The government wants to eliminate HIV transmission in New Zealand. What does that mean?
The government has announced an action plan to eliminate local transmission of HIV in New Zealand. Experts say it’s possible, but only if the stigma is removed, as Melanie Earley reports.
HIV diagnoses in New Zealand have steadily declined in recent years, and the government hopes new local cases of infection could be a thing of the past by 2032.
The HIV pandemic took hold in the early 1980s, when very little information was available about the disease.
Director of the Gay Men’s Sexual Health Research Group Dr Peter Saxton says New Zealand chose to treat the epidemic as a public health problem based on science rather than “morality and scapegoating” in the 1980s.
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“I believe we have been successful with our response to HIV over the past 40 years, we have not treated it as a moral issue like some other countries did at the time.
“We have one of the lowest rates of HIV infection in the world – we have almost zero among injecting drug users and very little to no transmission among sex workers.”
Chris McKeen / Stuff
Judith Mukakayange is a Rwandan refugee who educates communities about living with HIV
“We see it more concentrated among men who have sex with men, but it’s still relatively low on a per capita basis.”
However, things weren’t perfect, Saxton says, and one of the biggest issues that still lingers to some extent today is HIV-related stigma and discrimination.
“I think we have to recognize that we are in a very good position. I am proud to know that our record is better than most, but HIV has not gone away.
“HIV stigma continues to play a role in New Zealand and I think some people are still quite scared of it, even though it is now a manageable condition.
“The stigma around HIV needs to be eliminated, I think that’s the only way to eliminate HIV.”
Since national HIV surveillance began in New Zealand in 1985, there have been 5,430 HIV notifications and 757 AIDS-related deaths.
There are currently 2,839 people receiving subsidized antiretroviral treatment for HIV in New Zealand.
Burnett Foundation chief executive Joe Rich agrees New Zealand is doing well with the way HIV is managed, especially after the spike in cases in 2016.
“We haven’t had much government leadership in our HIV response so far,” says Rich, “but the announcement of the action plan is an exciting time for us and elimination is possible.”
Rich says he also believes that to completely eliminate HIV, more action is needed against the stigma of people living with HIV.
“We constantly have people living with HIV telling us that stigma is one of the hardest things for them to deal with right now.”
This stigma leads to barriers for people who get tested due to “shame and fear,” Rich says, and it’s something that continues to be a problem.
“Our foundation started in 1985 and at that time one of our founders told us that there was a real sense of panic and desperation in the gay community.
“Some people have lost their entire group of friends to HIV; the homosexuals of this generation were being wiped out.
Today, people know what HIV is and generally know how it is transmitted and how it is not transmitted, but there are still stubborn and hard-to-change attitudes that do not match what we know now.
Associate Minister of Health Dr Ayesha Verrall says main aims of government’s plan are to reduce locally acquired HIV infections, improve health and well-being of Maori people in relation to HIV , reduce the negative health consequences of HIV and reduce stigma and discrimination. around HIV.
Achieving these goals will require improvements in HIV surveillance, information and knowledge as well as support for people living with HIV, including addressing stigma and discrimination, Verrall said in a statement. press Saturday.
Verrall says she hopes Aotearoa could be the first country to eliminate HIV transmission.
“HIV prevention (including PrEP and condoms) and HIV treatment are free in New Zealand for anyone eligible for publicly funded healthcare. This is certainly part of the success factor to date in reducing transmission.
The HIV Action Plan will receive $18 million over four years starting in Budget 2022. The funding is in addition to existing spending on HIV prevention and surveillance, and Saxton says it is funding largest ever given to the HIV response in New Zealand.
Rich says that for the elimination strategy to work, more people would need to be reached and more widely available home HIV testing was needed.
“The real focus is on equity, and we need affected communities to design the responses. We don’t have a vaccine or cure for HIV, so we need to keep the momentum going for elimination.
An incredibly effective defense against HIV is pre-exposure prophylaxis (PrEP), which reduces the risk of becoming infected with HIV by up to 99% if used correctly, Rich says.
In June, access to the drug was expanded to only be available to a person engaging in a specific sexual activity and detail it to their doctor, a patient who tested negative for HIV and their doctor thinking the drug was appropriate for him.
Rich says that while expanding access has been good, there are still groups that don’t have access to PrEP, including international students living in New Zealand.
“Their health insurance doesn’t have sexual health coverage, and we’re not going to get to zero without everyone getting hit.
“We would like it to be treated, because people who are at increased risk of contracting HIV should not be excluded.
“I would also like home HIV testing to be more widely available because there is the issue of people not living near free sexual health clinics.”
Verrall says elimination will require a “concentrated effort”, but based on the Covid-19 experience, the government believes “ambitious” elimination targets can be achieved.
“Looking to the future, I want people living with HIV in New Zealand to feel supported, cared for and confident in the tools available to prevent transmission.”
Rich thinks elimination by 2023 is “absolutely possible”; a belief shared by Saxton, who says New Zealand has the tools to get to zero.
“Last year was the lowest number of new infections in 20 years. I have great faith in New Zealanders and our ability to do this.