World AIDS Day 2024 wrap up: moving forward together

LPV President, Craig Brennan has used his annual World AIDS Day address this year to call for a continued collective attention to drive meaningful change in advocacy, awareness treatments and community building. To an auditorium of politicians, scientists, journalists, community leaders and people living with HIV from all walks of life, Craig expressed his views on the most pressing issues and concerns facing the the HIV sector, and all PLHIV today. Here is his speech.

A few years ago—more than I’d like to admit—I was working in Silicon Valley. At a tech conference, the theme was boldly proclaimed: “Change Begins with Me.” It was everywhere—on posters , programs, even squishy stress balls. I bought into the ethos of digital disruption and innovation. The idea that one person’s effort could ignite incredible change resonated with me; I saw it all round me everyday.

Over those years, I saw how individual creativity could spark advancements that transformed industries and connected communities. Startups would emerge from a single idea; a frustrated students garage passion project could grow into a global platform. But over time, I came to realize something deeper: no matter how brilliant an individual’s idea is, lasting change only happens when we come together.

Those years, That lesson, shaped how I think about change. This idea, that transformation begins with one person but only thrives through collective effort, has become a cornerstone of how I work and I endeavor to lead.

Fast forward to today and this year’s Australian theme for World AIDS Day: “It Starts With Me.” At first look, it feels familiar—a call to action, a reminder of personal responsibility. But as someone living with HIV, I have to admit that slogans like these feel… incomplete.

As a positive person; Our lives, our history, our struggles—they didn’t just “start” today and certainly not with just me. The progress we’ve made has been decades in the making, forged through resilience, advocacy, and collective action. And while individual effort is vital, it has always been the power of communities uniting that has driven meaningful change.

Our History of Collective Action

I hope I don’t have to remind anyone, positive people have been here since the beginning of this fight—fighting not just for ourselves but for each other. The achievements of the HIV response weren’t born out of isolation. They were built by people coming together, pooling our courage, strength, and determination to create something bigger than ourselves.

Since the beginning

We’ve been advocating for our rights, challenging discriminatory laws, and pushing for the legal protections that ensure dignity and equality.
We’ve promoted awareness, sharing our stories to educate others, to reduce stigma, and dispel harmful myths.
We’ve advanced treatment, participating in research and clinical trials, literally being experimented on to support the medical advancements that have transformed what it means to live with HIV.
And we’ve built community—created support networks, fostered safe spaces, and connected people across Australia and beyond.

These accomplishments didn’t happen because of one person’s actions. They happened because of us—all of us—working together.

Moving Forward Together

Today, Australia’s HIV response stands as a testament to the power of collaboration—a community-led effort that unites governments, healthcare professionals, researchers, organizations, and individuals. While we’ve made extraordinary progress, we know there is still so much more to do.

In 2024, we cannot afford to rest. Embracing this year’s theme means recognizing that we are part of a collective movement, one that must continue to rise to meet new and evolving challenges:

We face new Financial Constraints: Cuts are already taking place. To achieve the bold goals we’ve set for ourselves, we must continue to demonstrate value in everything we do and amplify the innovative initiatives developed within our organisations and partnerships.
We need to Reach Beyond Traditional Approaches: A one-size-fits-all approach isn’t effective in 2024. We need to innovate, developing culturally sensitive strategies to reach diverse and marginalised populations; and we need those communities lead the way.
Supporting Marginalised Communities: We must ensure that multicultural communities, Indigenous peoples, women, transgender individuals, and others who don’t fit the predominant narrative are not left behind.
Educational Institutions’ Duty of Care: Im an very grateful to be here at RMIT today, I get to say this in context. With the epidemic gaining ground among international students, educational institutions have a responsibility to provide up-to-date information about HIV and sexual health, to all your students, in their own languages. You have the resources and opportunity to make a significant difference in the response by keeping your students well-informed and safe.

With this understanding, let’s delve deeper into the just 4 of the issues and concerns that I believe need our collective attention:

Aging with HIV
Law Reform and Criminalisation of People Living with HIV
Emergence of Virtual Elimination
Stigma in healthcare settings

Aging with HIV: Preparing for the Future

By 2030, the majority of people living with HIV in Australia will be over 50. This demographic shift brings with it a host of unique challenges that demand our immediate attention. While living with HIV was once considered a short-term prognosis, advancements in treatment now mean that many of us are living long and fulfilling lives. However, the reality is that aging with HIV is not the same as aging without it, and our systems are not yet fully prepared for what this means.

Aging with HIV presents a complex interplay between the natural aging process and the long-term effects of antiretroviral therapy. We are experiencing earlier onset of comorbidities—cardiovascular disease, diabetes, osteoporosis, and more (fun fact I have all of these)— so I speak from personal experience when I say they require specialised and integrated care. This is why we need gerontologists, the experts in aging, to become specialists in HIV as well. Recent conversations I’ve had at the ASHM Conference in Sydney highlighted that this shift is crucial. Gerontologists need to understand the specific healthcare needs of older people living with HIV so they can provide the best care possible as we make a broader healthcare care needs transition.

