A new report has provided insight into how Australia might close the gap in late HIV diagnoses, a key challenge that must be addressed if the country hopes to achieve its goal of virtually eliminating new HIV transmissions by 2030.
Figures released this week show that Australia still faces gaps in HIV prevention. While the latest data from the Kirby Institute indicate that Australia has met key global HIV testing and treatment targets, experts warn that progress is not being experienced equally across all communities.
To achieve Australia’s 2030 target, HIV diagnoses would need to fall by 90 per cent compared with 2010 levels, equating to approximately 90 new cases nationally each year. In 2025, there were 753 HIV diagnoses.
One area identified by health experts as particularly challenging is reaching people who do not test regularly and only discover they are living with HIV years after infection.
An HIV diagnosis is considered late when a person may have been living with HIV for four or more years without knowing their status and may already be experiencing HIV-related illness. In 2025, 33 per cent of diagnoses were classified as late.
The Newly Positive study, conducted by the Australian Research Centre in Sex, Health and Society (ARCSHS), found that many participants had interacted with the healthcare system before their diagnosis, but HIV testing was either not offered or warning signs were missed.
The study interviewed 51 people who had been diagnosed with HIV within the previous 12 months, along with 15 physicians providing HIV care.
Barriers to diagnosis included low HIV awareness among women and heterosexual men, uncertainty about access to HIV prevention and testing services among migrants, and missed opportunities by clinicians to recognise symptoms of early HIV infection.
Lead researcher Dr Dean Murphy said the findings showed Australia must strengthen testing and prevention efforts if it is to achieve its goal of eliminating HIV transmission by 2030.
“Australia’s HIV treatment system is working exceptionally well once people are diagnosed, but this research shows too many people are still falling through the cracks before they reach care,” Dr Murphy said.
“We heard from people who experienced symptoms consistent with early HIV infection but were not tested. Others delayed seeking a test because they didn’t know where to go, assumed services would be expensive, or worried about the impact a diagnosis might have on their visa status.”
The study found that women and heterosexual men generally had lower awareness of HIV and less experience with routine HIV testing.
Some women reported regular sexual health screening that did not include HIV testing, while other participants described missed opportunities for diagnosis after presenting to healthcare providers with symptoms consistent with HIV seroconversion illness.
Researchers also found that recently arrived migrants often struggled to find information about HIV and navigate Australia’s healthcare system. Participants reported lower awareness of preventative healthcare options, including PrEP, and some delayed testing because they were concerned about how a positive diagnosis might affect their immigration or residency status.
The report recommends new education programs for migrants about HIV testing and treatment, as well as encouraging doctors and healthcare workers to make HIV testing a routine part of sexual health check-ups.
Brent Clifton, Deputy Director of the National Association of People With HIV Australia (NAPWHA), said the findings confirmed what organisations in the sector have long understood about the importance of accessible testing.
“These findings confirm what our community has long known: early treatment, an undetectable viral load and strong peer support all contribute to a good quality of life for people with HIV. They’re also a reminder that stigma persists and that testing needs to stay easy and accessible,” Clifton said.
Researchers reported that once participants were diagnosed and started treatment, often within days, they quickly achieved an undetectable viral load. Most described treatment as highly effective, easy to manage and life-changing.
“Many participants spoke about the relief of achieving an undetectable viral load and learning they could live long, healthy lives and could not pass HIV on to sexual partners.
“The challenge now is making sure everyone who could benefit from testing, prevention and care is able to access those services early,” Dr Murphy 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
Co-editor
graeme@outinperth.com
