HIV Update 2012
2
Contents
Snapshot
1 Snapshot What’s Needed 2 HIV 101 3 Fact and Fiction 4 Testing 5 Treatment 7 HIV in New Zealand 9 Gay and Bisexual Men Most at Risk 10 Place of Infection and Immigration 11 Ethnicity and Age 13 HIV Prevention 15 The Future The Cost of HIV 17 Role of the NZAF
•
Overall, the HIV epidemic has been on the rise since 2000. In 2011, there was an encouraging drop in the number of HIV diagnoses but it’s too early to say if this indicates a downward trend.
•
Gay and bisexual men remain the population group most at risk of HIV in New Zealand, followed by heterosexual people in New Zealand-based African communities.
•
Effective treatment has meant fewer deaths and therefore a larger pool of people living with HIV which increases the number of people who can pass it on.
•
The cost of HIV to New Zealand is $27.5 million per annum. This figure can be expected to increase as the epidemic continues.
What’s Needed •
Smart and accessible HIV prevention programmes that promote condom and lube use to the population groups most at risk of HIV.
•
An increase in national testing for HIV, with a strong focus on pre- and post-test counselling and safe sex education.
•
An increase in HIV and sexual health research to ensure that New Zealand can effectively combat the HIV epidemic in the future.
•
Maintenance of the legislative framework that has decriminalised homosexuality, sex work and the possession of devices for injecting drugs which has contributed to New Zealand’s comparatively low HIV prevalence.
1
2
Contents
Snapshot
1 Snapshot What’s Needed 2 HIV 101 3 Fact and Fiction 4 Testing 5 Treatment 7 HIV in New Zealand 9 Gay and Bisexual Men Most at Risk 10 Place of Infection and Immigration 11 Ethnicity and Age 13 HIV Prevention 15 The Future The Cost of HIV 17 Role of the NZAF
•
Overall, the HIV epidemic has been on the rise since 2000. In 2011, there was an encouraging drop in the number of HIV diagnoses but it’s too early to say if this indicates a downward trend.
•
Gay and bisexual men remain the population group most at risk of HIV in New Zealand, followed by heterosexual people in New Zealand-based African communities.
•
Effective treatment has meant fewer deaths and therefore a larger pool of people living with HIV which increases the number of people who can pass it on.
•
The cost of HIV to New Zealand is $27.5 million per annum. This figure can be expected to increase as the epidemic continues.
What’s Needed •
Smart and accessible HIV prevention programmes that promote condom and lube use to the population groups most at risk of HIV.
•
An increase in national testing for HIV, with a strong focus on pre- and post-test counselling and safe sex education.
•
An increase in HIV and sexual health research to ensure that New Zealand can effectively combat the HIV epidemic in the future.
•
Maintenance of the legislative framework that has decriminalised homosexuality, sex work and the possession of devices for injecting drugs which has contributed to New Zealand’s comparatively low HIV prevalence.
1
HIV 101
AIDS =
Acquired Immune Deficiency Syndrome
HIV =
Human Immunodeficiency Virus
Fact and Fiction Oral sex: “If I have unprotected oral sex with an HIV positive person, am I at risk?” Under normal circumstances, no. There is a risk of contracting HIV through oral sex only if there are open sores or cuts in the mouth, however, unprotected oral sex does expose you to the risk of other sexually transmitted infections (STIs).
Massage: “I received a full body massage from a sex worker. Am I at risk of HIV?” No. HIV cannot be transmitted via skin-to-skin contact.
Insertive vs. Receptive Anal Sex: HIV is a virus that is transmitted through blood, semen, vaginal fluid, rectal mucous and breast milk. HIV cannot be transmitted by touching, kissing or sharing eating utensils. Once HIV is in a person’s bloodstream it begins to attack the immune system, killing healthy immune system cells that normally fight off infection. There is no cure for HIV so once it’s in a person’s bloodstream, it’s there for life. HIV can be treated with medication, known as antiretroviral drugs (ARVs). For more on ARVs see Treatment on page 5. Unprotected receptive anal sex carries the highest risk of sexual HIV transmission. The inside of the rectum is like a sponge; designed to absorb nutrients into the bloodstream from food passing through, meaning it can also easily absorb HIV from semen. Approximately 70 per cent of immune system cells are located in the gut and HIV has very rapid and substantial effects on these cells from soon after infection. Unprotected receptive vaginal sex carries the second highest risk of sexual HIV transmission. The cells that make up the vagina are less absorbent than those in the rectum. Vaginal cells are, however, still capable of allowing HIV to pass into the bloodstream. A person is most infectious in the weeks and months immediately after acquiring HIV. This is because HIV multiplies much faster than the time it takes for the body to produce antibodies. The deterioration and destruction of immune function will (without ARVs) lead to AIDS, the final stage of HIV infection.
