New Kirby Institute data show Australia has met key global HIV testing and treatment targets, but experts warn that progress is not being shared equally across communities. Ongoing late diagnoses and a rise in diagnoses among First Nations Australians require urgent attention.
First Nations Australians, recent migrants, and gay and bisexual men remain key populations where more work is needed. There is also ongoing concern about the number of people who are diagnosed late, meaning they have been unknowingly living with HIV for several years.
There were 753 HIV diagnoses in Australia in 2025, meaning HIV diagnoses have remained stable over the past three years, according to a report from the Kirby Institute at UNSW Sydney presented today at the joint Australasian HIV&AIDS and Sexual and Reproductive Health Conferences in Melbourne.
Over the past decade, HIV diagnoses in Australia have declined by one-quarter, down from 1,006 in 2016. After accounting for Australia’s growing population, the rate of HIV diagnoses has fallen by about one-third during that time. In 2016, around four in every 100,000 Australians were diagnosed with HIV; in 2025, this figure was closer to three per 100,000.
Australia’s next goal is to achieve the 2030 target of virtual elimination of HIV. Under this target, there would be 90 per cent fewer HIV diagnoses than in 2010, equating to approximately 90 new cases nationally each year.
“The decline we’ve seen in HIV diagnoses over the last decade shows Australia’s world-leading response is working. While HIV diagnoses increased modestly following a COVID-19-related decline associated with public health control measures, the longer-term trend remains downward,” says Dr Skye McGregor, an epidemiologist at the Kirby Institute and the report’s lead.
“However, accelerating this decline will require sustained and enhanced efforts. It is important we focus our efforts and address the inequities revealed by the data, ensuring testing, treatment and prevention options are accessible and available to everyone who needs them.”
In 2025, sex between gay and bisexual men accounted for 484 (64 per cent) HIV diagnoses, with heterosexual sex reported for 194 (26 per cent) diagnoses and injection drug use for 19 (3 per cent) diagnoses. Just over half (53 per cent) of gay and bisexual men diagnosed with HIV in 2025 were born overseas.
HIV remains uncommon among sex workers and people who inject drugs, reflecting the success of decades of community-led harm reduction and health promotion strategies.
UNAIDS set global fast-track targets for HIV testing and treatment by 2025: 95 per cent of people living with HIV diagnosed, 95 per cent of those diagnosed on treatment, and 95 per cent of those on treatment achieving viral suppression. Preliminary estimates indicate Australia met these targets in 2025.
“Reaching those targets at a national level in Australia is an incredible achievement, showing that when priority populations are given convenient and affordable access to the mechanisms that prevent HIV transmission and improve quality of life, transmission rates fall,” Dr McGregor said
“While Australia has reached important national milestones, the data show progress is not yet being shared equally across all communities. The next phase of the response must focus on improving equitable access to testing, treatment and prevention, particularly for groups experiencing higher diagnosis rates or late diagnosis.
“It is also essential that we continue to invest in, and grow, a regional approach to HIV prevention and care, and provide support to neighbouring Pacific Island countries such as Fiji and Papua New Guinea, which are experiencing concerning rises in HIV diagnoses.”
While diagnoses of new HIV cases have rapidly declined in Australia over the last decade, Fiji has experienced a rapid escalation in new cases, largely attributed to intravenous drug use and a lack of needle exchange programs.
Inequity persists for First Nations Australians
There were 37 HIV diagnoses among First Nations Australians in 2025. This is an increase on the average of 24 cases per year during the three years prior to 2025, and the second-highest number of diagnoses recorded over the past decade.
First Nations Australians were diagnosed at 1.9 times the rate of Australian-born non-Indigenous people in 2025, up from 1.6 times the rate in 2016. In the past three years, 36 per cent of these diagnoses were attributable to sex between gay and bisexual men, 33 per cent to heterosexual sex, 17 per cent to sex between gay and bisexual men combined with injecting drug use, and 7 per cent to injecting drug use alone.
First Nations Australians can face barriers to accessing culturally safe healthcare for many reasons, including discrimination within the health system, geographical barriers and inequitable access to healthcare.
“While HIV diagnoses among First Nations peoples have overall declined over the past decade, the reduction has not kept pace with the decline seen among non-Indigenous Australians. The increase in diagnoses over the past year is particularly concerning and should be a reminder that we need to closely monitor and rapidly respond where we see cases emerge,” said Robert Monaghan, Manager of the Yandamanjang First Nations Health Research Program at the Kirby Institute.
