Dr Jason Ong is a sexual health physician, epidemiologist, and health economist. He joins Radiotherapy to discuss the unintended consequences of migration policies impacting Australia's goal to end the HIV epidemic by 2030. He says that some people living with HIV are choosing cheaper, suboptimal treatment out of fear that their applications for permanent residency will be rejected because their medical spending must not total more than $51,000 over 10 years. This requirement is known as the Significant Cost Threshold and is designed to screen out applicants who might pose extra costs to Australia’s health system.

Australia is a world leader in the HIV response in terms of bringing down transmission rates as well as the viral load in sufferers, and is very close to reaching its elimination goals but this final barrier may prevent people from testing and/or choosing cheaper drugs.

Dr Ong emphasises how people living with HIV, when able to access treatment, are often highly functional and able to live long and productive lives and be valuable members of society. Lobbying efforts aim to see that threshold changed or better yet, have HIV removed from the list altogether, such as New Zealand who removed HIV from its migration evaluation list in 2021.