Australia's response to HIV/AIDS has contained the local epidemic. Centres of HIV epidemiology, clinical, social and virology research have contributed greatly to the understanding of clinical, pathophysiological, treatment and behavioural aspects of HIV/AIDS in those living with, and at risk for, HIV. Also underpinning the success in fighting HIV/AIDS is a highly regulated, quality assured public/private pathology enterprise interacting with the biomedical industry, pharmaceutical industry innovators and international research groups. Features of the Australian response to HIV have been partnerships of stakeholders, including researchers and pathologists, which have led to a series of formal, bipartisan, National HIV/AIDS Strategy documents and implementation programs operating in a universal access to health care environment. Innovation, such as in politically difficult harm reduction models of prevention, have been adopted and the documented success of the Australian needle and syringe program (NSP), human rights based legislative frameworks and evidenced-based public health policy decision-making has demonstrated that HIV epidemics in intravenous drug use (IVDU) and heterosexual populations can be largely prevented. Recent increases in HIV transmission in gay men reflected in rising rates of new HIV diagnoses, demand innovative approaches in prevention, testing and treatment. Findings from the Australian experience have relevance to other jurisdictions embarking on national strategy development in the HIV/AIDS domain.