The first 30 years of HIV in New Zealand: Review of the epidemiology

AIM: To summarise findings of the epidemiology of AIDS and HIV infection in New Zealand. METHOD: Key results from reports of AIDS and diagnosed HIV infection are presented. Where appropriate, data on HIV diagnoses are reported for the period 2010-2014 to indicate the current pattern of diagnoses. RESULTS: New Zealand has a well-described low prevalence epidemic of HIV infection, mostly concentrated in sub-populations of men who have sex with men (MSM), and heterosexual individuals from sub-Saharan Africa and South-East Asia. The former is largely due to transmission within New Zealand, whereas the latter mostly occurred overseas, although the difference has been less marked in recent years. The number of notified cases of AIDS peaked in the late 1980s, and dropped dramatically in the mid-1990s due to the introduction of effective antiretroviral treatments. Presently, most cases of AIDS are in people with previously undiagnosed HIV infection. In contrast, currently the annual number of diagnoses of HIV infection is higher than in the late 1990s, due to more occurring among MSM. Over the past 30 years, each sub-epidemic has demonstrated a distinct pattern, reflecting different determinants. HIV among people who inject drugs, sex workers, children and the general population has been restricted to very low levels. CONCLUSIONS: Control of HIV in New Zealand is favourable compared to many countries, however challenges remain, especially in prevention among MSM, and more timely diagnosis for all, especially those heterosexually infected. National monitoring of the clinical outcomes of people diagnosed with HIV would provide an indication of the provision of effective care and allow international benchmarking.