In 2022, 135 people were first known to have acquired HIV in New Zealand. This represents a slight increase from 2021 numbers, but still one of the lowest figures in two decades!
The latest HIV numbers out of the University of Otago AIDS Epidemiology Group are reassuring that HIV transmissions in New Zealand are on the decline. There were some uncertainties about the impact of the COVID-19 pandemic on access to HIV testing in the past few years, so to see similar numbers in 2022 as 2021, shows that we remain on track to ending local HIV transmissions!
A total of 135 cases were notified for 2022 – a slight increase from the 112 reported in 2021 but still lower than the 162 in 2020 and the second lowest number since 2002. Furthermore, the number of locally acquired infections, including among men who have sex with men (MSM), has increased only slightly from 2021 which was the lowest number reported in two decades.
In 2022, 34 MSM were diagnosed with HIV and thought to have contracted the virus in New Zealand. This is a 65% decrease from the peak in 2016.
Despite this, In 2022, we have also seen an increase in the number of MSM diagnosed with low CD4 cell counts, which suggests that these cases have been living with undiagnosed HIV for some time. Seeing a higher proportion of late diagnoses highlights the need for our communities to be in regular systems of testing for HIV and other STIs suitable to their sexual needs. The earlier a person living with HIV is diagnosed, the sooner they can get on treatment and live a healthier life.
The steady decline in the number of people with locally-acquired HIV means we are seeing the continued impact of local HIV prevention, like PrEP and condom use, and HIV testing efforts that allow for people to be diagnosed early and access medication to live healthy lives without the risk of passing HIV to their sexual partners (see U=U). This is great news.
We once again have a sign that we are starting to halt the epidemic, and we need to keep going. Now is not the time to relax our efforts!
In 2022, 6 Māori gay and bisexual men were diagnosed in New Zealand, and three out of those were thought to have acquired HIV locally, compared to an average of 9 for the preceding 5 years. The most significant decreases in number of new infections have been seen among European gay and bisexual men. At the same time, the numbers for other ethnic groups is decreasing at a slower rate. This means we need to do better to ensure equitable access to the benefits of combination HIV prevention.
With Kiwis’ heightened awareness of public health in light of COVID-19, it is now more important than ever for all New Zealanders to understand HIV prevention and the realities of HIV stigma for Aotearoa to continue to be a world leader in infectious disease response.
While we don’t know the exact number of people living with HIV in New Zealand, we know that, currently, 3033 people in New Zealand are receiving treatment for HIV.
The infections continue to disproportionately affect gay and bisexual men. Recent research shows that this population continues to have a 348x greater risk of HIV than heterosexual people in Aotearoa!
Despite the increased rates of HIV among gay and bisexual men, overall, New Zealand has a relatively low prevalence of HIV by international standards. 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 a strong human rights approach is also a key reason for this.
Gay, Bisexual and Other Men Who Have Sex With Men
Of the 135 new HIV notifications in New Zealand in 2022, 80 were gay, bisexual and other men who have sex with men (GBM).
In 2022, 45 MSM were first diagnosed with HIV in New Zealand and 35 were diagnosed overseas.
While gay and bisexual men account for only New Zealand's population, they are consistently over-represented in HIV diagnoses. There are three clear reasons for this.
Heterosexual Men & Women
In 2022, there were 27 people found to have acquired HIV from heterosexual sexual contact.
Of these 27, 17 were first diagnosed in New Zealand which is a decrease from 20 of those heterosexually infected individuals diagnosed in New Zealand in 2021. In 2022, 13 were thought to have acquired HIV in New Zealand, compared to 11 in 2021. The number of heterosexual men and women diagnosed with locally acquired HIV has in general remained stable with an average of 12 people per year over the past 10 years.
Among the heterosexually infected individuals in New Zealand in 2022, almost half had a low CD4 count at the time of diagnosis that was indicative of a relatively late-diagnosed infection.
While the number of heterosexual men and women infected in New Zealand in 2022 remained stable, the numbers of people who acquire HIV heterosexually each year are small and therefore subject to year-by-year fluctuations.
People who inject drugs
Low numbers of people who inject drugs (PWID) and the successful operation of an effective national needle exchange programme since 1988 has meant that PWID account for very few HIV infections in New Zealand.
In 2022, two people were reported as having acquired HIV through either injecting drug use or heterosexual sex, and one man through either injecting drug use or sex with a man. Of these three people, all had acquired HIV in New Zealand.
We are proud that blood to blood transmission continues to be rare in New Zealand due to the work of the Needle Exchange Programme across the country. This is a great example of the effectiveness of rational, community-focused, and science-led public health policy.
It is widely acknowledged that there are very few sex workers living with HIV in New Zealand. 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-led advocacy group focused on providing equal rights and safe working conditions for sex workers.
Between 1998-2022, there were 209 births to people known to be living with HIV in New Zealand. However, the AEG says, for children born in 2022 it is too soon to be sure about this as acquired HIV cannot be definitively ruled out until the child is slightly older.
Widespread pregnancy screening and effective treatment for pregnant people means that the transmission of HIV from parents to babies has been at very low levels.
AIDS in Aotearoa
AIDS stands for Acquired Immune Deficiency Syndrome. It is an advanced form of HIV. Not everyone that has HIV develops AIDS, largely thanks to advances in medications.
AIDS can develop when HIV is untreated, as the virus weakens a person’s immune system so their body is no longer able to protect itself against infections and diseases that a normal immune system would fight off.
In Aotearoa, there were 18 people (14 men, three women, and one trans woman) diagnosed with AIDS in 2022. Thirteen (72%) had their AIDS diagnosis within three months of being diagnosed with HIV and would not have had the opportunity for treatment to control progression of their HIV infection.
Two deaths from AIDS were also reported in 2022, but this number could rise due to delayed reports.