“First Nations peoples remain almost twice as likely to be diagnosed with HIV as non-Indigenous Australians. This inequity is unacceptable. We know that HIV is preventable and treatable, so we need to ask why these disparities persist and, more importantly, what we can do differently.
“Eliminating HIV transmission among Australia’s First Nations peoples must remain a critical national priority. The response needs to be driven by communities, not only delivered to them. We need culturally safe, locally relevant campaigns co-designed with First Nations communities and organisations, with a strong focus on testing, prevention, early diagnosis and access to treatment.”
Mixed results for gay and bisexual men
An HIV diagnosis is considered late when a person may have been living with HIV for four or more years without knowing their HIV status and may be experiencing HIV-related illnesses.
In 2025, 33 per cent of diagnoses were considered late. The proportion of diagnoses that were late was highest among people reporting heterosexual contact. Over the past five years, 58 per cent of HIV diagnoses among heterosexual men and 46 per cent among heterosexual women were late, compared with one-third of diagnoses among gay and bisexual men.
Over the same period, late diagnoses were almost twice as common among gay and bisexual men born in Southeast Asia (49 per cent) compared with those born in Australia (23 per cent). Australian-born heterosexual women were the least likely group to receive a late diagnosis (22 per cent).
“Late HIV diagnoses are a major health concern, heightening risks to both individual health outcomes and community transmission,” Dr McGregor said.
“The proportion of late diagnoses among heterosexual people and gay and bisexual men born in Southeast Asia shows there are clear gaps in access to timely testing. We need sustained investment in a range of culturally appropriate and accessible testing options, ensuring programs meet the needs of communities.”
Late diagnoses concerning
“The proportion of late diagnoses among heterosexual people and gay and bisexual men born in Southeast Asia shows there are clear gaps in access to timely testing. We need sustained investment in a range of culturally appropriate and accessible testing options, ensuring programs meet the needs of communities.”
A pathway foward
Scott Harlum, President of the National Association of People with HIV Australia (NAPWHA), welcomed the latest findings but noted the research also shows there are clear areas where more work is needed.
“Over the course of the epidemic in Australia, people with HIV have, as a community, contributed greatly to the prevention effort and have been so successful in minimising onward transmission that we have been able to avoid a wider, more generalised epidemic.
“People with HIV must be supported to continue this amazing work, and that support must incorporate the tools they need to live healthy lives with a good quality of life.
“More must be done to reduce the number of people who are diagnosed late.
“We must eliminate the key risk period for overseas-born men who have sex with men who are new to Australia, which is the time between their arrival in the country and becoming connected to care. We cannot leave them to navigate HIV, distress and risk alone and without the support they need during that critical period.
“And we must close the gap that First Nations people face when accessing health services. That requires more and better-targeted testing, and affordable and accessible treatment, prevention and care for all parts of the community that need it, when they need it.”
Dash Heath-Paynter, CEO of Health Equity Matters, also highlighted the need for equitable testing opportunities across all parts of the community.
“These results show that when people get equitable access to testing, treatment and prevention tools, transmission falls. But they also show the need to bolster efforts among First Nations people, overseas-born gay and bisexual men, and those diagnosed late.
“Closing these gaps means expanding PrEP access and culturally safe testing so every community can benefit, not just the ones already best served. It also means continuing to resource Australia’s neighbours, Fiji and Papua New Guinea, to address the serious HIV outbreaks occurring in those settings.”
For Jessica Michaels, Deputy CEO of ASHM, the challenge lies not only in increasing testing among specific communities but also in addressing potential blind spots among healthcare professionals.
“HIV is a very manageable condition, but early diagnosis is critical in ensuring the best health outcomes for people living with HIV. These findings indicate that testing is not happening equally across demographics, meaning cases are slipping through.
“We need to ensure healthcare workers are not making assumptions about people’s risk factors and are consistently offering HIV testing,” Michaels said.
The phrase “The Last Mile” grew out of the telecommunications industry, where it was discovered that connecting individual properties to networks was the most challenging task.
In 2024 the Australian government launched the Ninth National HIV Strategy with Health Minister Mark Butler restating Australia’s commitment to eliminate blood borne viruses and sexually transmitted infections by 2030.
In the journey toward ending HIV, Australia is now looking down its own Last Mile — which is why we’ve adopted the phrase for this new series of reports exploring 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 help us reach the 2030 targets.
Contact
Graeme Watson
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graeme@outinperth.com
