More than a decade after ART became widely available in Australia, people living with HIV (PLHIV) who are diagnosed and have initiated treatment are surviving longer and staying healthier than in the past. However, morbidity and mortality are still high among PLHIV, particularly among those who are not treated with ART. It is estimated that up to 30 to 40 per cent of PLHIV in Australia are not receiving ART. There is general consensus regarding commencing treatment for asymptomatic, previously untreated patients before the CD4 cell count drops below 350 cells/mm3. However, the exact point at which to commence ART is subject to continuous debate and review, along with emerging evidence of the risk-benefit ratio of earlier ART initiation (specifically at CD4 counts of 500 cells/mm3 or at diagnosis).

This study consists of multiple components, including desk research and review of data regarding the number and proportion of PLHIV currently on ART and statistical modelling to gauge the impact of changes in uptake and point of initiation of ART. The study also includes qualitative and quantitative research to assess views regarding the uptake and initiation of ART among PLHIV not currently on ART and ART prescribers. To date, a first online survey of ART prescribers’ attitudes towards, and practices of, ART prescription has been completed and a resulting paper is in press with a peer-reviewed journal. Group discussions have been undertaken with community treatment officers, and PLHIV not currently on ART are being interviewed; recruitment remains open for new participants.