Questions in Category: HIV & AIDS
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?
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 iformation 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.
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?
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?
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?
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...
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.
How does risk of HIV infection compare between oral sex and bare-backing a person having no detectable virus? If undetectable = 30-50 copies/ml (from a US website), what is an average loading for saliva?
Thanks for your query. The question addresses some complex issues so we’ve asked our senior researcher Peter Saxton to provide a response below. We’re also assuming that your question relates to anal sex between males; if this isn’t the case please let us know since HIV transmission risk is heavily influenced by the type of sex occurring e.g. anal sex vs vaginal sex.
Your question has several parts to it so take them one at a time.
First of all, from your posting it looks like you’re aware that oral sex is considered low risk for HIV. In fact, receptive oral sex is estimated to have a per-episode risk of HIV transmission of approximately 1 in 10,000, a risk that has been determined in NZ courts to not present a “significant risk” of HIV transmission. The reasons for this are important to clarify. Mainly, this is because the mouth does not contain high concentrations of cells that are vulnerable to HIV infection, nor does it contain many cells that harbour HIV virus. Also, saliva possesses protective qualities that help keep viruses and bacteria out of the body, in ways that anal mucus doesn’t. This is an important difference that explains why receptive oral sex is so much less risky than receptive anal sex as far as HIV is concerned – if someone ejaculates HIV infected semen into an anus, the risks for the HIV negative receptive man are far greater than if HIV infected semen is ejaculated into a mouth. The normally very low risk of oral sex is of course increased if the body’s immune system in the mouth is compromised, for example if you have bleeding gums, have recently had dental work, or if you have an ulcer. Even then, the risk from anal sex is still greater.
Second, unprotected anal sex is the most efficient way of sexually acquiring HIV. Again, the reason is due to the different biology of the anus. The anus has a very high concentration of cells that are both vulnerable to HIV infection, and which also harbour HIV virus. Sexually transmitted infections (STIs) such as syphilis, herpes, gonorrhoea and anal warts that are present in the anus can substantially heighten the risk of HIV acquisition and transmission, and many of these infections may go unnoticed and/or unchecked. In addition, a person with HIV is much more infectious in the early stages of infection, and when they have other STIs in addition to HIV (which may or may not be noticed/treated). Due to these issues and other biological and genetic factors, although the per contact risk of HIV transmission for unprotected receptive anal sex with an HIV positive man has recently been estimated at 1 in 70 episodes (and presents a “significant risk” of transmission in NZ law), in that study 12 of the 46 men who contracted HIV had experienced fewer than 10 episodes of unprotected receptive anal sex. It is still not well understood why some men become infected very quickly, and for others it takes many episodes. The probability of HIV transmission through unprotected anal sex can therefore be described as both high and variable. Receptive anal sex is also more risky than insertive anal sex, but both carry considerable transmission risks. Condoms effectively reduce this high biological risk by physically interrupting the way HIV is transmitted in the anus. By reducing the per contact risk to “below significant”, a condom also removes any legal risk (i.e. a man who knows he has HIV cannot be prosecuted for having anal sex if a condom is used).
Thirdly, you asked what effect an undetectable viral load might have on transmission risks. Four things are important to emphasise here:
(a) the term “undetectable” merely describes the limits of the viral load tests currently available. HIV is still present, albeit at levels that are below what the current test can detect. The phrase “undetectable” is increasingly being replaced with “low viral load” in order to more accurately communicate that HIV is not absent.
(b) viral load tests are only conducted a few times a year, and in between tests HIV levels can increase (“blip”) for different reasons – sometimes because the HIV positive individual is fighting off another infection (e.g. a cold or an STI) , sometimes for reasons unknown.
(c) standard viral load tests measure the quantity of HIV in blood, to help inform HIV treatment practices. However, it does not measure the quantity of HIV levels in semen, or in anal mucus, which are the main body fluids implicated in sexual practices. This is important because HIV levels in semen and in the anal mucus can differ from those measured in blood, meaning that a recent low blood viral load result may not mean that a person has low HIV viral load in semen or anal mucus. Unfortunately for gay and bisexual men, very little research has investigated HIV viral load in anal mucus, so it is difficult to say precisely in what ways it is different to HIV in semen or blood.
(d) while lower blood HIV viral loads can mean that a person is less infectious than someone with higher blood HIV viral loads, there is therefore mounting evidence that the last blood viral load test may not be a good indicator of current sexual infectiousness. Individuals with low blood viral load at their last test have transmitted HIV to sexual partners, even when that person has been adherent to HIV treatments, and in the absence of STIs.
For these reasons, it is still possible to contract HIV through unprotected anal sex with an HIV positive individual who has had a recent “undetectable” blood viral load test. For a one-off sexual encounter, the risk would be very difficult to quantify, because of the many variables at play – both known and unknown to both partners. Our practical recommendation is therefore to regard all unprotected anal sex as riskier than other sexual practices. It is also important to emphasise that condoms work very well to prevent HIV transmission through anal sex, and help protect both partner’s health in many other ways, while at the same time enabling partners to continue to enjoy having anal sex.
A short review of HIV treatment as prevention been published online which you might also find useful.
We hope this was helpful and answered your concerns, please let us know if you’d like to discuss this more.
I had protected anal sex with a guy who did not know his HIV status; he did not cum at all and he was wearing a condom whilst inside me. He put lube on his penis with his hands before he inserted it. I gave him a blowjob with the condom on and a handjob, he still did not ejaculate. The condom did not break, he gave me an unprotected hand job and I came. His lips touched my penis for a second but I pulled away. What is the risk of me being exposed to HIV ?
Hi. There is absolutely zero risk of contracting HIV in the situation you've described. HIV cannot be passed on through skin to skin contact ie: from his hands or lips touching your penis. HIV can only be sexually transmitted via unprotected anal or vaginal sex or through blood to blood contact. You have absolutely nothing to worry about here.