HIV in New Zealand
In 2018, 178 people were diagnosed with HIV in New Zealand. This is the second drop in HIV transmissions since 2011.
Consistent with previous findings, sexual transmission accounts for the vast majority of new HIV diagnoses in New Zealand. Gay and bisexual men remain the population group most at risk of HIV. There has been a sharp increase in HIV transmission in New Zealand over the last few years.
Of the 197 diagnoses in 2017, 128 were amongst gay, bisexual and other men who have sex with men, two of which were infected either through sex with another man or injecting drug use. Of these, 101 were first diagnosed in New Zealand and 27 had previously been diagnosed overseas. The number diagnosed in New Zealand in 2017 is lower when compared to 164 gay, bisexual and men who have sex with men diagnosed in New Zealand in 2016.
24 people (12 men and 12 women) were infected through heterosexual contact in 2017. Of these, 17 were first diagnosed in New Zealand. HIV diagnoses among heterosexual people have remained relatively stable in New Zealand since 2010, the numbers much smaller than those among of gay, bi and other men who have sex with men.
Of the total 197 diagnoses, the remaining 36 were infected by other or unknown means.
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 strong human rights approach is also a key reason for this. However, the number of gay and bisexual men infected in New Zealand has been rising steadily since 2011. 2017 has seen the first drop in total number diagnosed. This could signal modern prevention strategies such as Pre-Exposure Prophylaxis (PrEP) and Undetectable Viral Load (UVL) are contributing to the overall reduction, alongside with the condom culture that NZAF has carefully cultivated over the years.
A low number of people who inject drugs (PWID) and the successful operation of an effective national needle exchange programme since 1988 have 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.
Gay & Bisexual Men
Of the 197 people infected with HIV in New Zealand in 2017, 128 were gay and bisexual men.
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.
Annual HIV diagnoses in gay, bisexual and other men who have sex with men (MSM) New Zealand 1985-2017 (Red line)
In 2017, most gay and bisexual men diagnosed with HIV were of European ethnicity. The proportion of those who were of Asian ethnicity has increased over time, reflecting a change in New Zealand’s ethnic diversity.
In 2017 new diagnoses are predominantly amongst gay and bisexual men who are under 40 compared to 2016 when they were evenly spread across all age groups.
Of the gay and bisexual men diagnosed and infected in New Zealand in 2014-2017, the average annual number with a high initial CD4 count (an indication of a recently acquired infection) was 40, higher than the annual average of 24 for the period 2010-2013. This persistent increase in diagnosis of recent infections, along with the increase in total diagnoses suggests a true rise in incidence in recent years. This is a reflection of more new infections occurring among this group.
Research conducted by Otago University in 2011 measured undiagnosed HIV among Auckland’s gay and bisexual men. Of the men who took part and were living with HIV, 1 in 5 (21 per cent) did not know they had it. The study estimated that 1 in 15 (6.5 %) of gay and bisexual men in Auckland are living with HIV.
Heterosexual Men & Women
Of the 197 people infected with HIV in New Zealand in 2017, 24 were heterosexual men and women.
The annual number of heterosexual men and women infected in New Zealand has risen gradually since the mid-1990s, and for the last several years has remained just a little under the number infected overseas, although still much smaller than the number of gay and bisexual men.
Annual HIV diagnoses in heterosexual men and women in New Zealand 1985-2017 (Blue line)
HIV diagnoses among heterosexual people infected overseas increased sharply from 2002 to 2006. This corresponds to a large increase in immigrants and refugees between 2002 and 2004 from countries with a high prevalence of HIV. During this period, HIV screening was not a compulsory part of the immigration process in New Zealand. Heterosexual diagnoses began to decline from 2007 due to immigration policy changes in late 2005 which introduced mandatory HIV testing for residency applicants and people applying for visas for longer than 12 months.
Among all heterosexual men and women diagnosed with HIV in New Zealand, Africans remained the only ethnicity over-represented until 2015. In 2017, Asians too are over-represented with 42% of diagnoses among the Asian heterosexual population.
People Who Inject Drugs
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 one person became infected with HIV as a result of injecting drug use in 2017. Injecting Drug Use (IDU) is a cause for concern amongst this population group.
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
In 2016, no child was diagnosed with HIV infection through mother-to-child transmission in New Zealand. Since 2007, there have been no children with perinatally-acquired HIV born in New Zealand. However, as diagnosis may be delayed for many years, there may be children living with undiagnosed infection born since or even earlier.
There were two pregnant women diagnosed with HIV through antenatal testing in 2016. As the majority of pregnant women are now tested, this shows a very low prevalence among such women.
The AIDS Epidemiology Group (AEG) is based in the Department of Preventive and Social Medicine at the University of Otago. Since 1989 it has been responsible for national surveillance of AIDS and HIV infection in New Zealand.
The AEG epidemiological surveillance newsletters provide more detailed information about HIV and AIDS diagnoses in New Zealand.