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The story of HTLV-1 in Australia has been complicated by the extreme remoteness of many of the newly identified high-prevalence communities, and in the early investigations, the lack of ethical consent given in primary language to test samples for HTLV-1, the Australian experience tells us that HTLV-1 infections can become highly entrenched in communities that have preserved practices that allow an opportunity for HTLV-1 transmission.