2
“I’m never the receptive partner, so I’m not at risk, right?” Wrong. Although unprotected receptive anal sex carries the highest risk, it is still possible to contract HIV if you are the insertive partner and you are not wearing a condom. HIV can enter the body through vulnerable skin cells under the head of the penis or through the urethra.
Appearance: “He looks healthy so he must be HIV negative.” Wrong. It isn’t possible to tell if someone has HIV simply by their appearance. Highly effective HIV medication is now available and means that people living with HIV can lead healthy, normal lives often with no visible symptoms.
Testing: “I get tested regularly so I don’t have to use condoms every time, right?” Wrong. You could test negative for HIV and contract HIV through unprotected sex later the same day. HIV also has a window period of three months before it will show up in a test.
Treatment: “Some countries are saying that if people who test positive for HIV are put on treatment immediately, this will prevent them from passing HIV on. Is this correct?” This is wrong. Testing alone and treatment alone cannot guarantee to prevent the spread of HIV. Even if a person has a low viral load through treatment, it is still possible for HIV transmission to occur. A person’s viral load can also fluctuate. People living with HIV should use condoms and lube for sex every time.
3
HIV 101
AIDS =
Acquired Immune Deficiency Syndrome
HIV =
Human Immunodeficiency Virus
Fact and Fiction Oral sex: “If I have unprotected oral sex with an HIV positive person, am I at risk?” Under normal circumstances, no. There is a risk of contracting HIV through oral sex only if there are open sores or cuts in the mouth, however, unprotected oral sex does expose you to the risk of other sexually transmitted infections (STIs).
Massage: “I received a full body massage from a sex worker. Am I at risk of HIV?” No. HIV cannot be transmitted via skin-to-skin contact.
Insertive vs. Receptive Anal Sex: HIV is a virus that is transmitted through blood, semen, vaginal fluid, rectal mucous and breast milk. HIV cannot be transmitted by touching, kissing or sharing eating utensils. Once HIV is in a person’s bloodstream it begins to attack the immune system, killing healthy immune system cells that normally fight off infection. There is no cure for HIV so once it’s in a person’s bloodstream, it’s there for life. HIV can be treated with medication, known as antiretroviral drugs (ARVs). For more on ARVs see Treatment on page 5. Unprotected receptive anal sex carries the highest risk of sexual HIV transmission. The inside of the rectum is like a sponge; designed to absorb nutrients into the bloodstream from food passing through, meaning it can also easily absorb HIV from semen. Approximately 70 per cent of immune system cells are located in the gut and HIV has very rapid and substantial effects on these cells from soon after infection. Unprotected receptive vaginal sex carries the second highest risk of sexual HIV transmission. The cells that make up the vagina are less absorbent than those in the rectum. Vaginal cells are, however, still capable of allowing HIV to pass into the bloodstream. A person is most infectious in the weeks and months immediately after acquiring HIV. This is because HIV multiplies much faster than the time it takes for the body to produce antibodies. The deterioration and destruction of immune function will (without ARVs) lead to AIDS, the final stage of HIV infection.
2
“I’m never the receptive partner, so I’m not at risk, right?” Wrong. Although unprotected receptive anal sex carries the highest risk, it is still possible to contract HIV if you are the insertive partner and you are not wearing a condom. HIV can enter the body through vulnerable skin cells under the head of the penis or through the urethra.
Appearance: “He looks healthy so he must be HIV negative.” Wrong. It isn’t possible to tell if someone has HIV simply by their appearance. Highly effective HIV medication is now available and means that people living with HIV can lead healthy, normal lives often with no visible symptoms.