Mental health is a growing concern for older people living with HIV. Many of us are facing the compounded stigma of both HIV and aging. Social isolation is all too common, especially for those of us who have lost loved ones or who never expected to live into older age. The need for social support, mental health services, and community connection has never been greater. Without these systems in place, the emotional toll of aging with HIV can be overwhelming.

Our aged care support structure must also adapt. Many aged care facilities and home care services are unprepared to meet the needs of older people living with HIV. Too often, aged care workers lack the training or understanding needed to provide appropriate care without stigma or discrimination. At Living Positive Victoria we hear denial of service cases all too often – borne out of stigma and bigotry. In 2024 this is beyond unacceptable.

We need to ensure that the healthcare and aged care workforce are educated and prepared to support us with dignity and respect. At the same time, we must protect our right to privacy, as many older people living with HIV still rightfully fear disclosure.

Financial security is another pressing issue. Due to years of health challenges or career interruptions, many older people living with HIV face financial instability. This is exacerbated by the fact that some of us didn’t have the chance to plan for retirement due to the uncertain prognosis in earlier decades. Affordable housing, social security, and financial support services will be key to ensuring that older people living with HIV are not left vulnerable.

Aging with HIV demands coordinated action from governments, healthcare providers, and community organisations. While individual efforts are important, systemic change is needed to ensure that we live not only longer lives but healthier and more secure ones.

Law Reform and Criminalisation: Breaking Down Barriers

Outdated laws continue to unjustly target and stigmatise people living with HIV (PLHIV), despite the medical advancements that have transformed how we manage the virus.

One of the most glaring examples is the criminalisation of spitting. In states like New South Wales (NSW) and South Australia (SA), spitting is still treated as a potential mode of HIV transmission under assault laws. This is despite the clear scientific consensus that HIV cannot be transmitted through saliva. These laws are relics from a time of fear and misunderstanding, and they fuel stigma by implying that casual contact with PLHIV poses a threat, that we are inherently dangerous. We Are Not.

Another concerning example is recent changes to consent laws in Victoria. Let me be clear here – I fully support the broader intention here. Affirmative consent is essential! “Stealthing” is deplorable.

However, these laws extend to require PLHIV to disclose our status to sexual partners—even if we are undetectable and pose zero risk of transmission. The science is crystal clear: Undetectable = Untransmittable (U=U). When someone living with HIV is on effective treatment and has an undetectable viral load, we cannot transmit the virus to others. Forcing us to disclose our status despite this fact not only undermines scientific evidence but also violates our right to privacy and autonomy.

This legal requirement assumes that we are inherently dangerous, regardless of our medical reality, and punishes us for something that science tells us is irrelevant. By framing non-disclosure as a crime, the law invites discrimination and stigmatisation, treating us as criminals rather than individuals managing a health condition responsibly.

After living in the United States as long as I did I hold the right to privacy as sacrosanct. I believe this is especially true for people living with HIV. We should not be forced to disclose our status when there is no transmission risk. This law does nothing to protect public health; instead, it exposes us to unnecessary legal risks and social rejection.

The fight for law reform is essential. As science evolves, so too must the laws that govern how we live with HIV. Criminalisation laws based on outdated science and fear must be challenged and reformed. We need a legal system that reflects the realities of HIV in 2024—a system that respects our rights and dignity, rather than perpetuating fear-based discrimination.

Virtual Elimination: Unveiling the Reality

The concept of “virtual elimination” of HIV might look promising on paper, a headline-grabbing achievement that governments and organisations can proudly declare. And while the progress we’ve made toward reducing new transmissions is commendable, I believe it’s important to take a hard look at what “virtual elimination” actually means—and who it’s leaving behind.

Virtual elimination refers to reducing new HIV transmissions to a negligible number within a specific population. But here’s the issue: selective statistics mask the realities of marginalised communities that continue to experience HIV at disproportionately high rates. We cannot claim victory based on success in privileged demographics while others remain vulnerable and underserved.

In Australia, we’ve seen incredible strides in HIV prevention, particularly among well-resourced populations such as urban, predominantly white, cisgender gay men. But HIV doesn’t discriminate, and neither should our response. Communities that don’t fit this mould—multicultural populations, Indigenous peoples, heterosexual men and women, transgender individuals—continue to face significant barriers in accessing care and prevention. These populations are often sidelined in discussions of “virtual elimination.”

Take, for instance, multicultural communities. Many individuals from these backgrounds face language barriers, limited access to healthcare, and fear of legal repercussions due to discriminatory immigration policies. Without culturally tailored outreach and support, their needs remain unmet. The statistics may show that overall rates of transmission are declining. But for many migrants, the epidemic is far from over.

