelaide; Port Adelaide Community Health Service, Port Adelaide; Noarlunga Community Health Service, Adelaide; Northern Metropolitan Community Health Service NSP and Shopfront, Salisbury. Anglicare NSP Service, Hobart and Glenorchy; Clarence Community Health Centre, Clarence; Devonport Community Health Centre, Devonport; Salvation Army Launceston, Launceston. Barwon Health Drug and Alcohol Services, Geelong; Health Information Exchange, St Kilda; Health Works, Footscray; Inner Space, Collingwood; North Richmond NSP, North Richmond; Southern Hepatitis/HIV/AIDS Resource and Prevention Service (SHARPS), Melbourne. WA AIDS Council Mobile Exchange, Perth; Western Australia Substance Users Association (WASUA), Perth and South Coast. St Vincents Centre for Applied Medical Research (AMR) and NSW State Reference Laboratory for HIV at St Vincents Hospital, Sydney, NSW.
Annual Surveillance Report 2013 Advisory Committee

Dr Russell Waddell, Australasian Chapter of Sexual Health Medicine, Sydney, NSW Dr Benjamin Cowie, Australasian Society for HIV Medicine, NSW Ann Roberts, Australasian Society for HIV Medicine, NSW Simon Donohoe, Australian Federation of AIDS Organisations, Sydney, NSW Amy Bright, Australian Government Department of Health and Ageing, Canberra, ACT James Ward, Baker Institute, Alice Springs, NT Dr Limin Mao, Centre for Social Research in Health, The University of New South Wales, Sydney, NSW Helen Tyrrell, Hepatitis Australia, Canberra, ACT Jo Watson, National Association of People Living with HIV/AIDS, Sydney, NSW Associate Professor David Wilson (Chair), Professor Basil Donovan, Professor Lisa Maher, Associate Professor Rebecca Guy, Dr Iryna ZablotskaManos, Ann McDonald, Melanie Middleton, Andrew Nakhla, The Kirby Institute
2013
Summary
HIV infection
A total of 1253 cases of HIV infection was newly diagnosed in Australia in 2012, a 10% increase over the number in 2011. The annual number of new HIV diagnoses has gradually increased over the past 13 years, from 724 diagnoses in 1999. An estimated 25708 people were living with diagnosed HIV infection in Australia at the end of 2012. Trends in newly diagnosed HIV infection have differed across State and Territory health jurisdictions. In New South Wales, the rate of HIV diagnosis per 100000 population declined steadily from 6.3 in 2003 to 4.9 in 2010 and then increased to 6.2 in 2012. In Victoria, the rate increased from around 5.0 in 20032007 to 5.3 in 20082012. Population rates of HIV diagnosis increased over time in Queensland, from around 4.0 in 20032007 to 4.9 in 20082012, in Western Australia, from 3.1 to 4.0, and in Tasmania, from 1.4 to 2.8. Increasing HIV diagnosis rates were also reported in the Australian Capital Territory and in the Northern Territory but have remained relatively stable in South Australia. HIV continued to be transmitted primarily through sexual contact between men. The number of diagnoses of newly acquired HIV infection in Australia increased from 286 in 2008 to 397 in 2012. Diagnoses of newly acquired HIV infection indicate the lower bound to the number of cases of recent HIV transmission that have actually occurred in Australia. Use of a laboratory test for detecting recent HIV infection among cases newly diagnosed in 2012 resulted in an increase in cases with evidence of recent infection of 30%. The per capita rate of HIV diagnosis in the Aboriginal and Torres Strait Islander population was similar to that in the nonIndigenous population, excluding cases and populations from high HIV prevalence countries. Aboriginal and Torres Strait Islander cases of HIV infection differed from nonIndigenous cases, in that a substantially greater proportion were attributed to injecting drug use (13% compared with 2%) in the five years 20082012. Of 1364 cases of HIV infection newly diagnosed in 20082012, for which exposure to HIV was attributed to heterosexual contact, 58% were in people from high prevalence countries or their partners.
Viral hepatitis
The per capita rate of diagnosis of hepatitisB infection in Australia in 20082012 was stable at around 31 per 100000 population. The rate of diagnosis of newly acquired hepatitisB infection steadily declined in Australia from 1.2 in 2008 to 0.8 per 100000 population in 2012. An estimated 207000 people were living in Australia in 2012 with hepatitisB infection. An estimated 383 deaths in 2012 were attributable to chronic hepatitisB infection. The estimated prevalence of chronic hepatitisB infection in the Australian population was 0.97%. The per capita rate of diagnosis of hepatitisC infection declined from 52.5 in 2008 to 44.2 per 100000 population in 2012. An estimated 230000 people were living in Australia with chronic hepatitisC infection, including 58000 with moderate to severe liver disease. The reported annual number of diagnoses of newly acquired hepatitisC infection increased from 365 to 466 in 20082012 and accounted for 4.6% of new hepatitisC diagnoses in 2012. Based on reported cases, hepatitisB and hepatitisC transmission in Australia continued to occur predominantly among people with a recent history of injecting drug use. In 2012, chronic hepatitisB infection and chronic hepatitisC infection were the underlying causes of liver disease in 5.6% and 22% of liver transplants, respectively. The proportion of people seen at needle and syringe programs who reported having injected drugs for five years or less was stable in 20082012 at around 10%. Within this group, hepatitisC prevalence declined from 28% in 2008 to 17% in 2012.
Sexually transmissible infections other than HIV

Chlamydia was the most frequently reported notifiable condition in Australia in 2012 with 82707 diagnoses. The population rate of diagnosis of chlamydia in 2012 was 355 per 100000 population. The number of diagnoses of donovanosis declined from 2 in 2008 to 0 in 2011 and 1 in 2012, demonstrating the continuing success of efforts to eliminate donovanosis from the Australian population. The rate of diagnosis of gonorrhoea increased by 67%, from 35.1 per 100000 population in 2008 to 58.9 in 2012. The rate of diagnosis of infectious syphilis increased among males from 6.1 in 2008 to 6.7 in 2012. Increased rates of infectious syphilis in 2012 occurred in Queensland, Victoria and New South Wales and declining rates were reported in Western Australia and the Northern Territory. Substantially higher rates of diagnosis of chlamydia and gonorrhoea were recorded in the Aboriginal and Torres Strait Islander population compared with nonIndigenous population. Following the introduction of vaccination against human papilloma virus, the proportion of young women aged 21 years or younger who were diagnosed with genital warts decreased from 12.1% in 2007 to 1.1% in 2012.
2013
Main Findings
HIV infection
The annual number of new HIV diagnoses in Australia increased to 1253 cases in 2012, a 10% increase over the numbers diagnosed in 2011. The number of new diagnoses has steadily increased over the past 13 years from 724 cases in 1999 (Figure 1). The rate of HIV diagnosis per 100000 population has increased from 4.3 in 2003 to 5.4 in 2012, a 26% increase (Figure 2a and 2b). Figure 1
NUMBER 2 500 2 000 1 500 1000 500 0
Newly diagnosed HIV infection in Australia by year
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012 YEAR
New HIV diagnoses
Recent trends in the population rate of newly diagnosed HIV infection have differed across Australia. In New South Wales, the rate of HIV diagnosis declined from 6.3 per 100000 population in 2003 to 4.8 in 2010 and then increased to 6.2 in 2012 (Figure 2a). In Victoria, the rate of HIV diagnosis increased from around 5.0 in 20032007 to 5.3 in 20082012. Population rates of HIV diagnosis have increased over time in Queensland, from around 4.0 in 20032007 to 4.9 in 20082012, in Western Australia, from 3.1 to 4.0, and in Tasmania, from 1.4 to 2.8. Increases in the population rate of HIV diagnosis have also occurred in the Australian Capital Territory and in the Northern Territory but have remained relatively stable South Australia over the past 10 years. The median age at HIV diagnosis among males declined to 36 years in 2012 after having remained stable at 37 and 38 years from 2004 to 2011 (Table 1.1.1). Figure 2 (a) Newly diagnosed HIV infection, 20032012, by year and State/Territory
AGE STANDARDISED RATE PER 100 000 10 9 8 7 6 5 4 3 2 1 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR NSW QLD VIC Australia
Figure 2 (b) Newly diagnosed HIV infection, 20032012, by year and State/Territory
AGE STANDARDISED RATE PER 100 000 10 9 8 7 6 5 4 3 2 1 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR ACT NT SA TAS WA Australia
Of 1253 cases of HIV infection newly diagnosed in Australia in 2012, 190 (15.2%) had been previously diagnosed overseas (Table 1.1.3). These cases have generally been included in past counts and are included in the count for 2012. Figure 3
NUMBER 1 400 1 200 1 000 800 600 400 200 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Newly diagnosed HIV infection in Australia, 20032012, by newly acquired HIV status and year
YEAR OF HIV DIAGNOSIS Newly acquired HIV Other HIV diagnoses
Figure 4
AGE STANDARDISED RATE PER 100 000 3 2.5 2 1.5 1 0.5 0
Newly acquired HIV infection, 20032012, by year and State/Territory
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Among cases of newly diagnosed HIV infection, the proportion who acquired the infection in the 12 months prior to diagnosis gradually increased from 26% in 2007 to 32% in 2012 (Figure 3). The population rate of diagnosis of newly acquired HIV infection in New South Wales declined from 2.2 in 2003 to 1.6 in 2007 and increased to 2.3 and 2.5 in 2011 and 2012, respectively. The rate in Queensland increased from 1.1 in 20032007 to 1.3 in 20082012 whereas in Victoria, the rate was relatively stable over the past 10 years. In Western Australia, the rate in 20112012 was stable after substantial increases in 2010 and 2011 (Figure 4).
10
Figure 5
HIV diagnoses in Australia, 20082012, by HIV exposure category

6% 3% 25% 1% 9% 2%
2%
64% 3% 85%
NEWLY DIAGNOSED HIV INFECTION

Men who have sex with men Injecting drug use
NEWLY ACQUIRED HIV INFECTION

Heterosexual contact
Men who have sex with men and injecting drug use Other/undetermined
Transmission of HIV in Australia continues to occur primarily through sexual contact between men (Figure 5). In 20082012, 67% of new HIV diagnoses occurred among men who have sex with men, 25% were attributed to heterosexual contact, 2% to injecting drug use and exposure was undetermined in 6%. Men who have sex with men accounted for 88% of diagnoses of newly acquired HIV infection. Exposure to HIV was attributed to heterosexual contact and injecting drug use in 9% and 1%, respectively, of diagnoses of newly acquired HIV infection. Figure 6
AGE STANDARDISED RATE PER 100 000 32 28 24 20 16 12 8 4 0 Australia Other Oceania United Kingdom and Ireland Other Europe Middle East/ North Africa Sub-Saharan Africa Asia North America South/Central America and the Caribbean REGION OF BIRTH 2003 2007 2008 2012
HIV diagnoses in Australia, 20032012, by year and region of birth
A new HIV surveillance program has been established to provide a more complete indication of recent HIV transmission than is available through diagnoses of newly acquired infection. Testing of cases of HIV infection newly diagnosed in Australia in 2012 with a specialised laboratory test identified 125 additional cases of recent infection, resulting in a 30% increase over the number of diagnoses of newly acquired HIV infection. People born in Australia accounted for 54% of cases of HIV infection newly diagnosed in 20082012. Among Australian born cases, the rate of HIV diagnosis increased from 4.1 in 2008 and 2009 to 4.9 in 2012 (Figure 6). The rate of HIV diagnosis in the overseas born population increased from 7.1 in 2008 to 9.5 in 2012. The population rate of HIV diagnosis in the subSaharan Africanborn and Asianborn populations in the 5 years from 2008 to 2012 compared to the previous 5 years increased by 66% and the rate in the Oceania population other than Australia increased by 62%. Among cases of HIV infection newly diagnosed in the past five years, 10% were in people who reported speaking a language other than English at home.
11
Figure 7
New Zealand China Australia United Kingdom Canada Indonesia Italy France Spain Malaysia United States Vietnam Cambodia Myanmar Papua New Guinea Thailand
HIV prevalence in selected countries
200
400
600
800
1000
1200
HIV PREVALENCE PER 100 000
At the end of 2012, an estimated 2800034000 people were living with HIV infection in Australia of whom approximately 25700 were diagnosed with their infection. As an overall national prevalence (130 158 per 100000), the level of HIV infection in Australia is slightly lower than in the United Kingdom in 2011 (150 per 100000 population) and three to fourfold lower than in the United States in 2009 (456 per 100000) (Figure 7).
Viral hepatitis
The population rate of reported diagnoses of hepatitis A infection in Australia remained below at 1.3 per 100000 population in 20082012, except in 2009, when a large multijurisdictional outbreak of hepatitis A infection resulted in an increased rate of 2.6 (Table 2.1.1). Figure 8
NOTIFICATION RATE PER 100 000 40 35 30 25 20 15 10 5 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR Males Females
HepatitisB notifications, 20032012, by year and sex
12
Figure 9
NOTIFICATION RATE PER 100 000 80 70 60 50 40 30 20 10 0
HepatitisB notifications, 20032012, by year and age group
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
04
5 14
15 19
20 24
25 29
30 39
40+
The population rate of diagnosis of hepatitisB infection in Australia declined from 31.0 in 2008 to 29.1 in 2012 (Figure 8). The decreases in the rate of hepatitisB diagnosis were among people aged 2024 years, from 54.3 in 2003 to 39.8 in 2012 and among those aged 1519 years, from 27.1 in 2003 to 17.6 in 2012 (Figure 9). The number and rate of diagnosis of newly acquired hepatitisB decreased from 262 and 1.2 in 2008 to 193 and 0.8 in 2012 (Figure 10). The rate of diagnosis of newly acquired hepatitisB infection declined substantially from 2003 among people aged 1519 years, 2024 years and 2529 years (Figure 11). Adolescent catch up vaccination programs may have contributed in this reduction. However, the rate of diagnosis of newly acquired hepatitisB infection also declined among those aged 30 years or older. Figure 10
NOTIFICATION RATE PER 100 000 2.5 2 1.5 1 0.5 0
Newly acquired hepatitisB notifications, 20032012, by year and sex
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
Males
Females
13
Figure 11
NOTIFICATION RATE PER 100 000 5 4 3 2 1 0
Newly acquired hepatitisB notifications, 20032012, by year and age group
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
04
5 14
15 19
20 24
25 29
30 39
40+
In 2012, the estimated number of people living in Australia with chronic hepatitisB was 207000. As a national prevalence (0.97%), the level of hepatitisB infection in Australia is greater than in New Zealand and the United Kingdom but substantially less than prevalence levels in many countries of birth of people living in Australia (Figure 12). Figure 12 Estimated prevalence of chronic hepatitisB infection in Australia by country of birth
New Zealand United Kingdom Australia Sri Lanka Italy Greece India Korea, Republic of (South) Malaysia Fiji Philippines Cambodia Afghanistan Taiwan China (excluding Taiwan) Viet Nam 0 2 4 6 8 10 12 14
HEPATITIS B PREVALENCE (%)
The number and rate of diagnosis of hepatitisC infection per 100000 population declined from 11308 and 52.5 in 2008 to 10114 and 44.2 in 2012. Declines have been observed in all age groups. In the past ten years, the rate declined by 59% in the 1519 year age group, by 56% in the 2024 year age group and by 50% in the 2529 year age group (Figure 13).
14
Figure 13
HepatitisC notifications, 20032012, by year and age group
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
04
5 14
15 19
20 24
25 29
30 39
40+
Figure 14
NOTIFICATION RATE PER 100 000 12 10 8 6 4 2 0
Newly acquired hepatitisC notifications, 20032012, by year and age group
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
04
5 14
15 19
20 24
25 29
30 39
40+
Around 4.6% of cases of hepatitisC infection diagnosed in 20082012 were documented as having been acquired within the previous two years. Reported hepatitisC transmission continued to occur at the highest rate among adults aged 2024 and 2529 years (Figure 14), primarily those with a history of injecting drug use (Table 2.1.13). Among people who inject drugs seen at the Kirketon Road Centre in Sydney, hepatitisC incidence ranged 6.0 per 100 person years in 2009 to 14.8 in 2011 (Table 4.3.1). HepatitisC incidence among hepatitisC negative people who inject drugs enrolled in the HepatitisC Incidence and Transmission Studycommunity (HITSc) in Sydney was 10.2 per 100 person years in 2009 and 8.5 in the years 20112012 (Table 4.3.2). The vast majority of diagnoses of newly acquired hepatitisB infection and newly acquired hepatitisC infection occurred among Australian born people. The proportion of diagnoses of newly acquired hepatitisB infection among overseas born people was lower (Europe, North and South America and the Caribbean) or higher (Oceania, Middle East, Africa and Asia) than the proportion of people in Australia from these countries (Table 2.1.8). By contrast, the proportion of diagnoses of newly acquired hepatitisC was substantially lower than the proportion of people in Australia who were born overseas (Table 2.1.14). An estimated 207000 people were living with hepatitisB infection and 383 deaths were attributed to chronic hepatitisB infection in 2012 (Table 6.2.1). This is a significant increase compared with previous years and is the result of revised estimates of net overseas migration since the last Census in 2006. The prevalence of chronic hepatitisB infection in the Australian population was 0.97% and was greater than 10% among people born in Vietnam, China, Taiwan, Afghanistan and Cambodia (Table 2.4.1) An estimated 310000 people living in Australia in 2012 had been exposed to hepatitisC virus. Of these, 80000 people were estimated to have cleared their infection, 173500 had chronic hepatitisC infection and early liver disease (stage F0/1), 51500 had chronic hepatitisC infection and moderate liver disease (stage F2/3), and 6500 were living with hepatitisC related cirrhosis. HepatitisC prevalence in 2012 was approximately 140 times lower among blood donors (0.01%) than the estimated prevalence of hepatitisC infection in the Australian population as a whole (1.4%) (Figure 38).
15
Sexually transmissible infections other than HIV

Chlamydia was the most frequently reported infection in Australia in 2012, with 82707 newly diagnosed cases. The population rate of reported diagnoses more than doubled in both the male and female populations, from 125 in 2003 to 307 per 100000 male population in 2012, and from 181 in 2003 to 419 per 100000 female population in 2012 (Figure 15). Figure 15
NOTIFICATION RATE PER 100 000 450 400 350 300 250 200 150 100 50 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR Males Females
Chlamydia notifications, 20032012, by year and sex
Figure 16
NOTIFICATION RATE PER 100 000 2 000 1800 1600 1400 1200 1000 800 600 400 200 0
Chlamydia notifications, 20032012, by year and age group
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
04
5 14
15 19
20 24
25 29
30 39
40+
Increasing rates of diagnosis of chlamydia were reported in the majority of states and territories. Diagnoses in the 1524 year age group accounted for 81% of the annual number (Figure 16). In 20082012, the femaletomale sex ratio in the 1519 year age group was 3:1 whereas it was 1.3:1 in the 2029 year age group. Age and sex specific patterns of diagnosis may have been influenced by differential testing rates. In the Northern Territory, Queensland and Tasmania, the rates of chlamydia diagnosis declined in 2012 compared with 2011 and these declines are the first to have occurred in the past 10 years.
16
Figure 17
NOTIFICATION RATE PER 100 000 90 80 70 60 50 40 30 20 10 0
Gonorrhoea notifications, 20032012, by year and sex
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
Males
Females
Figure 18
NOTIFICATION RATE PER 100 000 200 180 160 140 120 100 80 60 40 20 0
Gonorrhoea notifications, 20032012, by year and age group
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
04
5 14
15 19
20 24
25 29
30 39
40+
Following a stable population rate of gonorrhoea diagnosis in both males and females in the years from 2003 to 2007, the rate increased to 84.3 and 36.1 among males and females, respectively, in 2012 (Figure 17). The rates of diagnosis of gonorrhoea increased almost 3 fold in New South Wales, 2.5 times in Victoria and by 53% in Queensland and 12% in Western Australia. In the past ten years, the rate of gonorrhoea diagnosis was highest among people aged 2024 years and 1519 years (Figure 18). Figure 19
NOTIFICATION RATE PER 100 000 14 12 10 8 6 4 2 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR Males Females
Infectious syphilis notifications, 20042012, by year and sex
17
Figure 20
Infectious syphilis notifications, 20042012, by year and age group
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
04
5 14
15 19
20 24
25 29
30 39
40+
The rate of diagnosis of infectious syphilis among men has remained above 9.0 over the past six years whereas the rate among women remained low at less than 2.0 per 100000 population (Figure 19). Diagnoses of infectious syphilis were almost completely confined to men who have sex with men. Over the past five years, rates of diagnosis of infectious syphilis were stable in New South Wales and Victoria, increasing in Queensland and declining in the Northern Territory and Western Australia. The rate of diagnosis of infectious syphilis was highest in the 3039, 2529 and in the 2024 year age groups (Figure 20). The rates of notification of chlamydia, gonorrhoea and infectious syphilis in the Northern Territory continue to be substantially higher than those in other states and territories. The continuing decline in the number of diagnoses of donovanosis, from 2 in 2008 to 0 in 2011 and 1 in 2012, may be a consequence of improved case ascertainment and treatment.
HIV, viral hepatitis and sexually transmissible infections in selected populations

Population groups regarded as priorities for prevention and health promotion activities under the most recent national strategies for HIV, hepatitisB, hepatitisC, sexually transmissible infections (STI) and the National Aboriginal and Torres Strait Islander Blood Borne Viruses and Sexually Transmissible Infections Strategy, include people living with HIV infection, men who have sex with men, Aboriginal and Torres Strait Islander people, sex workers, prison entrants, people who have injected drugs and young people. These population groups were identified as priority groups because they are recognised as either experiencing ongoing HIV, hepatitisB, hepatitisC or STI transmission, burdens of these infections or having the potential for increases in transmission.
Men who have sex with men

Men who have sex with men continue to make up the majority of people with diagnosed HIV infection in Australia. The overall number of new HIV diagnoses in this category in 20032007 and in 20082012 was 3302 and 3703, including 1208 (37%) and 1472 (39%) diagnoses of newly acquired HIV infection, respectively. Sexual transmission between men accounted for a higher proportion of diagnoses of newly acquired HIV infection (88%) than total HIV diagnoses (67%) among men. This difference is likely to reflect higher frequency of HIV antibody testing among men who have sex with men than among other groups at risk of HIV infection.
18
Figure 21
Newly acquired HIV infection among men who have sex with men seen at sexual health clinics, 20032012, by year and age group
1.8 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR
Younger than 25 years
NEWLY ACQUIRED HIV INFECTION (%)
25 years and older
Among men who have sex with men seen at metropolitan sexual health clinics, the percentage diagnosed with newly acquired HIV infection at younger than 25 years of age declined from 1.4% in 2005 to 0.5% in 2011 and then increased to 1.5% in 2012. Among men aged 25 years and older, the percentage with newly acquired infection declined from 1.3% in 2005 to 0.5% in 2010 and increased to 0.9 in 20112012 (Figure 21). Figure 22 Prevalence of unprotected anal intercourse with casual partners, 20032012, reported by men in Gay Community Periodic Surveys
36 30 24 18 12 6 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR Sydney Melbourne Queensland Adelaide Canberra Perth
The Gay Community Periodic Survey indicated that the proportion of Sydney respondents who reported unprotected anal intercourse with casual partners remained relatively stable at around 24% in 20032012 (Figure 22). The same survey carried out in Queensland indicates that the proportion of respondents reporting unsafe sexual behaviour increased from around 22% in 20032007 to around 24% in 20082012. The respondents in Melbourne also indicated an increase in unsafe sexual behaviour, from around 20% in 20032007, to 25% in 20082012. Recent declines in unsafe sexual behaviour were reported in Canberra and Perth.
PREVALENCE (%)
19
Figure 23
DIAGNOSIS RATE PER 100 000 14 12 10 8 6 4 2 0
Gonococcal rectal infection among men, 20032012, by State/Territory and year
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
NSW
NT
QLD
SA
VIC
WA
Surveillance data for gonorrhoea also provide an indication of unsafe sexual behaviour among men who have sex with men in Australia. The rate of rectal gonococcal isolates among men in New South Wales increased from around 6.0 in 20032007 to 6.9 in 20082012. In Victoria, the rate of rectal gonorrhoea isolates increased steadily from 4.1 in 2008 to 12.2 in 2012 (Figure 23).
Aboriginal and Torres Strait Islander people

The rates of HIV diagnosis per capita in the Aboriginal and Torres Strait Islander and the nonIndigenous population, excluding cases and populations from high HIV prevalence countries in subSaharan Africa and South East Asia, differed little in 20032012 (Figure 24). In the Aboriginal and Torres Strait Islander population, the rate of HIV diagnosis was relatively stable in 20032010 at around 4.5 and increased to 5.5 per 100000 population in 2012. In the nonIndigenous, nonhigh HIV prevalence country of birth population, the rate of HIV diagnosis was also relatively stable at around 4.2 in 20032010 and then increased to 5.1 in 2012. The recent trends in the rates of HIV diagnoses in the Aboriginal and Torres Strait Islander population are based on small numbers and may reflect localised occurrences rather than national patterns (see Tables 1.3.11.3.2). Figure 24
AGE STANDARDISED RATE PER 100 000 6 5 4 3 2 1 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR Aboriginal and Torres Strait Islander 1 Non-Indigenous
HIV diagnoses, 20032012, by Aboriginal and Torres Strait Islander status1 and year
The non-Indigenous category excludes cases and populations from high prevalence countries.
20
Figure 25
HIV diagnoses, 20082012, by Aboriginal and Torres Strait Islander status and HIV exposure category
8% 13% 2% 17% 6%
56% 18%
3%
72% 5%
ABORIGINAL AND TORRES STRAIT ISLANDER

Men who have sex with men Injecting drug use
1
NON-INDIGENOUS 1
Men who have sex with men and injecting drug use Other/undetermined
The non-Indigenous category excludes cases from high prevalence countries.
In 20082012, the most frequently reported route of HIV transmission was sexual contact between men in both the nonIndigenous cases (75%) and in the Aboriginal and Torres Strait Islander cases (61%). Heterosexual contact was the reported source of exposure to HIV in 18% of Aboriginal and Torres Strait Islander cases and in 17% of nonIndigenous, nonhigh prevalence country of exposure cases (Figure 25). Aboriginal and Torres Strait Islander cases differed from nonIndigenous cases in that a higher proportion of infections were attributed to injecting drug use (13% among Aboriginal and Torres Strait Islander cases vs 2% for nonIndigenous cases), and a higher proportion of infections were among women (22% among Aboriginal and Torres Strait Islander cases vs 8% for nonIndigenous nonhigh prevalence country of exposure cases in 2008 2012). The rate of diagnosis of hepatitisB infection in the Aboriginal and Torres Strait Islander population resident in the Northern Territory, South Australia, Tasmania and Western Australia declined from 156.1 in 2008 to 85.6 in 2012, and the rate of diagnosis of newly acquired hepatitisB infection was 5 or less in 20082012. In the nonIndigenous population, the rate of diagnosis of hepatitisB increased from 26.3 in 2008 to 31.5 in 2012. The population rate of diagnosis of newly acquired hepatitisB infection was around 1 per 100000 population in 20082012. Figure 26 HepatitisC notifications, 20082012, by Aboriginal and Torres Strait Islander status, State/Territory and year
ABORIGINAL AND TORRES STRAIT ISLANDER NON-INDIGENOUS
AGE STANDARDISED RATE PER 100 000
300 250 200 150 100 50 0 2008 2009 2010 2011 2012 YEAR
300 250 200 150 100 50 0 2008 2009 2010 2011 2012 YEAR
NT
SA
TAS
WA
21
The population rate of diagnosis of hepatitisC infection in the Aboriginal and Torres Strait Islander population resident in the Northern Territory, South Australia, Tasmania and Western Australia increased from 130.2 in 2008 to 166.2 per 100000 population in 2012 and decreased in the nonIndigenous population from 51.1 in 2008 to 40.3 in 2012. In the Northern Territory, the rate of hepatitisC diagnosis in the Aboriginal and Torres Strait Islander population declined from 51.1 in 2008 to 42.4 in 2012 and in the nonIndigenous population, from 106.5 in 2008 to 99.6 in 2012. In South Australia, Tasmania and Western Australia, the rate of hepatitisC diagnosis was substantially higher in the Aboriginal and Torres Strait Islander population than in the nonIndigenous population. Figure 27 Chlamydia notifications, 20082012, by Aboriginal and Torres Strait Islander status, State/Territory and year
2500 2000 1500 1000 500 0
2 500 2000 1500 1000 500 0
2008
2009
2010
2011
2012 YEAR
2008
2009
2010
2011
2012 YEAR
NT
QLD
SA
TAS
VIC
WA
The rate of diagnosis of chlamydia in the Aboriginal and Torres Strait Islander population was around 1300 in 20082012. In the nonIndigenous population resident in State/Territory jurisdictions other than the Australian Capital Territory and New South Wales, the rate of chlamydia diagnosis increased steadily from 274 in 2008 to 384 in 2012 (Figure 27). Figure 28 Gonorrhoea notifications, 20082012, by Aboriginal and Torres Strait Islander status, State/Territory and year
2 500 2 000 1 500 1 000 500 0
2500 2000 1500 1000 500 0
2008
2009
2010
2011
2012 YEAR
2008
2009
2010
2011
2012 YEAR
NT
QLD
SA
TAS
VIC
WA
The rate of diagnosis of gonorrhoea in the Aboriginal and Torres Strait Islander population resident in State/Territory jurisdictions other than the Australian Capital Territory and New South Wales increased from 772.4 in 2008 to 828.5 in 2012. In the nonIndigenous population, the rate of gonorrhoea diagnosis increased from 20.7 in 2008 to 40.3 in 2012 (Figure 28).
22
Figure 29
Infectious syphilis notifications, 20082012, by Aboriginal and Torres Strait Islander status, State/Territory and year
120 100 80 60 40 20 0 2008 2009 2010 2011 2012 YEAR
120 100 80 60 40 20 0 2008 2009 2010 2011 2012 YEAR VIC WA
ACT
NT
NSW
QLD
SA
TAS
The rate of diagnosis of infectious syphilis in the Aboriginal and Torres Strait Islander population resident in State/ Territory jurisdictions other than the Australian Capital Territory declined from 30 in 2008 to 27.2 in 2012 (Figure 29). The rate of infectious syphilis diagnosis in the Aboriginal and Torres Strait Islander population resident in the Northern Territory declined substantially whereas the rate increased in Queensland, from 11.8 in 2008 to 61.4 in 2012. The rate of diagnosis of infectious syphilis in the nonIndigenous population was stable at around 5.4 per 100000 population in 20082012.
People who inject drugs

