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I had sex with a guy and I was the top. I came inside him and the condom broke. Should I get PEP? This was anonymous sex and I don't know this man. How much does PEP cost?

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If the condom broke then there is a risk of contracting HIV. While the risk is greatest for the bottom, it is still high-risk for the top because if the bottom has HIV it can be highly concentrated in the lining of his ass which can then enter the tip of your penis.

PEP is free under certain circumstances, for example if you know that the person you were having sex with is HIV positive. If you aren't sure about his status then you may have to pay. In either case, we recommend visiting your local sexual health clinic or the emergency department of your nearest hospital as soon as possible to find out about your options. For PEP to be effective it needs to be started as soon as possible and no later than 72 hours after exposure to HIV.

I had sex with a prostitute (sex worker). She said she is healthy but I'm stressed. Can I get HIV?

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The rates of HIV among sex workers in New Zealand are very low compared to other countries. The risk of getting HIV from having unprotected oral sex with any person, including sex workers, is very low. It's also very low risk if you've had anal or vaginal sex with a condom. If you didn't use a condom for anal or vaginal sex then the risk is higher.

Why is unprotected anal sex more dangerous than unprotected vaginal sex?

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The inside of the rectum is like a sponge, absorbing nutrients into the bloodstream from food passing through, meaning it can also easily absorb HIV from semen. The cells of the vagina are much less absorbent and not as vulnerable to HIV. However it is still possible to contract HIV through unprotected vaginal sex.

How long does an HIV test take and when can I get the test results? I had sex without a condom a few weeks ago and I'm really worried.

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A rapid test for HIV at NZAF will give you results in just 20 minutes. Book a free and confidential test now.

Keep in mind evidence of HIV can be detected by some tests as early as 2 weeks after exposure, but it may take up to 3 months. Everyone responds differently to the virus.

Is an HIV test done through a GP 100% accurate? Is it the same as a rapid test that NZAF does?

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GPs do not offer rapid tests. They send people off to a lab and blood is taken there. People then have to wait a few days for results, but these tests are 100% accurate. Our rapid HIV tests are 100% sensitive to HIV, they are FDA approved and 98.9% specific to antibodies, and you will get your result in a few minutes. 

How much does HIV treatment cost? Does it cost more if you are not a citizen?

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HIV treatment in New Zealand is publicly funded and free, regardless of immigration status. However visits to a GP or other health professionals are likely to incur costs.  More information can be found on the Ministry of Health website https://www.health.govt.nz/new-zealand-health-system/eligibility-publicly-funded-health-services/guide-eligibility-publicly-funded-health-services

In NZ, people living with HIV need to be seen by an infectious diseases department or sexual health clinic to initiate medication, as only specialists are able to apply for a special authority for subsidised HIV medication. We advise people to continue to have medication prescribed by their specialist at regular appointments.

Can I apply for a visa to visit or live in New Zealand if I am living with HIV?

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Yes. People with HIV can apply for a visa, but that doesn’t guarantee they will be approved. Their health will be taken into account when assessing their visa application, as will the cost of their HIV treatment.  It is worth noting, however, that HIV is listed as a medical condition deemed to impose significant costs and/or demands on New Zealand's health and/or education services (read more), and therefore any visas approved will be done through a medical waiver process. 

 

I had sex with sex worker about a month ago, and I used a condom as protection. However I also realised that I had a small cut on my knee which was exposed to the bedding and her skin although there was no blood or any fluid contact on the cut. Now I have a bit of diarrhoea and feeling tired through this weekend not sure of why. With the situation I described, am I at risk for HIV?

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No. There would have been no risk of HIV infection as there was no bodily fluid contact and the HIV virus dies within minutes of being outside the human body anyway. You may have picked up a stomach bug in some other way or sometimes the stress of worrying about these things can cause us to feel unwell.

Last week I ended up in a massage parlor/brothel and had unprotected sex in the spa. The next day I found a small cut on the end of my penis. A week later I have pain at the end of my penis and a sore throat. I'm worried I have an STI or HIV. What should I do?

