HIV in New Zealand
In 2015, 224 people were diagnosed with HIV in New Zealand, with 109 of those having been infected in New Zealand. This is higher than 2014 when 217 were diagnosed.
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.
Of the 224 diagnoses in 2015, 153 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, 88 were infected in New Zealand. The number of gay and bisexual men infected in New Zealand rose sharply between 2001 and 2005, subsequently it was relatively stable for a number of years. However, 2015 is the fourth consecutive year that the number of gay and bisexual men diagnosed with HIV has increased. This signals the need for a re-energised response to preventing HIV among this group.
Forty-two people (25 men and 17 women) were infected through heterosexual contact in 2015. Of these, 16 were infected in New Zealand. There is an overall downward trend in HIV diagnosis among heterosexual New Zealanders since 2006.
Of the total 224 disgnoses, the remaining 29 were by other or unknown means.
Currently, around 3200 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 approaches is also a key reason for this. However, an increasing number of diagnoses among gay and bisexual men is concerning and indicates that more needs to be done to curb the epidemic among this group.
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 109 people infected with HIV in New Zealand in 2015, 88, or 81%, 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 and bisexual men in New Zealand 2005-2015 (excludes those previously diagnosed overseas)
In 2015, 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.
The age at diagnosis was evenly spread across all age groups for men who were infected through sex with other men, with the ages ranging from 18 to 80 years.
Of the gay and bisexual men diagnosed and infected in New Zealand in 2014 and 2015, the average annual number with a high initial CD4 count (an indication of a recently acquired infection) was 39, higher than the annual average of 24 for the period 2010-2013. This indicates an increase in the number of men with a recently acquired infection being diagnosed. This could be a reflection of more new infections occurring, or more testing of those at highest risk.
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. Further analysis shows that in 2015, 38% of gay and bisexual men diagnosed with HIV had significantly depleted immune systems indicating that they were diagnosed late in the progression of their HIV. These findings highlight the need for increased access to HIV testing, particularly to those most at risk of HIV.
Heterosexual Men & Women
Of the 109 people infected with HIV in New Zealand in 2015, 16 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 2005-2015 (excludes those previously diagnosed overseas)
HIV diagnoses among heterosexual people infected overseas increased sharply from 2002 to 2006. This corresponds with 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 remain the only ethnicity overrepresented.
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. Four people were diagnosed with HIV as a result of injecting drug use in 2015, two in New Zealand and two overseas. A futher two men were infected either through sex with another man or injecting drug use.
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 was no HIV infection among the study sample of more than 300 workers.
This is due, in large, to the good 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 2015, one child was diagnosed with HIV infection through mother-to-child transmission who was born overseas.
There were three pregnant women diagnosed with HIV through antenatal testing in 2015. 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.