In 2019, 212 people were first known to be infected with HIV in New Zealand. While this as an increase on the previous two years - locally acquired HIV continues to decrease.
The latest HIV numbers out of the University of Otago AIDS Epidemiology Group may appear at first glance to be a disheartening increase in cases. However, continued decline among cases acquired in New Zealand suggests we remain on a path to ending local HIV transmission.
A total of 212 cases were notified for 2019 – an increase from the 185 reported in 2018 and 201 in 2017. However, the number of locally acquired infections, especially among men who have sex with men (MSM), has continued to decrease.
In 2019, 58 MSM were diagnosed with HIV and thought to have contracted the virus in New Zealand, a 6.5% decrease from 2018 numbers.
So, while the 2019 data is rather complex, the insight we can draw from this local transmission number is encouraging. We believe this means we are seeing the continued impact of local HIV prevention and HIV testing efforts – which is great news.
We once again have a sign that we are starting to halt the epidemic.
With a larger proportion of 2019’s HIV notifications being for people previously diagnosed overseas, there is a responsibility to counter any xenophobic sentiment in response to the data.
While we will definitely need to look into why more people are acquiring HIV overseas – this is no reason to entertain any prejudice about those coming to our shores. In New Zealand anyone living with HIV can access free HIV treatment and will not pose a transmission risk here.
With Kiwis’ heightened awareness of public health in light of COVID-19, it is more important than ever for all New Zealanders to understand HIV prevention and the realities of HIV stigma for Aotearoa to continue to be a world leader in infectious disease response.
Currently, around 3500 people in New Zealand are estimated to be living with HIV.
Overall, New Zealand has a relatively low prevalence of HIV by international standards. This is largely due to the consistent promotion, since 1987, of condom and lube use for anal sex between men. A robust legislative environment based on a strong human rights approach is also a key reason for this. However, the number of gay and bisexual men infected in New Zealand steadily rose between 2011 and 2016. 2019 saw the third year of decreasing numbers of MSM thought to have been both diagnosed and infected in New Zealand.
Gay, Bisexual and Other Men Who Have Sex With Men
Of the 212 new HIV notifications in New Zealand in 2019, 141 were gay, bisexual and other men who have sex with men (GBM).
In 2019, 86 were first diagnosed in New Zealand and 55 had previously been diagnosed overseas. The number of MSM infected locally has continued to decline after the peak in 2016 (n=98) with a sharp decrease to 70 in 2017, then less of a decline to 62 in 2018, and 58 in 2019.
While gay and bisexual men account for only approximately 2.5% of New Zealand's population, they are consistently over-represented in HIV diagnoses. There are three clear reasons for this.
Heterosexual Men & Women
In 2019, there were 37 people found to be heterosexually infected with HIV.
Of these 37, 27 were first diagnosed in New Zealand which is an increase from the number of those heterosexually infected individuals diagnosed in New Zealand in 2018. Although, only 13 were thought to have been infected in New Zealand.
Among the heterosexually infected individuals in New Zealand in 2019, half had a CD4 count at the time of diagnosis that was indicative of relatively recent infection.
While it appears that the number of heterosexual men and women infected in New Zealand has increased in 2019, the number each year is very small and is therefore subject to year-by-year fluctuations.
People who inject drugs
Low numbers of people who inject drugs (PWID) and the successful operation of an effective national needle exchange programme since 1988 has meant that PWID account for very few HIV infections in New Zealand. Similarly, the widespread adoption of condom use among New Zealand sex workers has resulted in a low rate of HIV transmission in the New Zealand sex industry. Widespread pregnancy screening and effective treatment for pregnant women means that the transmission of HIV from mothers to babies is at very low levels. These results are considered highly successful worldwide.
Direct blood to blood transmission is no longer a regular occurrence in New Zealand due to the work of the Needle Exchange Programme across the country. Only three people became infected with HIV as a result of injecting drug use in 2019 - but two of those infections occured overseas.
It is widely acknowledged that there are very few sex workers in New Zealand with HIV. In fact, the latest published data in 2006 recorded there were no HIV infections among the study sample of more than 300 workers.
This is due, in large, to the work of the New Zealand Prostitutes Collective (NZPC). In operation since 1987, the NZPC is a nationwide community advocacy group focused on providing equal rights and safe working conditions for sex workers.
Mother to Child
Between 1998-2019, there were 181 births to women known to be HIV infected prior to delivery in New Zealand. None of these children have been infected with HIV. However, the AIDS Epi-Group says, for children born more recently in 2019 it is too soon to be sure about this as acquired HIV cannot be definitively ruled out until a child is over one year old.
In 2019, there were three women diagnosed with HIV through antenatal testing.