Persson Asha, Brown Graham, McDonald Ann, Körner Henrike
AIDS Educ Prev. 2014 Jun;26(3):245-55. doi: 10.1521/aeap.2014.26.3.245.
In Australia, unlike much of the rest of the world, HIV transmission through heterosexual contact remains a relatively rare occurrence. In consequence, HIV-prevention efforts have been firmly focused on male-to-male sex as the most frequent source of HIV transmission. There are emerging signs that this epidemiological landscape may be shifting, which raises questions about current and future HIV prevention strategies. Over the past decade, national surveillance data have shown an increase in HIV notifications for which exposure to HIV was attributed to heterosexual contact. This paper offers an epidemiological and sociocultural picture of heterosexual HIV transmission in Australia. We outline recent trends in heterosexually acquired HIV and discuss specific factors that shape transmission and prevention among people at risk of HIV infection through heterosexual contact. To illustrate the contextual dynamics surrounding HIV in this diverse population, we detail two key examples: HIV among people from minority ethnic backgrounds in New South Wales; and overseas-acquired HIV among men in Western Australia. We argue that, despite their differences, there are significant commonalities across groups at risk of HIV infection through heterosexual contact, which not only provide opportunities for HIV prevention, but also call for a rethink of the dominant HIV response in Australia.
在澳大利亚，与世界其他大部分地区不同，通过异性接触传播艾滋病毒的情况仍然相对罕见。因此，预防艾滋病毒的工作一直坚定地聚焦于男男性行为，将其视为艾滋病毒传播最常见的源头。有新迹象表明，这种流行病学格局可能正在发生变化，这引发了关于当前及未来艾滋病毒预防策略的问题。在过去十年中，国家监测数据显示，因异性接触感染艾滋病毒而被通报的病例有所增加。本文呈现了澳大利亚异性传播艾滋病毒的流行病学和社会文化情况。我们概述了异性感染艾滋病毒的近期趋势，并讨论了影响通过异性接触感染艾滋病毒风险人群传播和预防的具体因素。为了说明这个多样化人群中围绕艾滋病毒的背景动态，我们详细介绍两个关键例子：新南威尔士州少数族裔背景人群中的艾滋病毒情况；以及西澳大利亚州男性中境外感染的艾滋病毒情况。我们认为，尽管存在差异，但通过异性接触感染艾滋病毒风险人群之间存在显著的共性，这不仅为艾滋病毒预防提供了机会，也要求重新思考澳大利亚占主导地位的艾滋病毒应对措施。