Testing: “I get tested regularly so I don’t have to use condoms every time, right?” Wrong. You could test negative for HIV and contract HIV through unprotected sex later the same day. HIV also has a window period of three months before it will show up in a test.
Treatment: “Some countries are saying that if people who test positive for HIV are put on treatment immediately, this will prevent them from passing HIV on. Is this correct?” This is wrong. Testing alone and treatment alone cannot guarantee to prevent the spread of HIV. Even if a person has a low viral load through treatment, it is still possible for HIV transmission to occur. A person’s viral load can also fluctuate. People living with HIV should use condoms and lube for sex every time.
3
Testing
Treatment
An HIV test detects antibodies to HIV, rather than levels of HIV itself. The time between acquiring HIV and the development of antibodies in the bloodstream can be up to three months. This is referred to as the ‘window period’. Because of this window period it is not possible to find out if a person has HIV immediately after suspected exposure. The NZAF is trialling new testing technology that can detect HIV only days after infection.
In the mid 1990s, government subsidised and effective treatments for HIV called antiretroviral drugs (ARVs) were introduced and significantly impacted the HIV epidemic in New Zealand. A direct result of the introduction of ARVs is that the death rate for people with AIDS has decreased dramatically since 1997; there have been eight or fewer AIDS-related deaths per year for most of the 2000’s.
Once HIV is in a person’s bloodstream it multiplies very rapidly before the immune system begins to develop antibodies. This means that a person who has recently contracted HIV is most infectious during the first three to six months after infection. In 2006, the NZAF introduced FASTest, a rapid test for HIV. FASTest involves a quick and almost painless finger prick to produce a single drop of blood which is placed in the testing device. An accurate result is confirmed in just 20 minutes. NZAF FASTests are available at no cost through NZAF regional centres in Auckland, Wellington and Christchurch, and through NZAF contracted providers in most other areas of New Zealand.
www.FASTest.co.nz
While ARVs are an effective treatment, there is still no cure for HIV. ARVs mean that people living with HIV are generally healthier and have much greater life expectancy than previously. However, some people can have serious side effects such as kidney or liver failure and it is possible to become resistant to ARVs. ARVs are subsidised by PHARMAC and are available at little or no cost to New Zealand residents.
Around 80% of people living with HIV in New Zealand are on ARVs.
Free and confidential HIV, syphilis and hepatitis C tests with results in 20 minutes.
4
5
Testing
Treatment
An HIV test detects antibodies to HIV, rather than levels of HIV itself. The time between acquiring HIV and the development of antibodies in the bloodstream can be up to three months. This is referred to as the ‘window period’. Because of this window period it is not possible to find out if a person has HIV immediately after suspected exposure. The NZAF is trialling new testing technology that can detect HIV only days after infection.
In the mid 1990s, government subsidised and effective treatments for HIV called antiretroviral drugs (ARVs) were introduced and significantly impacted the HIV epidemic in New Zealand. A direct result of the introduction of ARVs is that the death rate for people with AIDS has decreased dramatically since 1997; there have been eight or fewer AIDS-related deaths per year for most of the 2000’s.
Once HIV is in a person’s bloodstream it multiplies very rapidly before the immune system begins to develop antibodies. This means that a person who has recently contracted HIV is most infectious during the first three to six months after infection. In 2006, the NZAF introduced FASTest, a rapid test for HIV. FASTest involves a quick and almost painless finger prick to produce a single drop of blood which is placed in the testing device. An accurate result is confirmed in just 20 minutes. NZAF FASTests are available at no cost through NZAF regional centres in Auckland, Wellington and Christchurch, and through NZAF contracted providers in most other areas of New Zealand.
www.FASTest.co.nz
While ARVs are an effective treatment, there is still no cure for HIV. ARVs mean that people living with HIV are generally healthier and have much greater life expectancy than previously. However, some people can have serious side effects such as kidney or liver failure and it is possible to become resistant to ARVs. ARVs are subsidised by PHARMAC and are available at little or no cost to New Zealand residents.
Around 80% of people living with HIV in New Zealand are on ARVs.
Free and confidential HIV, syphilis and hepatitis C tests with results in 20 minutes.
