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I grew up in the 1980s where AIDS, HIV and the spectre of the Grim Reaper bowling for AIDS victims, first terrified Australian television audiences. Looking back, I wonder if the Reaper has any regrets?

In 1987 the highly controversial Australian Grim Reaper TV commercial first aired, showing the Grim Reaper shrouded in mist Ten Pin Bowling - knocking over the pins of men, women and children. This groundbreaking government-funded advertisement was part of a $3 million education campaign that began on primetime TV, got the country talking and scared about AIDS and gay people.

Such was the message about the severity of this new virus called AIDS. True to its promise, at least 5,710 Australians died from the condition before medical intervention matured and a stabilising pharmaceutical cocktail of antiretrovirals becomes available and helped stem the body count.

The actual number of people who died from this condition in the early days will sadly never really be known. The stigma and discrimination around it meant that much of the data was hidden, not recorded or changed to 'cancer or related' make a death from it, more socially acceptable.

AIDS and HIV really became the social leprosy of the day ... Ms Patricia Kennedy OAM

But running a high visibility government approved education campaign, brings its own often unintended consequences that still linger today - many of them impacting the straight community as well.

First consequence

The first unintended consequence of the Reaper campaign was, in the words of Dr Ron Penny, now retired head of Immunology at Sydney’s St. Vincent’s Hospital, “[the belief] by some that the Reaper was [the] people with HIV infection, rather than the Reaper harvesting the dead.”

Second consequence

Today a lot of people still believe that HIV is only a ‘gay’ disease, even though in other parts of the world it’s predominantly a heterosexual condition. Of the total Australian HIV infection rate, 20% is attributed to heterosexual contact, with 1 in 10 being women; compared to more than 6 in 10 in other parts of the world.

Third consequence

Today many heterosexual men and women are failing to realise they’re at risk - and with many not being diagnosed until late into the disease progression when the virus has already caused real damage to a person’s immune system. This late diagnosis can have life-altering effects for yourself and others.

And this trend is not limited to Australia. According to the UK’s national health data, around a quarter of HIV Positive people the UK, don't know they have it.

Fourth consequence

A late diagnosis brings increased risks – for everyone. In the UK nearly half (49%) of all women who were diagnosed with HIV in 2015 didn't realise they had the condition until late in the progress of the virus. More than half (55%) of straight men who were diagnosed with HIV were also diagnosed late.

So what’s the problem with a late-stage diagnosis?

In normal healthy adults, the number of infection-fighting white blood cells is usually between 500 and 1,500. The higher the count of these white blood cells the better you’re able to fight HIV and other infections.

  • A late-stage diagnosis of HIV can mean the number of your white blood cells have already dropped to below 350.
  • This puts you at serious risk of HIV and other opportunistic infections.

Because a significant decline in your CD4 cells count can take up to three years, a late-stage diagnosis means you may have already suffered 3 years of damage to your immune system. It also means you significantly increased the risk of your passing the infection onto someone else.

A snapshot of HIV in Australia today

This snapshot of the latest HIV data for Australia is drawn from the Kirby Institute’s 2016 Annual Surveillance Report (year ending 31 December 2015).

In 2015, 1,025 people were newly diagnosed with HIV.
At the end of 2015, an estimated 25,313 people were living with HIV in Australia, of whom an estimated 2,619 (10%) were unaware of their HIV-positive status.
Over a quarter (29%) of new HIV diagnoses in Australia in 2015 were diagnosed late.

From the Grim Reaper until now

Today in Australia HIV infection is now classed as a chronic yet manageable health condition – no longer the death sentence it used to be in the 1980s. This means that people who contract HIV today can expect to live near-normal lifespans, as long as they continue to manage their condition and maintain their routine of antiretroviral drugs.

At its peak in the early 1990’s, about 1,000 Australians died from AIDS each year but today AIDS cases in Australia have plummeted since the arrival of antiretroviral medication in the mid-1990’s, which stops HIV from progressing to AIDS - where the immune system is so badly damaged it cannot fight off infection ... Professor Sharon Lewin - Director Peter Doherty Institute Melbourne

In 2013 a young Australian woman, Abby Landy shared her story about finding out she became HIV positive to a past boyfriend. Her story focuses on how HIV stigma, prejudice and a lack of understanding may actually cause more damage to a person than the virus.

The sad truth is that a lot of the discrimination people face as a result of their positive status is because people think it is an evil condition, for which someone is to blame for spreading. In reality, anyone can come into contact with and contract HIV, but until society at large can understand and accept that, the finger is often pointed at those who they think are responsible ... Abby Landy

Is the risk over now?

Is Australia immune now from the far-reaching effects of the HIV virus?

  • In the Asia-Pacific region, there are 180,000 cases of AIDS and 1.2 million cases of HIV reported each year.
  • There are 4.8 million people living with HIV in Asia and the Pacific but treatment access is still very low at just 33%.
  • HIV prevalence in India is only 0.3%, but its huge population means this equates to over 2.1 million people living with HIV.
  • Although China has pledged to meet the 2013 WHO treatment guidelines, the Chinese government does not make treatment data available.

HIV testing in Australia can be done anonymously, free and available to everyone. Regardless of the community you identify with, the message is for everyone to get tested and know their HIV status.

[The article below first appeared in LinkedIn Pulse on 1st December 2016]

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