Similarly, virtual elimination as a goal often overlooks the realities faced by Indigenous communities. Structural inequalities, lack of access to healthcare, and historical injustices continue to disproportionately impact their health outcomes. For Indigenous peoples, HIV is intertwined with broader systemic issues like poverty, housing instability, and lack of culturally safe services. Declaring we’ve “virtual eliminated” HIV in Paddington, while in neighbouring suburbs Indigenous communities are left grappling with these challenges feels, at best, disingenuous.

The emerging narrative risks erasing the experiences of women, particularly women of colour and transgender women, who often encounter gender-based violence, economic inequality, and social stigmas that increase their vulnerability to HIV. Their stories are frequently lost amid our self-congratulations around HIV prevention, even though they continue to be at risk.

To genuinely move toward ending HIV, we must be brutally honest with ourselves: “virtual elimination” isn’t enough if it doesn’t include everyone. We must ensure that the populations most at risk are not left behind as we declare progress in more privileged demographics. Our response must be inclusive and equitable, reflecting the full scope of the epidemic, not just the most convenient statistics.

Stigma in health care settings

Stigma in healthcare settings remains one of the most persistent and damaging barriers for people living with HIV. One in three people living with HIV in Australia report experiencing stigma in health care settings. For many of us, seeking care is fraught with fear—not just of judgment but of experiencing direct discrimination. A careless remark, a moment of hesitation, or even subtle changes in body language can carry the weight of stigma, leaving us feeling dehumanized, unwelcome, or unsafe.

As attending clinician worked though my information we discussed allergies – no problem, family history – no problem, being cautious of interactions with all the medication I take – little condescending but ok. As we got to the immune system compromised section – she looked me dead in the eyes and said, “Hmm; You look well.” I know no harm was intended, but wow. Was there some expectation that I shouldn’t look well? Was my health being silently judged? I responded with – ‘ooohh thank you” while on the inside I was raging. Though small, that remark put me on edge, making me hyper-aware of my status in a setting where I should have felt supported and safe.

I acknowledge that my experience was relatively minor compared to what others have faced. I’ve never been denied services, though I know people who have. I’ve never felt unsafe, though I know people who have. I’ve never been made to feel diminished or unworthy, though I know people who have. I recognize that I’ve been fortunate.

These experiences, big or small, intentional or not, erode trust in healthcare systems. Worse, they can discourage people living with HIV from seeking care altogether, out of fear of being mistreated or having their privacy violated. Breaches of confidentiality—whether through mishandled medical records or casual gossip—compound this stigma, leaving many of us feeling like our dignity and autonomy are not being respected.

If we are serious about creating a future where no one is left behind, healthcare settings must become stigma-free environments. Achieving this requires more than good intentions—it demands education and action. Healthcare providers must receive comprehensive training that reflects the realities of living with HIV today, debunks harmful myths, and empowers them to provide care that is compassionate, informed, and judgment-free. Every interaction matters, and every patient deserves to feel seen as a whole person—not defined by their HIV status.

At Living Positive Victoria, we’ve taken concrete steps to promote this kind of change. This year, in partnership with Bolton Clark to launch a set of resources designed to guide healthcare providers in creating positive interactions with people living with HIV. These materials focus not on what not to do but on what good care looks like—from affirming communication to respecting privacy and fostering trust. This proactive approach shifts the focus to dignity, respect, and partnership, ensuring that every patient interaction becomes an opportunity to strengthen trust and deliver meaningful care.

By embracing these tools and principles, we can transform healthcare into a safe and empowering space for people living with HIV. Together, we can ensure that stigma has no place in the care we receive.

Personal reflections

As we come to the close of our time together this morning, I’d like to share a personal reflection. When I’m not here advocating or volunteering with Living Positive Victoria, I spend my days working to bring high-speed fibre connections to communities across Australia. At first glance, helping build the nation’s broadband network and advocating for equity for people living with HIV might seem worlds apart. But to me, they share a common mission: building bridges that empower people and foster connection.

In both roles, collaboration and engagement are at the heart of what I do. Just as our broadband network relies on countless individuals working together to keep Australia connected, our collective efforts as a community are what drive meaningful change in the fight against HIV. It’s through these united actions—whether in advocacy, healthcare, or community building—that we find the strength to transform lives.

Today, after delving into just a small handful of the mountain of complexities and inequities surrounding HIV, I want to leave you with a sense of hope. Whether through technology or human connection, our ability to collaborate and create networks of support is what opens doors to education, healthcare, and opportunities for everyone—including the most marginalized among us. Change can begin with you.

This year for World AIDS Day, I invite you to reflect on how you can build bridges in your own lives. How can you contribute to collective efforts that strengthen not only those living with HIV but all members of our collective response?

Let’s turn isolation into inclusion and inequity into opportunity. By harnessing the power of our connections—technological and human—we will create a future where everyone has the chance to thrive.