Comparisons of trends in antiretroviral use and HIV notification rates between three Australian states.

Objective: Notification rates for HIV among men who have sex with men (MSM) have been increasing, but this increase has not been uniform across States and Territories. This paper aims to determine whether differences in the levels of antiretroviral therapy (ART) were associated with differences in HIV notification rates between Australian States.

Methods: An ecological analysis of HIV notification and S100 drug prescribing data between 1998 and 2005.

Main Results: HIV notification rates in 2005 per 100 individuals living with HIV were lowest in New South Wales (NSW) (4.5) and higher in Victoria (6.9) and Queensland (7.8). The proportion of individuals receiving ART in 2005 was lowest in NSW (40%) and higher in Victoria (60%) and Queensland (60%). There has been a significant decline in the proportion of individuals living with HIV receiving effective ART per year in NSW (p < 0.01) and Queensland (p < 0.01), but an increase in Victoria (p < 0.01).

Conclusion: Those States with the highest HIV notifications per 100 individuals living with HIV did not have the lowest proportion of individuals receiving ART.

Implications: These data indicate that the differences in HIV notifications between States do not appear to be due to differences in ART. However, changes in ART over time in some States may be contributing to the rise in HIV notifications.