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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.

I understand access to free or subsidised HIV treatment is only available to New Zealand citizens or Australian citizens living in New Zealand. Are NZ residency holders (not citizens) are eligible for access to free or subsidised HIV treatment as well?

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NZAF is not immigration specialists and we strongly advise you discuss your circumstances with an immigration expert.

All visa applications are on a case by case basis, so be honest in all correspondence with Immigration NZ. We suggest you contact Immigration to clarify your queries about healthcare funding.

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.

For more information visit the Immigration Service website.

I received a job opportunity from New Zealand but I'm living with HIV in Brazil. I would like to know if New Zealand provides HIV treatment for people who have work visas.

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People travelling to New Zealand on a work visa can access HIV treatment in New Zealand but it will not be funded by Pharmac. Depending on the drug combination the cost, unfunded, would be at least $1000 per month.

NZAF advises people to bring enough medication for the first three months. During that time NZAF can put them in contact with a hospital near where they are working so they can have blood tests. People are also advised to arrange for medication to be sent from their country of origin, so they do not have to pay for it here.

There can sometimes be delays when importing medication into the country, but Body Positive can help, possibly even supplying medication if there is an initial problem. It is also useful for people to bring a letter from their specialist.

 

Pharmac will only fund HIV treatment for New Zealand residents. It would be difficult for a person living with HIV to gain residency status in New Zealand unless they were in a relationship with a New Zealand citizen or had refugee status.

 

NZAF is not a licensed immigration advisor and you should seek advice from a licensed immigration advisor before making any decisions.

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

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Immigration New Zealand does not have specific policies on HIV as it is a part of their over-all health policy. 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.  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).

Here is a link to INZ's health requirements leaflet and health policy for residence and temporary visa application:

Generic health information can be found on the Immigration New Zealand's website.

I had sex with this girl, her vagina was wet but we both don't have wounds. I bathed shortly after sex, can I get HIV?

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Yes you can. HIV lives in vaginal fluids and there does not need to be wounds present for you to get infected. Using condoms for vaginal sex is the best way of protecting yourself from HIV. If you did not wear a condom, I advise you to get tested for HIV through your GP, sexual health centre or via the NZ AIDS Foundation which offer free rapid tests for HIV (you get your test results within 20 mins).

I had sex with sex worker about month ago, and I did use condom as protection the all time. 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 diarrhea and feeling tired through this weekend not sure of why. With situation I described, I am worried if I am at high risk?

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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 upset in some other way or sometimes the stress of worrying about these things can cause us to feel unwell.

How long does it take after the exposure to HIV for the symptoms to start showing? And what are the symptoms. I have had protected sex (used condom while getting a blowjob as well as sex) with a sex worker three days ago and now have a major cold and running nose, no temperature but mild headaches, I am worried...

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Hi there, the time it takes for the symptoms of HIV to be exposed is completely variable - some people experience symptoms a few weeks after being infected while others can go years without HIV being detected in their body. What we can say is that in the situation you've described, there is very little chance that you have contracted HIV. Wearing a condom is the best form of protection during sexual intercourse, and oral sex presents a low risk for HIV transmission. You've taken the right precautions and the New Zealand Prostitutes Collective also ensures high standards of health for sex workers in New Zealand, so it is very unlikely that the symptoms you have are indicative of HIV.

Last week I ended up in a massage parlor/brothel in Napier. I ended up having unprotected sex in the spa with one of the girls working there. 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 STD or HIV. What should I do? I'm now back in Australia. Should I be worried?

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Hi there, your risk of HIV or STI transmission is increased if your had a cut in the end of your penis during unprotected sex, particularly if it was raw or bleeding, as this could allow infected vaginal 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 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 with NZAF or a home test will give you results in just 20 minutes. Book a free and confidential test now. A test with a GP or sexual health centre may take up to 7 days.

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 and you should get tested.

I was wondering, I gave Oral sex to a person I don't really know, and pre cum came into my mouth, I did spit it out straight away, and he finished himself off with his hand. How much risk would I be in of catching HIV?

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The risk of HIV transmission via oral sex is extremely low. There is an enzyme in saliva that acts as a natural defense to HIV. The risk of transmission would only increase if HIV infected semen carrying a high viral load came into contact with open or bleeding cuts in your mouth.

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 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. 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. 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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Definitely not. 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 load 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 there is evidence that 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.

How long after the last time I have brushed and flossed my teeth would it be safe to have oral sex?

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The risk of transmitting HIV through oral sex is extremely low even with brushing/flossing, but common advice is that you should wait at least four hours after flossing. If you're worried about flossing then don't do it that day - just use mouthwash.

This only applies for HIV though, transmission of other STIs (eg syphilis and gonorrhoea) can still be passed on through oral sex. If you're concerned, you could use a condom for oral sex. There is also some evidence that gargling with Listerine can prevent gonorrhoea.

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 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.

How much does having an undetectable viral load reduce the risk of passing on HIV?

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People living with HIV who are on anti-retroviral treatment and maintain an undetectable viral load for at least six months do not sexually transmit HIV. Research of gay and bisexual men who are living with HIV and have an undetectable viral load, and their HIV-negative partners in the Opposites Attract Study reported no cases of HIV transmission in almost 17,000 reported acts of anal intercourse without a condom. While someone may have received an undetectable result on their last test, factors such as skipping doses of HIV medicine can cause their viral load to spike.

It's also important to know that the majority of HIV is passed on by people who don't yet know that they have it, so you can't assume or expect that all guys with HIV are on treatment and have an undetectable viral load.

How can I live a long life, even I have HIV? Is there any medicine that can stop the reproduction of virus in our veins or kill the virus? If so, where can I purchase this medicine? And is it expensive?

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There is no vaccine or cure for HIV, but there are numerous HIV treatment options available. Treatment for HIV is currently provided by highly active anti-viral therapy (HAART). These medications attack the virus at different points and stages in its life-cycle. A list of antiretrovirals can be found here (please note that not all meds listed are available or funded in NZ). In New Zealand, HIV medications need to be prescribed by a doctor, and the most common medications are free (funded by Pharmac). The first thing you should do is get a free HIV test by clicking on the link below. If the test is positive, you will be offered free counselling and support services, as well as referred to the appropriate doctor for treatment.

Can you contract HIV from kissing?

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Kissing on the mouth is extremely low risk for HIV transmission: the only time it would be possible if both people had open wounds in their mouths that were bleeding and kissed for a long, long time.

I do not understand how so many men have HIV, but no serious symptoms.

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Many people living with HIV continue to look and feel well throughout their lifetime. They may not even be aware that they are living with the virus. However, many HIV positive people do eventually develop different infections and cancers that the body would otherwise normally be able to fight.

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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