In 20032012, approximately 6% of HIV diagnoses in Australia were in people with a history of injecting drug use, of whom more than half were men who also reported sex with men. Figure 30
PREVALENCE (%) 70 60 50 40 30 20 10 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR Hepatitis C, female Hepatitis C, male HIV, female HIV, male
HIV and hepatitisC prevalence in needle and syringe programs, 20032012, by year and sex
23
Figure 31
PREVALENCE (%) 25 20 15 10 5 0
HIV prevalence at needle and syringe programs, 2012, by sexual identity
Heterosexual
Bisexual
Homosexual YEAR
Male
Female
HIV prevalence among people attending needle and syringe programs has remained low (around 1% in 20032012) (Figure 30) but in the subgroup of men who have sex with men, it was 21.4% in 2012 (Figure 31). Of 3293 men and 2251 women with a history of injecting drug use who were tested for HIV antibody at metropolitan sexual health centres in 20032012, 8 males (0.2%) and 1 woman (0.04%) were diagnosed with HIV infection (Figures 36 and 37). In contrast to the low HIV prevalence, hepatitisC prevalence among people attending needle and syringe programs remained at high levels in 20032012 (Figure 30). HepatitisC prevalence dropped among males from 63% in 2008 to 52% in 2012, and among females from 61% in 2008 to 54% in 2012. The decline in hepatitisC prevalence was not explained by demographic or laboratory factors. HepatitisC prevalence among people who inject drugs has remained stable from 2009. Figure 32 Prevalence of sharing among recent initiates to injecting1 seen at needle and syringe programs, 20032012, by year and sex
30 25 20 15 10 5 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR Male 1 Female
With a history of injecting drug use less than five years who were tested for HIV or hepatitisC.
The percentage of people attending needle and syringe programs who reported having injected drugs for five years or less remained stable at approximately 10% between 2008 and 2012; hepatitis C prevalence among these people declined from 28% in 2008 to 17% in 2012. The fluctuations in the prevalence of reported sharing of injecting equipment among women may be attributable to the relatively small number of women with a short duration of injecting drug use (Figure 32). The low proportion of people in the survey who reported having injected drugs for five years or less (around 9%) and the low proportion of survey respondents aged less than 20 years (around 2%) suggests that there has been a decrease in the prevalence of injecting drug use among young people.
PREVALENCE (%) 24
Heterosexual transmission of HIV infection

The number of new HIV diagnoses for which exposure to HIV was attributed to heterosexual contact increased from 1016 in 20032007 to 1364 in 20082012, accounting for 21% and 24.7% of total HIV diagnoses in 20032007 and in 20082012, respectively. Figure 33 Newly diagnosed HIV among men who report an exposure other than sex with men, 20032012, by year and HIV exposure category
90 80 70 60 50 40 30 20 10 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR From a high prevalence country Other/undetermined Heterosexual contact, partner from high prevalence country Injecting drug use, or partner an injecting drug user Heterosexual contact, partner other risk Heterosexual contact, not further specified
Figure 34
NUMBER 90 80 70 60 50 40 30 20 10 0
NUMBER
Newly diagnosed HIV among women, 20032012, by year and HIV exposure category
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
From a high prevalence country Other/undetermined
Heterosexual contact, partner from high prevalence country Injecting drug use, or partner an injecting drug user
Heterosexual contact, partner other risk Heterosexual contact, not further specified Heterosexual contact, bisexual partner
Men and women whose HIV infection was acquired in a high HIV prevalence country accounted for 37.6% and 40% of HIV diagnoses attributed to heterosexual contact in 20032007 and 20082012, respectively. In both five year intervals, the majority of cases came from high HIV prevalence countries in subSaharan Africa (58% in 20032007 and 75% in 2008 2012), South East Asia (32% in 20032007 and 22% in 20082012) and North Africa/Middle East (8% in 20032007 and 2% in 20082012). Women accounted for 65% and 60% of cases from high prevalence countries in 20032007 and in 20082012, respectively. Excluding cases from a high prevalence country, the number whose exposure to HIV was attributed to heterosexual contact increased by 29%, from 634 in 20032007 to 819 in 20082012. Men and women with HIV infection who reported a partner from a high prevalence country accounted for 34% and 30% of heterosexual cases newly diagnosed in 20032007, and in 20082012, respectively. Of new HIV diagnoses in 20082012 for which the country of birth of the heterosexual partner was reported (73.5%), 27% of partners were from a high prevalence country in subSaharan Africa, 71% were from a high prevalence country in South East Asia and 2% were from high prevalence countries in North Africa/Middle East. Cases with partners with other risks for HIV infection accounted for 25% and 19% of diagnoses in 20032007 and in 20082012, respectively. Heterosexual contact, not further specified, was reported in 41% of cases attributed to heterosexual contact in 20032007 and 51% in 20082012. The source of exposure to HIV remained undetermined for substantial numbers of men in 20032012 (Figure 33).
25
Figure 35
HIV infection attributed to heterosexual contact, 20082012, by region of birth

1% 3% 1%
4% 4% 6%
32%
Australia Other Oceania United Kingdom and Ireland Other Europe Middle East/North Africa Sub-Saharan Africa Asia South/Central America and the Caribbean
22%
28%
North America
Among 1364 cases of HIV infection diagnosed in Australia in 20082012 for which exposure to HIV was attributed to heterosexual contact, the country of birth was reported as Australia in 28%, subSaharan Africa in 32% and Asia in 22% (Figure 35). Figure 36 HIV prevalence among heterosexually active men seen at sexual health clinics, 20032012, by year and HIV exposure category
0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR Heterosexual contact in Australia Heterosexual contact overseas Injecting drug use
Figure 37
PREVALENCE (%)
HIV prevalence among heterosexually active women seen at sexual health clinics, 20032012, by year and HIV exposure category
0.4
PREVALENCE (%)
0.3
0.2
0.1
2003 2004
2005 2006
2007 2008
2009 2010
2011 2012 YEAR
Heterosexual contact in Australia
Heterosexual contact overseas
Injecting drug use
Sex work
26
HIV prevalence has remained below 0.5% among heterosexually active men and women seen through metropolitan sexual health clinics. In 20032012, HIV prevalence was less than 0.2% among men and women who reported a history of heterosexual contact in Australia (Figures 36 and 37). HIV prevalence remained less than 0.3% among men who reported heterosexual contact overseas. HIV prevalence remained low among women selfidentifying as sex workers, with or without a history of injecting drug use (Figure 37). Figure 38
PREVALENCE PER 100 000 DONATIONS 14 12 10 8 6 4 2 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR HIV Hepatitis C
HIV and hepatitisC prevalence per 100 000 donations in blood donors, 20032012, by year
Levels of HIV infection in blood donors, who undergo a screening interview to exclude those with recognised risk factors for HIV infection, have been below 1 per 100000 donations since 1985 (Figure 38).
Monitoring genital warts

The Genital Warts Surveillance Network aims to determine the population effects of the national human papillomavirus (HPV) vaccination program that began in mid2007 by monitoring the diagnosis rates of genital warts in various populations, and determining HPV vaccination rates. Figure 39
WARTS DIAGNOSES (%) 14 12 10 8 6 4 2 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR <21 years 21 30 years >30 years
Proportion of Australian born women diagnosed with genital warts at first visit, by age group, 20042012
The dotted line represents the start of the national HPV vaccination program in mid-2007.
Information available through the Genital Warts Surveillance Network indicates that the genital warts diagnosis rate among Australian born women, aged 21 years or younger in July 2007 and thus eligible for free HPV vaccine, was above 10% in 2007 and then declined to less than 2% in 2012 (Figure 39). Among Australian born heterosexual men in the same age group, the genital warts diagnosis rate was above 12% in 2007 and declined to less than 2% in 2012 (Figure 40). The genital warts diagnosis rate among homosexual and bisexual men has not followed a declining trend to the extent observed in the heterosexual population (Figure 41).
27
Figure 40
WARTS DIAGNOSES (%) 20 18 16 14 12 10 8 6 4 2 0
Proportion of Australian born heterosexual men diagnosed with genital warts at first visit, by age group, 20042012
2004
2005
2006
2007
2008
2009
2010
2011
2012 YEAR
<21 years
21 30 years
>30 years
Figure 41
Proportion of Australian born homosexual and bisexual men diagnosed with genital warts at first visit, by exposure, 20042012
10 9 8 7 6 5 4 3 2 1 0 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR
Homosexual men
WARTS DIAGNOSES (%)
Bisexual men
28
Illness and treatment in people with HIV infection and viral hepatitis
In the past 10 years, the proportion of cases diagnosed with advanced HIV infection, measured by a CD4+ cell count of less than 200 cells/l at HIV diagnosis, has declined slightly from 23.1% among cases diagnosed in 20032007 to 15.1% among cases diagnosed in 20082012 (Figure 42). However, the proportion with a late diagnosis, defined by a CD4+ cell count of less than 350 cells/l at HIV diagnosis, has increased slightly from 38.6% in 20032007 to 39.3% in 20082012 (Table 1.1.1). Figure 42
CD4+ CELL COUNT (%) 100 90 80 70 60 50 40 30 20 10 0 2010 2011 2012
Diagnoses of recent HIV infection and CD4+ cell count among other HIV diagnoses in Australia, 20102012, by year
YEAR <200 200 349 350 499 500+ recent infection
Advanced and late HIV diagnoses were least common among men who have sex with men (Figure 43). In 20082012, around 12% and 24% of HIV diagnoses among men who have sex with men were advanced and late HIV diagnoses, respectively, whereas advanced and late diagnoses accounted for 23% and 35% of diagnoses among people who injected drugs and for 28% and 50% of diagnoses among people with a history of heterosexual contact. Cases born in high HIV prevalence countries in subSaharan Africa and South East Asia had a relatively high rate of diagnosis with advanced HIV infection (Figure 44). Figure 43
PERCENTAGE 50 45 40 35 30 25 20 15 10 5 0
2003-2007 2008-2012 2003-2007 2008-2012 2003-2007 2008-2012 2003-2007 2008-2012
Late/advanced HIV diagnoses1, 20032012, by year and exposure category
Men who have sex with men
Injecting drug use
Other/ undetermined EXPOSURE CATEGORY
Advanced HIV diagnosis 1
Late HIV diagnosis
A late diagnosis of HIV infection is defined as newly diagnosed HIV infection with a CD4 count of less than 350 cells/l and advanced HIV infection as less than 200 cells/l.
29
Figure 44
PERCENTAGE 60 50 40 30 20 10 0
Late/advanced HIV diagnoses1, 20032012, by year and region of birth
20032007
20082012
20032007
20082012
20032007
20082012
20032007
20082012
20032007
20082012
20032007
20082012
20032007
20082012
20032007
20082012
20032007
20082012
Australia
Other Oceania
United Kingdom and Ireland
Other Europe
Middle East/ North Africa
Sub-Saharan Africa
Asia
North America
South/Central America and the Caribbean
COUNTRY / REGION OF BIRTH Advanced HIV diagnosis 1 Late HIV diagnosis
A late diagnosis of HIV infection is defined as newly diagnosed HIV infection with a CD4 count of less than 350 cells/l and advanced HIV infection as less than 200 cells/l.
There is no comprehensive registry of advanced illness related to hepatitisB and C in Australia. One indicator of the extent of illness caused by hepatitisC is the number of liver transplants due to chronic infection. Of 202 people who had a liver transplant in 2012, 67 (33.2%) had hepatitisC infection whereas hepatitisB was the primary cause of liver failure for 2 (1.0%) people having liver transplants (Table 2.3.1). Figure 45
PREVALENCE (%) 45 40 35 30 25 20 15 10 5 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YEAR None 3+ NRTI+NNRTI (not PI,not II )
1
Treatment uptake among people enrolled on the Australian HIV Observational Database, 20032012
Mono and Double therapy 3+ NNRTI+PI, NRTI (not II )

1
3+ NRTIPI (not NNRTI, not II1) 3+ II1, NRTI, NNRTI, PI
II = Integrase Inhibitor.
30
Figure 46
UNDETECTABLE VIRAL LOAD (%) 100 80 60 40 20 0
HIV viral load and CD4+ cell count, 20032012, by year

CD4 CELL COUNT (CELLS/L) 31 640 620 600 580 560 540 520 500 480 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 460
YEAR Undetectable viral load1 1 Mean CD4+ count
Undetectable viral load equals 50 copies/ml or less.
The Australian HIV Observational Database (AHOD) indicated that 88% of 2342 people under follow up in 2012 were receiving triple combination antiretroviral treatment for HIV infection (Figure 45). Of people receiving antiretroviral therapy who were monitored through AHOD, the proportion with undetectable viral load (<50 copies/ml) has increased from 58% in 2003 to 88% in 2012. The mean CD4+ cell count also steadily increased to 620cells/l in 2012 (Figure46). Of people enrolled in the Australian HIV Observational Database in 2012, 9% had been diagnosed with both HIV and hepatitisC antibody. Figure 47 Number of people dispensed drugs for HIV infection through the Highly Specialised Drugs Program, 20032012, by class of drug and year
14000 12000 10000 8000 6000 4000 2000 0 2008 2009 2010 2011 2012 YEAR NRTI NRTI1 NNRTI NNRTI1 Protease Inhibitor Fusion inhibitor Combination class agents Integrase inhibitor
Includes NRTI/NNRTIs in fixed dose combinations with other classes.
The number of NRTI and NNRTI, prescribed in fixed dose combinations with other drug classes, shown with dashed lines in Figure 47, indicates that the total number of NRTI and NNRTI drugs dispensed has remained stable over the past five years. Use of antiretroviral therapy by men who have sex with men participating in the Gay Community Periodic Surveys in Melbourne increased steadily from 69.7% in 2010 to 77.7% in 2012 whereas uptake in Queensland remained stable at close to 70% in 20102012. In Sydney, reported uptake of antiretroviral therapy increased from 70% in 2011 to 80% in 2012.
NUMBER
Figure 48
Number of people dispensed drugs for hepatitisC infection through the Highly Specialised Drugs Program, 20082012
3500 3000 2500 2000 1500 1000 500 0 2008 2009 2010 2011 2012 YEAR
Hepatitis C infection
The estimated number of people receiving treatment for hepatitis C infection through the Highly Specialised Drugs Program has declined from a peak of 3 397 in 2009 to 2 360 in 2012. The decline in the estimated number of people receiving treatment for hepatitisC infection may be due to delaying treatment uptake until new generation hepatitisC drugs become available or to treatment availability through participation in clinical trials.
NUMBER
32
2013
Tables
1
1.1
1.1.1
National surveillance for newly diagnosed HIV infection

National HIV Registry
Characteristics of cases of newly diagnosed HIV infection by year. Number of cases, median age, language spoken at home, State/Territory of HIV diagnosis, and percent of total cases by late and advanced HIV infection status, sex and HIV exposure category Number of new diagnoses of HIV infection, cumulative to 31 December 2012, by age group, year and sex Number of new diagnoses of HIV infection in Australia in 2012, by State/Territory and whether or not HIV infection was first diagnosed in Australia Number (percent) of new HIV diagnoses in Australia, 20082012, and age standardised rate per 100 000 population by year of HIV diagnosis and region of birth Median CD4+ cell count at diagnosis of HIV infection (number of HIV diagnoses with a CD4+ cell count), 20082012, by State/Territory, HIV exposure category, newly acquired infection status, sex and year Number of new diagnoses of HIV infection for which exposure to HIV was attributed to heterosexual contact, by exposure category of the heterosexual partner, year and sex Number of specimens tested for HIV antibody in public health laboratories, 20032012, by State/Territory and year of test 35 36 37 38 39 40 41
1.1.2 1.1.3 1.1.4 1.1.5 1.1.6 1.1.7
1.2
1.2.1
Monitoring incident HIV infection

Characteristics of diagnoses of newly acquired HIV infection, 20032012, by year. Total number of cases, median age and number of cases by State/Territory, HIV exposure category, evidence of newly acquired infection, sex and year Number of cases of HIV infection newly diagnosed in 2012, number with newly acquired HIV infection, number without newly acquired HIV infection with a matching BED capture enzyme immunoassay (BED-CEIA) record, number with BED-CEIA evidence only of incident infection and total number (%) of diagnoses of recent infection, by State/Territory Number of new diagnoses of HIV infection, 20102012, and proportion with recent infection by year of diagnosis and evidence of recent infection Number and percentage of isolates with resistance at one or more loci, by drug class against which resistance was detected and year 42
1.2.2
43 43 43
1.2.3 1.2.4
1.3
1.3.1
National surveillance for newly diagnosed HIV infection in Aboriginal and Torres Strait Islander people
Characteristics of cases of newly diagnosed HIV infection in Aboriginal and Torres Strait Islander people, 20032012, by year. Number of cases, median age and percent (number) of total cases by sex, newly acquired infection, late HIV diagnosis, State/Territory and HIV exposure category Rate of diagnosis of HIV infection, 20082012, by year, Aboriginal and Torres Strait Islander status and area of residence 44 45
1.3.2
1.4
1.4.1 1.4.2 1.4.3
National surveillance for perinatal exposure to HIV

Number and population rate of perinatal exposure to HIV among children born in Australia, 20032012, by State/Territory and year of birth Number of women whose perinatally HIV exposed children were born in Australia, 20032012, by time of the womans HIV diagnosis relative to the first exposed childs birth Number of women whose perinatally HIV exposed children were born in Australia, 20032012, and number of perinatally exposed children, by year of birth of the first exposed child and the womans HIV exposure category 46 46 47
33
1 HIV Infection
1.4.4 1.4.5
Number of perinatally exposed children born in Australia, 20032012, and number with diagnosed HIV infection by year of the childs birth and time of the womans HIV diagnosis relative to the childs birth Number of perinatally exposed children, born in 20032012 to women whose HIV infection was diagnosed antenatally, and number with diagnosed HIV infection by year of the childs birth and the proportion of women reporting use of interventions to reduce the risk of mother-to-child transmission
47
48
1.5
1.5.1
Global comparisons for HIV

Estimated HIV prevalence in selected countries 49
1 HIV Infection
34
1 1.1
Table 1.1.1
National surveillance for newly diagnosed HIV infection National HIV Registry
Characteristics of cases of newly diagnosed HIV infection by year. Number of cases, median age, language spoken at home, State/Territory of HIV diagnosis, and percent of total cases by late and advanced HIV infection status, sex and HIV exposure category
Year of HIV diagnosis
Characteristic Total cases Males (%) Median age (years) Male Female Language spoken at home3 English Other language Not reported
031 24 545 92.5
04 914 86.0
05 974 89.9
06 1 017 85.2
07 1 052 86.8
08 1 014 85.8
09 1 066 86.1
10 1 054 85.2
11 1 140 87.4
12 1 253 87.2
Total1,2 34 029 90.8
33 29
37 31
37 32
38 31
38 32
37 31
37 32
37 31
37 34
36 33
34 30
552 49 313
659 55 260
659 74 284
787 82 183
757 68 189
798 112 156
761 110 183
877 111 152
900 121 232
6 750 782 1 952
Late and advanced HIV infection status at HIV diagnosis(%)4 Late HIV diagnosis 23.0 20.2 Advanced HIV infection 15.5 16.3 State/Territory Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia HIV exposure category (%) 5 Men who have sex with men Men who have sex with men and injecting drug use Injecting drug use6 Heterosexual contact Person from a high prevalence country Partner with/at risk of HIV infection Not further specified Haemophilia/coagulation disorder Receipt of blood/tissue Mother with/at risk of HIV infection Health care setting Other undermined exposure
1 2 3 4 5 6
20.8 15.3
23.3 20.0
19.6 18.2
18.0 20.2
20.1 21.1
21.0 22.0
19.9 17.2
18.1 19.1
20.3 18.7
283 14 238 138 2 551 899 102 5 075 1 259
7 414 8 156 54 9 216 50
8 408 3 171 51 7 262 64
6 399 11 164 62 7 288 80
9 415 6 195 56 7 287 77
7 367 11 201 47 13 286 82
12 382 16 209 53 14 291 89
14 351 6 241 42 10 281 109
11 389 9 223 67 15 328 98
17 459 26 261 41 13 314 122
374 17 822 234 4 372 1 372 197 7 628 2 030
78.1 4.4 4.1 10.5 24.9 38.2 37.0 1.4 1.2 0.4 0.1 14.9
67.4 4.1 4.3 23.8 40.4 37.9 21.7 0.0 0.0 0.1 0.2 6.8
71.9 4.5 3.5 19.5 34.7 42.2 23.1 0.0 0.1 0.6 0.0 8.7
67.0 4.1 2.7 25.6 40.6 28.7 30.7 0.0 0.0 0.6 0.0 6.2
68.0 2.9 2.8 25.2 37.3 36.1 26.5 0.0 0.1 0.9 0.0 6.1
65.6 3.3 3.3 27.1 41.8 26.2 31.9 0.0 0.1 0.6 0.0 4.2
64.4 3.7 2.4 28.4 40.4 23.7 35.9 0.0 0.1 1.1 0.0 5.1
66.4 2.2 2.4 28.3 45.2 27.6 27.2 0.0 0.0 0.6 0.1 6.4
70.9 2.7 1.9 23.4 34.1 36.1 29.8 0.0 0.2 0.9 0.0 4.3
70.3 2.8 2.3 23.8 38.3 34.4 27.3 0.0 0.4 0.3 0.0 5.6
75.1 4.1 3.7 14.9 32.2 35.0 32.8 1.0 0.9 0.4 0.0 12.4
Late diagnosis and advanced infection for HIV diagnoses in 2003 only. Total percentage with late HIV diagnosis and advanced HIV infection in 20032012 only. Not adjusted for multiple reporting. Language spoken at home was sought among cases of HIV infection newly diagnosed from 1 January 2004. Late HIV diagnosis was defined as newly diagnosed HIV infection with a CD4+ cell count of 200 or more to less than 350 cells/l, and advanced HIV infection as newly diagnosed infection with a CD4+ cell count of less than 200 cells/l. The Other/undetermined exposure category was excluded from the calculation of the percentage of cases attributed to each HIV exposure category. Excludes men who have sex with men.
Source: State/Territory health authorities
35
1 HIV Infection
Table 1.1.2
Number of new diagnoses of HIV infection1, cumulative to 31 December 2012, by age group, year and sex
Age group (years) 01 212 1319 2024 2529 3039 4049 5059 60+ Not reported Sub-total Total2
1 2
Sex M F M F M F M F M F M F M F M F M F M F M F
03 45 22 90 24 441 95 2 729 258 4 580 362 8 567 443 4 163 164 1 468 60 481 69 134 32 22 698 1 529 24 545
04 0 1 0 0 8 6 63 23 98 28 310 31 191 21 85 12 31 4 0 0 786 126 914
05 0 1 2 2 10 3 70 13 113 14 322 43 218 16 99 4 41 1 1 0 876 97 974
06 1 3 2 1 9 6 54 18 118 36 301 48 242 25 101 9 38 2 0 0 866 148 1 017
07 1 1 4 5 8 2 64 11 129 29 310 55 253 19 96 12 47 4 1 0 913 138 1 052
08 1 1 4 1 7 6 86 23 134 25 276 57 234 22 89 7 39 2 0 0 870 144 1 014
09 0 2 3 8 10 3 71 12 151 33 305 53 232 22 115 10 31 3 0 0 918 146 1 066
10 1 1 3 2 12 3 70 20 140 37 276 60 244 17 105 9 47 2 0 0 898 151 1 054
11 1 1 3 5 12 6 91 8 172 25 308 55 238 35 126 6 45 2 0 0 996 143 1 140
12 0 0 1 0 17 6 110 20 205 32 326 65 241 23 127 10 65 3 0 0 1092 159 1 253
Total 50 33 112 48 534 136 3 408 406 5 840 621 11 301 910 6 256 364 2 411 139 865 92 136 32 30 913 2 781 34 029
Not adjusted for multiple reporting. Totals include 86 people whose sex was reported as transgender and 249 people whose sex was not reported.
1 HIV Infection
36
Table 1.1.3
Number of new diagnoses of HIV infection in Australia in 2012, by State/Territory and whether or not HIV infection was first diagnosed in Australia
Place of first diagnosis of HIV infection
State/Territory Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Total
Newly diagnosed in Australia 17 408 20 208 31 13 264 102 1 063
Newly diagnosed overseas 0 51 6 53 10 0 50 20 190
Total diagnoses 17 459 26 261 41 13 314 122 1 253
37
1 HIV Infection
1 HIV Infection
Table 1.1.4
Number (percent) of new HIV diagnoses in Australia, 20082012, and age standardised rate per 100 0001 population by year of HIV diagnosis and region of birth
2008 Age standardised rate 4.1 7.1 8.9 4.8 5.2 1.9 31.0 4.3 9.4 15.8 4.6 2009 Age standardised rate 4.1 8.6 6.7 6.3 7.5 5.9 36.3 6.3 10.5 15.5 4.9 2010 Age standardised rate 4.0 8.1 6.2 4.3 7.9 3.3 37.1 6.3 12.0 13.9 4.8 2011 Age standardised rate 4.5 8.6 8.0 5.0 8.5 5.7 27.3 7.0 11.8 20.7 5.3 2012 Age standardised rate 4.9 9.5 8.4 6.6 8.9 5.3 27.5 8.6 17.2 19.6 5.8
38 HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013
Region/Country of birth Australia Overseas born Other Oceania United Kingdom and Ireland Other Europe Middle East/North Africa Sub-Saharan Africa Asia North America South/Central America and the Caribbean Total with a reported country of birth Not reported Total
1
Number 576 402 60 49 35 6 99 115 14 24 978 36 1 014
% 56.8 39.6 5.9 4.8 3.5 0.6 9.8 11.3 1.4 2.4 96.4 3.6 100
Number 566 476 49 59 46 21 115 149 15 22 1 042 24 1 066
% 53.1 44.7 4.6 5.5 4.3 2.0 10.8 14.0 1.4 2.1 97.7 2.3 100
Number 561 467 43 43 54 13 121 158 17 18 1 028 24 1 052
% 53.3 44.4 4.1 4.1 5.1 1.2 11.5 15.0 1.6 1.7 97.7 2.3 100
Number 629 485 62 57 51 16 86 166 16 31 1 114 26 1 140
% 55.2 42.5 5.4 5.0 4.5 1.4 7.5 14.6 1.4 2.7 97.7 2.3 100
Number 675 557 65 58 52 19 93 214 25 31 1 232 21 1 253
% 53.9 44.5 5.2 4.6 4.2 1.5 7.4 17.1 2.0 2.5 98.3 1.7 100
Population estimates by country of birth and age group from the Australian Bureau of Statistics.
Table 1.1.5
Median CD4+ cell count at diagnosis of HIV infection (number of HIV diagnoses with a CD4+ cell count), 20082012, by State/Territory, HIV exposure category, newly acquired infection status, sex and year
Characteristic State/Territory Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia HIV exposure category Men who have sex with men1 Injecting drug use2 Heterosexual contact Other/undetermined Newly acquired HIV infection status Diagnoses of newly acquired infection3 Other HIV diagnoses4 Total
1 2 3 4
Sex
2008
2009
2010
2011
2012
M F M F M F M F M F M F M F M F
272 (4) 275 (6) 640(10) 460(10) 515(14) 635 (2) 218 (2) 465 (2) (1) 215 (2) 440(261) 409(306) 413(290) 440(332) 460(387) 450(37) 340(42) 356(29) 255(29) 470(43) 407 (7) 433(10) 418 (4) 307 (7) 245(18) (1) 680 (5) (1) (1) 372 (8) 410(131) 435(146) 375(182) 430(168) 480(219) 360(29) 380(24) 400(39) 420(22) 350(30) 418(41) 379(40) 357(36) 432(44) 440(28) 314 (5) 353 (9) 582 (6) 313(16) 440 (9) 490 (8) 713(10) 340 (9) 363(11) 336(13) 247 (5) 216 (3) (1) 357 (4) (0) 428(212) 442(229) 419(207) 433(192) 413(128) 290(31) 322(25) 388(30) 260(21) 399(21) 390(61) 344(56) 402(70) 372(62) 444(90) 321(20) 299(24) 364(28) 380(27) 420(25)
M M F M F M F
460(565) 447(624) 437(621) 451(664) 470(718) 483(19) 352(18) 400(17) 345(14) 559(16) 450 (7) (1) 511 (7) 275 (6) 360 (5) 300(115) 284(126) 254(130) 317(116) 338(118) 330(115) 320(121) 356(119) 341(105) 377(124) 348(26) 320(34) 321(40) 349(32) 324(45) 430 (8) 465(12) 440 (9) 457(11) 620 (9)
M F M F
535(225) 550(259) 524(275) 510(319) 550(322) 675(12) 630(13) 516(12) 592(15) 498(16) 385(500) 360(544) 330(533) 380(507) 370(575) 320(118) 307(121) 357(124) 305(106) 384(122) 420(855) 406(939) 400(945) 429(947) 435(1036)
Includes males who also reported a history of injecting drug use. Excludes men who have sex with men. Newly acquired HIV infection was defined as newly diagnosed HIV infection with a negative or indeterminate HIV antibody test result, or a diagnosis of primary HIV infection within one year of HIV diagnosis. Totals include 9 people whose sex was reported as transgender.
39
1 HIV Infection
1 HIV Infection
Table 1.1.6
Number of new diagnoses of HIV infection for which exposure to HIV was attributed to heterosexual contact, by exposure category of the heterosexual partner, year and sex
Year of HIV diagnosis 2008 2009 Male Female 59 55 3 1 22 7 15 0 69 1 0 8 60 150 57 38 17 2 8 8 0 0 66 4 4 1 14 43 131 65 44 20 1 5 3 1 1 51 2 10 1 8 30 121 2010 Male Female 50 44 4 2 27 2 25 0 54 0 0 6 48 131 75 54 19 2 7 7 0 0 45 5 1 1 10 28 127 2011 Male Female 26 25 1 0 32 5 27 0 60 0 0 10 50 118 60 39 19 2 9 8 1 0 53 3 7 0 17 26 122 2012 Male Female 40 31 8 1 28 2 26 0 54 2 0 6 46 122 68 43 23 2 7 4 1 2 55 3 5 1 15 31 130 219 195 20 4 127 19 108 0 304 7 0 39 258 650 20082012 Male Female 325 218 98 9 36 30 3 3 270 17 27 4 64 158 631 Total 544 413 118 13 163 49 111 3 574 24 27 4 103 416 1 281
HIV exposure category Person from a high prevalence country Sub-Saharan Africa South East Asia North Africa/Middle East Partner from a high prevalence country Sub-Saharan Africa South East Asia North Africa/Middle East Heterosexual contact with partner at risk Injecting drug use Bisexual man Partner with medically acquired HIV Partner with HIV infection whose exposure was other than those above Not further specified Total
Male Female 44 40 4 0 18 3 15 0 67 4 0 9 54 129
Table 1.1.7
Number of specimens tested for HIV antibody in public health laboratories, 20032012, by State/Territory and year of test
Year of HIV antibody test
State/ Territory ACT NSW NT QLD SA TAS VIC WA

