HOW SYDNEY BEAT BACK HIV

David llder on the control approach

In the 1990s, Sydney’s “Golden Mile” of Oxford Street was anything but, as sickness and pain swept the streets.

The inner-city suburb of Darlinghurst had emerged as a vibrant hub for the gay community. Then HIV hit, and soon the area was the epicentre of a devastating outbreak that, at its peak, claimed roughly 1000 lives a year in Australia.

“It was horrendous,” says David Elder, who was a palliative care nurse. “You’d be walking down the Golden Mile – from the Unicorn Hotel at Paddington down Oxford Street to the Exchange Hotel – and there’d be very, very sickly people everywhere.

“HIV seemed to be everywhere you looked, but it felt like there was nothing you could do about it.”

Yet 30 years later, the area has made progress few could have imagined at the height of the brutal epidemic: transmission of HIV has been “virtually eliminated”, say researchers, making it a blueprint for cities across the globe.

Between 2010 and 2022, new diagnoses plunged by 88 per cent in inner-city neighbourhoods once ravaged by the virus, according to analysis of national surveillance data by the University of New South Wales’ Kirby Institute. Last year, just 11 new cases were recorded.

Of the world’s most infamous HIV hotspots, only Amsterdam has reported similar declines in transmission, says Professor Andrew Grulich, an HIV epidemiologist who conducted the research.

“In the mid-’90s, HIV was a death sentence … and there was so much pessimism for decades that we would never be able to turn the situation around in places like Sydney, London, San Francisco, New York,” he says.