Australia's public health response to HIV and HCV: a role for ‘affected’ communities

This paper identifies a number of the key elements that underpinned the success of Australia's public health response to minimizing the spread of HIV. It is argued that one major factor was the high level of collaboration between health care professionals and “affected” communities, such as injecting drug users, sex industry workers and gay men. This collaboration allowed for the negotiation, development and implementation of the range of innovative HIV initiatives that were ultimately responsible for keeping HIV in the injecting drug use and sex industry to low levels. Despite the central role played by injecting drug users and their peer based organizations, the significance of their activities has gone largely unacknowledged by senior health bureaucrats and politicians. As a consequence, advice from injecting drug users and their peer‐based organizations on the current hepatitis C epidemic has been largely ignored. Instead of learning from Australia's HIV experience and involving these groups in consultation and advisory roles, the Federal Government has reverted to accepting advice from only established mainstream organizations. It is argued that the success of infection control outside mainstream communities, such as among injecting drug users, can most effectively be achieved through the involvement of these “affected” communities. There is a need at the local, national and international levels to ensure both the involvement of “affected” communities and that recognition is given to them for the significant and essential role they play in infection control.