1
2003 7 978 358 063 16 407 188 403 79 409 12 967 204 561 100 483 968 271
2004 14 388 347 064 15 323 206 322 83 970 12 754 152 284 102 694 934 799
2005 15 551 356 046 15 217 222 558 88 158 13 041 165 461 114 203 990 235
2006 16 565 322 569 7 247 238 509 88 552 12 573 183 508 101 277 970 800
2007 17 602 251 724 6 686 251 430 80 664 12 248 253 145 104 540 978 039
2008 19 443 191 873 7 782 253 778 95 696 13 346 231 844 124 688 938 450
2009 20 173 114 041 6 360 210 315 62 560 4 126 224 300 167 695 809 570
2010 151 320 6 924 135 198 61 252 4 447 148 623 134 241 642 005
2011 21 316 119 225 8 466 144 908 64 010 4 571 235 822 133 468 731 786
2012 22 435 128 425 10 065 148 677 42 501 16 038 200 331 173 890 742 362
Total
1
The number of specimens tested for HIV antibody in the ACT in 2010 was not available.
Source: National Serology Reference Laboratory, Australia
41
1 HIV Infection
1.2
Table 1.2.1

Characteristics of diagnoses of newly acquired HIV infection1, 20032012, by year. Total number of cases, median age and number of cases by State/Territory, HIV exposure category, evidence of newly acquired infection, sex and year
Characteristic Total cases Males (%) Median age (years) State/Territory Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia HIV exposure category Men who have sex with men Men who have sex with men and injecting drug use Injecting drug use 3 Heterosexual contact Health care setting Other/undetermined
Sex M M F
2003 286 96.2 33 34
2004 261 94.3 35 23
2005 281 96.8 35 27
2006 308 93.5 36 35
2007 278 95.7 35 35
2008 286 95.1 35 31
2009 301 94.7 36 29
2010 308 95.5 35 38
2011 379 95.5 35 35
2012 397 95.7 33 26
Total2 3 085 95.3 35 31
M F M F M F M F M F M F M F M F
0 0 153 4 0 0 26 3 15 1 0 0 69 3 12 0
2 0 113 5 2 0 42 3 15 1 1 0 62 4 9 1
1 0 128 3 1 0 42 1 15 0 2 0 74 4 9 1
3 1 110 7 2 0 57 1 17 0 0 0 85 8 14 2
2 0 112 4 1 0 48 4 7 0 0 0 82 3 14 1
0 0 123 6 2 0 44 2 6 1 1 0 81 5 15 0
3 0 114 8 4 3 60 2 6 0 2 0 88 2 8 0
3 0 125 2 2 0 54 4 4 1 2 0 89 5 15 1
4 0 166 4 2 1 58 4 5 0 5 0 97 4 25 4
10 0 177 8 2 1 61 3 6 0 4 0 92 2 28 2
28 1 1 321 51 18 5 492 27 96 4 17 0 819 40 149 12
M M M F M F M F M F
243 12 5 2 13 9 0 0 2 0 139 5 44 0 92 6
209 12 2 4 16 10 2 0 5 0 105 10 46 3 95 1
234 15 2 1 9 8 0 0 12 0 128 5 49 2 95 2
247 14 2 2 16 16 0 0 9 1 150 7 44 9 94 3
231 5 2 1 20 10 0 0 8 1 122 5 61 5 83 2
240 11 0 3 18 11 0 0 3 0 123 7 60 5 89 2
246 11 3 0 19 14 0 0 6 1 136 5 52 6 97 4
265 7 1 1 13 12 0 0 8 0 131 7 80 1 83 5
327 7 2 1 21 15 0 0 5 1 142 4 98 9 122 4
344 14 3 1 14 15 0 0 5 0 158 2 91 10 131 4
2 586 108 22 16 159 120 2 0 63 4 1 334 57 625 50 981 33
Evidence of newly acquired infection Testing history only M F Primary HIV infection only Testing history and primary HIV infection
1 2 3
M F M F
Newly acquired HIV infection was defined as newly diagnosed infection with a negative or indeterminate HIV antibody test result or a diagnosis of primary HIV infection within one year of HIV diagnosis. Totals include 5 people whose sex was reported as transgender. Excludes men who have sex with men.
1 HIV Infection
42
Table 1.2.2
Number of cases of HIV infection newly diagnosed in 2012, number with newly acquired HIV infection, number without newly acquired HIV infection with a matching BED capture enzyme immunoassay (BED-CEIA) record, number with BED-CEIA evidence only of incident infection and total number (%) of diagnoses of recent infection, by State/Territory
Number without newly acquired infection tested for incident infection 2 119 8 129 25 0 185 44 512 Number with incidence assay evidence only of incident infection 0 29 0 32 7 0 48 9 125 Total number (%) with recent infection3 10 116 3 96 13 4 142 39 423 58.8% 56.3% 11.5% 36.8% 31.7% 30.8% 45.2% 32.0% 42.3%
State/Territory Australian Capital Territory New South Wales1 Northern Territory Queensland South Australia Tasmania Victoria Western Australia Total
1 2 3
Number of new HIV diagnoses 17 206 26 261 41 13 314 122 1 000
Number with newly acquired infection2 10 87 3 64 6 4 94 30 298
Includes NSW cases newly diagnosed at St Vincents Hospital, Sydney, only. Newly acquired HIV infection was defined as newly diagnosed infection with a negative or indeterminate HIV antibody test result, or a diagnosis of primary HIV infection, within 12 months of HIV diagnosis. Recent infection includes cases with evidence of newly acquired HIV infection and cases with incidence assay evidence only of incident infection.
Source: State/Territory health authorities; NSW State Reference Laboratory for HIV/AIDS; Victorian Infectious Diseases Reference Laboratory
Table 1.2.3
Number of new diagnoses of HIV infection, 20102012, and proportion with recent infection by year of diagnosis and evidence of recent infection
2010 2011 869 368 271 97 42.3 2012 1 000 423 298 125 42.3 Total 2 689 1 099 821 278 40.9
Newly diagnosed infection1 Recent HIV infection2 Newly acquired infection3 Incidence assay evidence only of incident infection4 Proportion with recent infection (%)
1 2 3 4 Includes NSW cases newly diagnosed at St Vincents Hospital, Sydney, only.
820 308 252 56 37.6
Recent infection includes cases with newly acquired HIV infection plus cases with incident infection only, detected by the BED-CEIA. Newly acquired HIV infection was defined as newly diagnosed infection with a negative or indeterminate HIV antibody test result, or a diagnosis of primary HIV infection, within 12 months of HIV diagnosis. Number of cases of newly diagnosed HIV infection, excluding cases with newly acquired infection, tested for incident infection using the BED capture enzyme immunoassay (BED-CEIA).
Source: State/Territory health authorities; NSW State Reference Laboratory for HIV/AIDS; Victorian Infectious Diseases Reference Laboratory
Table 1.2.4
Number and percentage of isolates with resistance at one or more loci, by drug class against which resistance was detected and year
Drug class against which resistance was detected
Year of diagnosis 2007 2008 2009 2010 2011 2012

1
Total 81 90 108 88 94 91
% non-B subtypes 8.6 6.7 6.5 13.6 10.6 25.3
PI1 Number (%) 0 1 1 1 2 0 (0.0) (1.1) (0.9) (1.1) (2.1) (0.0)
NRTI1 Number (%) 3 3 6 7 4 3 (3.7) (3.3) (5.5) (7.9) (4.3) (3.3)
NNRTI1 Number (%) 5 5 8 4 1 7 (6.2) (5.6) (7.4) (4.5) (1.1) (7.7)
PI: protease inhibitor; NRTI: Nucleoside reverse transcriptase inhibitor; NNRTI: Non-nucleoside reverse transcriptase inhibitor.
Source: NSW State Reference Laboratory for HIV/AIDS; Victorian Infectious Diseases Reference Laboratory
43
1 HIV Infection
1.3
Table 1.3.1
National surveillance for newly diagnosed HIV infection in Aboriginal and Torres Strait Islander people
Characteristics of cases of newly diagnosed HIV infection in Aboriginal and Torres Strait Islander people1, 2003 2012, by year. Number of cases, median age and percent (number) of total cases by sex, newly acquired infection, late HIV diagnosis, State/Territory and HIV exposure category
Characteristic Total cases Males (%) Median age (years) Newly acquired infection (%) HIV status at diagnosis (%)2 Late HIV diagnosis Advanced HIV infection State/Territory (%) ACT NSW NT QLD SA TAS VIC WA HIV exposure category (%) Men who have sex with men Men who have sex with men, and injecting drug use Injecting drug use3 Heterosexual contact Haemophilia/coagulation disorder Receipt of blood/tissue Mother with/at risk for HIV infection Other/undetermined4
1 2 3 4
2003 23 73.9 34 17.4 (4)
2004 22 72.7 29 31.8 (7)
2005 18 83.3 33 16.7 (3)
2006 23 73.9 31 30.4 (7)
2007 19 84.2 33 26.3 (5)
2008 19 79.0 36 31.6 (6)
2009 24 83.3 37 29.2 (7)
2010 22 68.2 35 22.7 (5)
2011 23 73.9 33
2012 32 81.3 27
Total 225 77.3 33
21.7 (5) 31.3 (10) 26.2 (59)
4.3 26.1
4.5 31.8
5.6 11.1
13.0 8.7
21.1 10.5
21.1 15.8
12.5 33.3
18.2 9.1
4.3 34.8
9.4 18.7
11.6 20.4
17.4 (4) 4.3 (1) 26.1 (6) 8.7 (2) 0.0 (0) 21.7 (5) 21.7 (5)
18.2 (4) 4.5 (1) 22.7 (5) 9.1 (2) 4.5 (1) 18.2 (4) 22.7 (5)
0.0 (0) 11.1 (2) 0.0 (0) 44.4 (8) 0.0 (0) 0.0 (0) 11.1 (2) 33.3 (6)
0.0 (0) 38.1 (9) 0.0 (0) 23.8 (6) 0.0 (0) 0.0 (0) 9.5 (2) 28.6 (6)
0.0 (0) 42.1 (8) 0.0 (0) 26.3 (5) 5.3 (1) 0.0 (0) 15.8 (3) 10.5 (2)
0.0 (0) 38.9 (8) 5.6 (1) 11.1 (2) 22.2 (4) 0.0 (0) 0.0 (0) 22.2 (4)
0.0 (0) 39.1 (9) 0.0 (0) 30.4 (8) 8.7 (2) 4.4 (1) 4.4 (1) 13.0 (3)
0.0 (0) 31.8 (7) 4.5 (1) 36.4 (8) 4.5 (1) 0.0 (0) 13.6 (3) 9.1 (2)
0.0 (0) 0.0 (0) 0.0 (0) 21.7 (5) 34.4 (11) 29.8 (67) 8.7 (2) 6.2 (2) 3.6 (8) 34.8 (8) 40.6 (13) 30.7 (69) 4.3 (1) 3.1 (1) 6.2 (14) 4.3 (1) 0.0 (0) 1.3 (3) 4.3 (1) 15.6 (5) 11.6 (26) 21.7 (5) 0.0 (0) 16.9 (38)
31.8 (7) 52.4 (11) 13.6 (3) 13.6 (3) 40.9 (9) 0.0 (0) 0.0 (0) 0.0 (0) 4.3 (1) 0.0 (0) 19.0 (4) 28.6 (6) 0.0 (0) 0.0 (0) 0.0 (0) 4.5 (1)
27.8 (5) 47.8 (11) 27.8 (5) 16.7 (3) 27.8 (5) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 4.3 (1) 21.7 (5) 26.1 (6) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0)
47.4 (9) 15.8 (3) 15.8 (3) 21.1 (4) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0)
47.4 (9) 52.6 (10) 60.0 (12) 63.6 (14) 71.0 (22) 51.4 (110) 5.3 (1) 36.8 (7) 10.5 (2) 0.0 (0) 0.0 (0) 0.0 (0) 0.0 (0) 15.8 (3) 10.5 (2) 21.1 (4) 0.0 (0) 0.0 (0) 0.0 (0) 20.8 (5) 5.0 (1) 20.0 (4) 15.0 (3) 0.0 (0) 0.0 (0) 0.0 (0) 9.1 (2) 0.0 (0) 4.5 (1) 27.3 (6) 0.0 (0) 0.0 (0) 4.5 (1) 4.3 (1) 3.2 (1) 8.4 (18) 6.5 (2) 15.9 (34) 19.4 (6) 23.8 (51) 0.0 (0) 0.0 (0) 0.0 (0) 3.1 (1) 0.0 (0) 0.0 (0) 0.5 (1) 4.9 (11)
Indigenous status at HIV diagnosis was available for cases diagnosed in the Australian Capital Territory from 1 January 2005. Late HIV diagnosis was defined as newly diagnosed HIV infection with a CD4+ cell count of 200349 cells/l and advanced HIV infection was defined as newly diagnosed HIV infection with a CD4+ cell count of less than 200 CD4+ cells/l. Excludes men who have sex with men. The Other/undetermined HIV exposure category was excluded from the calculation of the percentage of cases attributed to each exposure category.
1 HIV Infection
44
Table 1.3.2
Rate1 of diagnosis of HIV infection, 20082012, by year, Aboriginal and Torres Strait Islander status and area of residence
Year of diagnosis
Area of residence Aboriginal and Torres Strait Islander status Major cities Inner regional Outer regional Remote Very remote Total Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2
2008 7 6 1 2 1 4 0 1 0 0 3 5
2009 10 6 1 2 2 2 3 1 1 3 4 5
2010 7 6 3 2 3 2 0 1 1 2 4 5
2011 7 6 2 2 2 2 0 1 5 1 4 5
2012 12 7 3 2 3 3 0 3 0 3 6 6
1 2
Rate per 100 000 population. Population estimates from 2006 Census of Population and Housing (Australian Bureau of Statistics). Includes diagnoses in people whose Aboriginal and Torres Strait Islander status was not reported.
45
1 HIV Infection
1.4
Table 1.4.1

Number and population rate1 of perinatal exposure to HIV among children born in Australia, 20032012, by State/Territory and year of birth
Year of birth
State/ Territory ACT NSW NT QLD SA TAS VIC WA Total

1 2
20032004 Number Rate 1 23 0 13 0 0 8 5 50 12.0 13.4 0.0 13.2 0.0 0.0 6.5 10.1 9.9
20052006 Number Rate 0 17 0 9 3 0 9 3 41 0.0 9.8 0.0 8.6 8.3 0.0 7.0 5.6 7.8
20072008 Number Rate 0 30 0 9 5 1 24 0 69 0.0 16.3 0.0 7.2 12.5 7.4 17.0 0.0 11.9
200920102 Number Rate 3 32 0 20 1 3 34 2 97 30.0 17.0 0.0 15.3 2.5 23.1 24.0 3.2 16.3
20112012 Number Rate 6 33 0 8 9 1 44 9 110 58.6 16.7 0.0 6.3 22.6 7.6 30.8 13.9 18.2
Average annual rate of perinatal HIV exposure per 100 000 livebirths. Number of livebirths by State/Territory and year from Births, Australia (Australian Bureau of Statistics). Includes 2 children born in 20092010 whose State/Territory of birth was not reported.
Source: Australian Paediatric Surveillance Unit: State/Territory health authorities
Table 1.4.2
Number of women whose perinatally HIV exposed children were born in Australia, 20032012, by time of the womans HIV diagnosis relative to the first exposed childs birth
Interval of the womans HIV diagnosis
First exposed childs year of birth 20032004 20052006 200720081 200920101,2 201120121
1
Before or at the birth (years) <1 12 >2 16 13 19 31 20 99 3 4 9 8 6 30 28 13 20 30 46 137
Total 47 30 48 69 72 266
After the birth 1 0 1 5 3 10
Total 49 34 52 75 77 287
Total
1 2
Totals include 1 woman whose first exposed child born in 20032004, 1 woman whose first exposed child born in 20072008, 5 women whose first exposed children born in 20092010 and 3 women whose first exposed children born in 20112012, whose the date of HIV diagnosis was not reported. Total includes 1 child with diagnosed HIV infection.
1 HIV Infection
46
Table 1.4.3
Number of women whose perinatally HIV exposed children were born in Australia, 20032012, and number of perinatally exposed children, by year of birth of the first exposed child and the womans HIV exposure category
20032007 Number of Number of exposed women children 9 96 11 3 43 16 1 1 21 0 4 109 11 111 13 4 46 21 1 1 25 0 4 126 20082012 Number of Number of exposed women children 6 160 10 11 75 21 1 5 37 0 12 178 10 218 14 15 104 30 2 7 46 0 13 241 20032012 Number of Number of exposed women children 15 256 21 14 118 37 2 6 58 0 16 287 21 329 27 19 150 51 3 8 71 0 17 367
Year of the first exposed childs birth/ HIV exposure category Injecting drug use Heterosexual contact Sex with injecting drug user Sex with bisexual male From a high prevalence country Sex with person from a high prevalence country Sex with person with medically acquired HIV Sex with person with HIV infection, other exposure Not further specified Receipt of blood/tissue Other/undetermined Total
Table 1.4.4
Number of perinatally exposed children born in Australia, 20032012, and number with diagnosed HIV infection by year of the childs birth and time of the womans HIV diagnosis relative to the childs birth
Interval of the womans HIV diagnosis Before or at the birth Number Number exposed with HIV 48 36 65 91 105 345 2 3 0 1 1 7 After the birth Number Number exposed with HIV 1 5 3 1 2 12 0 2 3 0 1 6 Total Number exposed1 50 41 69 97 110 367 Number with HIV2 2 5 3 2 2 14
Childs year of birth 200320041 20052006 200720081 200920101,2 201120121 Total

1 2
Totals include 1 exposed child born in 20032004, 1 exposed child born in 20072008, 5 exposed children born in 20092010 and 3 exposed children born in 20112012, for whom the date of the womans HIV diagnosis was not reported. Total includes 1 exposed child with HIV infection.
47
1 HIV Infection
Table 1.4.5
Number of perinatally exposed children, born in 20032012 to women whose HIV infection was diagnosed antenatally, and number with diagnosed HIV infection by year of the childs birth and the proportion of women reporting use of interventions to reduce the risk of mother-to-child transmission
Proportion of women reporting use of interventions 48 2.1 4.2 35.4 58.3 36 11.1 2.8 38.9 47.2 65 3.1 1.5 46.2 49.2 91 4.4 2.2 50.5 42.9 105 0.0 7.6 59.0 33.3 345 Number of children wwith HIV infection 2 1 0 0 1 3 2 0 0 1 0 0 0 0 0 1 0 0 1 0 1 0 0 1 0 7
Childs year of birth/ Reported use of interventions 20032004 No reported use of interventions Use of 1 intervention Use of 2 interventions Use of 3 interventions 20052006 No reported use of interventions Use of 1 intervention Use of 2 interventions Use of 3 interventions 20072008 No reported use of interventions Use of 1 intervention Use of 2 interventions Use of 3 interventions 20092010 No reported use of interventions Use of 1 intervention Use of 2 interventions Use of 3 interventions 20112012 No reported use of interventions Use of 1 intervention Use of 2 interventions Use of 3 interventions Total
1 HIV Infection
48
1.5
Table 1.5.1
Global comparisons for HIV

Estimated HIV prevalence in selected countries
HIV prevalence
Country Africa Mauritius3 Somalia3 South Africa3 Sudan South3 Zambia3 Zimbabwe3 Asia Pacific Australia Cambodia3 China3 Indonesia3 Japan3 Malaysia3 Myanmar3 New Zealand3 Papua New Guinea3 Philippines3 Republic of Korea3 Thailand3 Vietnam3 Europe France3 Germany3 Italy3 Spain3 United Kingdom4 North America Canada3 United States5
1 2 3 4 5 Estimated number of people living with HIV/AIDS. Rate per 100 000 population. Estimated HIV prevalence in people aged 15 49 years in 2011. Estimated HIV prevalence in 2011. Estimated HIV prevalence for people aged 13 in 2009.
20121
Rate2
7 400 30 000 5 100 000 130 000 800 000 1 000 000
1 000 700 17 300 3 100 12 500 14 900
25 708 56 000 771 000 370 000 7 900 80 000 210 000 2 600 24 000 19 000 15 000 480 000 240 000
120 600 <100 300 <100 400 600 100 700 <100 <100 1 200 500
160 000 73 000 150 000 150 000 96 000
400 200 400 400 150
71 300 1 148 200
208 456
49
1 HIV Infection
1 HIV Infection
50
2013
Tables
2
2.1
2.1.1 2.1.2 2.1.3 2.1.4 2.1.5 2.1.6 2.1.7 2.1.8 2.1.9 2.1.10 2.1.11 2.1.12 2.1.13 2.1.14 2.1.15 2.1.16
National surveillance for viral hepatitis

Notification of viral hepatitis to the National Notifiable Diseases Surveillance System
Number and rate of diagnosis of hepatitis A infection, 20082012, by State/Territory and year Number of diagnoses of hepatitis A infection, 20082012, by age group, year and sex Number and rate of diagnosis of hepatitisB infection, 20082012, by State/Territory and year Number of diagnoses of hepatitisB infection, 20082012, by age group, year and sex Number and rate of diagnosis of newly acquired hepatitisB infection, 20082012, by State/Territory and year 53 53 54 54 55
Number of diagnoses of newly acquired hepatitisB infection, 20082012, by age group, year and sex 55 Number of diagnoses of newly acquired hepatitisB infection, 20082012, by exposure category, year and sex Number and percentage of diagnoses of newly acquired hepatitisB infection, 20082012, and the Australian population, by region/country of birth and year Number and rate of diagnosis of hepatitisC infection, 20082012, by State/Territory and year 56 57 58
Number of diagnoses of hepatitisC infection, 20082012, by age group, year and sex 58 Number of diagnoses of newly acquired hepatitisC infection, 20082012, by State/Territory and year Number of diagnoses of newly acquired hepatitisC infection, 20082012, by age group, year and sex Number of diagnoses of newly acquired hepatitisC infection, 20082012, by exposure category, year and sex Number and percentage of diagnoses of newly acquired hepatitisC infection, 20082012, and the Australian population, by region/country of birth and yearr Number of diagnoses of hepatitis D infection, 20082012, by State/Territory and year Number of diagnoses of hepatitis D infection, 20082012, by age group, year and sex 58 59 59 60 61 61
2.2
2.2.1 2.2.2 2.2.3 2.2.4 2.2.5 2.2.6 2.2.7 2.2.8
National surveillance for viral hepatitis in Aboriginal and Torres Strait Islander people
Number (percent) of diagnoses of hepatitis A infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status Number and rate of diagnosis of hepatitisB infection, 20082012, by year, State/Territory and Aboriginal and Torres Strait Islander status Number (percent) of diagnoses of hepatitisB infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status Number and rate of diagnosis of newly acquired hepatitisB, 2008 2012, by year, State/Territory and Aboriginal and Torres Strait Islander status Number (percent) of diagnoses of newly acquired hepatitisB infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status Number and rate of diagnosis of hepatitisC infection, 20082012, by year, State/Territory and Aboriginal and Torres Strait Islander status Number (percent) of diagnoses of hepatitisC infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status Number (percent) of diagnoses of hepatitis D infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status 62 62 63 63 64
65 65
51
2 Viral Hepatitis
64
2.3
2.3.1
Long term outcomes among people with chronic viral hepatitis

Number (percent) of liver transplants, 1985 2011, by year and primary cause of liver disease, and hepatitis status for cases where the primary diagnosis was hepatocellular carcinoma 66
2.4
2.4.1
Global comparisons of hepatitisB virus prevalence

Estimated HBV prevalence in selected countries 67
2 Viral Hepatitis
52
2 2.1
National surveillance for viral hepatitis Notification of viral hepatitis to the National Notifiable Diseases Surveillance System
Number and rate1 of diagnosis of hepatitis A infection, 20082012, by State/Territory and year
Year of diagnosis
Table 2.1.1

1
2008 Number Rate 5 69 3 71 20 1 85 22 276 1.6 1.0 2.3 1.6 1.3 0.2 1.6 1.0 1.3
2009 Number Rate 6 98 1 56 59 5 304 35 564 1.4 1.4 0.4 1.3 3.7 1.1 5.5 1.5 2.6
2010 Number Rate 5 83 3 40 4 4 95 32 266 1.3 1.2 1.6 0.9 0.3 0.8 1.8 1.4 1.2
2011 Number Rate 3 57 3 26 6 4 34 12 145 0.8 0.8 1.1 0.6 0.4 0.8 0.6 0.5 0.6
2012 Number Rate 1 42 3 34 7 2 62 14 165 0.3 0.6 1.0 0.7 0.4 0.4 1.1 0.5 0.7
Age standardised rate per 100 000 population. Population estimates by State/Territory and year from Australian Demographic Statistics (Australian Bureau of Statistics).
Source: National Notifiable Diseases Surveillance System
Table 2.1.2
Number of diagnoses of hepatitis A infection, 20082012, by age group, year and sex
Year of diagnosis
Age group 04 514 1519 2024 2529 3039 4049 5059 60+ Total
M 9 35 12 20 21 22 14 15 10 158
2008 F 6 25 7 21 13 10 15 8 13 118
T 15 60 19 41 34 32 29 23 23 276
M 13 29 22 47 26 56 35 26 25 279
2009 F 6 21 23 38 24 64 43 38 28 285
T 19 50 45 85 50 120 78 64 53 564
M 12 35 9 11 12 21 11 14 9 134
2010 F 14 23 14 10 15 15 15 9 17 132
T 26 58 23 21 27 36 26 23 26 266
M 5 15 6 9 11 18 5 7 9 85
2011 F 4 9 5 3 9 14 2 6 8 60
T 9 24 11 12 20 32 7 13 17 145
M 7 12 6 7 17 8 10 3 10 80
2012 F 4 24 5 8 10 9 7 2 16 85
T 11 36 11 15 27 17 17 5 26 165
53
2 Viral Hepatitis
Table 2.1.3
Number and rate1 of diagnosis of hepatitisB infection, 20082012, by State/Territory and year
Year of diagnosis
State/Territory ACT NSW NT QLD SA TAS VIC WA Total

1
2008 Number Rate 58 2 489 200 873 431 67 1 916 647 6 681 15.6 35.5 94.3 20.5 27.4 14.4 35.6 29.1 31.0
2009 Number Rate 106 2 618 161 1 052 458 85 2 018 712 7 210 27.8 36.9 72.9 24.1 28.8 18.2 36.5 30.7 32.7
2010 Number Rate 95 2 561 160 1 113 432 54 1 954 769 7 138 24.6 35.6 68.5 25.1 26.9 11.4 34.8 32.6 31.9
2011 Number Rate 95 2 525 161 893 412 50 1 980 657 6 773 23.4 34.8 69.6 19.8 25.7 10.7 34.8 27.0 29.9
2012 Number Rate 106 2 327 205 863 399 72 1 907 823 6 702 25.9 31.8 81.5 18.9 24.5 15.4 33.0 32.3 29.1
Table 2.1.4
Number of diagnoses of hepatitisB infection, 20082012, by age group, year and sex
Year of diagnosis
Age group 04 514 1519 2024 2529 3039 4049 5059 60 + Not reported Total
1
M 14 80 167 352 481 977 810 441 307 2
2008 F
T1
M 2 79 187 396 540 1 052 855 532 313 7
2009 F
T1
M 10 73 162 340 532 1 044 772 507 355 2
2010 F
T1
M 5 56 141 355 566 979 755 537 334 1
2011 F
T1
M 8 45 177 340 583 1 008 746 494 352 4
2012 F
T1
10 24 59 141 126 295 407 769 560 1 049 848 1 844 462 1 278 296 739 226 534 2 8
4 6 50 129 137 325 363 768 603 1 159 937 2 016 517 1 380 340 876 220 539 3 12
10 20 37 111 127 293 382 733 653 1 207 932 2 002 485 1 266 382 891 245 608 3 7
3 8 26 83 106 247 331 701 599 1 184 855 1 865 448 1 213 332 872 258 596 0 4
5 14 31 77 80 258 299 647 554 1 149 870 1 900 455 1 204 368 864 232 585 0 4
3 631 2 996 6 681
3 963 3 174 7 210
3 797 3 256 7 138
3 729 2 958 6 773
3 757 2 894 6 702
Totals include diagnoses in people whose sex and age group was not reported.
2 Viral Hepatitis
54
Table 2.1.5
Number and rate1 of diagnosis of newly acquired hepatitisB infection, 20082012, by State/Territory and year
Year of diagnosis

1
2008 Number Rate 1 45 8 46 11 15 88 48 262 0.3 0.6 4.3 1.1 0.7 3.4 1.6 2.1 1.2
2009 Number Rate 5 37 4 51 10 14 90 38 249 1.3 0.5 1.5 1.2 0.6 3.2 1.6 1.7 1.1
2010 Number Rate 3 35 4 57 21 6 70 32 228 0.6 0.5 1.5 1.3 1.3 1.3 1.3 1.4 1.0
2011 Number Rate 2 30 4 46 9 14 72 18 195 0.4 0.4 1.5 1.0 0.6 3.1 1.3 0.7 0.9
2012 Number Rate 2 29 5 55 16 10 52 24 193 0.5 0.4 1.8 1.2 1.0 2.2 0.9 1.0 0.8
Table 2.1.6
Number of diagnoses of newly acquired hepatitisB infection, 20082012, by age group, year and sex
Year of diagnosis
Age group 04 514 1519 2024 2529 3039 4049 5059 60 + Total
M 1 1 7 17 33 50 40 15 17 181
2008 F 1 2 5 20 13 25 9 3 3 81
T 2 3 12 37 46 75 49 18 20 262
M 1 1 3 13 32 49 36 15 14 164
2009 F 0 0 4 7 14 33 11 9 7 85
T 1 1 7 20 46 82 47 24 21 249
M 1 3 5 13 23 38 34 22 11 150
2010 F 5 1 4 9 15 18 11 8 7 78
T 6 4 9 22 38 56 45 30 18 228
M 1 0 4 10 19 47 24 18 10 133
2011 F 0 0 3 11 9 23 10 5 1 62
T 1 0 7 21 28 70 34 23 11 195
M 1 0 4 11 19 31 35 20 19 140
2012 F 1 1 2 6 11 15 12 5 0 53
T 2 1 6 17 30 46 47 25 19 193
55
2 Viral Hepatitis
2 Viral Hepatitis
Table 2.1.7
Number of diagnoses of newly acquired hepatitisB infection1, 20082012, by exposure category, year and sex
Year of diagnosis 2008 2009 F 9 8 7 1 0 4 1 2 1 5 30 T 42 24 1 20 3 2 10 5 5 4 20 112 M 36 23 7 12 4 2 3 3 2 7 88 164 F 20 10 9 1 1 2 1 0 2 49 85 T 56 33 7 21 5 3 5 4 2 9 137 249 M 32 6 0 5 1 0 7 3 3 6 93 150 2010 F 18 8 7 1 0 1 0 4 5 42 78 T 50 14 0 12 2 0 8 3 7 11 135 228 M 30 11 5 5 1 0 10 2 2 14 64 133 2011 F 14 6 6 0 1 5 3 1 1 31 62 T 44 17 5 11 1 1 15 5 3 15 95 195 M 20 12 3 9 0 0 1 2 2 13 90 140 2012 F 10 8 8 0 0 0 2 2 1 30 53 T 30 20 3 17 0 0 1 4 4 14 120 193
Exposure category Injecting drug use Sexual contact Men who have sex with men Heterosexual contact Not further specified Blood/tissue recipient Skin penetration procedure Healthcare exposure Household contact Other Undetermined Total
1
M 33 16 1 13 2 2 6 4 3 3 15 82
Includes diagnoses in SA, TAS and VIC in 2008 2012 and diagnoses in ACT, NSW and NT in 20092012.
Table 2.1.8
Number and percentage of diagnoses of newly acquired hepatitisB infection, 20082012, and the Australian population, by region/country of birth and year
Year of diagnosis 2008 2009 Percent 35.1 73.9 26.1 3.3 4.3 4.3 1.1 0.0 10.9 0.0 2.2 64.9 100 Number 105 70 35 6 12 2 4 1 10 0 0 144 249 Percent 42.2 66.7 33.3 5.7 11.4 1.9 3.8 1.0 9.5 0.0 0.0 57.8 100 Number 142 96 46 2 4 8 6 7 17 1 1 86 228 2010 Percent 62.3 67.6 32.4 1.4 2.8 5.6 4.2 4.9 12.0 0.7 0.7 37.7 100 Number 123 89 34 7 4 2 6 2 13 0 0 72 195 2011 Percent 63.1 72.4 27.6 5.7 3.3 1.6 4.9 1.6 10.6 0.0 0.0 36.9 100 Number 83 62 21 1 2 6 3 1 7 0 1 110 193 2012 Percent 43.0 74.7 25.3 1.2 2.4 7.2 3.6 1.2 8.4 0.0 1.2 57.0 100
Region/ country of birth Total with a reported country of birth Australia Overseas born Other Oceania United Kingdom and Ireland Other Europe Middle East/North Africa Sub-Saharan Africa Asia North America South/Central America and the Caribbean Not reported Total
1 HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013 57
Number 92 68 24 3 4 4 1 0 10 0 2 170 262
Australian population1 21 507 719 69.8 24.6 2.8 5.4 4.5 1.4 1.3 8.1 0.5 0.5 5.6
Population estimates by region/country of birth from 2011 Census by the Australian Bureau of Statistics.
2 Viral Hepatitis
Table 2.1.9
Number and rate1 of diagnosis of hepatitisC infection, 20082012, by State/Territory and year
Year of diagnosis

1
2008 Number Rate 201 3 653 212 2 575 584 347 2 412 1 324 11 308 54.3 52.2 92.1 60.2 37.0 74.4 44.9 59.2 52.5
2009 Number Rate 163 3 789 166 2 634 556 283 2 510 1 145 11 246 42.7 53.5 70.8 60.3 34.8 59.8 45.7 49.5 51.2
2010 Number Rate 223 3 765 170 2 681 530 264 2 585 1 066 11 284 57.9 52.4 72.8 60.4 33.0 54.6 46.2 45.1 50.6
2011 Number Rate 189 3 331 209 2 424 460 229 2 326 1 077 10 245 48.8 46.1 84.7 53.8 28.5 48.0 41.2 44.3 45.4
2012 Number Rate 147 3 290 195 2 376 471 265 2 234 1 136 10 114 37.2 45.1 77.1 51.9 28.9 56.1 39.0 45.1 44.2
Table 2.1.10
Number of diagnoses of hepatitisC infection, 20082012, by age group, year and sex
Year of diagnosis
1
2008 F
T1 20 21 306 1 086 1 591 3 205 2 872 1 707 499 1
2009 F
T1 16 31 272 970 1 532 3 171 2 859 1 876 511 8
2010 F
T1 22 26 249 951 1 499 3 232 2 779 1 970 537 19
M 6 11 107 508 802 1 879 1 707 1 238 324 5
2011 F 5 10 131 365 495 978 796 599 233 1
T1 11 22 238 880 1 302 2 878 2 506 1 837 562 9
M 6 7 143 624 808 1 808 1 588 1 198 360 5
2012 F 9 10 111 323 478 975 772 595 258 0
T1 15 18 254 949 1 293 2 800 2 365 1 795 618 7
8 11 12 9 131 174 612 470 951 635 2 048 1 150 1 915 951 1 170 533 268 228 0 0
4 12 14 16 127 144 513 453 881 641 2 075 1 073 1 923 926 1 306 565 254 256 1 0
10 12 14 10 113 133 540 396 854 606 1 992 1 201 1 838 932 1 338 626 311 224 10 5
7 115 4 161 11 308
7 098 4 086 11 246
7 020 4 145 11 284
6 587 3 613 10 245
6 547 3 531 10 114
Totals include diagnoses in people whose sex was not reported.
Table 2.1.11
Number of diagnoses of newly acquired hepatitisC infection, 20082012, by State/Territory and year
Year of diagnosis
2008 6 26 6 43 21 163 100 365
2009 8 41 5 38 22 193 93 400
2010 12 38 0 43 23 205 76 397
2011 9 53 3 33 27 168 120 413
2012 15 47 0 77 23 179 125 466
2 Viral Hepatitis
Dashes () indicate that data were not available.
58
Table 2.1.12
Number of diagnoses of newly acquired hepatitisC infection, 20082012, by age group, year and sex
Year of diagnosis
1
M 0 0 22 55 62 52 22 3 3 0 219
2008 F 1 0 19 31 36 42 11 4 2 0 146
T 1 0 41 86 98 94 33 7 5 0 365
M 1 0 18 76 52 70 18 5 1 0 241
2009 F 5 2 11 43 41 34 15 4 0 0 155
T1 6 2 29 119 93 104 33 9 1 4 400
M 2 1 8 59 47 59 34 13 0 0 223
2010 F 3 0 20 47 36 48 15 3 2 0 174
T 5 1 28 106 83 107 49 16 2 0 397
M 1 0 15 64 84 68 39 11 1 0 283
2011 F 0 2 23 32 26 24 14 7 1 0 129
T1 1 2 38 97 110 92 53 18 2 0 413
M 1 0 18 91 66 66 46 16 2 0 306
2012 F 0 1 19 32 43 40 19 4 2 0 160
T 1 1 37 123 109 106 65 20 4 0 466
Totals include 4 cases whose sex and age group was not reported and 1 case whose sex was not reported.
Table 2.1.13
Number of diagnoses of newly acquired hepatitisC infection, 20082012, by exposure category, year and sex
Year of diagnosis
Exposure category Injecting drug use Sexual contact Blood/tissue recipient Skin penetration procedure Healthcare exposure Household contact Other Undetermined Total
1
M 160 6 0 6 2 1 14 30 219
2008 F 95 8 0 4 3 0 9 27 146
T 255 14 0 10 5 1 23 57 365
M 164 7 0 4 1 0 27 38 241
2009 F 95 8 0 4 11 2 12 23 155
T 259 15 0 8 12 2 39 65 400
M 158 8 0 5 4 2 22 24 223
2010 F 103 3 0 5 38 1 6 18 174
T 261 11 0 10 42 3 28 42 397
M 173 6 0 13 1 1 19 70 283
2011 F 62 7 0 2 5 1 6 46 129
T 236 13 0 15 6 2 25 116 413
M 165 6 0 4 0 0 19 112 306
2012 F 96 3 0 2 0 0 7 52 160
T 261 9 0 6 0 0 26 164 466
59
2 Viral Hepatitis
2 Viral Hepatitis
Table 2.1.14
Number and percentage of diagnoses of newly acquired hepatitisC infection, 20082012, and the Australian population, by region/country of birth and yearr
Year of diagnosis 2008 2009 Percent 77.3 88.3 11.7 1.1 3.2 1.1 0.7 0.7 4.6 0.4 0.0 22.7 100 Number 174 149 25 5 5 4 2 2 3 2 2 226 400 Percent 43.5 85.6 14.4 2.9 2.9 2.3 1.1 1.1 1.7 1.1 1.1 56.5 100 Number 179 154 25 5 7 4 2 1 4 1 1 218 397 2010 Percent 45.1 86.0 14.0 2.8 3.9 2.2 1.1 0.6 2.2 0.6 0.6 54.9 100 Number 202 188 14 2 3 0 1 1 4 1 2 211 413 2011 Percent 48.9 93.1 6.9 1.0 1.5 0.0 0.5 0.5 2.0 0.5 1.0 51.1 100 Number 180 160 20 2 4 2 1 3 8 0 0 286 466 2012 Percent 38.6 88.9 11.1 1.1 2.2 1.1 0.6 1.7 4.4 0.0 0.0 61.4 100
Region/country of birth Total with a reported country of birth Australia Overseas born Other Oceania United Kingdom and Ireland Other Europe Middle East/North Africa Sub-Saharan Africa Asia North America South/Central America and the Caribbean Not reported Total
1
Number 282 249 33 3 9 3 2 2 13 1 0 83 365
Australian population1 21 507 719 69.8 24.6 2.8 5.4 4.5 1.4 1.3 8.1 0.5 0.5 5.6
Population estimates by region/country of birth from 2011 Census by the Australian Bureau of Statistics.
Table 2.1.15
Number of diagnoses of hepatitis D infection, 20082012, by State/Territory and year

Year of diagnosis

2008 0 13 1 7 0 0 14 6 41
2009 0 9 0 13 0 0 13 0 35
2010 0 9 0 20 1 0 6 0 36
2011 0 12 0 7 1 0 16 2 38
2012 0 5 0 6 8 0 9 2 30
Table 2.1.16
Number of diagnoses of hepatitis D infection, 20082012, by age group, year and sex
Year of diagnosis
M 0 0 3 2 4 11 7 4 2 0 33
2008 F 0 0 1 0 0 1 4 1 1 0 8
T 0 0 4 2 4 12 11 5 3 0 41
M 0 0 4 2 5 3 7 3 0 0 24
2009 F 0 0 1 1 4 1 0 1 2 1 11
T 0 0 5 3 9 4 7 4 2 1 35
M 0 1 1 4 2 1 11 8 0 0 28
2010 F 0 0 0 1 0 5 1 1 0 0 8
T 0 1 1 5 2 6 12 9 0 0 36
M 0 0 1 0 1 7 5 7 2 0 23
2011 F 0 0 0 2 2 3 6 0 2 0 15
T 0 0 1 2 3 10 11 7 4 0 38
M 0 0 1 1 3 5 6 4 1 0 21
2012 F 0 1 0 1 0 1 1 4 1 0 9
T 0 1 1 2 3 6 7 8 2 0 30
61
2 Viral Hepatitis
2.2
Table 2.2.1
National surveillance for viral hepatitis in Aboriginal and Torres Strait Islander people
Number (percent) of diagnoses of hepatitis A infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status
Aboriginal and Torres Strait Islander status
Aboriginal and Torres Strait Islander 0 0 0 0 0 0 0 0 0 (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) (0.0) (0.0)
Non-Indigenous 1 41 3 25 7 2 55 14 148 (100.0) (97.6) (100.0) (73.5) (100.0) (100.0) (88.7) (100.0) (89.7)
Not reported 0 1 0 9 0 0 7 0 17 (0.0) (2.4) (0.0) (26.5) (0.0) (0.0) (11.3) (0.0) (10.3)
Total 1 42 3 34 7 2 62 14 165
Table 2.2.2
Number and rate1 of diagnosis of hepatitisB infection, 20082012, by year, State/Territory2 and Aboriginal and Torres Strait Islander status
Year of diagnosis
State/ Aboriginal and Torres Strait Territory Islander status NT SA TAS WA Total Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3
2008 Number Rate 115 85 26 405 0 67 55 592 196 1 149 281.6 52.0 140.3 26.5 0.0 15.5 109.4 26.6 156.1 26.3
2009 Number Rate 79 82 19 439 2 83 33 679 133 1 283 203.0 47.8 75.5 28.7 11.6 19.3 71.5 30.3 105.3 29.3
2010 Number Rate 75 85 23 409 1 53 42 727 141 1 274 181.8 49.6 109.4 26.8 8.2 12.3 100.3 32.6 116.3 29.2
2011 Number Rate 75 86 29 383 2 48 53 604 159 1 121 185.8 50.6 133.5 25.3 12.4 11.2 91.5 27.1 119.6 25.7
2012 Number Rate 61 144 20 379 0 72 43 780 124 1 375 143.8 84.4 78.3 24.8 0.0 16.7 66.8 34.9 85.6 31.5
1 2 3
Age standardised rate per 100 000 population. Population estimates by State/Territory, year and Aboriginal and Torres Strait Islander status from 2011 Census of Population and Housing (Australian Bureau of Statistics). State/Territory health jurisdictions in which Aboriginal and Torres Strait Islander status was reported for more than 50% of diagnoses in each year. Includes diagnoses in people whose Aboriginal and Torres Strait Islander status was not reported.
2 Viral Hepatitis
62
Table 2.2.3
Number (percent) of diagnoses of hepatitisB infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status
Aboriginal and Torres Strait Islander status1

1
Aboriginal and Torres Strait Islander 0 61 20 0 43 200 (0.0) (29.8) (5.0) (0.0) (5.2) (3.0)
Non-Indigenous 104 134 373 52 694 2 488 (98.1) (65.4) (93.5) (72.2) (84.3) (37.1)
Not reported 2 2 147 10 604 6 20 1 139 86 4 014 (1.9) (92.3) (4.9) (70.0) (1.5) (27.8) (59.7) (10.4) (59.9)
Total 106 2 327 205 863 399 72 1 907 823 6 702
Data not shown for State/Territory health jurisdictions in which Aboriginal and Torres Strait Islander status was not reported for more than 50% of diagnoses.
Table 2.2.4
Number and rate1 of diagnosis of newly acquired hepatitisB, 2008 2012, by year, State/Territory2 and Aboriginal and Torres Strait Islander status
Year of diagnosis
State/ Aboriginal and Torres Strait Territory Islander status NSW NT QLD SA TAS VIC WA Total Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3
2008 Number Rate 5 40 4 4 8 38 0 11 0 15 1 87 2 46 20 241 3.0 0.6 12.8 2.6 4.6 0.9 0.0 0.7 0.0 3.6 3.0 1.6 3.7 2.1 4.1 1.2
2009 Number Rate 4 33 0 4 4 47 0 10 2 12 3 87 0 38 13 231 2.8 0.5 0.0 2.3 2.0 1.1 0.0 0.6 11.6 3.0 8.8 1.6 0.0 1.7 2.4 1.1
2010 Number Rate 2 33 1 3 10 47 0 21 0 6 4 66 2 30 19 206 1.4 0.5 1.8 1.7 7.3 1.1 0.0 1.4 0.0 1.5 11.9 1.2 2.6 1.3 3.8 1.0
2011 Number Rate 3 27 1 3 8 38 0 9 1 13 1 71 1 17 15 178 1.8 0.4 1.2 1.6 4.9 0.9 0.0 0.6 6.6 3.2 3.1 1.3 0.9 0.8 2.6 0.9
2012 Number Rate 1 28 4 1 7 48 2 14 0 10 3 49 2 22 19 172 0.6 0.4 4.9 0.6 4.4 1.2 6.8 0.9 0.0 2.4 9.1 0.9 2.7 1.0 3.4 0.8
1 2 3
63
2 Viral Hepatitis
Table 2.2.5
Number (percent) of diagnoses of newly acquired hepatitisB infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status

1
Non-Indigenous 2 (100.0) 24 (82.8) 1 (20.0) 28 (50.9) 14 (87.5) 10 (100.0) 45 (86.5) 22 (91.7) 146 (75.6)
Not reported 0 4 0 20 0 0 4 0 28 (0.0) (13.8) (0.0) (36.4) (0.0) (0.0) (7.7) (0.0) (14.5)
Total 2 29 5 55 16 10 52 24 193
Table 2.2.6
Number and rate1 of diagnosis of hepatitisC infection, 20082012, by year, State/Territory2 and Aboriginal and Torres Strait Islander status
Year of diagnosis
State/ Aboriginal and Torres Strait Territory Islander status NT SA TAS WA Total Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3
2008 Number Rate 26 186 48 536 21 326 130 1 194 225 2 242 51.5 106.5 161.9 34.9 116.1 75.1 190.3 53.5 130.2 51.1
2009 Number Rate 27 139 48 508 10 273 140 1 005 225 1 925 52.3 80.7 171.0 33.0 65.4 62.5 194.0 45.1 128.3 43.8
2010 Number Rate 24 146 68 462 13 251 134 932 239 1 791 47.1 86.1 239.3 30.0 72.8 56.3 196.9 41.8 140.2 40.8
2011 Number Rate 44 165 37 423 11 218 148 929 240 1 735 85.5 93.3 143.2 27.5 66.6 49.5 206.9 41.8 140.7 39.5
2012 Number Rate 23 172 64 407 21 244 187 949 295 1 772 42.4 99.6 222.5 26.3 109.3 55.7 265.6 42.6 166.2 40.3
1 2 3
2 Viral Hepatitis
64
Table 2.2.7
Number (percent) of diagnoses of hepatitisC infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status

1
Aboriginal and Torres Strait Islander 23 64 21 187 731
Non-Indigenous 164 380 182 910 3 444
Not reported 114 2 807 8 1 332 27 62 1 550 39 5 939 (77.6) (85.3) (4.1) (56.1) (5.7) (23.4) (69.4) (3.4) (58.7)
Total 147 3 290 195 2 376 471 265 2 234 1 136 10 114
(11.8) (13.6) (7.9) (16.5) (7.2)
(84.1) (80.7) (68.7) (80.1) (34.1)
Table 2.2.8
Number (percent) of diagnoses of hepatitis D infection, 2012, by State/Territory and Aboriginal and Torres Strait Islander status

1
Non-Indigenous 0 (0.0) 5 (100.0) 0 (0.0) 4 (66.7) 7 (87.5) 0 (0.0) 7 (77.8) 1 (50.0) 24 (80.0)
Not reported 0 0 0 2 0 0 2 0 4 (0.0) (0.0) (0.0) (33.3) (0.0) (0.0) (22.2) (0.0) (13.3)
Total 0 5 0 6 8 0 9 2 30
65
2 Viral Hepatitis
2 Viral Hepatitis
2.3
Table 2.3.1

Number (percent) of liver transplants, 1985 2011, by year and primary cause of liver disease, and hepatitis status for cases where the primary diagnosis was hepatocellular carcinoma
Year
Diagnosis HepatitisB HepatitisC HepatitisB/C/D Hepatocellular carcinoma HepatitisB HepatitisC HepatitisB/C/D Hepatitis negative Other1 Total
1 2
19852002 109 220 12 44 15 18 1 10 1 040 (7.6) (15.4) (0.8) (3.1) (1.1) (1.3) (0.1) (0.7) (73.0)
2003 6 (5.4)
2004 8 (5.4)
2005 8 (6.1)
2006 3 (2.3)
2007 3 (2.5)
2008 3 (1.9)
2009 7 (4.8)
2010 6 (3.1)
2011 9 (4.6)
2012 2 (1.0)
Total2 164 653 34 218 55 103 4 56 1 885 2 954
30 (26.8) 3 6 1 4 0 1 (2.7) (5.4) (0.9) (3.6) (0.0) (0.9)
43 (29.3) 0 11 2 6 1 2 (0.0) (7.5) (1.4) (4.1) (0.7) (1.4)
45 (34.1) 2 10 4 3 0 3 (1.5) (7.6) (3.0) (2.3) (0.0) (2.3)
31 (23.8) 2 10 3 5 0 2 (1.5) (7.7) (2.3) (3.8) (0.0) (1.5)
30 (25.2) 2 (1.7)
43 (27.7) 5 (3.2)
41 (28.1) 1 (0.7)
48 (25.0) 3 (1.6)
55 (28.4) 3 (1.5)
67 (33.2) 1 (0.5)
19 (16.0) 6 (5.0) 11 (9.2) 0 (0.0) 2 (1.7) 65 (54.6) 119 (100.0)
21 (13.5) 6 (3.9) 9 (5.8) 1 (0.6) 5 (3.2) 83 (53.5) 155 (100.0)
24 (16.4) 5 (3.4) 8 (5.5) 0 (0.0) 11 (7.5) 73 (50.0) 146 (100.0)
26 (13.5) 5 (2.6) 13 (6.8) 0 (0.0) 8 (4.2) 109 (56.8) 192 (100.0)
24 (12.4) 4 (2.1) 14 (7.2) 0 (0.0) 6 (3.1) 103 (53.1) 194 (100.0)
23 (11.4) 4 (2.0) 12 (5.9) 1 (0.5) 6 (3.0) 109 (54.0) 202 (100.0)
67 (59.8) 112 (100.0)
85 (57.8) 147 (100.0)
67 (50.8) 132 (100.0)
84 (64.6) 130 (100.0)
1 425 (100.0)
Includes other causes of chronic liver disease and fulminant hepatitis. Data available to 31 December 2012. Australia and New Zealand Liver Transplant Registry
Source:
2.4
Table 2.4.1
Country

Estimated HBV prevalence in selected countries
HepatitisB prevalence rate (%) 12.5 12.3 11.7 10.5 10.3 7.4 5.8 5.6 5.3 3.2 3.1 2.4 2.4 1.0 0.5 0.5
Viet Nam China (excluding Taiwan) Taiwan Afghanistan Cambodia Philippines Fiji Malaysia Korea, Republic of (South) India Greece Sri Lanka Italy Australia United Kingdom New Zealand
Source: VIDRL/ASHM HepatitisB Epidemiology Mapping Project; Victorian Infectious Diseases Reference Laboratory & Australasian Society for HIV Medicine, 2013
67
2 Viral Hepatitis
2 Viral Hepatitis
68
2013
Tables
3
3.1
3.1.1 3.1.2 3.1.3 3.1.4 3.1.5 3.1.6 3.1.7 3.1.8 3.1.9
National surveillance for sexually transmissible infections

Notification of specific sexually transmissible infections to the National Notifiable Diseases Surveillance System
Number and rate of diagnosis of chlamydia, 20082012, by State/Territory and year Number of diagnoses of chlamydia, 20082012, by age group, year and sex Number of diagnoses of donovanosis, 20082012, by State/Territory and year Number of diagnoses of donovanosis, 20082012, by age group, year and sex Number and rate of diagnosis of gonorrhoea, 20082012, by State/Territory and year Number of diagnoses of gonorrhoea, 20082012, by age group, year and sex Number and rate of diagnosis of infectious syphilis, 20082012, by State/Territory and year Number of diagnoses of infectious syphilis, 20082012, by age group, year and sex Number of diagnoses of infectious syphilis, 20082012, by sexual exposure, sex worker status, facility of diagnosis, year and sex 71 71 71 72 72 72 73 73 74
3.2
3.2.1 3.2.2 3.2.3 3.2.4 3.2.5 3.2.6 3.2.7 3.2.8 3.2.9 3.2.10 3.2.11 3.2.12 3.2.13 3.2.14 3.2.15
National surveillance for sexually transmissible infections in Aboriginal and Torres Strait Islander people
Number and rate of diagnosis of chlamydia, 2008 2012, by year, State/Territory and Aboriginal and Torres Strait Islander status 75
Number of diagnoses of chlamydia, 2008 2012, by age group, Aboriginal and Torres Strait Islander status and year 76 Number of diagnoses of chlamydia, 2012, by Aboriginal and Torres Strait Islander status, sex and age group 76
Number (percent) of diagnoses of chlamydia, 2012, by State/Territory and Aboriginal and Torres Strait Islander status 77 Rate of diagnosis of chlamydia, 2008 2012, by year, Aboriginal and Torres Strait Islander status and area of residence Number and rate of diagnosis of gonorrhoea, 2008 2012, by year, State/Territory and Aboriginal and Torres Strait Islander status 77 78
Number of diagnoses of gonorrhoea, 2008 2012, by age group, Aboriginal and Torres Strait Islander status and year 79 Number of diagnoses of gonorrhoea, 2012, by Aboriginal and Torres Strait Islander status, sex and age group 79
Number (percent) of diagnoses of gonorrhoea, 2012, by State/Territory and Aboriginal and Torres Strait Islander status 80 Rate of diagnosis of gonorrhoea, 2008 2012, by year, Aboriginal and Torres Strait Islander status and area of residence Number and rate of diagnosis of infectious syphilis, 2008 2012, by year, State/Territory and Aboriginal and Torres Strait Islander status Number of diagnoses of infectious syphilis, 2008 2012, by age group, Aboriginal and Torres Strait Islander status and year 80 81 82
Number of diagnoses of infectious syphilis, 2012, by Aboriginal and Torres Strait Islander status, sex and age group 82 Number (percent) of diagnoses of infectious syphilis, 2012, by State/Territory and Aboriginal and Torres Strait Islander status Rate of diagnosis of infectious syphilis, 2008 2012, by year, Aboriginal and Torres Strait Islander status and area of residence 83 83
69
3 Sexually Transmissible Infections
3.3
3.3.1 3.3.2
Gonococcal isolates
Number of gonococcal isolates referred to the Australian Gonococcal Surveillance Programme in 2012 by State/ Territory, sex and site and antibiotic resistance Number of gonococcal isolates in New South Wales referred to the Australian Gonococcal Surveillance Programme, 20082012, by sex, site and year 84 84
70
3 3.1
Table 3.1.1
National surveillance for sexually transmissible infections Notification of specific sexually transmissible infections to the National Notifiable Diseases Surveillance System
Number and rate of diagnosis of chlamydia, 20082012, by State/Territory and year
Year of diagnosis

1
2008 Number Rate1 988 13 985 2 289 15 190 3 656 1 475 12 202 8 642 58 427 238.2 197.8 879.9 345.5 232.5 309.4 220.6 375.3 265.4
2009 Number Rate1 945 14 949 2 445 16 694 3 758 1 470 13 906 8 830 62 997 222.7 207.5 907.8 367.8 234.5 303.3 243.1 368.1 278.4
2010 Number Rate1 1 161 18 255 2 662 19 216 4 335 2 014 16 486 10 177 74 306 267.4 251.5 974.8 417.2 266.7 413.2 284.3 416.4 324.4
2011 Number Rate1 1 261 20 575 2 629 18 647 5 132 1 777 19 226 11 675 80 922 289.1 283.3 973.1 401.2 314.5 368.4 329.6 466.2 351.1
2012 Number Rate1 1 283 21 293 2 532 18 849 4 848 1 787 20 312 11 803 82 707 290.8 291.5 928.3 399.3 296.8 372.5 345.8 456.0 355.1
Table 3.1.2
Number of diagnoses of chlamydia, 20082012, by age group, year and sex

Year of diagnosis
Age group (years) 04 514 1519 2024 2529 3039 4049 5059 60 + Not reported Total
1
2008 F
T1
2009 F
T1
2010 F
T1
2011 F
T1
2012 F
T1
12 11 24 50 495 546 3701 11228 14961 8197 12964 21188 5096 5496 10610 3992 3404 7406 1735 861 2604 595 218 815 206 42 248 10 10 25 23594 34729 58427
19 24 43 67 492 560 4092 12148 16262 9384 13715 23128 5356 6019 11391 4202 3546 7755 1789 860 2651 650 233 884 219 49 268 16 12 55 25794 37098 62997
18 26 46 87 597 685 5306 14614 19968 10897 15956 26920 6492 6530 13056 4875 3991 8891 2161 1063 3230 840 251 1092 298 46 345 21 34 73 30995 43108 74306
16 20 36 89 615 706 5492 16168 21689 12157 17584 29796 7058 7166 14244 5072 4273 9357 2251 1192 3446 894 269 1164 343 54 398 33 50 86 33405 47391 80922
20 19 39 89 653 742 5383 15511 20932 12220 18108 30354 7380 7359 14761 5706 4532 10255 2552 1242 3796 991 327 1319 385 51 437 23 44 72 34749 47846 82707
Year of diagnosis State/ Territory NT QLD WA Total