4
5
HIV in New Zealand Sexual transmission accounts for the vast majority of new HIV diagnoses in New Zealand. Gay and bisexual men are the population group most at risk by a large margin, however it is encouraging that in 2011, HIV diagnoses for this group were the lowest since 2002. HIV diagnoses among heterosexual New Zealanders continue a steady downward trend. For the first time in New Zealand, research conducted by the University of Otago AIDS Epidemiology Group 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 did not know they had it. The study estimated that 1 in 15 gay or bisexual men in Auckland is now living with HIV. Overall, New Zealand 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 In 2011, 109 people were approaches is also a key reason diagnosed with HIV in New Zealand. for this success.
The best estimate of the number of people living with HIV is 2000.
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 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. These are both considered remarkable successes worldwide.
7
HIV in New Zealand Sexual transmission accounts for the vast majority of new HIV diagnoses in New Zealand. Gay and bisexual men are the population group most at risk by a large margin, however it is encouraging that in 2011, HIV diagnoses for this group were the lowest since 2002. HIV diagnoses among heterosexual New Zealanders continue a steady downward trend. For the first time in New Zealand, research conducted by the University of Otago AIDS Epidemiology Group 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 did not know they had it. The study estimated that 1 in 15 gay or bisexual men in Auckland is now living with HIV. Overall, New Zealand 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 In 2011, 109 people were approaches is also a key reason diagnosed with HIV in New Zealand. for this success.
The best estimate of the number of people living with HIV is 2000.
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 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. These are both considered remarkable successes worldwide.
7
Gay and Bisexual Men Most at Risk Gay and bisexual men are overwhelmingly the population group most at risk of HIV in New Zealand. There are several reasons for this: 1. 2. 3.
Gay and bisexual men have anal sex at higher rates than any other group and rectal cells are more susceptible to HIV infection than vaginal cells. Semen and rectal mucous carry more HIV than vaginal fluid. The prevalence of HIV is already far higher among gay and bisexual men than in the rest of the population, making the risk of exposure greater.
Of the 109 people diagnosed with HIV in New Zealand in 2011, 59 were men who were infected through sex with other men. At the time of publication there were a further 15 men for whom the mode of transmission was unknown. It is highly likely that some of them will also be gay or bisexual men.
Number of annual HIV diagnoses
Exposure category: Annual HIV diagnoses by Western blot antibody testing, 1997-2011 (Note: Does not distinguish between infections acquired in NZ and overseas) 110 100 90 80 70
Homosexual Homosexual & IDU Heterosexual IDU
60 50 40 30 20 10 0
97 98 99 2000 01 02 03
04 2005
06
07
08
09
2010
11
Source: Data provided by AEG, Department of Preventative and Social Medicine, University of Otago.
9
Gay and Bisexual Men Most at Risk Gay and bisexual men are overwhelmingly the population group most at risk of HIV in New Zealand. There are several reasons for this: 1. 2. 3.
Gay and bisexual men have anal sex at higher rates than any other group and rectal cells are more susceptible to HIV infection than vaginal cells. Semen and rectal mucous carry more HIV than vaginal fluid. The prevalence of HIV is already far higher among gay and bisexual men than in the rest of the population, making the risk of exposure greater.
Of the 109 people diagnosed with HIV in New Zealand in 2011, 59 were men who were infected through sex with other men. At the time of publication there were a further 15 men for whom the mode of transmission was unknown. It is highly likely that some of them will also be gay or bisexual men.
Number of annual HIV diagnoses
Exposure category: Annual HIV diagnoses by Western blot antibody testing, 1997-2011 (Note: Does not distinguish between infections acquired in NZ and overseas) 110 100 90 80 70
Homosexual Homosexual & IDU Heterosexual IDU
60 50 40 30 20 10 0
97 98 99 2000 01 02 03
04 2005
06
07
08
09
2010
11
Source: Data provided by AEG, Department of Preventative and Social Medicine, University of Otago.
9
Place of Infection and Immigration
Ethnicity and Age
Whether people are infected with HIV in New Zealand or overseas is crucial for the planning and delivery of HIV prevention programmes and health services. However, while New Zealand organisations can tailor HIV prevention programmes to the groups most at risk of HIV in this country, they have little control over off-shore prevention initiatives.
