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During the mid-1980s Australia experienced a remarkable decline in

HIV incidence that can rightly be considered a public health milestone of global

importance. The effects of this decline lasted for about 20 years and greatly

benefited all Australians. In contrast, as we enter the mid-2000s, we see the global

epidemic continues to intensify, HIV vaccines remain a distant possibility, and

Australia is experiencing rising HIV incidence again. Clearly, better understanding

of HIV prevention has important implications both for Australia and the world.

Therefore, we believe, it is timely to revisit Australian experiences of the mid-1980s

in order to understand those early events better.

To gauge the influence (if any) of government strategies, funding levels and other

events during a period of dramatic decline in HIV transmission, incidence figures

are mapped against Federal HIV/AIDS funding patterns and the occurrence of key

national interventions and events. The analysis reveals that the greatest decline in

HIV preceded almost all substantive initiatives undertaken at the national level,

which are often held responsible for Australia’s successful early containment of

HIV. In particular, dramatic declines were already well advanced and/or preceded

(i) substantive growth in national HIV/AIDS prevention education funding, (ii)

publication of the first National AIDS Strategy, (iii) establishment of key national

HIV/AIDS bodies and (iv) promulgation of the ‘Ottawa Charter’. Explanations for,

and lessons learned from Australia’s dramatic early declines in HIV incidence are

discussed.