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Your risk of HIV or STI transmission is increased if you had a cut on the end of your penis during unprotected sex, particularly if it was raw or bleeding, as this could allow infected fluid to get into your bloodstream. It's impossible to say whether your symptoms are related without having a test, so we would encourage you to have a full STI screening and HIV test through your GP or nearest sexual health clinic. It's important to note that with HIV has a window period of up to three months and is detected in a test after this period.

Where in New Zealand can I get free condoms?

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Go here to see if we can send you some free condoms or where you can go to find some.

How risky is oral sex for HIV transmission?

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Extremely low. Risk only increases if there are open and bleeding cuts in the mouth. Read more about what sexual activities place you at risk of contracting HIV.

What’s the difference between HIV and AIDS?

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HIV stands for Human Immunodeficiency Virus and is a virus that attacks the immune system, killing off healthy immune system cells that normally fight off infection. HIV is transmitted through blood, semen, anal mucous, vaginal fluid and breast milk.

AIDS stands for Acquired Immune Deficiency Syndrome and is the term used to indicate complete deterioration and destruction of immune function - the final stage of HIV. People with HIV who are on consistent antiretroviral (ARV) treatment can expect to lead long and healthy lives and may never progress to AIDS.

How long can I expect to live if I contract HIV?

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Remember that an HIV diagnosis doesn’t have to stop you living a full and healthy life. With the right treatment and care, you can expect to live just as long as someone who doesn’t have HIV. HIV shouldn’t stop you doing the things you want to do in your life.

Is HIV present in pre-cum?

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Yes. It is possible for pre-cum to transmit HIV via unprotected anal sex. Transmission through pre-cum during unprotected oral sex is extremely low.

What are the chances of developing resistance to my HIV treatment?

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Antiretroviral Therapy uses three different types of drugs to fight HIV – targeting the virus at different stages of its life cycle. The risk of developing resistance to treatment is low as long as you are adherent and do not have a strain of HIV that is resistant to the treatment that you are on.

Resistance to treatment most often arises when the level of HIV treatment in your blood is not high enough to fully suppress the virus. This can happen if medication is not taken as prescribed resulting in a spike in viral load. When this happens, newly replicated viruses that have genes that make them resistant to treatment are selected to survive and continue to replicate. Another way of developing resistance is if you have unprotected sex or share needles with another person who has a resistant strain of HIV and is not undetectable. The strain of HIV that they have would have to be resistant to the treatment that you are on for it to be able to replicate in your body, even if you are taking your medication as prescribed.

What’s the difference between a CD4 count and viral load count?

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A viral load count is a measure of the number of HIV particles in your blood at a given point in time. Low and undetectable viral loads reduce your chance of passing HIV on. 

A CD4 count is a measure of the number of CD4 cells in the blood. HIV attacks these cells so they are no longer able to do their job fighting infection and therefore conversely to viral loads, the fewer CD4 cells a person has, the more susceptible they become to a wide range of infections. 

Can I still enjoy a drink while on treatment?

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Yes. Unlike many medications, HIV medications do not interact negatively with alcohol.

What’s the difference between PrEP and PEP?

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PrEP and PEP are both HIV medications taken by people who do not have HIV. 

PrEP (Pre-Exposure Prophylaxis) is an HIV medication for people who are HIV negative - taken to reduce the risk of acquiring HIV by up to 99%.

PEP (Post-Exposure Prophylaxis) is a medication given to people who may have been exposed to HIV. Although PEP is not foolproof, if taken within 72 hours of being exposed to HIV, it is likely to reduce the chances of contracting HIV. For PEP to be most effective, it needs to be taken as soon as possible after an episode of unprotected anal sex.

Should I be worried about the toxicity levels found in HIV treatments?

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Treatments for HIV these days are far less toxic than they once were and side effects much less of a concern. There are some side effects associated with treatment that will be experienced differently by different people. Managing any side effects that do arise is something your HIV specialist will help you with. The research now shows that the benefits of being on treatment, and preferably as early as possible, far outweigh any issues related to toxicity. If you are worried about this, talk to your HIV specialist.

Do I still have to disclose my HIV-positive status even if my viral load is undetectable?