Ethnicity
Trends over the last ten years show consistently that the majority of gay and bisexual men contract HIV in New Zealand, whereas the majority of heterosexual people contract HIV overseas. In 2011, 44 (75%) of the 59 gay and bisexual men diagnosed with HIV were reported to have contracted HIV here, compared to only 10 (36%) of the 28 heterosexual people diagnosed.
Of the 59 gay and bisexual men diagnosed with HIV in 2011:*
HIV diagnoses among heterosexual people 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 twelve months.
Number
Place of infection: Annual HIV diagnoses in homosexual/bisexual males* by Western blot antibody testing 1997-2011
100 90 80 70 60 50 40 30 20 10 0
Unknown Overseas
23
18
20
23
26
23
New Zealand
Other or unknown ethnicity 10% Pacifc 3%
European 68%
Asian 10%
Among heterosexuals, Africans remain the only ethnicity significantly and consistently over-represented in HIV diagnoses. In 2011, Asian heterosexuals appear to be over-represented however, the small number of actual diagnoses is not statistically significant and is not consistent when looking at a five or ten year trend.
Other or unknown ethnicity 7% Pacific 4% Maori 7% Of the 28 heterosexual people (16 men and 12 women) diagnosed with HIV in 2011:*
European 36% Asian 18% African 29%
15
18
Maori 8%
14
5 21
12
12
9
21
21
21
11
22
27
29
48
97 98 99 2000 01 02 03
52
66
54
54
64
58
69
44
Age Age at diagnosis was evenly spread across all age groups for both gay and bisexual men and heterosexual men and women in 2011.
04
2005
06
07
08
09
2010
11
*Includes both homosexual/bisexual and homosexual/bisexual/IDU. Source: Data provided by AEG, Department of Preventative and Social Medicine, University of Otago.
10
In 2011, most gay and bisexual men diagnosed with HIV were European; this is consistent with figures for the last ten years.
A person can be living with HIV for months or even years before diagnosis so it is not possible to determine age at the time of infection. *Source: Data provided by AEG, Department of Preventative and Social Medicine, University of Otago.
11
Place of Infection and Immigration
Ethnicity and Age
Whether people are infected with HIV in New Zealand or overseas is crucial for the planning and delivery of HIV prevention programmes and health services. However, while New Zealand organisations can tailor HIV prevention programmes to the groups most at risk of HIV in this country, they have little control over off-shore prevention initiatives.
Ethnicity
Trends over the last ten years show consistently that the majority of gay and bisexual men contract HIV in New Zealand, whereas the majority of heterosexual people contract HIV overseas. In 2011, 44 (75%) of the 59 gay and bisexual men diagnosed with HIV were reported to have contracted HIV here, compared to only 10 (36%) of the 28 heterosexual people diagnosed.
Of the 59 gay and bisexual men diagnosed with HIV in 2011:*
HIV diagnoses among heterosexual people 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 twelve months.
Number
Place of infection: Annual HIV diagnoses in homosexual/bisexual males* by Western blot antibody testing 1997-2011
100 90 80 70 60 50 40 30 20 10 0
Unknown Overseas
23
18
20
23
26
23
New Zealand
Other or unknown ethnicity 10% Pacifc 3%
European 68%
Asian 10%
Among heterosexuals, Africans remain the only ethnicity significantly and consistently over-represented in HIV diagnoses. In 2011, Asian heterosexuals appear to be over-represented however, the small number of actual diagnoses is not statistically significant and is not consistent when looking at a five or ten year trend.
Other or unknown ethnicity 7% Pacific 4% Maori 7% Of the 28 heterosexual people (16 men and 12 women) diagnosed with HIV in 2011:*
European 36% Asian 18% African 29%
15
18
Maori 8%
14
5 21
12
12
9
21
21
21
11
22
27
29
48
97 98 99 2000 01 02 03
52
66
54
54
64
58
69
44
Age Age at diagnosis was evenly spread across all age groups for both gay and bisexual men and heterosexual men and women in 2011.