2008 1 1 0 2
2009 0 1 0 1
2010 0 1 0 1
2011 0 0 0 0
2012 0 0 1 1
71
Table 3.1.3
Number of diagnoses of donovanosis, 20082012, by State/Territory and year
Table 3.1.4
Number of diagnoses of donovanosis, 20082012, by age group, year and sex

Year of diagnosis
Age group (years) 014 1519 2024 2529 3039 4049 50 + Total
M 0 0 1 0 0 0 1 2
2008 F 0 0 0 0 0 0 0 0
T 0 0 1 0 0 0 1 2
M 0 0 0 0 0 0 1 1
2009 F 0 0 0 0 0 0 0 0
T 0 0 0 0 0 0 1 1
M 0 0 0 1 0 0 0 1
2010 F 0 0 0 0 0 0 0 0
T 0 0 0 1 0 0 0 1
M 0 0 0 0 0 0 0 0
2011 F 0 0 0 0 0 0 0 0
T 0 0 0 0 0 0 0 0
M 0 1 0 0 0 0 0 1
2012 F 0 0 0 0 0 0 0 0
T 0 1 0 0 0 0 0 1
Table 3.1.5
Number and rate of diagnosis of gonorrhoea, 20082012, by State/Territory and year

Year of diagnosis

1
2008 Number Rate1 21 1 330 1 550 1 638 493 25 929 1 693 7 679 5.4 18.9 601.8 37.5 31.4 5.3 17.0 74.0 35.1
2009 Number Rate1 55 1 653 1 551 1 787 373 21 1 489 1 347 8 276 13.1 23.1 579.0 39.6 23.4 4.5 26.4 56.4 36.9
2010 Number Rate1 56 2 301 1 933 2 385 473 20 1 751 1 403 10 322 13.6 31.8 712.0 52.1 29.0 4.1 30.6 57.9 45.4
2011 Number Rate1 128 2 883 1 952 2 954 445 19 1 879 1 839 12 099 30.1 39.7 726.9 64.0 27.5 3.9 32.5 73.4 52.8
2012 Number Rate1 92 4 129 1 536 2 700 499 35 2 543 2 115 13 649 21.3 56.5 568.1 57.5 30.7 7.4 43.3 82.8 58.9
Table 3.1.6
Number of diagnoses of gonorrhoea, 20082012, by age group, year and sex

Year of diagnosis
1
M 1 28 747 1 144 911 1 178 639 264 84 4 996
2008 F 2 150 843 663 383 415 147 48 19 2 2 672
T1 3 178 1 591 1 811 1 295 1 594 787 312 103 5 7 679
M 6 27 796 1 304 1 071 1 271 646 289 100 1 5 511
2009 F 5 106 838 803 414 389 121 44 15 1 2 736
T1 11 134 1 640 2 110 1 486 1 663 767 333 115 17 8 276
M 3 35 928 1 625 1 391 1 583 933 367 139 4 7 008
2010 F 4 150 1 055 929 487 443 147 49 16 3
T1 7 186 1 984 2 561 1 882 2 028 1 082 416 155 21
M 4 43 1 027 1 815 1 569 1 822 1 145 493 170 5 8 093
2011 F 7 188 1 283 1 022 640 543 186 69 24 5
T1 11 231 2 311 2 841 2 211 2 369 1 331 564 196 34
M 4 46 1 039 2 120 1 957 2 292 1 376 495 190 7 9 526
2012 F 5 193 1 225 1 106 598 594 255 105 26 9
T1 9 239 2 264 3 227 2 556 2 890 1 631 600 216 17
3 283 10 322
3 967 12 099
4 116 13 649
72
Table 3.1.7
Number and rate of diagnosis of infectious syphilis, 20082012, by State/Territory and year
Year of diagnosis

1
2008 Number Rate1 4 427 83 195 49 8 380 176 1 322 1.0 6.1 33.8 4.5 3.1 1.7 7.0 7.8 6.1
2009 Number Rate1 11 530 38 192 56 10 388 89 1 314 2.9 7.5 15.1 4.4 3.5 2.1 6.9 3.8 5.9
2010 Number Rate1 14 421 43 227 25 6 299 85 1 120 3.8 5.9 16.5 5.1 1.5 1.2 5.2 3.6 5.0
2011 Number Rate1 9 419 30 335 56 6 332 125 1 312 2.4 5.8 11.4 7.3 2.9 1.3 5.8 5.1 5.8
2012 Number Rate1 15 510 14 387 43 14 474 77 1 534 3.8 7.0 5.1 8.4 2.7 2.9 8.2 3.1 6.7
Table 3.1.8
Number of diagnoses of infectious syphilis, 20082012, by age group, year and sex
Year of diagnosis
1
M 0 0 42 100 175 372 328 116 42 0 1 175
2008 F 0 8 35 29 21 29 10 11 3 0 146
T1 0 8 77 129 196 401 339 127 45 0 1 322
M 0 0 29 124 162 336 365 132 46 0 1 194
2009 F 0 3 11 24 22 34 10 8 4 0 116
T1 0 3 40 148 184 370 375 140 50 4 1 314
M 0 0 32 117 140 280 267 112 47 0 995
2010 F 0 1 14 25 18 31 19 8 2 0 118
T1 0 1 46 142 158 313 286 120 49 5 1 120
M 0 7 47 123 154 303 325 120 53 0 1 132
2011 F 0 8 43 37 24 27 18 6 4 0 167
T1 0 15 90 161 178 330 343 126 57 12 1 312
M 0 2 38 161 188 356 363 203 72 0 1 383
2012 F 0 6 34 29 22 32 16 5 4 0 148
T1 0 8 72 191 212 388 379 208 76 0 1 534
73
Table 3.1.9
Number of diagnoses of infectious syphilis, 20082012, by sexual exposure, sex worker status, facility of diagnosis, year and sex
Year of diagnosis
Characteristic Sexual exposure Heterosexual contact Men who have sex with men Other/undetermined2 Not reported2
2008 F
T1
2009 F
T1
2010 F
T1
2011 F
T1
2012 F
T1
82 470 170 453
67 19 60
149 470 190 513
92 525 38 539
53 9 54
145 525 51 593
94 434 49 418
73 13 32
167 434 68 451
134 546 56 396
105 21 41
239 546 90 437
114 684 72 513
90 31 27
205 684 104 541
Sex work in the past 12 months Current sex work 4 No sex work 125 591 Undetermined2 455 Not reported2 Place of diagnosis Public hospital Sexual health clinic Family planning clinic General practice Other Undetermined2 Not reported2 Total
1 2
3 28 55 60
7 153 647 515
0 67 528 599
1 16 41 58
1 83 573 657
3 59 482 451
5 12 68 33
8 71 556 485
0 102 449 581
3 24 82 58
3 126 543 640
1 72 476 834
2 8 89 49
3 80 567 884
27 95 0 61 54 317 621 1 175
17 6 0 2 30 25 66
44 101 0 63 84 343 687
24 69 0 46 42 441 572 1 194
8 5 0 5 16 24 58
32 74 0 51 58 469 630
56 177 1 170 66 342 183 995
23 18 0 6 11 34 26
79 195 1 176 77 382 210
58 201 1 180 64 423 205 1 132
34 25 0 7 15 50 36
92 226 1 187 80 485 241
55 181 3 86 66 474 518 1 383
30 20 0 8 5 53 32
85 201 3 94 71 528 552
146 1 322
116 1 314
118 1 120
167 1 312
148 1 534
Totals include diagnoses in people whose sex was not reported. A characteristic was reported as undetermined when the information was sought in the State/Territory health jurisdiction but not reported, and as not reported when the information was not sought.
74
3.2
Table 3.2.1
National surveillance for sexually transmissible infections in Aboriginal and Torres Strait Islander people
Number and rate1 of diagnosis of chlamydia, 2008 2012, by year, State/Territory2 and Aboriginal and Torres Strait Islander status
Year of diagnosis
State/ Aboriginal and Torres Strait Territory Islander status NT QLD SA TAS VIC WA Total Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3
2008 Number Rate 1397 892 2316 12874 220 3436 24 1451 73 12129 1297 7345 5327 38127 1917 524 1151 308 584 229 84 337 152 223 1432 329 1126 274
2009 Number Rate 1356 1089 2314 14380 190 3568 30 1440 66 13840 1228 7602 5184 41919 1860 646 1144 344 495 238 105 333 138 255 1312 340 1085 301
2010 Number Rate 1475 1187 3059 16157 286 4049 34 1980 111 16375 1572 8605 6537 48353 2045 702 1501 387 763 269 133 459 223 302 1693 385 1367 347
2011 Number Rate 1555 1074 3201 15446 302 4830 45 1732 146 19080 1643 10032 6892 52194 2129 639 1575 370 793 321 164 405 298 352 1753 449 1434 375
2012 Number Rate 1386 1146 3066 15783 319 4529 39 1748 141 20171 1622 10181 6573 53558 1899 672 1540 378 788 301 156 407 298 372 1745 455 1378 384
1 2 3
75
Table 3.2.2
Number of diagnoses of chlamydia1, 2008 2012, by age group, Aboriginal and Torres Strait Islander status and year
Year
Age group (years) Aboriginal and Torres Strait Islander status 04 514 1519 2029 3039 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2
2008 6 17 245 207 2 193 9 338 2 138 21 632 540 4 661 152 1 600 38 492 15 155 5 327 38 127
2009 5 31 202 256 2 168 10 388 2 162 23 902 499 4 930 113 1 628 26 562 9 170 5 184 41 919
2010 5 35 289 295 2 757 12 552 2 668 26 855 622 5 634 150 2 000 33 704 13 216 6 537 48 353
2011 3 23 287 283 2 902 13 575 2 906 29 327 585 5 838 170 2 081 35 732 4 254 6 892 52 194
2012 2 36 309 307 2 673 13 038 2 725 30 221 629 6 418 186 2 356 41 845 8 270 6 573 53 558
4049 5059 60 + Total3
1 2 3
In State/Territory health jurisdictions in which Aboriginal and Torres Strait Islander status was reported for more than 50% of diagnoses in each year. Includes diagnoses in people whose Aboriginal and Torres Strait Islander status was not reported. Includes diagnoses in people whose age was not reported.
Table 3.2.3
Number of diagnoses of chlamydia1, 2012, by Aboriginal and Torres Strait Islander status, sex and age group
Age group (years)
Aboriginal and Torres Strait Islander status Aboriginal and Torres Strait Islander Non-Indigenous2
Sex Male Female Total3 Male Female Total3 Male Female Total3
04 1 1 2 18 18 36 19 19 38
514 49 260 309 28 279 307 77 539 616
1519 843 1 828 2 673 3 227 9 789 13 038 4 070 11 617 15 711
2029 1 027 1 696 2 725 13 094 17 093 30 221 14 121 18 789 32 946
3039 271 358 629 3 525 2 882 6 418 3 796 3 240 7 047
4049 86 100 186 1 531 824 2 356 1 617 924 2 542
5059 24 17 41 637 207 845 661 224 886
60 + 5 3 8 237 32 270 242 35 278
Total4 2 306 4 263 6 573 22 317 31 166 53 558 24 623 35 429 60 131
Total
1 2 3 4
State/Territory health jurisdictions in which Aboriginal and Torres Strait Islander status was reported for more than 50% of diagnoses in each year. Includes diagnoses in people whose Aboriginal and Torres Strait Islander status was not reported. Includes diagnoses in people whose sex was not reported. Includes diagnoses in people whose age was not reported.
76
Table 3.2.4
Number (percent) of diagnoses of chlamydia, 2012, by State/Territory1 and Aboriginal and Torres Strait Islander status

1
Aboriginal and Torres Strait Islander 1 386 3 066 319 39 141 1 622 6 792
Non-Indigenous 968 8 184 4 191 1 144 10 497 9 303 34 762
Not reported 1 256 20 626 178 7 599 338 604 9 674 878 41 153 (97.9) (96.9) (7.0) (40.3) (7.0) (33.8) (47.6) (7.4) (49.8)
Total 1 283 21 293 2 532 18 849 4 848 1 787 20 312 11 803 82 707
(54.7) (16.3) (6.6) (2.2) (0.7) (13.7) (8.2)
(38.2) (43.4) (86.4) (64.0) (51.7) (78.8) (42.0)
Table 3.2.5
Rate1 of diagnosis of chlamydia, 2008 2012, by year, Aboriginal and Torres Strait Islander status and area of residence
Year of diagnosis
2008 610 276 417 226 1 756 305 2 464 333 2 648 318 1 438 275
2009 658 305 387 261 1 657 328 2 269 324 2 629 264 1 400 302
2010 877 349 496 318 2 175 371 3 123 361 2 982 335 1 765 349
2011 970 378 679 335 2 485 396 3 072 380 2 823 329 1 861 377
2012 1 039 387 692 340 2 488 405 2 897 406 2 398 383 1 775 386
1 2
77
Table 3.2.6
Number and rate1 of diagnosis of gonorrhoea, 2008 2012, by year, State/Territory2 and Aboriginal and Torres Strait Islander status
Year of diagnosis
State/ Aboriginal and Torres Strait Territory Islander status NT QLD SA TAS VIC WA Total Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3
2008 Number Rate 1382 1934.5 168 98.5 691 947 141 352 0 25 10 919 358.5 22.7 388.9 23.2 0.0 5.8 19.5 17.0
2009 Number Rate 1412 1962.5 139 82.6 669 1118 164 209 0 21 11 1478 333.7 26.8 463.2 13.7 0.0 5.0 25.7 27.3
2010 Number Rate 1770 2457.2 163 97.2 976 1409 234 239 1 19 13 1738 839 564 3833 4132 479.5 33.8 661.8 15.4 4.1 4.4 31.3 32.0 956.6 24.9 841.6 29.5
2011 Number Rate 1798 2476.2 154 96.5 1329 1625 214 231 0 19 12 1867 661.8 38.8 592.8 15.2 0.0 4.3 29.0 34.4
2012 Number Rate 1323 1862.2 213 124.9 1113 1587 198 301 0 35 25 2518 562.5 37.8 546.6 20.1 0.0 8.2 64.7 46.4
1223 1448.1 470 21.1 3447 2881 772.4 20.7
913 1046.1 434 19.0 3169 3399 699.7 24.3
1153 1304.9 686 29.7 4506 4582 979.4 32.7
1145 1264.5 970 43.3 3804 5624 828.5 40.3
1 2 3
78
Table 3.2.7
Number of diagnoses of gonorrhoea1, 2008 2012, by age group, Aboriginal and Torres Strait Islander status and year
Year of diagnosis
Age group (years) Aboriginal and Torres Strait Islander status 04 514 1519 2029 3039 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2
2008 3 4 166 11 1 147 350 1 387 1 177 519 685 169 416 44 182 12 56 3 447 2 881
2009 4 4 117 15 1 064 444 1 382 1 489 468 757 109 393 17 210 8 70 3 169 3 399
2010 1 2 155 26 1 315 509 1 637 1 788 558 872 140 568 23 239 4 107 3 833 4 132
2011 7 2 208 21 1 619 449 1 881 1 971 608 993 152 677 30 320 1 116 4 506 4 582
2012 4 4 199 29 1 358 604 1 550 2 574 503 1 243 147 723 39 305 4 126 3 804 5 624
4049 5059 60 + Total3
1 2 3
Table 3.2.8
Number of diagnoses of gonorrhoea1, 2012, by Aboriginal and Torres Strait Islander status, sex and age group
Age group (years)
Sex Male Female Total Male Female Total3 Male Female Total3
04 2 2 4 2 2 4 4 4 8
514 37 162 199 6 23 29 43 185 228
1519 513 845 1 358 350 254 604 863 1 099 1 962
2029 758 792 1 550 1 992 581 2 574 2 750 1 373 4 124
3039 269 234 503 1 047 193 1 243 1 316 427 1 746
4049 96 51 147 615 108 723 711 159 870
5059 27 12 39 255 50 305 282 62 344
60 + 4 0 4 111 15 126 115 15 130
Total4 1 706 2 098 3 804 4 385 1 234 5 624 6 091 3 332 9 428
Total
1 2 3 4
State/Territory health jurisdictions in which Aboriginal and Torres Strait Islander status was reported for more than 50% of diagnoses in each year. Includes diagnoses in people whose Aboriginal and Torres Strait Islander status was not reported. Includes diagnoses in people whose sex was not reported. Includes diagnoses in people whose age was not reported.
79
Table 3.2.9
Number (percent) of diagnoses of gonorrhoea, 2012, by State/Territory1 and Aboriginal and Torres Strait Islander status

1
Aboriginal and Torres Strait Islander 1 1 323 1 113 198 0 25 1 145 3 904 (1.1) (86.1) (41.2) (39.7) (0.0) (1.0) (54.1) (28.6)
Non-Indigenous 91 168 800 284 32 1 607 967 4 930 (98.9) (10.9) (29.6) (56.9) (91.4) (63.2) (45.7) (36.1)
Not reported 0 3 049 45 787 17 3 911 3 4 815 (0.0) (73.8) (2.9) (29.1) (3.4) (8.6) (35.8) (0.1) (35.3)
Total 92 4 129 1 536 2 700 499 35 2 543 2 115 13 649
Table 3.2.10
Rate1 of diagnosis of gonorrhoea, 2008 2012, by year, Aboriginal and Torres Strait Islander status and area of residence
Year of diagnosis
Area of residence Major cities Inner regional Outer regional Remote Very remote Total
Aboriginal and Torres Strait Islander status Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2
2008 146 22 37 6 719 23 2 290 31 2 436 51 931 21
2009 109 27 54 10 630 22 2 043 36 2 332 40 856 25
2010 124 33 64 10 854 26 2 659 39 2 628 79 1 035 30
2011 192 36 107 12 1 225 31 2 610 41 2 982 77 1 217 33
2012 240 45 165 15 1 089 30 2 384 55 2 193 91 1 027 41
1 2
80
Table 3.2.11
Number and rate1 of diagnosis of infectious syphilis, 2008 2012, by year, State/Territory2 and Aboriginal and Torres Strait Islander status
Year of diagnosis
State/ Aboriginal and Torres Strait Territory Islander status ACT NSW NT QLD SA TAS VIC WA Total Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3 Aboriginal and Torres Strait Islander Non-Indigenous3
2008 Number Rate 0 4 7 420 66 17 22 173 5 44 0 8 3 377 77 99 180 1142 0 1.0 4.5 6.3 115.6 9.7 11.8 4.1 17.9 2.9 0.0 1.8 9.1 7.0 86.5 4.5 30.0 5.4
2009 Number Rate 1 10 11 519 37 1 29 163 8 48 0 10 1 387 33 56 120 1194 11.3 2.6 7.4 7.8 71.7 0.6 18.0 3.9 30.3 3.1 0.0 2.3 3.1 7.1 39.0 2.5 22.3 5.7
2010 Number Rate 0 14 8 413 40 3 70 157 4 21 0 6 1 298 19 66 142 978 0.0 3.9 5.1 6.2 73.8 1.6 38.6 3.8 13.1 1.4 0.0 1.3 3.0 5.4 25.8 3.0 25.0 4.6
2011 Number Rate 0 9 4 415 28 2 119 216 14 42 1 5 5 327 29 96 200 1112 0.0 2.5 3.0 6.2 42.1 1.3 59.5 5.2 62.7 2.1 6.6 1.2 15.7 6.0 40.7 4.3 32.4 5.2
2012 Number Rate 1 14 8 502 13 1 117 270 9 34 0 14 6 468 13 64 167 1367 20.9 3.8 5.5 7.5 20.3 0.7 61.4 6.5 34.6 2.2 0.0 3.2 16.2 8.7 21.5 2.9 27.2 6.5
1 2 3
81
Table 3.2.12
Number of diagnoses of infectious syphilis1, 2008 2012, by age group, Aboriginal and Torres Strait Islander status and year
Year of diagnosis
Age group (years) 04 514 1519 2029 3039
Aboriginal and Torres Strait Islander status Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2 Aboriginal and Torres Strait Islander Non-Indigenous2
2008 0 0 8 0 51 26 58 267 29 372 25 314 8 119 1 44 180 1 142
2009 0 0 3 0 18 22 39 293 37 333 14 361 8 132 1 49 120 1 194
2010 0 0 1 0 26 20 56 244 33 280 18 268 8 112 0 49 142 978
2011 0 0 12 3 67 23 59 280 32 298 20 323 8 118 2 55 200 1 112
2012 0 0 7 1 46 26 62 341 29 359 16 363 6 202 1 75 167 1 367
4049 5059 60 + Total3
1 2 3
Table 3.2.13
Number of diagnoses of infectious syphilis1, 2012, by Aboriginal and Torres Strait Islander status, sex and age group
Age group (years)
Sex Male Female Total Male Female Total3 Male Female Total3
04 0 0 0 0 0 0 0 0 0
514 2 5 7 0 1 1 2 6 8
1519 17 29 46 21 5 26 38 34 72
2029 34 28 62 315 23 341 349 51 403
3039 19 10 29 337 22 359 356 32 388
4049 11 5 16 352 11 363 363 16 379
5059 4 2 6 199 3 202 203 5 208
60 + 0 1 1 72 3 75 72 4 76
Total 87 80 167 1 296 68 1 367 1 383 148 1 534
Total
1 2 3
State/Territory health jurisdictions in which Aboriginal and Torres Strait Islander status was reported for more than 50% of diagnoses in each year. Includes diagnoses in people whose Aboriginal and Torres Strait Islander status was not reported. Includes diagnoses in people whose sex was not reported.
82
Table 3.2.14
Number (percent) of diagnoses of infectious syphilis, 2012, by State/Territory1 and Aboriginal and Torres Strait Islander status
Non-Indigenous 14 (93.3) 457 (89.6) 1 (7.1) 256 (66.1) 34 (79.1) 14 (100.0) 417 (88.0) 64 (83.1) 1 257 (81.9)
Not reported 0 45 0 14 0 0 51 0 110 (0.0) (8.8) (0.0) (3.6) (0.0) (0.0) (10.8) (0.0) (7.2)
Total 15 510 14 387 43 14 474 77 1 534
Table 3.2.15
Rate1 of diagnosis of infectious syphilis, 2008 2012, by year, Aboriginal and Torres Strait Islander status and area of residence
Year of diagnosis
2008 8 7 7 1 14 3 101 1 129 5 33 5
2009 8 7 3 2 24 2 53 66 6 22 6
2010 5 6 2 1 36 3 86 1 68 6 26 5
2011 15 6 7 2 30 1 116 1 101 5 36 5
2012 15 8 6 2 40 1 96 1 58 1 30 7
1 2
83
3.3
Table 3.3.1
Gonococcal isolates
Number of gonococcal isolates referred to the Australian Gonococcal Surveillance Programme in 2012 by State/Territory, sex and site and antibiotic resistance
State/Territory
Sex and Site Males Urethra Rectal Pharynx DGI1 Other/Not specified Total Females Cervix Rectal Pharynx DGI1 Other/Not specified Total Antibiotic Resistance (%) Ceftriaxone2 Ciprofloxacin Azithromycin Penicillin Total
1 2 Disseminated gonococcal infection. Decreased susceptibility.
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Total
26 18 10 0 0 54
877 282 279 1 10 1 449
214 1 0 4 2 221
392 68 37 2 3 502
83 34 12 0 0 129
9 2 2 0 0 13
547 340 197 1 31 1 116
313 31 25 6 1 376
2 461 776 562 14 47 3 860
2 0 0 0 0 2
187 3 66 0 7 263
108 0 0 6 0 114
195 3 4 11 4 217
19 0 2 0 1 22
1 0 0 0 0 1
112 2 16 0 3 133
162 2 4 3 1 172
786 10 92 20 16 924
3.6 33.9 0 14.3 56
4.5 31.7 0.5 28.3 1 712
0 2.8 0.3 3.1 335
2.4 16.9 2.1 25.8 719
0.7 32.7 0.7 35.3 151
0 35.7 0 35.7 14
8.4 45.8 2.7 53.3 1 249
1.2 23.8 0.6 20.5 548
4.4 30.3 1.3 32.1 4 784
Source: Australian Gonococcal Surveillance Programme
Table 3.3.2
Number of gonococcal isolates in New South Wales referred to the Australian Gonococcal Surveillance Programme, 20082012, by sex, site and year
Year of diagnosis
Sex and Site Males Urethra Rectal Pharynx Other/Not specified Total
2008
2009
2010
2011
2012
457 181 99 3 740
523 193 101 8 825
644 328 184 39 1 195
689 248 201 7 1 145
877 282 279 11 1 449
Females Cervix Rectal Pharynx Other/Not specified Total Total
102 1 11 3 117 857
100 4 15 5 124 949
113 2 11 7 133 1 328
135 8 41 3 187 1 322
187 3 66 7 263 1 712
Source: Australian Gonococcal Surveillance Programme
84
2013
Tables
4
4.1
4.1.1
HIV, viral hepatitis and sexually transmissible infections in selected populations

HIV seroprevalence among people seen at sexual health clinics
Number of people seen at selected metropolitan sexual health clinics in Australia, 20082012, number tested for HIV antibody, number (percent) newly diagnosed with HIV infection and number (percent) newly diagnosed with HIV infection following a previous negative test by sex, clinic and year Number of people seen at selected metropolitan sexual health clinics in Australia, 20082012, number tested for HIV antibody, number (percent) newly diagnosed with HIV infection and number (percent) newly diagnosed following a previous negative test by year, sex and exposure category Number of people seen at selected metropolitan sexual health clinics in Australia, 20082012, number tested for HIV antibody, number (percent) newly diagnosed with HIV infection and number (percent) newly diagnosed following a previous negative test by year, sex and age group 86
4.1.2
88
4.1.3
90
4.2
4.2.1
HIV and hepatitisC seroprevalence among people who inject drugs

Number of participating needle and syringe programs (NSP), 20082012, number of people who inject drugs who were tested for HIV or hepatitisC antibody (percent of clients seen) and number (percent) with HIV or hepatitisC antibody by year, State/Territory and sex Number of people who inject drugs seen at needle and syringe programs who were tested for HIV or hepatitisC antibody, 20082012, and percent with HIV or hepatitisC antibody by year, age group, time since first injection, type of drug last injected among those reporting less than three years since first injection, and sex Number of people who inject drugs seen at needle and syringe programs who were tested for HIV or hepatitisC antibody, 20082012, and percent with HIV or hepatitisC antibody by year, sexual identity, sex work last month, region of birth, main language spoken at home by parents and sex 92
4.2.2
94
4.2.3
97
4.3
4.3.1 4.3.2
Incidence of hepatitisC infection among people who inject drugs

Incidence of hepatitisC infection among people who inject drugs seen at the Kirketon Road Centre, Sydney, 20082012 Incidence of hepatitisC virus infection among people who inject drugs enrolled in the HepatitisC Incidence and Transmission Study community (HITS-c), Sydney, 20092012 100 101
4.4
4.4.1 4.4.2 4.4.3 4.4.4
HIV, hepatitisB surface antigen and hepatitisC antibody in blood donors

Number of donations tested for HIV antibody at blood services, number of donations positive for HIV antibody and prevalence of HIV antibody, 19852012, by State/Territory and years of donation 102
Number of blood donors in Australia with HIV antibody, 19852012, by HIV exposure category and sex, and number of new HIV infections in blood donors with a previous donation negative for HIV antibody by years of donation 103 Number of donations tested for hepatitisB surface antigen at blood services, number of donations positive for hepatitisB surface antigen and prevalence of hepatitisB surface antigen by State/Territory and year of donation 104 Number of donations tested for hepatitisC antibody at blood services, number of donations positive for hepatitisC antibody and prevalence of hepatitisC antibody, by State/Territory and year of donation 105
4.5
4.5.1 4.5.2

