In 2021, 112 people were first known to be infected with HIV in New Zealand. This represents a substantial decrease from 2020 numbers, and the lowest figure in two decades!
The latest HIV numbers out of the University of Otago AIDS Epidemiology Group are very encouraging, despite some uncertainties around COVID-19 impacts on testing volumes. We can also see a significant decline among cases acquired in New Zealand, so it appears we remain on track to ending local HIV transmissions!
A total of 112 cases were notified for 2021 – a decrease from the 162 reported in 2020 and 208 in 2019. Furthermore, the number of locally acquired infections, especially among men who have sex with men (MSM), has continued to decrease.
In 2021, 29 MSM were diagnosed with HIV and thought to have contracted the virus in New Zealand. This is a 43.1% decrease from 2020 numbers, and over 70% decrease from the peak in 2016.
Among MSM, we have also seen a decline in the number of people diagnosed with high CD4 cell counts, which gives us a good idea about those who have contracted HIV recently. Seeing a reduction in this group of diagnoses suggests that HIV incidence is declining in Aotearoa.
We believe this 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 2021, 8 Māori gay and bisexual men were diagnosed in New Zealand, and 7 out of those were thought to have acquired HIV locally, compared to an average of 10.2 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 groups have remained relatively stable. 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, 2964 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 population rates of HIV that are over 348 times higher than among heterosexuals 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 112 new HIV notifications in New Zealand in 2021, 70 were gay, bisexual and other men who have sex with men (GBM).
In 2021, 41 MSM were first diagnosed with HIV in New Zealand and 29 had previously been diagnosed overseas.
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.
Heterosexual Men & Women
In 2021, there were 29 people found to be heterosexually infected with HIV.
Of these 29, 26 were first diagnosed in New Zealand which is a slight decrease from 28 of those heterosexually infected individuals diagnosed in New Zealand in 2020. Only 11 were thought to have acquired HIV in New Zealand, compared to an average of 10.4 from preceding five years.
Among the heterosexually infected individuals in New Zealand in 2021, 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 2021 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. There were 6 infections among people who injected drugs (3 of those had additional sexual risk factors identified) in 2021; of those 6 infections, 1 was thought to have been acquired overseas
We are proud that blood to blood transmission continues to be rare 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.
Sex Workers
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.
Mother to Child
Between 1998-2021, there were 206 births to women known to be living with HIV in New Zealand. None of these children have been infected with HIV. However, the AIDS Epi-Group says, for children born in 2021 it is too soon to be sure about this as acquired HIV cannot be definitively ruled out until the child is slightly older.
In 2021, there were two women diagnosed with HIV through antenatal testing which reinforces the need to continue the effective antenatal screening programme.
Widespread pregnancy screening and effective treatment for pregnant women means that the transmission of HIV from mothers to babies has been at very low levels.