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New Zealand law requires people living with HIV to take ‘reasonable precautions’ to avoid passing on HIV. The only case to ever come before the courts in New Zealand was for vaginal intercourse. It found that condoms are needed to be used as a precaution. That means that legally, if you are not using condoms during penetrative sex, you must disclose your HIV status. There has not been a case in New Zealand to test whether an undetectable viral load would be considered ‘reasonable precaution’.

How long does it take to get to undetectable?

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Everyone responds uniquely to treatment. If you have been on treatment for 6 months or more, and you are taking your medication as prescribed, you have a good chance of significantly reducing your viral load. However, the exact amount of time it takes to get to undetectable will be different for everyone. Not everyone will be able to obtain an undetectable viral load.

If my viral load is undetectable, can I stop taking my meds?

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No. Remaining on treatment is key to keeping your viral load under control and stopping the HIV virus from replicating. If you stop taking your medication even for a week or two, you give HIV the opportunity to replicate more quickly, increasing your viral load and the risk of developing resistance to your treatment.

Is it possible to become undetectable if I am not on meds?

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By far the majority of people need HIV medication to get their viral load down and keep it there.  A very small percentage of people living with HIV have successfully managed their viral load without medication. This group, referred to as ‘elite controllers’, are estimated to make up less than half of 1% of all people living with HIV.

Once the viral load is undetectable, does it stay that way forever?

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No. Viral loads can go up and down. Small blips are not uncommon even if you are taking your medication as prescribed. Regular monitoring of your HIV viral load is an important part of your treatment regimen.

If I do start HIV treatment and can’t tolerate it, can I stop?

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There are a range of treatment options, so if you are experiencing issues it is very likely that there will be another treatment that is better for you. This is something you will want to discuss with your HIV specialist. Always keep in mind that not adhering to your treatment carries the risk of developing resistance to certain HIV drugs – meaning your treatment options may be reduced. Any changes to medication need to be managed carefully under the guidance of your specialist.

Does having an STI impact on viral load?

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Being undetectable does not protect you or your partner(s) from other STIs and if an HIV-negative person has an STI they are at higher risk of getting HIV. There is also evidence that STIs can increase the viral load of someone living with HIV who is not on treatment. However, the presence of an STI does not increase the possibility of transmission if the HIV-positive person is on effective antiretroviral therapy.

What are the signs/symptoms of having HIV?

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Not everyone who gets HIV will experience any short-term symptoms. So, symptoms or not, it's important to test twice a year - or more often if you haven't been playing safe.  In some people, symptoms may occur from two to four weeks after HIV infection and may include flu-like symptoms that are easily confused with other infections, such as fatigue, fever, night sweats, sore throat, swollen lymph nodes, headache, loss of appetite or skin rash. These symptoms usually last less than two weeks although they can last as long as 10 weeks. If you‘ve recently had unprotected anal sex and experience any of these symptoms, you should have an HIV test with NZAF, your emergency room, GP or sexual health service.

Also, keep in mind that not all doctors will recognise the symptoms of HIV. If you see a doctor because you have one of the symptoms listed above, it’s important to explain that you feel at risk of HIV and ask to be tested, even if they don't suggest it. Don't assume you will be tested for HIV just because they take your blood. Ask to be sent a copy of the results.

How long does it take for PrEP to be effective?

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If you're using daily PrEP to provide protection during anal sex, you need to take it daily for 7 days prior to any sex without condoms to ensure that the levels of the drug have built up to provide enough protection.  You also need to continue taking it daily for 28 days following the last episode of anal sex without condoms for maximum protection.

Cisgender gay and bisexual guys can also start it with a double dose (two pills at once, and continue with single pill every 24 hours), and the protective effect should kick in after two hours. If you keep having sex then keep taking a PrEP pill each day. After you’re done having sex, keep taking a pill each for two days after the last episode of sex.  

Can you contract HIV from kissing?

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No. Kissing on the mouth is extremely low risk for HIV transmission; The only time it would be possible is if both people had open wounds in their mouths that were bleeding and kissed for a long, long time.

What type of condom is inside the free condom packs that you provide?

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The condoms in our free condom and lube packs are Gold Knight 56mm ultra thin as well as a lube. We also have Moment 49 mm narrow fit condoms and Shield XL 60mm for a larger fit.

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