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Legislative Assembly for the ACT: 1998 Week 4 Hansard (25 June) . . Page.. 1108 ..

MR MOORE (continuing):

Finally, the ACT Government is committed to supporting harm minimisation principles underpinning all sexual health and blood-borne disease strategies. The concept of harm minimisation in the area of drug use means we should strive to minimise the actual and potential harms associated with alcohol and other drug use, not just aim to eliminate use. Similarly, this strategy aims to support a healthy society by approaching the complex area of sexual and blood-borne diseases in a rational, tolerant, non-judgmental and humanitarian way. It is an approach based on the empowerment of those whose health is at greatest risk. This strategy aims both to prevent and to minimise the harm caused through these diseases, which are the subject of much misunderstanding and fear.

As I mentioned, this strategic plan moves beyond the third national strategy on HIV/AIDS to establish a more integrated approach between strategies to address HIV/AIDS and HCV. Although this plan takes a broad sexual health and blood-borne diseases approach, it is recognised that HIV/AIDS and HCV are the appropriate primary focus for this plan because of the significant long-term impacts of these infections on the people and communities affected by them. The two epidemics are at very different stages. HIV has been recognised as a major public health problem since the early 1980s, and the new infection rate has plateaued due to promotion and adoption of safe sex practices. HCV has been seen as a significant public health risk since the late 1980s, but the infection rate, especially among intravenous drug users, continues to climb. Despite these differences, some strategies that have been useful in addressing HIV/AIDS can be usefully applied to HCV. The value of an integrated approach to these conditions applies particularly to prevention and education, as some target populations are more likely to behave in ways that put them at risk of contracting both HIV and HCV.

As of 30 September 1997 it was estimated there were 208 people living with HIV in the ACT, of which 38 have been diagnosed as having AIDS. There were eight new notifications of HIV in the ACT between September 1996 and September 1997. HCV was first reported as a virus in 1989. Since then 1,554 notifications of HCV have been recorded in the ACT. There are about 300 cases of HCV notified in the ACT each year. The true prevalence of HCV in the ACT is likely to be much higher. It is now the most commonly notified infectious disease in the ACT. The majority of notifications are in the 21 to 30 age group. There is no vaccine available for the virus. The effects of hepatitis C vary considerably. Around 80 per cent of people who are infected will have long-term illness. Up to 25 per cent of those infected will have serious liver damage after 20 years, and half of these will progress to liver failure or liver cancer after five to 10 years.

As members may be aware, the ACT has established a comprehensive response to the HIV/AIDS epidemic and more recently has begun to address the consequences of the HCV epidemic. The ACT provides a wide range of HIV/AIDS services through community-based organisations as well as through the hospital system and primary health care services provided by GPs. Many of the services provide all levels of service to identify it as crucial to overall management of HIV. Others may operate on only one or two of the levels but have in place referral and information sharing systems to facilitate seamless service provision to consumers.

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