Number of Australian born women seen for the first time at sexual health services participating in the Genital Wart Surveillance Network, 2004 2012, and number (percent) diagnosed with genital warts by year and age group 106 Number of Australian born men seen for the first time at sexual health services participating in the Genital Wart Surveillance Network, 2004 2012, number (percent) diagnosed with genital warts, by age group, gender of sexual partners, and year
107
85
4 Seroprevalence
4 Seroprevalence
4 4.1
Table 4.1.1
HIV, viral hepatitis and sexually transmissible infections in selected populations HIV seroprevalence among people seen at sexual health clinics
Number of people seen at selected metropolitan sexual health clinics in Australia, 20082012, number tested for HIV antibody, number (percent) newly diagnosed with HIV infection and number (percent) newly diagnosed with HIV infection following a previous negative test by sex, clinic and year
Sexual health clinic Sydney Sexual Health Centre, NSW Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) 4 615 2 297 25 (1.1) 20 (1.1) 4 925 2 551 36 (1.4) 28 (1.4) 5 382 2 750 25 (1.0) 21 (0.0) 6 029 2 587 43 (1.7) 35 (1.7) 6 823 2 487 42 (1.7) 35 (1.7) RPA Sexual Health Clinic, NSW1 1 420 886 10 (1.1) 2 (0.6) 1 485 890 22 (2.5) 5 (1.4) 1 567 985 21 (2.1) 8 (1.8) Brisbane Sexual Health Clinic, QLD 3 795 1 582 7 (0.4) 5 (0.5) 4 058 1 469 12 (0.8) 11 (1.2) 3 800 1 397 5 (0.4) 4 (0.4) 3 107 940 3 (0.3) 3 (0.4) 3 506 1 120 3 (0.3) 2 (0.3) Gold Coast Sexual Health Service, QLD 1 799 767 7 (0.9) 0 (0.0) 1 750 537 5 (0.9) 3 (1.4) 2 102 932 1 (0.1) 1 (0.03) 2 112 1 083 7 (0.6) 4 (1.2) 2 393 996 12 (1.2) 4 (1.2) Clinic 275 Adelaide, SA 4 086 3 420 9 (0.3) 7 (0.3) 4 138 3 546 5 (0.1) 4 (0.2) 4 436 3 845 8 (0.2) 6 (0.3) 4 777 4 078 11 (0.3) 8 (0.3) 4 878 4 149 11 (0.3) 11 (0.4) Melbourne Sexual Health Centre, VIC 8 335 3 738 47 (1.3) 42 (1.7) 9 162 5 546 56 (1.0) 50 (1.2) 10 423 6 620 45 (0.5) 40 (0.8) 12 346 6 990 48 (0.7) 41 (0.8) 15 601 8 586 45 (0.5) 35 (0.5)
Year 2008
Total 22 630 11 804 95 (0.8) 74 (1.0) 24 033 13 649 114 (0.8) 96 (1.0) 27 563 16 430 94 (0.6) 74 (0.7) 29 856 16 568 134 (0.8) 96 (0.7) 34 768 18 323 134 (0.7) 95 (0.7)
2009
2010
2011
2012
Sexual health clinic Sydney Sexual Health Centre, NSW Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) 2 761 1 193 3 (0.3) 1 (0.1) 3 052 1 297 1 (0.1) 1 (0.1) 3 084 1 353 0 (0.0) 0 (0.0) 3 486 1 336 1 (0.1) 1 (0.1) 3 855 1 165 1 (0.1) 0 (0.0) RPA Sexual Health Clinic, NSW1 608 349 0 (0.0) 0 (0.0) 658 374 0 (0.0) 0 (0.0) 634 349 2 (0.6) 0 (0.0) Brisbane Sexual Health Clinic, QLD 2 490 669 0 (0.0) 0 (0.0) 2 548 712 1 (0.1) 1 (0.2) 2 203 552 0 (0.0) 0 (0.0) 1 810 394 0 (0.0) 0 (0.0) 2 012 486 0 (0.0) 0 (0.0) Gold Coast Sexual Health Service, QLD 1 375 496 0 (0.0) 0 (0.0) 1 223 313 0 (0.0) 0 (0.0) 1 549 605 1 (0.2) 0 (0.0) 1 443 668 3 (0.6) 1 (0.6) 1 684 590 0 (0.0) 0 (0.0) Clinic 275 Adelaide, SA 2 407 1 947 0 (0.0) 0 (0.0) 2 281 1 893 0 (0.0) 0 (0.0) 2 383 2 012 1 (0.05) 0 (0.0) 2 579 2 096 0 (0.0) 0 (0.0) 2 622 2 140 1 (0.05) 1 (0.08) Melbourne Sexual Health Centre, VIC 6 683 2 187 2 (0.1) 1 (0.07) 7 183 2 553 2 (0.1) 2 (0.01) 8 617 4 253 0 (0.0) 0 (0.0) 8 556 3 885 2 (0.1) 2 (0.1) 8 762 4 126 0 (0.0) 0 (0.0)
Year 2008
Total 15 716 6 492 5 (0.08) 2 (0.05) 16 287 6 768 4 (0.06) 4 (0.08) 18 444 9 124 2 (0.02) 0 (0.0) 18 532 8 753 6 (0.1) 4 (0.1) 19 569 8 856 4 (0.05) 1 (0.02)
HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013 87
2009
2010
2011
2012
RPA Sexual Health Clinic, NSW, opened in 2009.
Source: Collaborative group on sentinel surveillance in sexual health clinics
4 Seroprevalence
4 Seroprevalence
Table 4.1.2
Number of people seen at selected metropolitan sexual health clinics in Australia, 20082012, number tested for HIV antibody, number (percent) newly diagnosed with HIV infection and number (percent) newly diagnosed following a previous negative test by year, sex and exposure category
HIV exposure category
Year 2008 Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%)
Men who have sex with men1 8 410 5 153 85 (1.6) 70 (1.8) 9 305 6 727 108 (1.6) 91 (1.6) 11 441 8 482 90 (1.1) 72 (1.0) 12 945 8 651 129 (1.5) 95 (1.3) 15 179 9 705 129 (1.3) 91 (1.1)
Men who have sex with men1, age < 25 years 1 845 1 228 14 (1.2) 13 (1.4) 2 122 1 144 15 (1.3) 12 (1.1) 2 508 1 968 15 (0.8) 5 (0.4) 2 984 1 444 12 (0.8) 5 (0.4) 3 518 2 286 25 (1.1) 21 (1.3)
Injecting drug use 507 314 1 (0.3) 1 (0.4) 461 284 0 (0.0) 0 (0.0) 454 278 0 (0.0) 0 (0.0) 473 267 0 (0.0) 0 (0.0) 414 253 0 (0.0) 0 (0.0)
Heterosexual contact overseas 3 632 1981 6 (0.3) 2 (0.2) 3 694 2 101 2 (0.1) 2 (0.2) 4 204 2 571 0 (0.0) 0 (0.0) 4 588 2 639 1 (0.04) 0 (0.0) 5 959 3 297 2 (0.06) 2 (0.1)
Heterosexual contact in Australia 9 306 4 259 2 (0.05) 1 (0.04) 9 706 4 438 4 (0.1) 3 (0.1) 10 170 4 953 3 (0.06) 2 (0.08) 10 068 4 874 8 (0.8) 1 (0.08) 11 245 4 971 3 (0.06) 2 (0.08)
Other men 775 97 1 (1.0) 0 (0.0) 867 99 0 (0.0) 0 (0.0) 1 294 146 1 (0.7) 0 (0.0) 1 782 137 1 (0.2) 0 (0.0) 1 971 97 0 (0.0) 0 (0.0)
Total 22 630 11 804 95 (0.8) 74 (1.0) 24 033 13 649 114 (0.8) 96 (1.0) 27 563 16 430 94 (0.6) 74 (0.7) 29 856 16 568 134 (0.8) 96 (0.9) 34 768 18 323 134 (0.7) 95 (0.8)
2009
2010
2011
2012
HIV exposure category Year 2008 Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Sex worker2 3 783 1 656 1 (0.06) 0 (0.0) 4 245 2 459 1 (0.04) 1 (0.04) 5 413 3 225 0 (0.0) 0 (0.0) 4 719 2 799 2 (0.1) 2 (0.1) 4 186 2 619 1 (0.04) 0 (0.0) Injecting drug use 360 207 0 (0.0) 0 (0.0) 338 193 0 (0.0) 0 (0.0) 292 192 0 (0.0) 0 (0.0) 356 208 0 (0.0) 0 (0.0) 286 154 0 (0.0) 0 (0.0) Heterosexual contact overseas 2 447 1 125 1 (0.09) 1 (0.2) 2 571 954 0 (0.0) 0 (0.0) 2 873 1 511 1 (0.07) 0 (0.0) 3 101 1 577 3 (0.2) 1 (0.1) 3 903 1 870 1 (0.05) 0 (0.0) Heterosexual contact in Australia 8 278 3 274 3 (0.09) 1 (0.06) 8 168 2 903 3 (0.1) 3 (0.17) 8 782 3 949 1 (0.03) 0 (0.0) 8 934 3 942 1 (0.03) 1 (0.05) 9 589 3 852 2 (0.05) 1 (0.05) Other women 848 230 0 (0.0) 0 (0.0) 965 259 0 (0.0) 0 (0.0) 1 084 247 0 (0.0) 0 (0.0) 1 422 227 0 (0.0) 0 (0.0) 1 605 281 0 (0.0) 0 (0.0) Total 15 716 6 492 5 (0.08) 2 (0.05) 16 287 6 768 4 (0.06) 4 (0.08) 18 444 9 124 2 (0.02) 0 (0.0) 18 532 8 753 6 (0.1) 4 (0.1) 19 569 8 776 4 (0.05) 1 (0.02)
2009
2010
2011
2012
1 2
Includes men with a history of injecting drug use. Includes women with a history of injecting drug use.
4 Seroprevalence
4 Seroprevalence
Table 4.1.3
Number of people seen at selected metropolitan sexual health clinics in Australia, 20082012, number tested for HIV antibody, number (percent) newly diagnosed with HIV infection and number (percent) newly diagnosed following a previous negative test by year, sex and age group
Age group (years)
Year 2008 Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%) Men seen Tested Newly diagnosed (%) Previously negative (%)
1319 846 464 0 (0.0) 0 (0.0) 981 515 3 (0.6) 2 (1.1) 1 153 690 0 (0.0) 0 (0.0) 1 283 722 1 (0.2) 0 (0.0) 1 516 720 2 (0.3) 2 (0.7)
2029 10 483 5 554 31 (0.6) 27 (0.8) 11 315 6 574 45 (0.7) 39 (0.9) 12 761 7 723 34 (0.4) 25 (0.5) 13 997 7 833 57 (0.7) 41 (0.9) 16 434 8 633 55 (0.6) 42 (0.8)
3039 6 130 3 188 35 (1.1) 25 (1.0) 6 315 3 635 39 (1.1) 32 (1.1) 7 078 4 247 30 (0.7) 24 (0.7) 7 869 4 453 39 (0.9) 31 (0.9) 9 057 4 923 49 (1.0) 34 (0.9)
4049 3 054 1 511 20 (1.3) 16 (1.4) 3 254 1 777 17 (1.0) 13 (0.9) 3 974 2 305 21 (0.9) 17 (1.0) 3 990 2 091 28 (1.3) 19 (1.2) 4 641 2 385 19 (0.8) 10 (0.5)
5059 1 394 707 4 (0.6) 3 (0.6) 1 465 783 9 (1.1) 9 (1.5) 1 715 992 7 (0.7) 6 (0.9) 1 799 966 8 (0.8) 4 (0.6) 2 020 1 029 9 (0.9) 7 (0.9)
60+ 723 380 5 (1.3) 3 (1.1) 703 365 1 (0.3) 1 (0.4) 882 473 2 (0.7) 2 (0.6) 918 503 1 (0.2) 1 (0.3) 1 099 633 0 (0.0) 0 (0.0)
Total 22 630 11 804 95 (0.8) 74 (1.0) 24 033 13 649 114 (0.8) 96 (1.0) 27 563 16 430 94 (0.6) 74 (0.7) 29 856 16 568 134 (0.8) 96 (0.9) 34 768 18 323 134 (0.7) 95 (0.8)
Total 22 630 11 804 95 (0.8) 74 (1.0) 24 033 13 649 114 (0.8) 96 (1.0) 27 563 16 430 94 (0.6) 74 (0.7) 29 856 16 568 134 (0.8) 96 (0.7) 34 768 18 323 134 (0.7) 95 (0.7)
2009
2010
2011
2012
Age group (years) Year 2008 Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) Women seen Tested Newly diagnosed (%) Previously negative (%) 1319 1 520 548 0 (0.0) 0 (0.0) 1 490 515 0 (0.0) 0 (0.0) 1 557 675 0 (0.0) 0 (0.0) 1 663 659 0 (0.0) 0 (0.0) 1 876 574 0 (0.0) 0 (0.0) 2029 8 379 3 475 2 (0.06) 1 (0.05) 8 744 3 390 3 (0.09) 3 (0.1) 9 795 4 661 1 (0.02) 0 (0.0) 10 129 4 581 3 (0.1) 2 (0.1) 10 873 4 697 2 (0.04) 0 (0.0) 3039 3 804 1 650 1 (0.06) 1 (0.08) 3 990 1 910 0 (0.0) 0 (0.0) 4 739 2 540 1 (0.04) 0 (0.0) 4 622 2 386 2 (0.1) 1 (0.1) 4 556 2 343 1 (0.04) 1 (0.4) 4049 1 507 630 1 (0.2) 0 (0.0) 1 562 772 1 (0.1) 1 (0.1) 1 735 934 0 (0.0) 0 (0.0) 1 553 859 1 (0.1) 1 (0.1) 1 631 947 1 (0.1) 0 (0.0) 5059 415 162 0 (0.0) 0 (0.0) 409 149 0 (0.0) 0 (0.0) 491 248 0 (0.0) 0 (0.0) 445 230 0 (0.0) 0 (0.0) 517 263 0 (0.0) 0 (0.0) 60+ 91 27 1 (3.8) 0 (0.0) 92 32 0 (0.0) 0 (0.0) 127 66 0 (0.0) 0 (0.0) 120 38 0 (0.0) 0 (0.0) 116 32 0 (0.0) 0 (0.0) Total 15 716 6 492 5 (0.08) 2 (0.05) 16 287 6 768 4 (0.06) 4 (0.08) 18 444 9 124 2 (0.02) 0 (0.0) 18 532 8 753 6 (0.1) 4 (0.1) 19 569 8 856 4 (0.05) 1 (0.02) Total 22 630 11 804 95 (0.8) 74 (1.0) 24 033 13 649 114 (0.8) 96 (1.0) 27 563 16 430 94 (0.6) 74 (0.7) 29 856 16 568 134 (0.8) 96 (0.7) 34 768 18 323 134 (0.7) 95 (0.7)
2009
2010
2011
2012
4 Seroprevalence
4.2
Table 4.2.1

Number of participating needle and syringe programs (NSP), 20082012, number of people who inject drugs who were tested for HIV or hepatitisC antibody (percent of clients seen) and number (percent) with HIV or hepatitisC antibody by year, State/Territory and sex
2008 State/ Territory ACT4 NSW NT QLD SA TAS VIC WA Total 2009 State/ Territory ACT NSW NT QLD SA TAS VIC4 WA Total 2010 State/ Territory ACT NSW NT QLD SA TAS VIC WA Total Number of NSP 1 22 3 8 7 4 5 3 53 Number of clients tested (% of clients seen)1 Male Female Total2 72 422 55 408 129 68 305 121 1580 25 243 23 123 84 38 131 92 97(82) 671(38) 78(28) 536(38) 214(41) 106(58) 438(56) 213(29) Number (%) with HIV antibody Male Female 0(0.0) 8(1.9) 0(0.0) 11(2.7) 0(0.0) 0(0.0) 2(0.7) 0(0.0) 21(1.3) 0(0.0) 0(0.0) 0(0.0) 0(0.0) 1(1.2) 0(0.0) 0(0.0) 1(1.1) 2(0.3) Number (%) with hepatitisC antibody3 Male Female Total2 48(69) 228(54) 29(53) 180(45) 54(43) 30(44) 204(67) 65(55) 838(53) 15(60) 135(56) 8(35) 58(48) 38(45) 18(47) 72(55) 54(59) 63(66) 365(54) 37(47) 241(46) 93(44) 48(45) 278(64) 119(56) Number of NSP 1 20 3 8 7 4 6 2 51 Number of clients tested (% of clients seen)1 Male Female Total2 36 488 51 581 155 73 215 126 1725 22 320 25 209 91 47 116 85 58(67) 816(39) 76(29) 795(59) 246(53) 121(16) 333() 212(29) Number (%) with HIV antibody Male Female 0(0.0) 12(2.5) 0(0.0) 10(1.7) 2(1.3) 0(0.0) 3(1.4) 1(0.8) 28(1.6) 0(0.0) 0(0.0) 0(0.0) 0(0.0) 1(1.1) 0(0.0) 0(0.0) 1(1.2) 2(0.2) Number (%) with hepatitisC antibody3 Male Female Total2 21(58) 272(56) 20(40) 244(42) 65(42) 38(52) 120(57) 60(48) 840(49) 13(59) 193(60) 9(36) 94(45) 36(40) 24(53) 60(52) 42(49) 34(59) 468(58) 29(39) 339(43) 101(41) 63(53) 182(55) 102(48) Number of NSP 1 22 2 8 7 4 6 2 52 Number of clients tested (% of clients seen)1 Male Female Total2 18 563 46 335 96 33 199 106 1396 8 297 27 161 92 24 93 62 26 () 867 (33) 73 (40) 498 (35) 189 (45) 57 (25) 292 (36) 168 (73) Number (%) with HIV antibody Male Female 0 (0.0) 15 (2.7) 1 (2.2) 9 (2.7) 0 (0.0) 0 (0.0) 2 (1.0) 2 (1.9) 29(2.1) 0 (0.0) 3 (1.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 3(0.4) Number (%) with hepatitisC antibody3 Male Female Total2 12 (67) 379 (70) 23 (50) 182 (55) 30 (32) 26 (81) 141 (75) 59 (58) 852(63) 6 (75) 208 (74) 15 (58) 91 (57) 24 (27) 19 (79) 58 (64) 32 (54) 18 (69) 591 (71) 38 (53) 275 (56) 54 (29) 45 (80) 199 (72) 91 (57)
Total2 0 (0.0) 19 (2.2) 1 (1.4) 9 (1.8) 0 (0.0) 0 (0.0) 2 (0.7) 2 (1.2) 33(1.5)
764 2170(36)
453(61) 1311(62)
Total2 0(0.0) 13(1.6) 0(0.0) 10(1.3) 3(1.2) 0(0.0) 3(0.9) 2(1.0) 31(1.2)
915 2657(45)
471(52) 1318(50)
Total2 0(0.0) 8(1.2) 0(0.0) 11(2.1) 1(0.5) 0(0.0) 2(0.5) 1(0.5) 23(1.0)
759 2353(38)
398(53) 1244(53)
4 Seroprevalence
92
2011 State/ Territory ACT NSW NT QLD SA TAS VIC WA Total 2012 State/ Territory ACT NSW NT QLD SA TAS VIC WA Total
1 2 3 4
Number of NSP 1 21 3 8 7 4 6 3 53
Number of clients tested (% of clients seen)1 Male Female Total2 64 455 46 376 129 43 335 112 1560 31 224 21 148 76 25 162 77 95 (56) 682 (36) 68 (33) 528 (40) 207 (51) 68 (28) 499 (55) 190 (77)
Number (%) with HIV antibody Male Female 0 (0.0) 5 (1.1) 1 (2.2) 8 (2.1) 2 (1.6) 0 (0.0) 4 (1.2) 1 (0.9) 21(1.4) 0 (0.0) 1 (0.5) 0 (0.0) 0 (0.0) 3 (4.0) 0 (0.0) 0 (0.0) 3 (3.9) 7(0.9)
Total2 0 (0.0) 7 (1.0) 1 (1.5) 8 (1.5) 5 (2.4) 0 (0.0) 4 (0.8) 4 (2.1) 29(1.2)
Number (%) with hepatitisC antibody3 Male Female Total2 44 (71) 220 (49) 22 (55) 158 (43) 67 (52) 17 (40) 229 (69) 69 (63) 826(54) 12 (39) 129 (59) 10 (48) 63 (43) 31 (41) 14 (56) 93 (59) 34 (47) 56 (60) 350 (52) 32 (52) 221 (43) 98 (48) 31 (46) 324 (66) 104 (57)
764 2337(41)
386(52) 1216(53)
Number of NSP 1 20 3 8 7 4 6 3 52
Number of clients tested (% of clients seen)1 Male Female Total2 53 465 30 415 123 36 304 120 1546 25 223 15 153 73 38 128 63 78 (65) 697 (47) 46 (21) 570 (45) 197 (42) 74 (28) 433 (52) 184 (79)
Number (%) with HIV antibody Male Female 0 (0.0) 7 (1.5) 1 (3.3) 7 (1.7) 2 (1.6) 0 (0.0) 1 (0.3) 0 (0.0) 18(1.2) 0 (0.0) 0 (0.0) 0 (0.0) 2 (1.3) 4 (5.5) 0 (0.0) 0 (0.0) 3 (4.8) 9(1.3)
Total2 0 (0.0) 8 (1.2) 1 (2.2) 9 (1.6) 6 (3.1) 0 (0.0) 1 (0.2) 3 (1.6) 28(1.2)
Number (%) with hepatitisC antibody3 Male Female Total2 34 (64) 213 (47) 11 (37) 183 (45) 51 (42) 17 (47) 214 (71) 71 (59) 794(52) 16 (64) 121 (55) 5 (33) 83 (54) 28 (39) 17 (46) 83 (65) 31 (48) 50 (64) 338 (50) 16 (35) 267 (47) 79 (41) 34 (47) 297 (69) 103 (56)
718 2279(46)
384(54) 1184(53)
At first attendance during the survey week. Totals include people whose sex was reported as transgender and people whose sex was not reported. Number tested for hepatitisC antibody excludes cases with insufficient blood for testing. The number of NSP clients seen was not reported.
Source: Collaboration of Australian Needle and Syringe Programs
93
4 Seroprevalence
Table 4.2.2
Number of people who inject drugs seen at needle and syringe programs who were tested for HIV or hepatitisC antibody, 20082012, and percent with HIV or hepatitisC antibody by year, age group, time since first injection, type of drug last injected among those reporting less than three years since first injection, and sex
2008 Male Age group Less than 20 years 20 to 24 years 25 to 34 years 35 to 44 years 45+ years Not reported Time since first injection Less than 5 years 5 to 9 years 10 to 14 years 15 to 19 years 20+ years Not reported Total 21 86 468 529 287 5 141 175 265 241 539 35 1 396 Number tested Female Total1 16 73 297 241 136 1 84 126 189 130 224 11 764 37 159 767 773 428 6 225 302 455 372 769 47 2 170 Percent with HIV antibody Male Female Total1 0.0 0.0 1.5 2.7 2.8 0.0 5.7 0.6 1.1 3.3 1.5 2.9 2.1 0.0 0.0 1.0 0.0 0.0 0.0 0.0 0.0 1.1 0.0 0.5 0.0 0.4 0.0 0.0 1.4 1.8 1.9 0.0 3.6 0.3 1.3 2.2 1.2 2.1 1.5 Percent with hepatitisC antibody Male Female Total1 29 30 55 67 81 60 22 41 61 60 83 58 63 44 47 59 64 72 0 37 50 57 70 79 30 61 35 38 57 66 78 50 28 45 59 64 82 52 62
Last drug injected among those reporting less than 3 years since first injection Amphetamines Heroin Other opiates All other drugs Not reported Total
28 8 10 19 2 67
14 15 10 4 0 43
42 23 20 23 2 110
14.3 12.5 0.0 0.0 0.0 7.5
0.0 0.0 0.0 0.0 0.0 0.0
9.5 4.4 0.0 0.0 0.0 4.6
14 25 30 16 0 18
21 50 30 75 0 38
17 41 30 26 0 26
4 Seroprevalence
33 12 14 30 1 90
18 21 24 2 2 67
51 33 39 32 3 158
3.0 0.0 0.0 3.3 0.0 2.2
0.0 0.0 0.0 0.0 0.0 0.0
2.0 0.0 0.0 3.1 0.0 1.3
0 25 7 7 0 7
22 30 17 50 0 23
8 28 13 9 0 13
94
17 18 19 33 0 87
15 11 7 4 0 37
33 29 26 37 0 125
5.9 5.6 0.0 0.0 0.0 2.3
0.0 0.0 0.0 0.0 0.0 0.0
3.0 3.5 0.0 0.0 0.0 1.6
6 22 21 7 0 10
13 45 0 75 0 27
9 31 15 8 0 15
95
4 Seroprevalence
Last drug injected among those reporting less than 3 years since first injection Amphetamines 18 Heroin 10 Other opiates 11 All other drugs 74 Not reported 1 Total 114
11 18 12 7 0 48
29 28 24 81 1 163
5.6 0.0 9.1 0.0 0.0 1.8
0.0 0.0 0.0 0.0 0.0 0.0
3.5 0.0 4.2 0.0 0.0 1.2
11 20 27 7 0 11
27 35 25 14 0 28
17 30 25 7 0 15
Last drug injected among those reporting less than 3 years since first injection Amphetamines 10 Heroin 15 Other opiates 8 All other drugs 92 Not reported 1 Total 126
1
17 10 6 3 0 36
27 26 14 95 1 163
10.0 0.0 0.0 0.0 0.0 0.8
0.0 0.0 0.0 0.0 0.0 0.0
3.7 0.0 0.0 0.0 0.0 0.6
20 21 50 3 0 10
41 20 33 0 0 31
33 24 43 3 0 15
Totals include people whose sex was reported as transgender and people whose sex was not reported.
4 Seroprevalence
96
Table 4.2.3
Number of people who inject drugs seen at needle and syringe programs who were tested for HIV or hepatitisC antibody, 20082012, and percent with HIV or hepatitisC antibody by year, sexual identity, sex work last month, region of birth, main language spoken at home by parents and sex
2008 Male Sexual identity Heterosexual Bisexual Homosexual Not reported Sex work last month No Yes Not reported Country/region of birth Australia Overseas born Other Oceania Asia United Kingdom and Ireland Other Not reported 1 228 56 62 50 1 264 39 93 1 181 194 34 21 68 71 21 Number tested Female Total1 537 152 48 27 633 91 40 650 102 27 7 43 25 12 728 28 8 764 1 767 209 112 82 1 905 131 134 1 836 300 63 28 113 96 34 2 037 101 32 2 170 Percent with HIV antibody Male Female Total1 0.2 5.4 37.1 0.0 2.1 5.1 0.0 2.0 2.6 8.8 4.8 0.0 1.4 0.0 2.2 1.4 0.0 2.1 0.2 1.3 0.0 0.0 0.5 0.0 0.0 0.5 0.0 0.0 0.0 0.0 0.0 0.0 0.4 0.0 0.0 0.4 0.2 2.9 20.6 0.0 1.6 2.3 0.0 1.5 2.0 6.4 3.6 0.0 1.0 0.0 1.6 1.0 0.0 1.5 Percent with hepatitisC antibody Male Female Total1 64 59 43 73 63 73 55 63 63 41 89 61 68 70 62 75 59 63 61 63 62 54 60 66 81 60 65 50 50 72 72 91 62 54 86 61 63 62 51 67 62 67 63 62 63 44 80 65 69 78 62 69 66 62
Main language spoken at home by parents English 1 299 Other language 73 Not reported 24 Total 1 396
Total
1 725
97
4 Seroprevalence
Main language spoken at home by parents English 1 628 Other language 72 Not reported 25
Main language spoken at home by parents English 1 486 Other language 75 Not reported 19 Total 1 580
Main language spoken at home by parents English 1 444 Other language 100 Not reported 16
4 Seroprevalence
Total
1 560
98
Main language spoken at home by parents English 1 446 Other language 96 Not reported 4 Total
1
1 546
99
4 Seroprevalence
4.3
Table 4.3.1

Incidence of hepatitisC infection among people who inject drugs seen at the Kirketon Road Centre, Sydney, 20082012
Person years at risk Number newly diagnosed Incidence per 100 person years
Year/ Age group 2008 Less than 20 years 2029 years 30+ years Total 2009 Less than 20 years 2029 years 30+ years Total 2010 Less than 20 years 2029 years 30+ years Total 2011 Less than 20 years 2029 years 30+ years Total 2012 Less than 20 years 2029 years 30+ years Total
Source: Kirketon Road Centre
3.1 18.8 43.9 65.7
0 1 5 6
0 5.3 11.4 9.1
2.3 19.3 45.5 67.2
1 2 1 4
42.7 10.4 2.2 6
0.8 16.8 43.1 60.7
0 4 2 6
0 23.8 4.6 9.9
0.7 11.9 34.8 47.4
2 4 1 7
285.7 33.7 2.9 14.8
0.4 7.7 19.3 27.4
1 1 0 2
251.9 13 0 7.3
4 Seroprevalence
100
Table 4.3.2
Incidence of hepatitisC virus infection among people who inject drugs enrolled in the HepatitisC Incidence and Transmission Study community (HITS-c), Sydney, 20092012
Person years at risk Number newly diagnosed Incidence per 100 person years
Year/ Age group 2009 Less than 20 years 2029 years 30+ years Total 2010 Less than 20 years 2029 years 30+ years Total 2011 Less than 20 years 2029 years 30+ years Total 2012 Less than 20 years 2029 years 30+ years Total
Source: The Kirby Institute
4.2 35 19.7 58.9
1 4 1 6
23.5 11.4 5.1 10.2
3.7 46.6 37.5 87.7
0 5 1 6
0 10.7 2.7 6.8
1.8 57.4 46.8 106
1 3 5 9
57 5.2 10.7 8.5
0.7 44.7 48.6 94
0 5 3 8
0 11.2 6.2 8.5
101
4 Seroprevalence
4 Seroprevalence
4.4
Table 4.4.1
HIV, hepatitisB surface antigen and hepatitisC antibody in blood donors

Number of donations tested for HIV antibody at blood services, number of donations positive for HIV antibody and prevalence of HIV antibody1, 19852012, by State/Territory and years of donation
198522002 Tests Positive 195 633 5 164 642 153 591 3 122 219 1 641 783 408 695 4 406 731 1 486 492 16 579 786 1 40 1 31 6 1 17 13 110 20032004 Positive 5 0 3 1 0 0 0 9 20052006 Positive 2 0 1 1 0 1 0 5

3
Prevalence 0.5 0.8 0.7 1.0 0.4 0.2 0.4 0.9 0.7
Tests 660 010 20 039 462 505 189 913 50 328 536 706 233 840 2 153 341
Prevalence 0.8 0.0 0.6 0.5 0.0 0.0 0.0 0.4
Tests 731 741 19 322 476 755 222 315 59 686 505 378 220 642 2 235 839
Prevalence 0.3 0.0 0.2 0.4 0.0 0.2 0.0 0.2
Total

