'You couldn't full enjoy sex'AIDS epidemic 'over'
It's a monumental victory almost 20 years in the making: the AIDS epidemic is over, Australia's AIDS and HIV experts announced on Sunday. 
The spread of the fearsome infection has become gradually less ferocious over the last 20 years with the introduction of antiretrovirals and rigorous awareness campaigns. 
Sunday's announcement was not triggered by some AIDS counter ticking back to pre-epidemic proportions. 
"There's no magic number or threshold for measuring this," said Head of HIV Epidemiology and Prevention Program at the UNSW Kirby Institute, Professor Andrew Grulich.
"We just don't see much AIDS in Australia anymore. We've seen less visibility among gay men [a high risk group] for a very long time." 
Long gone are the days of the grim reaper TV ads of the mid 1980s. In the early 90s roughly 1000 Australians died of AIDS each year.
Almost two decades after effective treatments - including antiretrovirals - were introduced the number of AIDS cases has fallen dramatically. 
Australia's HIV rate is 20 per cent less than the US. Hospitals no longer have or need dedicated HIV wings, and the virus is far from a death sentence.
But shedding its 'epidemic' tag doesn't mean the feared infection can't still kill.
Australia's AIDS experts chose their words carefully when they announced an end to the epidemic on Sunday. 
AIDS may no longer fit the epidemic definition: a rapid increase in the number of cases of a disease above what is normally expected. But this was not a signal for complacency.
"Yes, AIDS as a public health threat is over that's certainly not the case for HIV in Australia," Professor Grulich said. 
HIV diagnoses has risen by 13 per cent in the last decade, national data shows. 
Mostly because people are living longer with HIV than they used to thanks to antiretroviral and improved HIV-targeted healthcare. 
"People still die of AIDS. It can't be ignored at a societal or individual level," Professor Grulich said. 
While new diagnoses of AIDS are uncommon in Australia, 150 people present with very advanced immunodeficiency per year because they have not been tested and identified early, Professor Grulich said. 
"We still see serious AIDS-related lymphoma developing in people with advanced immunodeficiency and they die of that cancer," he said. 
The past 10 years has also seen a rise in unsafe sex, Professor Grulich said. 
"When you don't have the ever present threat of a deadly disease hanging over you as was the case for gay men in the early 90s then of course behaviour will change," he said. 
"The reality is that you won't take as many steps to protect yourself.
"We need to ensure that all people who might have had a risk episode be tested. It's critical to make sure they don't suffer unnecessary illness. 
"Our treatments are so good that most people recover. You get tested early, you get good treatment and people can lead a pretty normal life."
The price of our success is investment in prevention, in community organisations, research, surveillance, which are a cost but are hugely cost effective, he said. 
It's a success that stems from a public health system that offers free access to GPs, free testing at sexual health clinics and community based testing for gay men. 
Improving access to the pre-exposure prophylaxis drug Truvada was the next crucial step to eradicating new HIV infections among gay men, Professor Grulich said.