The Australian HIV Observational Database Temporary Residents Access Study (ATRAS): Two year follow up

Researchers from the Kirby Institute and the National Association of People with HIV Australia (NAPWHA) have released a second round of results from the first study in Australia to collect information on HIV positive patients who are not eligible for Medicare.

 
The main objectives of ATRAS are to provide systematically collected information on visa status and HIV related information for a subgroup of HIV positive patients who are ineligible for antiretroviral treatment via Medicare. The study provides antiretroviral treatment to 180 HIV-positive people who are temporary residents in Australia and therefore not eligible for Medicare.
 
Key findings:

  • After one and two years of follow-up in ATRAS the proportion with an undetectable viral load had increased to 89% (one year follow-up) and 94% (two-years of follow-up) from 47% at enrolment.
  • By July 2014 with an average of two years of follow-up, 79 patients no longer required ART support via ATRAS. The majority (N=60; 76%) of these patients had become eligible for Medicare.
  • ARTAS supplied ART will cease in November 2015, at which time it is estimated that at least 61 of the 180 patients will still be Medicare ineligible.
  • There are an estimated 464 HIV-positive temporary residents in care over the past year who are ineligible for Medicare. 101 of these are in ATRAS.
  • Mathematical modelling suggests providing ART successfully to all Medicare ineligibles would avert a median of 81 new infections over 5 years.
  • While the total discounted costs for treatment of all HIV positive temporary residents of five years is median $26,354,092, the total savings in lifetime discounted treatments costs for the 81 new HIV infections averted is median $29, 411,170.

Stakeholder quotes

Australia’s response to HIV is guided by a new National HIV/AIDS Strategy, which has set a bold target to achieve the virtual elimination of new HIV infections in Australia by 2020.  To achieve this target we need to ensure that all people have access to HIV testing, treatment and prevention services, no matter which State or Territory they live in.

Being on HIV treatment has proven health benefits and also greatly reduces the risk of transmitting HIV to others.  HIV treatment is cost effective in terms of averting new HIV infections and other health costs.

The findings of the ATRAS study reinforce the need for a truly national approach to offering HIV treatment to all people living with HIV in Australia who aren’t eligible for Medicare.

 We cannot ignore vulnerable groups at risk because our success in eliminating new HIV infections hinges on leaving no group behind.  NAPWHA calls on all States and Territories and the Commonwealth government to work together to achieve a nationally consistent approach to providing HIV treatment to people living in Australia who aren’t able to access Medicare.  - Aaron Cogle, Executive Director, NAPWHA

 

Media Inquiries:

Lucienne Bamford
Communications Officer

The Kirby Institute, UNSW Australia

lbamford@kirby.unsw.edu.au

(02) 9385 0550

Date published: 
Tuesday, 31 March 2015

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