3
Tests 777 269 22 954 494 355 259 888 67 926 564 850 245 298 2 432 540
20072008 Positive 3 0 5 1 0 5 1 15
Prevalence 0.4 0.0 1.0 0.4 0.0 0.9 0.4 0.6
Tests 852 771 23 392 542 824 271 126 85 716 615 685 262 509 2 654 023
20092010 Positive 2 0 6 0 0 2 0 10
Prevalence 0.2 0.0 1.1 0.0 0.0 0.3 0.0 0.4
Tests 860 983 22 164 537 294 263 983 98 450 632 257 259 702 2 674 833
20112012 Positive 1 1 3 1 0 3 1 10
Prevalence 0.1 4.5 0.6 0.4 0.0 0.5 0.4 0.4
Tests 195 633 9 047 416 261 462 5 635 952 2 849 008 770 801 7 261 607 2 708 483 28 730 362
All years Positive 1 53 2 49 10 1 28 15 159
Prevalence 0.5 0.6 0.8 0.9 0.4 0.1 0.4 0.6 0.6
Total
1 2 3
Prevalence per 100 000 donations. From 1 May 1985. HIV antibody testing of blood donors in the ACT carried out in NSW from 1 July 1998.
Source: Australian Red Cross Blood Service
Table 4.4.2
Number of blood donors in Australia with HIV antibody, 19852012, by HIV exposure category and sex, and number of new HIV infections in blood donors with a previous donation negative for HIV antibody by years of donation
19852002 M F 20 4 24 0 1 0 26 75 30 0 25 1 1 5 3 35 16 20032004 M F 4 1 1 0 0 0 2 8 5 0 1 0 0 0 0 1 2 20052006 M F 1 0 1 0 0 0 0 2 1 0 3 0 0 0 0 3 2 20072008 M F 5 1 4 0 0 0 3 13 4 0 2 0 0 0 0 2 0 20092010 M F 2 0 5 0 0 0 0 7 3 0 3 0 0 0 0 3 2 20112012 M F 2 0 5 0 0 0 1 8 2 0 1 0 0 0 1 2 1 All years F Total 0 35 1 1 5 4 46 23 34 6 75 1 2 5 36 159 68
HIV exposure category Men who have sex with men1 Injecting drug use Heterosexual contact Person from a high prevalence country Receipt of blood/tissue Other Undetermined Total New HIV infection2
1 2
M 34 6 40 0 1 0 32 113 45
Includes one male who also reported a history of injecting drug use. Year of HIV infection was estimated as the midpoint between the date of last HIV negative donation and the date of HIV positive donation.
4 Seroprevalence
4 Seroprevalence
Table 4.4.3
Number of donations tested for hepatitisB surface antigen at blood services, number of donations positive for hepatitisB surface antigen and prevalence of hepatitisB surface antigen1, by State/Territory and year of donation
2008 Positive 46 0 16 9 1 44 8 124 2009 Positive 46 2 13 9 0 35 20 125 2010 Positive 44 1 22 6 1 38 11 123
State/ Territory NSW/ACT NT QLD SA TAS VIC WA Total
Tests 387 669 11 981 256 224 134 384 37 257 289 338 124 581 1 241 434
Prevalence 11.9 0.0 6.2 6.7 2.7 15.2 6.4 10.0
Tests 424 627 12 123 270 890 138 255 41 010 310 968 130 714 1 328 587
Prevalence 10.8 16.5 4.8 6.5 0.0 11.3 15.3 9.4
Tests 428 144 11 269 271 934 132 871 44 706 304 717 131 795 1 325 436
Prevalence 10.3 8.9 8.1 4.5 2.2 12.5 8.3 9.3

1 Prevalence per 100 000 donations.
Tests 441 983 11 554 274 814 134 363 48 248 319 371 132 049 1 362 382
2011 Positive 46 3 16 6 1 31 15 118
Prevalence 10.4 26.0 5.8 4.5 2.1 9.7 11.4 8.7
Tests 419 000 10 610 262 480 129 620 50 202 312 886 127 653 1 312 451
2012 Positive 40 1 20 7 3 24 18 113
Prevalence 9.5 9.4 7.6 5.4 6.0 7.7 14.1 8.6
Table 4.4.4
Number of donations tested for hepatitisC antibody at blood services, number of donations positive for hepatitisC antibody and prevalence of hepatitisC antibody1, by State/Territory and year of donation
2008 Positive 61 0 31 9 4 20 5 130 2009 Positive 52 1 22 14 5 24 10 128 2010 Positive 40 1 16 7 1 16 4 85
Tests 387 669 11 981 256 224 134 384 37 257 289 338 124 581 1 241 434
Prevalence 15.7 0.0 12.1 6.7 10.7 6.9 4.0 10.5
Tests 424 627 12 123 270 890 138 255 41 010 310 968 130 714 1 328 587
Prevalence 12.2 8.2 8.1 10.1 12.2 7.7 7.7 9.6
Tests 428 144 11 269 271 934 132 871 44 706 304 717 131 795 1 325 436
Prevalence 9.3 8.9 5.9 5.3 2.2 5.3 3.0 6.4

1 Prevalence per 100 000 donations.
Tests 441 983 11 554 274 814 134 363 48 248 319 371 132 049 1 362 382
2011 Positive 33 1 16 5 1 14 11 81
Prevalence 7.5 8.7 5.8 3.7 2.1 4.4 8.3 5.9
Tests 419 000 10 610 262 480 129 620 50 202 312 886 127 653 1 312 451
2012 Positive 31 1 26 5 2 19 7 91
Prevalence 7.4 9.4 9.9 3.9 4.0 6.1 5.5 6.9
4 Seroprevalence
4 Seroprevalence
4.5
Table 4.5.1

Number of Australian born women seen for the first time at sexual health services participating in the Genital Wart Surveillance Network, 2004 2012, and number (percent) diagnosed with genital warts by year and age group
Warts diagnosis1 Australian born women aged 21 years Australian born women aged 2130 years 1 919 240 1 809 235 1 927 238 2 028 229 1 810 128 1 924 130 1 971 92 1 840 57 2 038 64 Australian born women aged >30 years 1 326 51 1 250 59 1 226 66 1 368 77 1 259 49 1 330 67 1 270 80 1 217 54 1 255 67
2004 Seen No. with warts (%) 2005 Seen No. with warts (%) 2006 Seen No. with warts (%) 2007 Seen No. with warts (%) 2008 Seen No. with warts (%) 2009 Seen No. with warts (%) 2010 Seen No. with warts (%) 2011 Seen No. with warts (%) 2012 Seen No. with warts (%)
1 Data from 8 services from NSW, NT, QLD, TAS, VIC, WA.
981 86 908 92 956 100 1 104 127 1 192 70 1 288 36 1 451 17 1 525 13 1 447 16
(8.8)
(12.5)
(3.8)
(10.1)
(13.0)
(4.7)
(10.5)
(12.3)
(5.4)
(11.5)
(11.3)
(5.6)
(5.9)
(7.1)
(3.9)
(2.8)
(6.8)
(5.0)
(1.2)
(4.7)
(6.3)
(0.8)
(3.1)
(4.4)
(1.1)
(3.1)
(5.3)
Source: Genital Warts Surveillance Network
Table 4.5.2
Number of Australian born men seen for the first time at sexual health services participating in the Genital Wart Surveillance Network, 2004 2012, number (percent) diagnosed with genital warts, by age group, gender of sexual partners, and year
Warts diagnosis1 Australian born heterosexual men aged 21 years Australian born heterosexual men aged 2130 years 1 627 275 1 664 311 1 582 291 1 744 318 1 892 285 2 151 301 2 297 254 2 190 194 2 319 179 Australian born heterosexual men aged 2130 years 1 765 256 1 646 217 1 544 197 1 641 182 1 628 148 1 821 185 1 853 195 1 749 165 1 872 182 Australian born homosexual men 1 102 100 1 149 114 1 189 86 1 234 115 1 214 92 1 493 101 1 589 121 1 489 93 1 661 96 Australian born bisexual men 292 26 314 26 301 23 334 19 324 22 314 19 397 25 337 24 325 20
2004 Seen No. with warts (%) 2005 Seen No. with warts (%) 2006 Seen No. with warts (%) 2007 Seen No. with warts (%) 2008 Seen No. with warts (%) 2009 Seen No. with warts (%) 2010 Seen No. with warts (%) 2011 Seen No. with warts (%) 2012 Seen No. with warts (%)
1 Data from 8 services from NSW, NT, QLD, TAS, VIC, WA.
321 23 280 20 301 42 387 47 492 30 686 33 784 14 731 16 663 10
(7.2)
(16.9)
(14.5)
(9.1)
(8.9)
(7.1)
(18.7)
(13.2)
(9.9)
(8.3)
(13.9)
(18.4)
(12.8)
(7.2)
(7.6)
(12.1)
(18.2)
(11.1)
(9.3)
(5.7)
(6.1)
(15.1)
(9.1)
(7.6)
(6.8)
(4.8)
(14.0)
(10.2)
(6.8)
(6.0)
(1.8)
(11.1)
(10.5)
(7.6)
(6.3)
(2.2)
(8.9)
(9.4)
(6.2)
(7.1)
(1.5)
(7.7)
(9.7)
(5.8)
(6.1)
Source: Genital Warts Surveillance Network
4 Seroprevalence
4 Seroprevalence
108
2013
Tables
5
5.1
5.1.1
Risk behaviour
Sexual, injecting and HIV antibody testing behaviour among men who have sex with men
Number of men who have sex with men participating in the Periodic Surveys, 20082012, prevalence of anal intercourse by partner type, city and year of survey, and prevalence of injecting drug use and HIV antibody testing by city and year of survey 110
5.2
5.2.1
Sexual and injecting behaviour among people who inject drugs

Number of people who inject drugs seen at needle and syringe programs who were tested for HIV or hepatitisC antibody, 20082012, percent reporting HIV and hepatitisC tests within the last twelve months, number reporting sexual intercourse in the last month, and percent reporting condom use at last intercourse by year, age group, sexual identity and sex 111 Number of people who inject drugs seen at needle and syringe programs who were tested for HIV or hepatitisC antibody, 20082012, percent reporting HIV and hepatitisC tests within the last twelve months, number reporting sexual intercourse in the last month, and percent reporting condom use at last intercourse by year, age group, sexual identity and sex 114
5.2.2
109
5 Risk Behaviour
5 Risk Behaviour
110
Risk behaviour
5.1
Sexual, injecting and HIV antibody testing behaviour among men who have sex with men
Table 5.1.1
Number of men who have sex with men participating in the Periodic Surveys, 20082012, prevalence of anal intercourse by partner type, city and year of survey, and prevalence of injecting drug use and HIV antibody testing by city and year of survey
2008 2186 31.2 23.1 8.1 1 888 71 1 973 70.4 2 421 59.3 2 825 62.3 2 515 58.2 1 138 65.8 1 183 59.9 1 518 58 1 535 58.5 1 222 63.4 1 850 63.9 2240 32.6 27.6 7.8 2 707 34 25.6 6.9 3 176 27.6 22.4 5.2 2 828 29.5 23.8 5.9 1 223 33.3 24.9 5.1 1 257 33.9 24.2 6.1 1 641 30.1 24.5 5.3 1 660 28.5 23.4 5.9 1 317 39.1 30 3 2 002 33.6 24.3 6.2
2009
Sydney1,2 2010 2011 2012 2008 2012 2008 2 061 32.5 24.8 6.7 1 916 67.8
Queensland1 2009 2010 2011
Melbourne1 2009 2010 2011 2 425 35 27.1 4.5 2 211 62.4 1 919 34.8 26.3 4.9 1 757 61.5
2012 2 034 28.6 23.3 9.5 1 877 68.2
Sample size Unprotected anal intercourse with regular partners1 Unprotected anal intercourse with casual partners1 Injecting drug use1,3
Sample size HIV antibody testing4
Canberra 2012 790 27.3 25.2 755 59.4 281 67.1 289 38.9 34.7 2009 2011 269 42.2 17.7 259 67.3 2008 717 34.6 26.9 686 57.3
2009 896 27.5 22.5 858 66.3 965 50.5 654 51.9 1 031 30.9 16.4 697 29.5 22.1
Adelaide 2010 2011
Perth 2010 912 34.8 31.4 882 62.9
2012 815 35.9 26.5 787 48.7
Sample size Unprotected anal intercourse with regular partners1 Unprotected anal intercourse with casual partners1 Injecting drug use5
Sample size HIV antibody testing4
Age-standardised and venue-adjusted prevalence.
The Gay Community Periodic Survey in Sydney includes February survey data only.
Injecting drug use in the previous 6 months.
HIV antibody testing in the previous 12 months excluding men with diagnosed HIV infection.
Age standardised and venue adjusted prevalence was not calculated due to the relatively small number of men in Adelaide, Canberra and Perth reporting injecting drug use.
Source: Centre for Social Research in Health; The Kirby Institute; State AIDS Councils; State-based People living with HIV/AIDS organisations
5.2
Table 5.2.1
Sexual and injecting behaviour among people who inject drugs

Number of people who inject drugs seen at needle and syringe programs who were tested for HIV or hepatitisC antibody, 20082012, percent reporting HIV and hepatitisC tests within the last twelve months, number reporting sexual intercourse in the last month, and percent reporting condom use at last intercourse by year, age group, sexual identity and sex
2008 Number tested M F Time since first injection Less than 5 years 5 to 9 years 10 to 14 years 15 to 19 years 20+ years Not reported Last drug injected Amphetamine Heroin Other opiates All other drugs Not reported Total 141 175 265 241 539 35 362 494 401 113 26 1396 84 126 189 130 224 11 238 253 218 43 12 % reporting recent HIV test M F T1 48 57 52 50 48 54 49 51 51 48 42 50 55 50 52 46 45 9 45 52 46 51 58 48 50 54 52 49 47 43 47 52 49 49 47 50 % reporting recent hepatitisC test M F T1 57 65 58 59 55 51 56 58 60 51 50 58 62 57 52 48 47 36 50 54 50 53 75 52 59 62 56 55 52 49 53 57 57 52 58 55 Number reporting IDU last month M F T1 117 160 244 223 474 30 313 438 381 95 21 1248 73 113 161 121 198 6 200 230 201 32 9 190 274 406 345 677 37 516 670 584 129 30 % using after someone else M F T1 7 14 17 16 14 6 11 16 14 16 15 14 25 17 15 18 11 18 15 15 17 19 0 16 14 16 16 17 13 9 13 16 15 17 11 15
T1 225 302 455 372 769 47 604 749 621 158 38
764 2170
672 1929
T1 260 342 583 551 855 66 649 907 814 225 62
915 2657
805 2362
111
5 Risk Behaviour
T1 204 281 472 480 865 51 613 797 687 244 12
759 2353
660 2073
T1 261 230 400 474 909 63 632 783 655 262 5
764 2337
675 2056
5 Risk Behaviour
112
2012 Number tested M F Time since first injection Less than 5 years 5 to 9 years 10 to 14 years 15 to 19 years 20+ years Not reported Last drug injected Amphetamine Heroin Other opiates All other drugs Not reported Total
1
T1 257 212 361 425 961 63 577 773 605 309 15
% reporting recent HIV test M F T1 38 49 49 54 46 48 46 52 47 38 36 47 62 55 53 51 45 50 46 54 47 61 50 50 43 51 50 53 46 48 46 53 47 42 40 48
% reporting recent hepatitisC test M F T1 43 50 53 60 54 57 50 61 54 43 27 53 65 64 62 55 51 44 56 59 54 59 50 57 48 56 57 58 53 52 52 61 54 46 33 55
Number reporting IDU last month M F T1 149 114 188 252 644 33 327 466 393 190 4 1380 50 78 134 131 229 14 188 234 171 41 2 201 193 325 386 876 48 521 704 565 233 6
% using after someone else M F T1 7 16 21 18 15 28 17 20 12 12 14 16 10 13 22 19 12 20 15 14 18 17 0 16 8 15 22 18 14 25 16 18 14 13 10 16
200 123 206 278 695 44 355 507 416 257 11 1546
55 88 152 143 262 18 216 262 187 49 4
718 2279
636 2029
113
5 Risk Behaviour
Table 5.2.2
Number of people who inject drugs seen at needle and syringe programs who were tested for HIV or hepatitisC antibody, 20082012, percent reporting HIV and hepatitisC tests within the last twelve months, number reporting sexual intercourse in the last month, and percent reporting condom use at last intercourse by year, age group, sexual identity and sex
2008 Number tested M F Age group Less than 20 years 20 to 24 years 25 to 34 years 35 to 44 years 45+ years Not reported Sexual identity Heterosexual Bisexual Homosexual Not reported Total 21 86 468 529 287 5 1 228 56 62 50 1 396 16 73 297 241 136 1 % reporting recent HIV test M F T1 48 50 56 50 42 40 49 63 69 44 50 63 48 54 48 35 0 46 57 48 44 48 54 49 55 49 40 33 48 58 60 44 50 % reporting recent hepatitisC test M F T1 57 63 64 55 51 60 56 70 69 56 58 75 64 52 51 42 0 50 60 48 52 52 65 64 60 53 48 50 54 62 60 55 55 Number reporting sexual intercourse M F T1 13 64 312 279 113 2 686 33 39 25 783 14 58 218 153 64 0 27 122 531 433 180 2 % using condoms at last intercourse2 M F T1 46 56 38 27 27 50 31 48 62 44 34 57 38 36 27 25 0 28 48 26 31 33 52 48 38 27 26 50 30 48 47 38 34
T1 37 159 767 773 428 6
537 1 767 152 209 48 112 27 82 764 2 170
348 1 035 116 150 27 68 16 42 507 1 295
T1 70 207 930 939 510 1
684 2 207 146 229 37 87 48 134 915 2 657
428 1 243 115 165 25 54 40 84 608 1 546
5 Risk Behaviour
114
T1 34 163 766 825 563 2
558 1 954 124 188 36 86 41 125 759 2 353
355 1 110 88 118 24 56 20 62 487 1 346
T1 34 142 748 824 580 9
547 1 943 141 203 38 91 38 100 764 2 337
332 1 062 93 125 20 44 20 42 465 1 273
2012 Number tested M F Age group Less than 20 years 20 to 24 years 25 to 34 years 35 to 44 years 45+ years Not reported Sexual identity Heterosexual Bisexual Homosexual Not reported Total
1 2
T1 28 141 657 856 595 2
% reporting recent HIV test M F T1 45 46 51 47 45 100 46 59 48 52 47 67 75 54 50 42 0 48 56 61 54 50 50 52 52 48 44 50 47 58 55 51 48
% reporting recent hepatitisC test M F T1 50 52 58 52 52 100 53 62 48 59 53 50 75 63 53 49 100 55 60 68 56 57 50 57 60 52 52 100 54 61 58 57 55
Number reporting sexual intercourse M F T1 16 79 262 306 143 0 694 40 21 51 806 5 27 180 165 70 1 21 106 446 474 215 1
% using condoms at last intercourse2 M F T1 63 43 37 27 24 0 29 48 52 47 32 40 52 34 28 27 0 28 47 0 38 32 57 45 36 28 26 0 29 48 35 43 32
22 108 412 585 418 1 1 350 69 42 85 1 546
6 32 241 266 172 1
718 2 279
448 1 263
Totals include people whose sex was reported as transgender and people whose sex was not reported. Includes only those who reported sexual intercourse in the last month.
Source: Collaboration of Australian Needle and Syringe Programs HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2013 115
5 Risk Behaviour
506 1 859 127 200 31 77 54 143
314 1 010 94 136 11 34 29 83
5 Risk Behaviour
116
2013
Tables
6
6.1
6.1.1
Estimates of the number of people living with HIV infection and viral hepatitis
Estimates of the number of people living with diagnosed HIV infection
Estimated number of people living with diagnosed HIV infection in 2012 by State/Territory of HIV diagnosis and sex 118
6.2
6.2.1 6.2.2
Estimates of the number of people living with viral hepatitis

Estimated number of people living with hepatitisB virus infection in 2012 Estimated number of people living with hepatitisC virus infection in 2012 by stage of liver disease 118 118
117
6 Case Estimates
6 6.1
Table 6.1.1
Estimates of the number of people living with HIV infection and viral hepatitis Estimates of the number of people living with diagnosed HIV infection
Estimated number of people living with diagnosed HIV infection in 2012 by State/Territory of HIV diagnosis and sex
Male 236 11 583 157 3 257 946 145 5 425 1 288 23 037 Female 38 1 101 40 439 147 25 534 347 2 671 Total 274 12 684 197 3 696 1 093 170 5 959 1 635 25 708 % 1.1 49.3 0.8 14.4 4.3 0.7 23.2 6.4 100.0
Source: State/Territory health authorities; The Kirby Institute
6.2
Table 6.2.1
Characteristic
Estimates of the number of people living with viral hepatitis

Estimated number of people living with hepatitisB virus infection in 2012
Number 207 000 Plausible range 170 000245 000
HepatitisB prevalence in 2012 During 2012 Deaths attributable to chronic hepatitisB
383
295624
Note: Using an alternative methodology, the number of people living with hepatitisB virus infection in Australia in 2011 was estimated at 218 000 (plausible range 192000284 000). Accessible from: http://onlinelibrary.wiley.com/doi/10.1111/1753-6405.12049/abstract. Source: VIDRL/ASHM HepatitisB Epidemiology Mapping Project; Victorian Infectious Diseases Reference Laboratory & Australasian Society for HIV Medicine, 2013
Table 6.2.2
Characteristic
Estimated number of people living with hepatitisC virus infection in 2012 by stage of liver disease
Number 310 000 80 000 173 500 51 500 6 500 Plausible range 239 000 391 000 60 800 99 200 132 000 215 000 39 100 63 700 4 550 8 450
Total hepatitisC prevalence Exposed to hepatitisC but not chronically infected Chronic hepatitisC infection with stage F0/1 liver disease Chronic hepatitisC infection with stage F2/3 liver disease Living with hepatitisC-related cirrhosis During 2012 HepatitisC-related liver failure HepatitisC-related hepatocellular carcinoma
Source: Linear extrapolations of estimates from HepatitisC Virus Projections Working Group
260 132
182338 92172
6 Case Estimates
118
2013
Tables
7
7.1
7.1.1 7.1.2
Uptake of treatment for HIV infection and viral hepatitis

Uptake of antiretroviral treatment for HIV infection
Antiretroviral treatment among people enrolled in the Australian HIV Observational Database in 2012 Number of men with diagnosed HIV infection participating in the Gay Community Periodic Surveys, 20082012 and proportion reporting use of antiretroviral treatment for HIV infection, by city and year 120 121
7.2
7.2.1
Monitoring prescriptions for HIV treatment

Number of people prescribed antiretroviral treatment through the Highly Specialised Drugs (S100) Program by antiretroviral agent and year 122
7.3
7.3.1
Monitoring prescriptions for viral hepatitis

Number of people dispensed drugs for hepatitisC infection through the Highly Specialised Drugs (S100) Program, by year 123
119
7 Treatments
7 7.1
Table 7.1.1
Uptake of treatment for HIV infection and viral hepatitis Uptake of antiretroviral treatment for HIV infection
Antiretroviral treatment among people enrolled in the Australian HIV Observational Database in 2012
Current antiretroviral treatment1 Mono and Double therapy 114 3+ NRTIPI 3+ NwRTI 3+ NNRTI+PI, (not NNRTI, +NNRTI NRTI not II) (not PI, not II) (not II) 575 950 99 3+ II, NRTI, NNRTI, PI 441
Characteristic Total number Sex Male Female Age at enrolment (years) Less than 30 3039 4049 50+ Exposure category Men who have sex with men Other/not reported Viral load at enrolment (copies/ml) Less than 400 40010,000 10,000+ Not reported CD4+ count at enrolment (cells/l) Less than 200 200500 500+ Not reported AIDS prior to enrolment No Yes HepatitisC antibody positive No Yes No test done Regimen of longest duration in 2011 None Mono and Double therapy 3+ NRTIPI (not NNRTI, not II) 3+ NRTI+NNRTI (not PI,not II) 3+ NNRTI+PI, NRTI (not II) 3+ II, NRTI, NNRTI, PI
1
None 163
Total 2 342
150 (92) 13 (8)
109 (96) 5 (4)
507 (88) 68 (12)
872 (92) 78 (8)
96 (97) 3 (3)
419 (95) 22 (5)
2 153 189
24 (15) 85 (52) 31 (19) 23 (14)
4 (4) 29 (25) 49 (43) 32 (28)
63 (11) 204 (35) 198 (34) 110 (19)
103 (11) 315 (33) 320 (34) 212 (22)
9 (9) 29 (29) 39 (39) 22 (22)
35 (8) 119 (27) 169 (38) 118 (27)
238 781 806 517
131 (80) 32 (20)
97 (85) 17 (15)
424 (74) 151 (26)
680 (72) 270 (28)
79 (80) 20 (20)
362 (82) 79 (18)
1 773 569
42 (28) 57 (39) 49 (33) 15
24 (23) 69 (66) 12 (11) 9
92 (17) 357 (65) 100 (18) 26
97 (11) 610 (69) 173 (20) 70
24 (24) 56 (57) 19 (19) 0
68 (16) 265 (63) 85 (20) 23
347 1 414 438 143
4 (3) 53 (35) 95 (63) 11
11 (11) 42 (40) 51 (49) 10
52 (10) 237 (44) 246 (46) 40
74 (8) 365 (41) 446 (50) 65
10 (12) 41 (48) 35 (41) 13
54 (13) 179 (44) 173 (43) 35
205 917 1 046 174
160 (98) 3 (2)
86 (75) 28 (25)
492 (86) 83 (14)
820 (86) 129 (14)
75 (76) 24 (24)
329 (75) 112 (25)
1 962 379
136 (83) 13 (8) 14 (9)
95 (83) 9 (8) 10 (9)
449 (78) 67 (12) 59 (10)
783 (82) 59 (6) 108 (11)
90 (91) 7 (7) 2 (2)
357 (81) 56 (13) 28 (6)
1 910 211 221
152 (93) 1 (1) 3 (2) 3 (2) 1 (1) 3 (2)
7 (6) 102 (89) 2 (2) 1 (1) 0 (0) 2 (2)
29 (5) 4 (1) 529 (92) 10 (2) 0 (0) 3 (1)
73 (8) 3 (0) 6 (1) 866 (91) 0 (0) 2 (0)
2 (2) 0 (0) 3 (3) 4 (4) 90 (91) 0 (0)
22 (5) 5 (1) 22 (5) 19 (4) 5 (1) 368 (83)
285 115 565 903 96 378
NRTI: Nucleoside reverse transcriptase inhibitor; NNRTI: Non-nucleoside reverse transcriptase inhibitor; PI: protease inhibitor; II: Integrase Inhibitor.
Source: Australian HIV Observational Database
7 Treatments
120
Table 7.1.2
Number of men with diagnosed HIV infection participating in the Gay Community Periodic Surveys, 20082012 and proportion1 reporting use of antiretroviral treatment for HIV infection, by city and year
Year of survey
City Melbourne Sample size Proportion reporting use of antiretroviral therapy Queensland Sample size Proportion reporting use of antiretroviral therapy Sydney2 Sample size Proportion reporting use of antiretroviral therapy Adelaide, Canberra & Perth (combined)3 Sample size Proportion reporting use of antiretroviral therapy
1 2 3 Age standardised and venue adjusted prevalence.
2008
2009
2010
2011
2012
152 63.3
145 61.3
214 69.7
162 72.6
157 77.7
85 66.1
74 61.5
123 68.5
125 69.7
95 69.8
298 70.6
267 73.5
286 68.9
351 70.6
313 80.2
31 72.7
46 62.9
96 76.4
53 89.1
63 83.3
The Sydney Gay Community Periodic Survey includes February survey data only. Adelaide, Canberra and Perth (combined) includes data from Perth only in 2008, from Adelaide and Canberra in 2009, from Adelaide and Perth in 2010, from Adelaide and Canberra in 2011 and from Adelaide and Perth in 2012.
Source: Centre for Social Research in Health; The Kirby Institute; State AIDS Councils, State/Territory organisations representing people living with HIV/AIDS
121
7 Treatments
7.2
Table 7.2.1
Monitoring prescriptions for HIV treatment

Number of people prescribed antiretroviral treatment through the Highly Specialised Drugs (S100) Program by antiretroviral agent and year
Year of prescription1, 2
Antiretroviral agent Nucleoside analogue reverse transcriptase inhibitors Abacavir Didanosine Emtricitabine Lamivudine Stavudine Zidovudine Lamivudine & Zidovudine Abacavir & Lamivudine Abacavir, Lamivudine & Zidovudine Tenofovir Tenofovir & Emtricitabine Non-nucleoside analogue reverse transcriptase inhibitors Delavirdine Efavirenz Nevirapine Etravirine Rilpivirine Protease inhibitors Atazanavir Darunavir Fosamprenavir Indinavir Lopinavir & ritonavir Ritonavir Saquinavir Tipranavir Fusion inhibitors Enfuvirtide Maraviroc Integrase inhibitor Raltegravir Combination Class Agents Tenofovir, Emtricitabine & Efavirenz Tenofovir, Emtricitabine & Rilpivirine Total patients3 Total cost ($000s)
4
2008
2009
2010
2011
2012
595 322 181 1 051 145 190 980 2 367 276 1 419 4 097
544 229 131 921 104 156 846 2 243 240 1 294 5 246
492 163 211 822 77 128 719 2 220 163 1 586 4 772
473 117 146 718 48 98 602 2 179 133 1 967 4 510
425 84 157 609 36 70 461 2 041 103 2 039 4 404
6 2 762 2 667 -
7 2 996 2 791 155 -
6 2 003 2 809 403 -
973 2 728 456 -
738 2 376 454 18
2 254 407 233 76 1 775 2 413 167 31
2 609 685 219 52 1 871 2 850 148 27
2 879 887 181 31 1 734 3 181 121 20
2 906 1 058 148 21 1 581 3 098 95 15
2 582 1 131 111 18 1 341 2 652 72 11
118 -
60 -
37 55
22 118
13 122
287
821
1 250
1 848
2 250
10 200 136 625
10 900 156 810
2 013 12 400 181 508
2 873 12 700 200 165
2 786 217 12 800 210 005
The number of people dispensed each antiretroviral drug during a calendar year was estimated by calculating the average of the total number of people dispensed each drug during the corresponding financial year quarters. Number of person years for July - December 2009 onwards estimated from the HSD Program Public Hospital Dispensed National Pack Number Report because of changes to S100 data collection methodology. Dashes (-) indicate that data were not available. Total patients calculated as (Lamivudine + Combivir (Lamivudine & Zidovudine)+Trizivir (Abacavir, Lamivudine & Zidovudine)+Kivexa (Abacavir & Lamivudine)+Emtricitabine +Truvada(Tenofovir & Emtricitabine) + Atripla(Tenofovir & Emtricitabine & Efavirenz) + Exiplera(Tenofovir & Emtricitabine & Rilpivirine) )/the proportion of patients in the Australian HIV Observational Database receiving any of the previously mentioned drugs in each year. Estimates of total patients are rounded to nearest 100 patients. Public Hospital Expenditure.
2 3
Source: Highly Specialised Drugs (S100) Program
7 Treatments
122
7.3
Table 7.3.1
Monitoring prescriptions for viral hepatitis

