WA’s highly mobile population is being blamed for increased rates of HIV infection in the state over the past decade.
The number of West Australians diagnosed with HIV has more than doubled in 10 years, with 119 new cases reported last year, slightly down from a high of 121 the previous year.
Speaking at the HIV and Mobile Populations conference in Perth, acting director general of the Health Department, Bryan Stokes, said the rising infection rate was partly because of the mobile nature of the WA population.
This included travel to South-East Asia for business and pleasure, the prevalence of fly-in, fly-out workers (FIFO), the high number of people coming to the state to live and work, and the scattered nature of rural and remote towns.
“This increase in HIV notifications was in part attributable to a rise in the number of overseas-acquired HIV infections,” Dr Stokes told the conference.
“Between 2009 and 2013, most overseas cases acquired their infection in sub-Saharan Africa.
“The vast majority – that is 88 per cent – of people who acquired HIV there were born in the region, while about half of the people who acquired HIV in South-East Asia were born there, and about 35 per cent were Australian-born.”
Dr Stokes said WA’s pattern of HIV infection was more complicated than those of other states.
“Western Australia has possibly one of the most complex and rapidly changing HIV epidemiology of all Australian jurisdictions,” he said.
“How we respond to HIV is confounded by issues such as distance as well as equity of access to treatment and care for people living in regional and remote areas of Western Australia.”
Resource boom significant factor in HIV rates
Senior research fellow at the Australian research Centre for Sex, Health and Society Graham Brown said WA’s resource boom was a significant contributing factor.
“HIV and issues of mobility became more evident in WA in the lead up to and during the resource boom,” he said.
“When the community has a resource boom, there is more money and there is more travel generally.”
However, he said it was not all about FIFO workers.
“There’s probably an over-emphasis on fly-in, fly-out workers who are part of the resources boom but they’re not the driving force,” he said.
“But there are a number of Western Australians working on a fly-in, fly out basis for a range of industries, not only resources, who may now be living in Thailand or Indonesia and flying in and out of there.”
Dr Brown said those contracting HIV overseas were usually older, more experienced travellers who did not consider themselves at risk.
“The epidemiology indicates that most of the West Australians flying abroad and contracting HIV are not young, inexperienced backpackers,” he said.
“They’re actually people who travel a lot and feel very comfortable in those countries.”
Gay, heterosexual infection rates equal in WA
He said rates of infection were about the same among gay men as among heterosexuals.
“On the east coast, about 65-70 per cent of new infections are men who have sex with men. In Western Australia it’s more like about 50 per cent,” he said.
Dr Brown said mobility was fast becoming an issue in HIV rates in other states, and WA was well placed to take the lead in developing a national strategy to reduce infections resulting from mobility.
“WA has a strong opportunity to play a leading role in a national response to this issue,” he said.
“What we need is evidence based programs and policies – not a return to the old-style 18th century control-the-borders approach.”
Manager of the Health Department’s Sexual Health and Blood-borne virus program Lisa Bastian said heterosexual men and migrants with HIV were likely to have been diagnosed late.
She said the department was working on a range of strategies to increase awareness among vulnerable groups, including theatre about HIV aimed at young people in African communities.