HIV Epidemic in NZ: Rise in infections for gay men a serious concern

Gay and bisexual men and other men who have sex with men (MSM) continue to be the most affected group. Of the 217 newly reported diagnoses, 136 (63%) were MSM. Eighty-six (86) of these men were infected in New Zealand compared to 69 in 2013.

“This is the third year in a row that the number of gay and bisexual men infected with HIV has increased which is seriously concerning,” says Shaun Robinson, Executive Director, New Zealand AIDS Foundation (NZAF). “While it is too early to know if this is a long term trend it confirms the need for increased HIV prevention awareness in the community and ramp up prevention action.”

The government invests $4.2 million per annum and the New Zealand AIDS Foundation provides an integrated package of HIV prevention activity focused on promoting condom use and HIV testing and treatment; particularly for men who have sex with men.

HIV prevention has been very successful in New Zealand and we continue to have a prevalence rate amongst MSM that is one of the lowest in the world at 6.5%. This is less than half that of Australia where MSM HIV prevalence is 14% (it is 24% in San Francisco and close to 20% in London).

“2014s results need to be seen in this overall context, but it is essential that we take the rising number of infections seriously” said Mr. Robinson.

The increase in new infections in 2014 is likely the result of a range of factors:

• Some gay and bisexual men are simply not responding to the messages to use condoms and lubricant. While 80% of gay men are high condom users, 20% are not. They may have concluded that HIV is not something to worry about or that they can tell who is infectious and who is not. Sadly this has led to new infections of HIV which remains an incurable disease.

• HIV testing numbers across New Zealand have been increasing and have nearly doubled in 10 years. This is likely to be diagnosing some of the 20% of MSM who have HIV but do not know it. If the number of undiagnosed cases is reduced this is a good thing. While these men may have been infected some years ago these infections will be showing in the statistics in the year in which they were diagnosed. Once diagnosed, people with HIV can take medication that both improves their health and dramatically reduces their ability to pass on the virus.

• New migrant populations are coming to New Zealand in increasing numbers and many have different levels of understanding of sexuality and HIV/AIDS. These changes are demonstrated by the number of Asian MSM being diagnosed with HIV (13% in 2014).

• Nearly 1 in 6 of the MSM who contracted HIV in 2014 was infected overseas where efforts to promote condom use have been far less effective.

• If diagnosed early people with HIV now live a full life span, thanks to modern treatment. This is a major improvement on the situation in the 1980s and 1990s. It also means that there is pressure on the prevention of HIV as there are more people each year that can potentially pass on the virus to someone else.

“NZAF is very focused on the 2014 epidemiology results. We are determined to improve on New Zealand’s good record in HIV prevention and not to let it go backwards,” said Mr. Robinson.

NZAF will be ramping up prevention efforts in the following ways:

• The promotion of condoms is being taken to even more sophisticated levels to target the 20% of MSM who do not use them regularly.

• HIV testing is being promoted more extensively in a wide variety of settings so as to reduce the rate of undiagnosed and late diagnosed HIV. Reducing stigma associated with HIV which will encourage testing.

• Early access to HIV treatment is being advocated for people with the virus so as to capture the benefits of their reduced infectivity a well as the health benefits for the person. PHARMAC will be lobbied to fund the removal of the CD4 threshold to access treatments

• NZAF is stepping up its work with specific cultural communities to gain their support and understanding in combating HIV.

• PrEP, the use of HIV medications by people who do not have the virus, is being explored for people are at high risk of infection and who resist condoms use.