If the condom broke then there is a risk of contracting HIV. While the risk is greatest for the bottom, it is still high-risk for the top because if the bottom has HIV it can be highly concentrated in the lining of his ass which can then enter the tip of your penis.

PEP is free under certain circumstances, for example if you know that the person you were having sex with is HIV positive. If you aren't sure about his status then you may have to pay. In either case, we recommend visiting your local sexual health clinic or the emergency department of your nearest hospital as soon as possible to find out about your options.

For PEP to be effective it needs to be started as soon as possible and no later than 72 hours after exposure to HIV.

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

The rates of HIV among sex workers in New Zealand are very low compared to other countries. The risk of getting HIV from having unprotected oral sex with any person, including sex workers, is very low. It's also very low risk if you've had anal or vaginal sex with a condom. If you didn't use a condom for anal or vaginal sex then the risk is higher.

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

The inside of the rectum is like a sponge, absorbing nutrients into the bloodstream from food passing through, meaning it can also easily absorb HIV from semen. The cells of the vagina are much less absorbent and not as vulnerable to HIV. However it is still possible to contract HIV through unprotected vaginal sex.

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

Wondering if you could be at risk? Use our tool to find out your risk.

A rapid test for HIV at one of our clinics will give you results in just 20 minutes. Book a free and confidential test now.

Or you can order a self-test and get your results at home in 20 minutes. 

Keep in mind evidence of HIV can be detected by some tests as early as 2 weeks after exposure, but it may take up to 3 months. Everyone responds differently to the virus.

GPs send people off to a lab and blood is taken there. People then have to wait a few days for results, but these tests are 100% accurate.

Our rapid HIV tests are 100% sensitive to HIV, they are FDA approved and 98.9% specific to antibodies, and you will get your result in a few minutes. 

Book a test or order a self test here. 

HIV treatment in New Zealand is publicly funded and free, regardless of immigration status. However visits to a GP or other health professionals are likely to incur costs. More information can be found on the Ministry of Health website 

In Aotearoa, people living with HIV need to be seen by an infectious diseases department or sexual health clinic to initiate medication, as only specialists are able to apply for a special authority for subsidised HIV medication. We advise people to continue to have medication prescribed by their specialist at regular appointments.

Yes. Recently, NZ has changed some of the rules and HIV is no longer automatically considered a condition deemed to impose significant costs to public health system. We believe this means that it is now easier for people living with HIV to be granted visas and migrate to NZ. However, each applicant’s health status may still be considered by Immigration NZ on a case-by-case basis, especially when there are other health considerations. HIV screenings are part of immigration medicals in some, but not all cases, so it is a really good idea to work closely with an immigration adviser that will be able to recommend the best course of action.

It’s okay to have sex with a guy.

Always use condoms in order to prevent contracting a sexually transmitted infection and spreading an STI to anyone else.  It’s best to first talk to your girlfriend about having sex outside of the relationship so that you don’t hurt her feelings. You may find it useful to speak a bit more about sexuality. You might want to consider accessing our or another counselling service.

Started having sex? Here's some things you might want to know 

- Having anal sex for the first time
- How to have anal sex
- Butt Lube 101
- All about Condoms

No. There would have been no risk of HIV infection as there was no bodily fluid contact and the HIV virus dies within minutes of being outside the human body anyway. You may have picked up a stomach bug in some other way or sometimes the stress of worrying about these things can cause us to feel unwell.

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

Your risk of HIV or STI transmission is increased if you had a cut on the end of your penis during unprotected sex, particularly if it was raw or bleeding, as this could allow infected fluid to get into your bloodstream.

It's impossible to say whether your symptoms are related without having a test, so we would encourage you to have a full STI screening and HIV test through your GP or nearest sexual health clinic. It's important to note that with HIV has a window period of up to three months and is detected in a test after this period.

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

Go here to see if we can send you some free condoms or where you can go to find some. 

Or go here to find out where to loads of free condoms in Aotearoa. 

Extremely low. Risk only increases if there are open and bleeding cuts in the mouth. Read more about why oral sex has such a low risk of HIV transmission. 

Read more about what sexual activities place you at risk of contracting HIV.

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

HIV stands for Human Immunodeficiency Virus and is a virus that attacks the immune system, killing off healthy immune system cells that normally fight off infection. HIV is transmitted through blood, semen, anal mucous, vaginal fluid and breast milk.

AIDS stands for Acquired Immune Deficiency Syndrome and is the term used to indicate complete deterioration and destruction of immune function - the final stage of HIV. People with HIV who are on consistent antiretroviral (ARV) treatment can expect to lead long and healthy lives and may never progress to AIDS.