04
2005
06
07
08
09
2010
11
*Includes both homosexual/bisexual and homosexual/bisexual/IDU. Source: Data provided by AEG, Department of Preventative and Social Medicine, University of Otago.
10
In 2011, most gay and bisexual men diagnosed with HIV were European; this is consistent with figures for the last ten years.
A person can be living with HIV for months or even years before diagnosis so it is not possible to determine age at the time of infection. *Source: Data provided by AEG, Department of Preventative and Social Medicine, University of Otago.
11
HIV Prevention The NZAF’s response to the HIV epidemic over the last 25 years has been the promotion of ‘condoms and lube for sex every time’. International research shows that condoms are extremely effective against the onward transmission of HIV when used correctly and consistently.
Get it On! is the NZAF’s social marketing programme specifically targeted at New Zealand’s gay and bisexual men’s communities. Get it On! encourages condom use through positive messages that endorse condoms as a natural part of great sex. These messages are promoted in the environments where gay and bisexual men engage; popular hang-out spots, social venues and virtual networking spaces. Research shows that gay and bisexual men are engaging in internet and mobile-based sexual networking at very high rates, so a key component of Get it On! is its online and smartphone app presence. The Get it On! website has been tremendously successful, boasting 20,000 visits on average per month in 2011. Community engagement plays a crucial role in the Get it On! programme; interacting with gay and bisexual men on an individual and collective basis in bars, clubs, sex on site venues and at events. Get it On! sponsored numerous community events in 2011, the largest being the annual Get it On! Big Gay Out in Auckland which attracts between 12-14,000 people. The Get it On! message for 2012, Love Your Condom (LYC), is being promoted through multiple channels including outdoor (billboards and bus shelter ads), ambient (wall projections), posters, online, social media and through event sponsorship. The creative concept behind LYC encourages gay and bisexual men to take condom use to the next level and form a condom movement, reinforcing the core tenet of the NZAF’s HIV prevention programme which is the creation of a condom culture where condom use is the norm.
13
HIV Prevention The NZAF’s response to the HIV epidemic over the last 25 years has been the promotion of ‘condoms and lube for sex every time’. International research shows that condoms are extremely effective against the onward transmission of HIV when used correctly and consistently.
Get it On! is the NZAF’s social marketing programme specifically targeted at New Zealand’s gay and bisexual men’s communities. Get it On! encourages condom use through positive messages that endorse condoms as a natural part of great sex. These messages are promoted in the environments where gay and bisexual men engage; popular hang-out spots, social venues and virtual networking spaces. Research shows that gay and bisexual men are engaging in internet and mobile-based sexual networking at very high rates, so a key component of Get it On! is its online and smartphone app presence. The Get it On! website has been tremendously successful, boasting 20,000 visits on average per month in 2011. Community engagement plays a crucial role in the Get it On! programme; interacting with gay and bisexual men on an individual and collective basis in bars, clubs, sex on site venues and at events. Get it On! sponsored numerous community events in 2011, the largest being the annual Get it On! Big Gay Out in Auckland which attracts between 12-14,000 people. The Get it On! message for 2012, Love Your Condom (LYC), is being promoted through multiple channels including outdoor (billboards and bus shelter ads), ambient (wall projections), posters, online, social media and through event sponsorship. The creative concept behind LYC encourages gay and bisexual men to take condom use to the next level and form a condom movement, reinforcing the core tenet of the NZAF’s HIV prevention programme which is the creation of a condom culture where condom use is the norm.
13
The Future HIV is no longer the death sentence it was in the early days of the epidemic. Comparatively few people die of AIDS-related deaths these days thanks to ARV treatment. Effective treatment means that the pool of people living with HIV will continue to grow, which in turn means that the number of people who can pass on HIV will continue to rise. The successful reduction of annual HIV transmission rates will depend on three critical approaches: 1. 2. 3.
Increasing condom and lube use among the most at-risk population groups. Increasing testing and diagnosing new infections early. Treating HIV to reduce infectiousness.
HIV diagnoses dropped in 2011, which is encouraging but it is too soon to consider this representative of a downward trend in HIV transmission.