Number of people dispensed drugs for hepatitisC infection through the Highly Specialised Drugs (S100) Program, by year1
Pegylated Interferon and Ribavarin Total cost ($000s)2
Year 2008 January - March April - June July - September3 October - December 2009 January - March April - June July - September October - December 2010 January - March April - June July - September October - December 2011 January - March April - June July September October December 2012 January - March April - June July September October December
1 2 3
2 324 2 478 2 416 2 298
10 263 11 174 10 704 10 311
2 235 2 497 2 673 2 632
10 124 11 346 11 983 11 777
2 387 2 500 2 605 2 366
10 702 11 205 11 969 10 937
2 061 2 103 2 020 1 746
9 712 10 176 10 098 9 170
1 564 1 627 2 024 1 865
8 399 8 471 10 977 10 477
An estimated 3 172, 3 397, 3 286, 2 643 and 2 360 people were receiving treatment throughout 2008 to 2012, respectively. Calculations were based on the assumption that 50% of people were receiving treatment for 6 months and the remaining 50% were receiving treatment for 12 months. Public hospital expenditure only. Number of person years from September 2008 was estimated from the HSD Program Public Hospital Dispensed National Pack Number Report.
Source: Highly Specialised Drugs (S100) Program
123
7 Treatments
7 Treatments
124
2013
Methodological notes
1 1.1 National surveillance for newly diagnosed HIV infection National HIV Registry
National surveillance for newly diagnosed HIV infection
Newly diagnosed HIV infection is a notifiable condition in each State/Territory health jurisdiction in Australia. Cases of newly diagnosed HIV infection were notified through State/Territory health authorities to the national HIV surveillance centre on the first occasion of diagnosis in Australia. Information sought at notification of HIV infection included State/Territory of diagnosis, namecode (based on the first two letters of the family name and the first two letters of the given name), sex, date of birth, Aboriginal and Torres Strait Islander status, date of HIV diagnosis, CD4+ cell count at diagnosis, source of exposure to HIV and evidence of newly acquired HIV infection. Information on country of birth has been reported by all health jurisdictions for cases of HIV infection newly diagnosed in Australia from 1 January 2002. Information on language spoken at home has been reported by New South Wales, Victoria and Queensland for cases of HIV infection newly diagnosed from 1 January 2004 and by all jurisdictions from 2008. Reporting of a previous HIV diagnosis overseas was introduced for cases of HIV infection newly diagnosed in Australia from 1 January 2007 (Table 1.1.3). Advanced HIV infection was defined as newly diagnosed HIV infection with a CD4+ cell count of less than 200 cells/l, and late HIV diagnosis was defined as newly diagnosed HIV infection with a CD4+ cell count of 200 or more and less than 350 cells/l. In New South Wales, information on cases of newly diagnosed HIV infection was sought only from the diagnosing doctor prior to 2008. From 2008, information was also sought from the doctors to whom the person with HIV infection was referred, and follow up was carried out for cases for which the information sought at HIV notification was incomplete. These new procedures resulted in more complete information on new HIV diagnoses and reassignment of cases found to have been newly diagnosed in earlier years. The surveillance systems for newly diagnosed HIV infection are described in Guy et al (2007) and McDonald et al (1994b). The National Serology Reference Laboratory, Australia (Dax and Vandenbelt 1993), carried out monitoring of HIV antibody testing.
1.2
Information on the date of the last negative or indeterminate test or date of onset of primary HIV infection has been routinely sought through each State/Territory health jurisdiction for cases of HIV infection newly diagnosed in Australia from 1 January 1991. Newly acquired HIV infection was defined as newly diagnosed infection with evidence of a negative or indeterminate HIV antibody test or a diagnosis of primary HIV infection within 12 months of HIV diagnosis. The surveillance system for newly acquired HIV infection is described in McDonald et al (1994).
Monitoring incident HIV infection using specialised serological laboratory tests

Cases of HIV infection, newly diagnosed in Queensland, South Australia, Victoria, Western Australia and at the NSW State Reference Laboratory for HIV, were tested for incident HIV infection using the BED capture enzyme immunoassay (BEDCEIA; Parekh et al 2002). Cases with a normalised optical density of less than 0.8 were classified as incident HIV infection and cases with a normalised optical density of 0.8 or higher were classified as established HIV infection. The cutoff of 0.8 corresponds to detection of incident HIV infection within 160 days of HIV acquisition. Cases of HIV infection with a BEDCEIA result were linked to cases notified to the National HIV Registry to retrieve the date of first HIV diagnosis in Australia, evidence of newly acquired HIV infection and self report of exposure to HIV.
125
Monitoring transmitted drug resistance in Australian HIV1 isolates

The NSW State Reference Laboratory for HIV/AIDS at St Vincents Hospital, Sydney, and the Victorian Infectious Diseases Reference Laboratory, Melbourne, perform genotypic antiretroviral drug resistance testing on a selection of cases of newly acquired HIV1 infection. Results from these tests, including HIV1 subtype and HIV1 drug resistance mutations, were compiled and forwarded to the Surveillance and Evaluation Program at The Kirby Institute for analysis. The specific drug resistance mutations collected were based on the recommended World Health Organisation form, as published by Shafer et al 2007. For this analysis, HIV1 drug resistance mutations were grouped by the class of drug they conferred resistance against.
1.3
National surveillance for newly diagnosed HIV infection among Aboriginal and Torres Strait Islander people
Information on Aboriginal and Torres Strait Islander status was routinely sought at diagnosis of HIV infection in the Northern Territory, Queensland, South Australia, Tasmania and Western Australia from 1985. Information on Aboriginal and Torres Strait Islander status was available for cases of HIV infection newly diagnosed in New South Wales from January 1992, from June 1998 in Victoria and from January 2005 in the Australian Capital Territory. Nationally, information on Aboriginal and Torres Strait Islander status at diagnosis of HIV infection was sought prospectively from May 1995. For HIV diagnoses prior to 1995, Aboriginal and Torres Strait Islander status was obtained retrospectively through State/Territory health authorities. In 20032012, Aboriginal and Torres Strait Islander status was reported at HIV diagnosis, by State/Territory health authorities other than the Australian Capital Territory prior to January 2005, in 99% of cases. Further information is available in Guthrie et al (2000). Population rates of newly diagnosed HIV infection by Aboriginal and Torres Strait Islander status were calculated using experimental estimates of the Aboriginal and Torres Strait Islander population, adjusted for undercount of Aboriginal and Torres Strait Islander status (ABS 2008). The area of residence by Aboriginal and Torres Strait Islander status was calculated using the 2006 census population distribution, based on the Australian Standard Geographical Classification. The rate of HIV diagnosis in the nonIndigenous population was calculated using cases other than those whose exposure to HIV occurred in a high HIV prevalence country and the Australian population other than populations from high HIV prevalence countries in subSaharan Africa and South East Asia.
1.4
Cases of perinatal exposure to HIV were reported to the national HIV surveillance centre by paediatricians, through the Australian Paediatric Surveillance Unit, and through assessment of perinatal exposure in children born to women with diagnosed HIV infection. Cases of newly diagnosed HIV infection in women and their exposed children were notified through national HIV/AIDS surveillance procedures. Further details are given in McDonald et al (1997), McDonald et al (2001) and McDonald et al (2009).
1.5

Global comparisons
The data in Table 1.5.1 were obtained from the following sources: Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance dataUnited States and 6 U.S. dependent areas2010. HIV Surveillance Supplemental Report 2012; 17 (No 3, part A). http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Published June 2012. Accessed 27 September 2013 Health Protection Agency. HIV in the United Kingdom: 2012 Report: London: Health Protection Services, Colindale. November 2012. Joint United Nations Programme on HIV/AIDS (UNAIDS). Global report: UNAIDS report on the global AIDS epidemic 2012. UNAIDS, 2012. http://www.unaids.org Public Health Agency of Canada. Summary: Estimates of HIV prevalence and incidence in Canada, 2011. Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, 2012. http://webqa. phacaspc.gc.ca/aidssida/publication/survreport/estimat2011eng.php
126
2 2.1
National surveillance for viral hepatitis Notification of viral hepatitis to the National Notifiable Diseases Surveillance System
New diagnoses of hepatitis A and hepatitisB, newly acquired hepatitisB and prevalent cases of hepatitisC infection were notifiable conditions in all State/Territory health jurisdictions in Australia. Cases were notified by the diagnosing laboratory, medical practitioner, hospital or a combination of these sources, through State/Territory health authorities, to the National Notifiable Diseases Surveillance System. Population rates of diagnosis of viral hepatitis were calculated for each State/Territory using yearly population estimates, provided by the Australian Bureau of Statistics. HepatitisB infection and hepatitisC infection was classified as newly acquired if evidence was available of acquisition in the 24 months prior to diagnosis (Communicable Diseases Network Australia 2004). Diagnoses of newly acquired hepatitisB infection was notifiable in all health jurisdictions. Diagnoses of newly acquired hepatitisC infection were recorded in all health jurisdictions other than Queensland. Information on selfreport of exposure to hepatitisB and hepatitisC is reported in a subset of diagnoses of newly acquired infection in the health jurisdictions which monitor incident hepatitisB and C. Exposure to hepatitisC was categorised into a hierarchy of risk for infection. For example, if injecting drug use was reported as well as a history of surgery, blood transfusion or tattoos, exposure was categorised as injecting drug use. Exposure to hepatitisC was categorised as household transmission when a case reported sharing items such as a toothbrush or razor with a person with documented hepatitisC infection, in the absence of other exposures to hepatitisC.
2.2
National surveillance for viral hepatitis among Aboriginal and Torres Strait Islander people
Information was sought on Aboriginal and Torres Strait Islander status for diagnoses of hepatitis A, prevalent and newly acquired hepatitisB, prevalent and newly acquired hepatitisC and hepatitis D notified to the National Notifiable Diseases Surveillance System. Population rates of diagnoses of viral hepatitis were calculated by year and State/Territory of diagnosis (in those jurisdictions for which Aboriginal and Torres Strait Islander status was reported in more than 50% of diagnoses in each year 20082012) using the 2012 census population distribution available through the Australian Bureau of Statistics.
2.3
A network of liver transplant centres in Australia and New Zealand has collected information on the characteristics of people undergoing liver transplantation. People undergoing liver transplantation have been routinely tested for hepatitisB infection and for hepatitisC infection since antibody testing became available in 1990. Information was sought on the primary and secondary causes of liver disease including the results of tests for hepatitisB virus and hepatitisC virus. The information was forwarded to the Liver Transplant Registry located at Princess Alexandra Hospital in Brisbane.
2.4

The data in Table 2.4.1 were obtained from the following sources: Kowdley K, Wang C, Welch S, Roberts H. Prevalence of chronic hepatitisB among foreign-born persons living in the United States by country of origin. Hepatology. Epub 2012 Feb 16 Turnour CE, Cretikos MA, Conaty SJ. Prevalence of chronic hepatitisB in South Western Sydney: evaluation of the country of birth method using maternal seroprevalence data. Aust N Z J Public Health. 2011;35(1):2226. The prevalence estimates for Australia presented in this table were taken from Table 6.2.1
127
3 3.1
National surveillance for sexually transmissible infections Notification of specific sexually transmissible infections to the National Notifiable Diseases Surveillance System
Diagnoses of specific sexually transmissible infections were notified by State/Territory health authorities to the National Notifiable Disease Surveillance System, maintained by the Australian Government Department of Health and Ageing. Chlamydia was notifiable in all health jurisdictions except New South Wales prior to 1998; chlamydia was made notifiable in New South Wales in 1998. Gonorrhoea was a notifiable condition in all health jurisdictions and infectious syphilis became notifiable in all jurisdictions in 2004. In most health jurisdictions, diagnoses of sexually transmissible infections were notified by the diagnosing laboratory, the medical practitioner, hospital or a combination of these sources (see Table below). Table Source of notification of specific sexually transmissible infections to the National Notifiable Diseases Surveillance System by State/Territory
ACT Doctor Laboratory Hospital Doctor Laboratory Hospital Doctor Laboratory Hospital Not notifiable NSW Laboratory NT Doctor Laboratory Doctor Laboratory Doctor Laboratory Doctor Laboratory QLD Doctor Laboratory Hospital Doctor Laboratory Hospital Doctor Laboratory Hospital Doctor Laboratory Hospital SA Doctor Laboratory Doctor Laboratory Doctor Laboratory Doctor Laboratory TAS Doctor Laboratory Hospital Doctor Laboratory Hospital Laboratory VIC Doctor Laboratory Doctor Laboratory Doctor Laboratory Doctor Laboratory WA Doctor
Diagnosis
Gonorrhoea
Infectious syphilis
Doctor Laboratory Hospital Laboratory
Doctor
Chlamydia
Doctor
Donovanosis
Laboratory
Laboratory
Doctor Laboratory
3.2
National surveillance for sexually transmissible infections among Aboriginal and Torres Strait Islander people
Information on Aboriginal and Torres Strait Islander status in diagnosed cases of chlamydia, gonorrhoea and infectious syphilis was sought through doctor notification in the Australian Capital Territory, the Northern Territory, Queensland, South Australia, Victoria and Western Australia. New South Wales and Tasmania were the only health authorities that sought information on Aboriginal and Torres Strait Islander status through laboratory notification. Population rates of diagnosis of specific sexually transmissible infections were calculated by year and State/Territory of diagnosis using the 2011 census population distribution available through the Australian Bureau of Statistics.
3.3
Gonococcal isolates
The Australian Gonococcal Surveillance Programme (AGSP) is a collaborative project involving gonococcal reference laboratories in each State/Territory and is coordinated by the NSW Gonococcal Reference Laboratory at the Prince of Wales Hospital, Sydney. The primary objective of the programme is to monitor antibiotic susceptibility of isolates of Neisseria gonorrhoeae, to assist in the effective treatment of gonorrhoea. Information on sex and site of isolation of gonococcal strains was also collected (AGSP 2012).
128
4 4.1
HIV, viral hepatitis and sexually transmissible infections in selected populations HIV seroprevalence among people seen at sexual health clinics
A network of selected metropolitan sexual health clinics provided, at the end of each quarter and annually, tabulations of the number of people seen, the number tested for HIV antibody and the number newly diagnosed with HIV infection, broken down by sex, age group, HIV exposure category and HIV antibody testing history. Potential exposure to HIV was categorised according to the persons reported sexual behaviour in the 12 months prior to being seen at the clinic and any history of injecting drug use. HIV antibody testing history was subdivided into two categories: any history of HIV antibody testing prior to being seen at the clinic and HIV antibody testing in the 12 months prior to being seen. The proportion of men who have sex with men with newly acquired HIV infection was based on the number of men seen at the clinic during the year who had a negative HIV antibody test within 12 months of their last HIV antibody test. Further information is available in McDonald et al (2001).
4.2
All clients attending needle and syringe program (NSP) sites during one week in 2008 (51 sites), 2009 (51 sites), 2010 (52 sites) 2011 (52 sites) and 2012 (52 sites) were asked to complete a brief, selfadministered questionnaire and to provide a finger prick blood spot sample for HIV and hepatitisC antibody testing. NSP sites were selected on the basis of large numbers of clients and representation from all State/Territory health jurisdictions. Further information is available in MacDonald et al (1997 and 2000).
4.3
Incidence of hepatitisC infection was monitored among people with a history of injecting drug use attending the Kirketon Road Centre, a primary care clinic in central Sydney. Incidence of hepatitisC infection was calculated among people who were retested following a negative test for hepatitisC antibody when first assessed at the Centre. Repeat hepatitisC antibody testing was carried out, based on the assessment of risk behaviour for hepatitisC infection. The timing of hepatitisC seroconversion was estimated as the midpoint between the last negative test and the first positive test. Indeterminate hepatitisC antibody tests were considered to be negative in the analysis. The HepatitisC Incidence and Transmission Studycommunity (HITSc) is a prospective observational study of hepatitisC antibody negative people who inject drugs. Participants are tested for hepatitisC antibody and RNA every six months. Incidence of hepatitisC infection was calculated among people completing at least one followup visit since enrolment and date of infection was estimated as the midpoint between the last negative and the first positive test.
4.4
HIV, hepatitisB surface antigen and hepatitisC antibody among blood donors
All blood donations in Australia have been screened for HIV1 antibodies since May 1985, for HIV2 antibodies since April 1992 and for hepatitisC antibody from 1990. Prior to donation, all donors are required to sign a declaration that they do not have a history of any specified factors associated with a higher risk of HIV infection and other bloodborne infections. In all State/Territory health jurisdictions, detailed information is routinely sought on donors found to have antibody to HIV1, HIV2 or hepatitisC, and reports are routinely forwarded to The Kirby Institute. Further details of the national data collection on HIV infection in blood donors are given in NCHECR (1996), and Kaldor et al (1991).
4.5
Genital warts surveillance network
The Genital Warts Surveillance Network is a surveillance system to monitor the diagnosis of genital warts in Australia and is funded by bioCSL Pty Ltd.The network comprises eight sexual health services in New South Wales, Northern Territory, Queensland, Tasmania, Victoria and Western Australia. The aim of the network is to determine the population effects of the national human papillomavirus (HPV) vaccination program that began in mid2007 by monitoring the diagnosis rates of genital warts in various populations, and determining HPV vaccination rates (Ali H et al. 2013). Routinely collected data at sexual health services includes data on demographics, sexual behaviour, wart diagnosis and HPV vaccination status. These data are extracted directly from patient management information systems at each site and are collated at The Kirby Institute. For this analysis, only the Australian born patients seen for the first time at sexual health services were included. Genital warts diagnosis rates were calculated by dividing the total number of patients seen at the clinic by the number of patients diagnosed with genital warts, multiplied by 100.
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5 5.1
Risk behaviour Sexual, injecting and HIV antibody testing behaviour among men who have sex with men
The Sydney Gay Community Periodic Survey commenced in 1996 with the objective of providing information on sexual behaviour in a broad cross section of gay community attached men in Sydney. In February of each year, men who have sex with men were recruited at the Sydney Gay and Lesbian Mardi Gras Fair Day or at one of several gay community venues or medical clinics during the subsequent week. In August/September of each year, the sample was available only for the venues. Results from the two surveys in each year have been combined. The questionnaire was selfcompleted and takes approximately 5 minutes to answer. Information was sought on participant demographics, level of gay community attachment, sexual practices with regular and casual male partners, injecting drug use, patterns of testing for HIV antibody and other sexually transmissible infections, and antiretroviral use for respondents with HIV infection. The Adelaide, Brisbane, Melbourne and Perth Gay Community Periodic Surveys commenced in 1998 and the Canberra Gay Community Periodic Survey commenced in 2000. The Brisbane (including small numbers of men recruited in Cairns and on the Sunshine and Gold Coasts) and Melbourne surveys were carried out annually (June and January/February, respectively); the Adelaide and Perth surveys were carried out every two years (in October/ November) and the Canberra survey is conducted every three years (in November). The surveys used similar recruitment strategies and a compatible survey instrument. Men who have sex with men were recruited at the local equivalent of Sydneys Mardi Gras Fair Day (the Pride Fair in Brisbane and Picnic in the Park in Adelaide) or at one of a small number of community venues or medical clinics during the subsequent week. The sites were selected to be comparable with the range of sites used in the Sydney surveys.
5.2
Sexual, injecting and blood borne virus testing behaviour among people who inject drugs
Information on sexual behaviour, history of injecting drug use and HIV and hepatitisC testing history was obtained by client completion of a questionnaire administered at 51 needle and syringe programs in 2008, 51 in 2009, 52 in 2010, 52 in 2011 and 52 in 2012. Further information is available in MacDonald et al (1997 and 2000).
6 6.1
Estimates of the number of people living with HIV infection and viral hepatitis Estimates of the number of people living with diagnosed HIV infection
The estimated number of people living with diagnosed HIV was based on cumulative cases of newly diagnosed HIV infection notified to the National HIV Registry, adjusted for estimated numbers of deaths. For each case, information on the year of birth, postcode of usual place of residence at the time of diagnosis, sex, CD4 count and date of HIV diagnosis was used in a computer modelling algorithm. The computer model simulated progression of disease, including potential development of AIDSdefining conditions, using CD4 counts at HIV diagnosis and established rates of change in CD4 count (Mellors et al 1997).Probabilisticallydefined mortality was simulated using the age, sex and State/Territorystratified ABS general population mortality data, AIDS status and previously calculated standardised mortality ratios for people living with HIV and AIDS in Australia (Nakhaee et al 2009).
6.2
Estimates of the number of people living with hepatitisB infection
Estimates of the number of people living with hepatitisB virus infection were developed through the Victorian Infectious Diseases Reference Laboratory/Australasian Society for HIV Medicine HepatitisB Epidemiology Mapping Project. The estimates presented were derived from two sources: A deterministic compartmental mathematical model of hepatitisB virus infection in the Australian population from 19512050. Using the Census method, attributing prevalence of chronic hepatitisB prevalence by country of birth and also by Aboriginal and Torres Strait Islander status, applied to the Australian population data provided in the 2011 Census. For details see MacLachlan et al ANZJPH 2013 The burden of chronic hepatitisB virus infection in Australia, 2011 Accessible from http://onlinelibrary.wiley.com/doi/10.1111/17536405.12049/abstract
The model was parameterised using a wide range of data sources including the ABS, existing mathematical models, surveillance notifications, epidemiological research and clinical studies. Important factors such as migration, attributable and allcause mortality, the ageing of the population, the variable natural history of chronic HBV infection and the impact of vaccination were all incorporated.
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6.3
Estimates of the number of people living with hepatitisC infection
Estimates of the number of people living with hepatitisC virus were derived by the HepatitisC Virus Projections Working Group, a collaborative group formed under the auspices of MACASHHs HepatitisC SubCommittee. Estimates were derived from mathematical models in the following way. First, the number of people who had injecting drugs in Australia over the last three decades was estimated. Based on this pattern of injecting drug use, and estimates of hepatitisC incidence among injecting drug users derived from cohort studies, hepatitisC incidence as a result of injecting drug use was estimated. These estimates of hepatitisC incidence due to injecting drug use were then adjusted in accordance with epidemiological data to allow for hepatitisC infections through other transmission routes, including receipt of blood or blood products. Estimates of the number of people experiencing longterm sequelae of hepatitisC infection were then obtained from the estimated pattern of hepatitisC incidence using rates of progression derived from cohort studies. Estimates of the numbers of people living with hepatitisC in 2009 were adjusted to allow for mortality related to hepatitisC infection, injecting drug use and unrelated to hepatitisC infection or injecting. Further details are given in the Working Groups Report (MACASHH, 2006).
7 7.1
Uptake of treatment for HIV and viral hepatitis Uptake of antiretroviral treatment for HIV infection
The Australian HIV Observational Database (AHOD) is a collaborative study, recording observational data on the natural history of HIV infection and its treatment. The primary objective of the AHOD is to monitor the pattern of antiretroviral treatment use by demographic factors and markers of HIV infection stage. Other objectives are to monitor how often people with HIV infection change antiretroviral treatments and the reasons for treatment change. Information is collected from hospitals, general practitioner sites and sexual health centres throughout Australia. Participating sites contribute data biannually from established computerised patient management systems. Core variables from these patient management systems are transferred electronically to The Kirby Institute, where the data are collated and analysed. By March 2013, 28 participating clinical sites enrolled over 3800 people into the AHOD. Data from all 28 participating clinical sites was included in the analysis in Table 7.1.1. A person with HIV infection was classified as not on treatment if they were under active follow up in 2012 and either had no treatment records or had received treatment for at most 14 days. If the person received more than one treatment regimen during 2012, the treatment regimen of longest duration was included in the analysis in Table 7.1.1. Viral load and CD4+ cell counts were measured within three months of the date of cohort enrolment. A detailed summary of treatments data from the AHOD is published in the Australian HIV Observational Database Annual Report (The Kirby Institute 2013). Selfreported use of antiretroviral therapy for the treatment of HIV infection was monitored among men who have sex with men with HIV infection participating in the Gay Community Periodic Surveys in Adelaide, Brisbane, Canberra, Melbourne, Perth and Sydney.
7.2
Monitoring prescriptions for HIV treatments
All antiretroviral treatments for HIV infection, and some treatments for HIV/AIDS opportunistic infections, are funded through the Highly Specialised Drugs (HSDs) Program, a joint Australian Government and State/Territory mechanism for the supply of HSDs. The HSDs Program is coordinated federally by the Australian Government Department of Health and Ageing. The number of people dispensed each antiretroviral drug during a calendar year was estimated from the proportional quarterly change in total allocated dose calculated as the product of dispensed pack numbers and dose per pack and applied to the 2008 quarter 1 and quarter 2 S100 patient numbers. A moving average filter incorporating the previous 2 quarters, current quarter and following quarter was applied to account for seasonal variation in reported numbers. Patient numbers for antiretroviral drugs introduced after 2008 (rilpivirine, etravirine, maraviroc, atripla and eviplera) were estimated using patient dose years based on dispensed pack numbers and dose per pack and using usual adult daily dosing. The number of people dispensed lamivudine was also estimated using patient dose years based on dispensed pack numbers and dose per pack and using usual adult daily dosing. This was because patient numbers dispensed lamivudine were only reported as an aggregate of the number of people dispensed lamivudine for HIV treatment and HBV treatment but later reports included disaggregated data on dispensed lamivudine pack numbers. The reported number of people prescribed each treatment was for people treated in community and day services only. Hospital inpatients, and people treated in pharmaceutical companysponsored clinical trials or expanded
131
access schemes, were excluded. The Australian Government covers the cost of antiretroviral treatment for people seen in community or day services. State/Territory health authorities meet the cost of inpatient supply and costs associated with the management of these drugs. The total number of people receiving treatment for HIV infection was estimated by summing the number of people dispensed (lamivudine + kivexa + combivir + trizivir + emtricitabine + truvada + atripla + eviplera) through the S100 Program, divided by the proportion of people enrolled on AHOD who were receiving any of these mutually exclusive antiretroviral treatments during the same calendar year.
7.3
Monitoring prescriptions for treatment of viral hepatitis
The number of prescriptions for lamivudine, adefovir and entacavir for treatment of hepatitisB infection, for interferon and ribavirin therapy, pegylated interferon and ribavirin combination therapy and pegylated interferon only, was monitored through the Highly Specialised Drugs (HSDs) Program, a joint Australian Government and State/Territory mechanism for the supply of HSDs. The HSDs Program is coordinated federally by the Australian Government Department of Health and Ageing. In 2003, the estimated number receiving treatment dropped to 1142, possibly due to the expected inclusion of pegylated interferon and ribavirin into the HSD program in late 2003. In 2004 and 2005, the estimated number of people receiving combination interferon and ribavirin for hepatitisC infection was 1831 and 1847, respectively. In 2006, the number receiving treatment for hepatitisC infection increased to 2847, due to removal in April 2006, of the requirement for biopsy proven liver damage prior to treatment. In 2007 and 2008, 3539 and 3562 people were receiving treatment. The estimates were based on the assumption that 50% of patients were receiving treatment for 6 months, and the remaining were receiving treatment for 12 months.
132
2013
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2013

The Kirby Institute for infection and immunity in society 2013

Prepared by Melanie Middleton, Megan Tapia, David Wilson, Ann McDonald

The Kirby Institute

Tables 33 Methodological notes 125

State/Territory health departments

Australian Gonococcal Surveillance Programme

Collaborative group on sentinel surveillance in sexual health clinics

Genital Warts Surveillance Network

Australian HIV Observational Database

Collaboration of Australian Needle and Syringe Programs

Annual Surveillance Report 2013 Advisory Committee

Sexually transmissible infections other than HIV

Newly diagnosed HIV infection in Australia by year

New HIV diagnoses

YEAR OF HIV DIAGNOSIS Newly acquired HIV Other HIV diagnoses

Newly acquired HIV infection, 20032012, by year and State/Territory

HIV diagnoses in Australia, 20082012, by HIV exposure category

NEWLY DIAGNOSED HIV INFECTION

NEWLY ACQUIRED HIV INFECTION

HIV diagnoses in Australia, 20032012, by year and region of birth

HIV prevalence in selected countries

HIV PREVALENCE PER 100 000

HepatitisB notifications, 20032012, by year and sex

HepatitisB notifications, 20032012, by year and age group

Newly acquired hepatitisB notifications, 20032012, by year and sex

Newly acquired hepatitisB notifications, 20032012, by year and age group

HEPATITIS B PREVALENCE (%)

HepatitisC notifications, 20032012, by year and age group

Newly acquired hepatitisC notifications, 20032012, by year and age group

Sexually transmissible infections other than HIV

Chlamydia notifications, 20032012, by year and sex

Chlamydia notifications, 20032012, by year and age group

Gonorrhoea notifications, 20032012, by year and sex

Gonorrhoea notifications, 20032012, by year and age group

Infectious syphilis notifications, 20042012, by year and sex

Infectious syphilis notifications, 20042012, by year and age group

HIV, viral hepatitis and sexually transmissible infections in selected populations

Men who have sex with men

Younger than 25 years

NEWLY ACQUIRED HIV INFECTION (%)

25 years and older

Gonococcal rectal infection among men, 20032012, by State/Territory and year

Aboriginal and Torres Strait Islander people

ABORIGINAL AND TORRES STRAIT ISLANDER

The non-Indigenous category excludes cases from high prevalence countries.

AGE STANDARDISED RATE PER 100 000

AGE STANDARDISED RATE PER 100 000

2500 2000 1500 1000 500 0

2 500 2000 1500 1000 500 0

AGE STANDARDISED RATE PER 100 000

2 500 2 000 1 500 1 000 500 0

2500 2000 1500 1000 500 0

AGE STANDARDISED RATE PER 100 000

120 100 80 60 40 20 0 2008 2009 2010 2011 2012 YEAR

120 100 80 60 40 20 0 2008 2009 2010 2011 2012 YEAR VIC WA

People who inject drugs

HIV prevalence at needle and syringe programs, 2012, by sexual identity

Heterosexual transmission of HIV infection

From a high prevalence country Other/undetermined

HIV infection attributed to heterosexual contact, 20082012, by region of birth

2011 2012 YEAR

Heterosexual contact in Australia

Heterosexual contact overseas