Whose responsibility is it to ensure that Australia stays on track in reaching it’s goal of achieving the virtual elimination of HIV by 2030?
It’s a question that came up at the Better Together Conference which was held in Adelaide in November 2025.
With time ticking away to achieve the ambitious goal of achieving a significant reduction in new transmissions of the virus, an interesting conversation opened up about government, community and personal responsibility, and then in turn accountability on all levels too.
At the community gathering OUTinPerth hosted a community discussion about HIV and the 2030 goals. To encourage a free flow of ideas and debate, the discussion was held under the Chatham House Rule. Participants understood that the substance of the discussions would be reported, but neither the identification or the affiliation of the participants could be revealed.
It’s a technique the OUTinPerth team have previously effectively used to generate community discussions about discrimination and stigma across a range of topics from sexual practices, to racism and HIV.
Virtual elimination of HIV is defined as a 90% reduction in HIV transmission numbers from a baseline established in 2010. For Australia that would mean by 2030 only 90 cases of HIV notification would be occurring annually.
Even with a significant reduction there would still be people contracting HIV, and experts have anticipated that they will come from distinct groups of people in society.
Men who have sex with men, but don’t identify as men, people born overseas, Indigenous Australians, women, street present people, those getting a late diagnosis and people who are just generally let down by the systems people have to navigate for healthcare and other vital needs will be those still needing help, but also potentially the most difficult to reach with preventative health messages and initiatives. There has also been concern over young Australians and their knowledge of safe sex practices and current treatment regimes.
Participants at the conference discussed the issue with a series of provocations to kick off the discussion, including asking what people though were the biggest barriers and roadblocks to achieving the 2030 goals.
Gaps in the knowledge of medical professionals, especially General Practitioners was noted, as well as the ongoing shame and stigma that still exists for many people living with HIV more than four decades after the battle against the virus began.
Additional challenges were reported for migrants and refugees with a wide range of factors cited including different levels of healthcare being available based on people’s visa status, and challenges in language and communication and overall health literacy.
Gaps in education were highlighted, with people feeling there were few changes to HIV and sexual education in recent decades. It was also noted that women are often left out of these important discussions.
When it came to reaching out to men who have sex with men, but don’t identify as being gay, or part of part of the LGBTIQA+ communities those in the discussion suggested that outreach work in the space where people meet remains a key tactic, as does ensuring that educational materials use the right language for that cohort.
The attendees also shared their thoughts on the question of what does the next generation of HIV advocacy would need to look like, to be able to achieve the 2030 goals.
Concern was raised that advocacy efforts in some areas had become restrained and more conservative. Where health promotion messages in the past might have been bold, featured sex positive content and caught people’s attention over the years they’d become softer and less provocative. For some of the target audiences though a more subtle messaging was clearly needed. Right message, in the right voice, for the right audience is essential.
The question of who had the responsibility to achieve the 2030 goals was also debated. Is this solely the work of health ministers and bureaucrats? Does it fall to each state’s organisation with a mission statement to tackle the challenge, or does it fall further than WAAC, ACON, Thorne Harbour Health and the like?
What role do media outlets and journalists play in the challenge, and how do we measure personal responsibility and accountability? Centering community led responses was deemed to be an essential element of the answer. Cultivating relationships in each distinct community group was a must-have, and buddy systems, mentoring and wide spread communication and consolations are needed.
Ensuring there are people with lived experience and skills in public advocacy was also called for so that young people could hear from people living with HIV, who are on medication with undetectable viral loads, and living full lives.
Ensuring sex education programs across the country were delivering a message about HIV that is suitable for today was also at the top of people’s lists. With decades of messaging about HIV being a death sentence, it was noted that the unlearning and relearning was a complicated process and there was a fear that outdated messages were still being spread.
Finally we asked those attending their thoughts on how we get more people testing for HIV, and testing regularly.
There was a strong support for encouraging doctors to make asking about sexual health testing as common as greeting patients as they walk into the surgery. While the idea was also floated that more overt encouragement of getting sexually active people to test regularly could be a pathway for change – we can send out kits for bowel cancer, how about notes for HIV testing?
What a breakthrough it would be if we could get to a stage where a doctor saying “I’m going to test your liver function” was as common and casual as saying “I’m just going to check for HIV.”
There was also a call for testing to be made available in a wide range of outreach locations including universities, sex on premises venues, community groups and other spaces. Alongside improved access to self testing kits via vending machines and mail out systems.
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
