Fighting AIDS - a community response

When AIDS was first diagnosed in Australia in 1982, the initial public reaction was one of fear and ignorance. But a Monash researcher says Australia's overall response to the disease prevented the full-blown epidemic that was experienced in many other parts of the world. DIANE SQUIRES reports.

It was among the most graphic television images of the 1980s. Footage of the Grim Reaper in a bowling alley knocking down men, women and children shocked thousands of Australians and sent out a clear message - AIDS does not discriminate.

The advertisement was part of a broader campaign aimed at scaring the Australian community into taking action to prevent HIV/AIDS from spreading. The result was a drop in the number of new HIV infections from 2500 a year in the mid-1980s to fewer than 500 a year less than a decade later.

Dr Paul Sendziuk, a postdoctoral fellow in Monash's School of Historical Studies, has spent the past six years charting the history of HIV/AIDS in Australia and believes it is the country's pragmatic and innovative response that helped limit the spread.

Dr Paul Sendziuk

Indeed, Australia's approach is frequently cited by the World Health Organisation as a model for other countries to emulate.

"The public's anxiety about AIDS was manifested in persecution against homosexuals," Dr Sendziuk says. "During the first months of the first reported case of AIDS in Australia, a Sydney dentist banned homosexual patients and numerous gay men were evicted from their homes or denied accommodation."

In an attempt to limit the spread of AIDS, some community groups called for mandatory testing of high-risk groups such as homosexuals, injecting drug users and prostitutes, the quarantining of infected individuals and the screening of the entire population for HIV antibodies.

However, the state and federal governments took a different approach, bringing together medical experts and representatives of the communities most affected by AIDS.

The result was an approach to AIDS prevention that, at the time, was unlike any other country - it relied on community participation and education.

By the end of 1987, the state and federal governments were funding campaigns emphasising the need for safe sex, prime-time television was airing advertisements for condoms, sex and AIDS education courses were introduced in secondary schools, and needle and syringe exchange outlets had been established in most states.

"Instead of saying to kids 'don't have sex', we effectively said 'we'd rather you didn't have sex, but if you are going to here are some condoms'," Dr Sendziuk says. "The syringe program was an acknowledgement that while we didn't want people using drugs, we didn't want them getting AIDS either.

"In effect, Australia was one of only a few countries in the world to seriously invest in harm minimisation programs and empower the communities most at risk to care for themselves." Dr Sendziuk says his research, which will be published in a book, titled Learning To Trust, in October, has implications for future health programs and public policy.

"It provides a historical example for the continued debate about harm minimisation and community empowerment models of health programs," he says. "It justifies a community empowerment approach as a response to public policy. For instance, we could use this approach to help our Indigenous communities. It also raises an argument for safe injecting rooms and prescription heroin."

Dr Sendziuk is now taking his research further to consider what individuals and organisations can do to improve health outcomes within the community.

Action: For more information, contact Dr Paul Sendziuk on +61 3 9905 2179 or email paul.sendziuk@arts.monash.edu.au.