Australia has set the goal of virtual elimination of new transmissions of HIV by 2030, we sat down with Ryan Oliver, Chair of Positive Organisation Western Australia (POWA) to get a better understanding of what that entails.
This is the third story in OUTinPerth’s The Last Mile project which is exploring strategies on how Australia can reach it’s 2030 goals for HIV.
Can you tell us a little about your journey, leading up to your current role as Chair of POWA?
My [HIV] diagnosis was something that really made me stop and think about my life and make changes. For me, it was part of not living ‘the lie’. At the time I was closeted, both as gay and with my status.
It was a turning point in my life where I started to be honest with myself as to who I was – that was back in 2008/2009. I’ve now lived in Perth for the last 13 years! Yes, I’m a Kiwi-Aussie, I take the best of both sides of the Tasman.
Since you’ve come to Perth, you’ve been very involved as a voice for people who are HIV Positive – tell us about the organisations you’ve been working with.
Originally, I started as the community representative here in WA for NAPWHA (National Association of People with HIV), the national peak body, before we had a positive organisation here in Perth.
It was about eight years ago that we incorporated POWA, which is a peer-based organisation for HIV Positive people living in Western Australia.
The main focuses of the organisation are around facilitating opportunities for social engagement within the community, because we know that HIV Positive people do suffer with higher mental health issues and isolation.
Social isolation can be a huge factor in someone’s mental health, and we also know combatting social isolation helps with someone’s quality of life. That’s a really big thing for people living with HIV. Now that we understand ‘undetectable’ and we have people on treatment, it’s about ensuring that quality of life is that of any standard citizen.
How would you describe the recent changes we’ve seen in HIV prevention and treatment?
We’ve seen huge changes, even if you just go from the last five years. We didn’t even have PrEP available for anyone who was HIV Negative and wanted to take management of risk into their own hands. PrEP was a huge game changer for both HIV Positive and Negative people, because it meant that HIV Negative people had their own control of a safer sex strategy.
Then we’ve seen injectables come in the last 24 months. This has been a huge game changer for those of us that live on medication every day, whether that’s just the simple fact of not having to take a pill every day.
For people like me, I used to struggle a lot with reflux from the medication, and now I’ve found going on to the injectable I have noticed those co-morbidities are reduced somewhat. Injectables are about to be huge going forward. Potentially we’ll even see injectable PrEP come through – we’re already seeing it worldwide, but we haven’t got it here in Australia. I think that’s mainly a cost issue.
Looking at the big picture – we have set the goal here in Australia for virtual elimination of new transmission of HIV by 2030. New figures show we may not be able to make that goal.
In your opinion, how important is that goal in the overall landscape?
I think it’s a great target to have. I think we also need to be really careful that we don’t get taken up with the idea of ‘virtual elimination’ and think that’s the end of HIV.
We have to remember that even with virtual elimination, we’re still going to have people diagnosed with HIV. We will still have HIV Positive people who have to live the rest of their lives, taking treatment and living with the daily stigma of HIV.
I think it’s really important for a public health response, looking at that data coming through, that we recognise we probably won’t achieve it.
I think in WA we have a real opportunity to maybe reach it as a state, but that is going to take input from all of the organisations, as well as the Department of Health, to achieve that.
We often see news stories about a “major breakthrough” towards a cure for HIV. We understand these can be frustrating, because those stories usually reveal that would still decades away from practical.
As a person living with HIV, is a cure something you think about? How do you feel about that kind of reporting?
It’s not something I think about. Especially now that I’m on the injectable treatment, I go to my doctor once every two months,
The injectable that I’m on is about to launch a trial to see if it can be used every four months. Three times a year. Otherwise, I live a very “normal” life.
I think for a lot of people with HIV, they just go on their medication and they carry on with their lives. That’s not to diminish those that really struggle to get an undetectable viral load as they don’t have all the same treatment options.
I’m sure there are HIV Positive people who long for the day there will be a cure. I think the media, especially mainstream media, are very good at blowing out of proportion any little development towards a cure.
Working towards virtual elimination – how to we make sure we reach a diverse range of people and don’t leave anyone behind?
This is something that leaders in the community are asking questions about often. It’s important we don’t leave anyone behind.
I think we have some really good programs around rapid testing. NAPWHA has a free HIV testing program, so you can go to a website and punch in your details and they will post out a free HIV rapid test – you can do it in the privacy of your own home.
We’re also seeing uptake from regional and remote areas because people are able to test privately, without going to the family or community doctor.
If you had a wishlist of what activities you’d like to see happening more frequently – what’s on it?
Testing, testing , testing! That’s really important if we want to reach our virtual elimination goals.
Then it’s around peer navigation, so that when people have a diagnosis, they’re instantly put in touch with a peer that helps them navigate the health system, helps them to navigate social issues, because we do know that getting people onto treatment and into good housing and counselling helps improve quality of life.
The phrase ‘The Last Mile’ grew out of the telecommunications industry where they discovered connecting individual properties to networks was the most challenging task.
In the journey of HIV, Australia is looking down The Last Mile. Which why we adopted the phrase for this new series of reports that explores how the goals of 2030 can be achieved.
This is a Solutions Based Journalism project. The goal is to interrogate the challenge, explore the data, hear the stories and experiences and present the ideas and practices that will hopefully lead us to all achieving the 2030 goals.
Contact
Graeme Watson
Co-editor
graeme@outinperth.com
