title: HIV diagnoses in Australia: diverging epidemics within a low-prevalence country.
abstract: OBJECTIVE
  To describe recent trends in the diagnosis of HIV infection in Australia.
  
  
  METHODS
  Analysis of national surveillance system data for 1993-2006.
  
  
  METHODS
  Number and population rate of new HIV diagnoses by year, exposure route and demographic characteristics.
  
  
  RESULTS
  Between 1993 and 2006, 12 313 new diagnoses of HIV infection were reported in Australia. From 1993 to 1999, the annual number of diagnoses declined by 32% from 1056 to 718, and then increased by 31% from 763 in 2000 to 998 in 2006. Between 2000 and 2006, diagnosis rates significantly increased in Victoria, Queensland, South Australia and Western Australia. The most frequent route of HIV exposure was male-to-male sex, accounting for 70% of diagnoses. Heterosexual contact accounted for 18% of cases, with just over half of these people born in or having a sexual partner from a high-prevalence country. Exposure by injecting drug use remained infrequent.
  
  
  CONCLUSIONS
  The number of HIV diagnoses has risen in the past 7 years, but not in New South Wales, which has long had the highest rates. The differences in rates between states/territories are likely to be due to divergent trends in sexual risk behaviour in men having male-to-male sex, which remains the predominant route of HIV transmission in Australia. There is a need for effective, innovative and evidence-based programs for HIV prevention, particularly among men having male-to-male sex.
authors.affiliation: Centre for Epidemiology and Population Health Research, Burnet Institute, Melbourne, Victoria, Australia.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Guy
authors.forename: Ann M
authors.initials: AM
authors.lastname: McDonald
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Bartlett
authors.forename: Jo C
authors.initials: JC
authors.lastname: Murray
authors.forename: Carolien M
authors.initials: CM
authors.lastname: Giele
authors.forename: Therese M
authors.initials: TM
authors.lastname: Davey
authors.forename: Ranil D
authors.initials: RD
authors.lastname: Appuhamy
authors.forename: Peter
authors.initials: P
authors.lastname: Knibbs
authors.forename: David
authors.initials: D
authors.lastname: Coleman
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Hellard
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Grulich
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications