How is HIV transmitted?
HIV in New Zealand What’s HIV? What’s AIDS? What’s the difference? HIV is a virus that slowly destroys a person’s immune system. HIV causes AIDS, an advanced form of HIV infection but with modern treatment HIV usually doesn’t progress to AIDS. We say a person has AIDS when HIV has weakened their immune system so much that it can no longer fight off specific infections and cancers. There is no vaccine or cure for HIV or AIDS.
HIV stands for Human Immunodeficiency Virus AIDS stands for Acquired Immune Deficiency Syndrome Useful Websites www.nzaf.org.nz www.FASTest.co.nz www.aidsmap.com www.thebody.com www.avert.org
There are only a few ways to transmit HIV. In NZ, almost all HIV transmission is through unprotected sexual contact. There are very low rates of HIV transmission from direct contact with blood and from mother to baby. HIV can be transmitted: • sexually; through semen, anal mucous and vaginal fluid • direct blood to blood contact • breast feeding HIV cannot be transmitted through contact with: • tears • saliva • sweat • urine and faeces
HIV cannot be transmitted by biting, kissing, hugging, or sharing swimming pools, toilets, and eating utensils with a person who is living with HIV. There is also zero risk of acquiring HIV from insect bites or animals,
What about New Zealand? How many people are living with HIV? HIV is a global problem. At present, there are 33.2 million people in the world living with HIV. NZ has around 2000 people living with HIV which is a very low number compared with most other countries. In NZ, gay and bisexual men, and people from African communities are most affected by HIV. Over the last decade, approximately 80% of gay and bisexual men diagnosed with HIV were infected in NZ, while approximately 80% of heterosexual people were infected overseas.
Treatment for HIV These days, there very effective drugs for HIV called antiretroviral treatments, or ARVs. ARVs decrease the amount of virus in a person’s body so they can usually live long, satisfying lives. For some people, ARVs will lower the level of HIV in their blood to the point where it can’t be detected by modern testing equipment. This is called undectable viral load. With an undetectable viral load HIV can only be transmitted through very high risk activities like sharing needles or unsafe sex. Unsafe sex is particularly risky because even when a person’s blood has undetectable viral load, the level of HIV in sexual fluids (semen etc.) can be much higher.
HIV in NZ Sexual transmission accounts for the vast majority of new HIV diagnoses in NZ. Gay and bisexual men are the population group most at risk by a large margin. In 2011, HIV diagnoses for this group were the lowest since 2002 but it is too early to say if this is a trend. HIV diagnoses among heterosexual NZer’s have continued a steady downward trend since 2007. Overall, NZ has done very well in controlling HIV and continues to have one of the lowest HIV prevalence rates in the world. This is largely due to the consistent promotion of condom and lube use for anal sex between men since 1987. A robust legislative environment based on strong human rights approaches is also a key reason for this success. A low number of injecting drug users and the successful operation of an effective needle exchange programme since the late 1980s has meant that injecting drug use accounts for very few HIV infections in NZ. Similarly, the widespread adoption of condom use among sex workers has resulted in a low rate of HIV transmission in the NZ sex industry. These are both considered remarkable successes worldwide.
Can I find out who has HIV? No. This information is completely confidential and private in the same way that information about any other medical condition is. People living with HIV can choose to tell their employers, schools or service providers when they feel comfortable and safe enough to do so but they do not have a legal obligation to do so.
So, if I don’t know who has HIV how can I protect myself and others from from it? Different activities have different levels of risk for HIV. The sexual activity with the highest risk is unprotected anal sex. However, condoms are an effective barrier against HIV because HIV cannot pass through an intact condom. If you have had anal or vaginal sex and used a condom, it is incredibly unlikely that you have been at risk, and the same is true of oral sex even without a condom. The number of gay and bisexual men and people from NZ’s African communities who are living with HIV are much higher than any other population groups in NZ. Because there are
more people from these communities who are living with HIV, the number of people who can potentially transmit HIV to their sexual partners is higher. So using condoms and lube for anal or vaginal sex everytime is strongly recommended for gay and bisexual men and people from NZbased African communities. Sharing injecting equipment is one of the most risky activities for HIV. Injecting drug users must use clean needles which are available for little or no cost through NZ’s excellent needle exchange programme. It is possible to prevent mother-to-child transmission of HIV with ARVs. NZ’s antenatal screening progamme for HIV has been very effective at reducing mother-to-child transmission to almost zero.
What about abstinence? Sexual transmission of HIV is not possible if you do not have sex. However, abstaining from sex is extremely difficult for the majority of people. While there may be some individuals who can abstain, abstinence will not work to prevent HIV for the vast majority of people.
Where can I get an HIV test? Rapid HIV tests which give a result in 20 minutes are available free through the NZAF throughout NZ. Free testing is also available at Sexual Health Services and Youth Health Centres or for varying prices at Family Planning Clinics and GPs. Go to www.fastest.co.nz or call 0800 80 2437 for information about testing.
How can I help look after a person who’s living with HIV? The single, biggest issue that people with HIV in NZ face is stigma and discrimination. Learning about HIV and sharing information with your whanau and friends is the best thing you can do to support the people in your life who are living with HIV. With effective ARV treatment, people living with HIV do not require HIV-specific plans or special treatment. NZ employers and educational facilities are required to have policies that manage risk for HIV and other infections (e.g. letting the school know if your child has chicken pox, and training staff about standard workplace health and safety policies). www.nzaf.org.nz