The Cost of HIV In 2011, AEG data showed that 1,600 people living with HIV in New Zealand received funded ARV treatment. The average cost of ARVs per person was $17,244 per annum, making the total cost of ARVs in 2011 approximately $27.5 million. If we assume that the numbers of new diagnoses per year continue at rates shown over the last ten years, the cost of ARVs alone could increase by approximately $2 million per annum (if 80% of people start ARVs immediately). Every HIV diagnosis that is prevented eliminates a potential cost of $17,244 per year in HIV-related health care and leads to a healthier community.
$27.5 million p/a 15
The Future HIV is no longer the death sentence it was in the early days of the epidemic. Comparatively few people die of AIDS-related deaths these days thanks to ARV treatment. Effective treatment means that the pool of people living with HIV will continue to grow, which in turn means that the number of people who can pass on HIV will continue to rise. The successful reduction of annual HIV transmission rates will depend on three critical approaches: 1. 2. 3.
Increasing condom and lube use among the most at-risk population groups. Increasing testing and diagnosing new infections early. Treating HIV to reduce infectiousness.
HIV diagnoses dropped in 2011, which is encouraging but it is too soon to consider this representative of a downward trend in HIV transmission.
The Cost of HIV In 2011, AEG data showed that 1,600 people living with HIV in New Zealand received funded ARV treatment. The average cost of ARVs per person was $17,244 per annum, making the total cost of ARVs in 2011 approximately $27.5 million. If we assume that the numbers of new diagnoses per year continue at rates shown over the last ten years, the cost of ARVs alone could increase by approximately $2 million per annum (if 80% of people start ARVs immediately). Every HIV diagnosis that is prevented eliminates a potential cost of $17,244 per year in HIV-related health care and leads to a healthier community.
$27.5 million p/a 15
Role of the NZAF Mission To prevent the transmission of HIV and provide support for people living with HIV, their wha-nau and families.
The NZAF is New Zealand’s national HIV prevention and health services organisation. The work of the NZAF includes HIV prevention, testing and health services, science and advocacy. This work is funded by the Ministry of Health, trusts and grant-making bodies and donations from individuals and businesses. The NZAF National Office is in Auckland, there are centres in Auckland, Wellington and Christchurch, and contracted professionals providing testing and health services in most other areas of New Zealand. The NZAF is a registered charity that grew out of gay community initiatives in the 1980s and today brings history, passion, commitment, expertise and diversity to meet the emerging trends of the HIV epidemic and the changing needs of the communities it serves.
For more information visit
www.nzaf.org.nz
Koromakinga
Ki te -arai i te tuku o te HIV me te tautoko i ngata-ngata e mau ana i te HIV me o ratou wha-nau.
16
17
Role of the NZAF Mission To prevent the transmission of HIV and provide support for people living with HIV, their wha-nau and families.
The NZAF is New Zealand’s national HIV prevention and health services organisation. The work of the NZAF includes HIV prevention, testing and health services, science and advocacy. This work is funded by the Ministry of Health, trusts and grant-making bodies and donations from individuals and businesses. The NZAF National Office is in Auckland, there are centres in Auckland, Wellington and Christchurch, and contracted professionals providing testing and health services in most other areas of New Zealand. The NZAF is a registered charity that grew out of gay community initiatives in the 1980s and today brings history, passion, commitment, expertise and diversity to meet the emerging trends of the HIV epidemic and the changing needs of the communities it serves.
For more information visit
www.nzaf.org.nz
Koromakinga
Ki te -arai i te tuku o te HIV me te tautoko i ngata-ngata e mau ana i te HIV me o ratou wha-nau.
16
17
New Zealand AIDS Foundation National Office t e
09 303 3124 contact@nzaf.org.nz 31 Hargreaves Street St Mary’s Bay Auckland, 1011
NZAF Burnett Centre t e
09 309 5560 contact.burnett@nzaf.org.nz 35 Hargreaves Street St Mary’s Bay Auckland, 1011
t e
04 381 6640 contact.awhina@nzaf.org.nz Level 1, 187 Willis Street Wellington, 6011
NZAF Awhina Centre NZAF South/Te Tok-a
t e
03 379 1953 contact.tetoka@nzaf.org.nz 253 Cashel Street Christchurch, 8011
FREEPHONE 0800 80 2437 www.nzaf.org.nz