Learn more about HIV

Remember that an HIV diagnosis doesn’t have to stop you living a full and healthy life. With the right treatment and care, you can expect to live just as long as someone who doesn’t have HIV. HIV shouldn’t stop you doing the things you want to do in your life.

Learn more about living with HIV.

Yes. It is possible for pre-cum to transmit HIV via unprotected anal sex. Transmission through pre-cum during unprotected oral sex is extremely low.

Worried about the risk of an event? You can use our tool to find out your risk.

Antiretroviral Therapy uses three different types of drugs to fight HIV – targeting the virus at different stages of its life cycle. The risk of developing resistance to treatment is low as long as you are adherent and do not have a strain of HIV that is resistant to the treatment that you are on.

Resistance to treatment most often arises when the level of HIV treatment in your blood is not high enough to fully suppress the virus. This can happen if medication is not taken as prescribed resulting in a spike in viral load. When this happens, newly replicated viruses that have genes that make them resistant to treatment are selected to survive and continue to replicate. Another way of developing resistance is if you have unprotected sex or share needles with another person who has a resistant strain of HIV and is not undetectable. The strain of HIV that they have would have to be resistant to the treatment that you are on for it to be able to replicate in your body, even if you are taking your medication as prescribed.

Learn more about HIV treatments.

A viral load count is a measure of the number of HIV particles in your blood at a given point in time. Low and undetectable viral loads reduce your chance of passing HIV on. 

A CD4 count is a measure of the number of CD4 cells in the blood. HIV attacks these cells so they are no longer able to do their job fighting infection and therefore conversely to viral loads, the fewer CD4 cells a person has, the more susceptible they become to a wide range of infections. 

Yes. Unlike many medications, HIV medications do not interact negatively with alcohol.

Learn more about HIV treatments.

PrEP and PEP are both HIV medications taken by people who do not have HIV. 

PrEP (Pre-Exposure Prophylaxis) is an HIV medication for people who are HIV negative - taken to reduce the risk of acquiring HIV by up to 99%.

PEP (Post-Exposure Prophylaxis) is a medication given to people who may have been exposed to HIV. Although PEP is not foolproof, if taken within 72 hours of being exposed to HIV, it is likely to reduce the chances of contracting HIV. For PEP to be most effective, it needs to be taken as soon as possible after an episode of unprotected anal sex.

Treatments for HIV these days are far less toxic than they once were and side effects much less of a concern. There are some side effects associated with treatment that will be experienced differently by different people. Managing any side effects that do arise is something your HIV specialist will help you with. The research now shows that the benefits of being on treatment, and preferably as early as possible, far outweigh any issues related to toxicity. If you are worried about this, talk to your HIV specialist.

Learn more about HIV treatments.

New Zealand law requires people living with HIV to take ‘reasonable precautions’ to avoid passing on HIV. The only case to ever come before the courts in New Zealand was for vaginal intercourse. It found that condoms are needed to be used as a precaution. That means that legally, if you are not using condoms during penetrative sex, you must disclose your HIV status. There has not been a case in New Zealand to test whether an undetectable viral load would be considered ‘reasonable precaution. 

Learn more about HIV disclosure.

Everyone responds uniquely to treatment. If you have been on treatment for 6 months or more, and you are taking your medication as prescribed, you have a good chance of significantly reducing your viral load. However, the exact amount of time it takes to get to undetectable will be different for everyone. Not everyone will be able to obtain an undetectable viral load.

Yes, however having sex without a condom always carries the risk of STIs, particularly if you are having sex with other guys as well as your regular partner.

There is also a very small risk that when two people living with HIV have sex without a condom that reinfection will occur, if one partner has a strain of HIV that is resistant to the treatment that the other guy is on. However, if you’re taking HIV medication and have an undetectable viral load you can’t pass on HIV, and therefore this won't be an issue.

Learn more about living with HIV.

No. Remaining on treatment is key to keeping your viral load under control and stopping the HIV virus from replicating. If you stop taking your medication even for a week or two, you give HIV the opportunity to replicate more quickly, increasing your viral load and the risk of developing resistance to your treatment.

Learn more about U=U. 

By far the majority of people need HIV medication to get their viral load down and keep it there. A very small percentage of people living with HIV have successfully managed their viral load without medication. This group, referred to as ‘elite controllers’, are estimated to make up less than half of 1% of all people living with HIV.

Learn more about U=U.

No. Viral loads can go up and down. Small blips are not uncommon even if you are taking your medication as prescribed. Regular monitoring of your HIV viral load is an important part of your treatment regimen.

Learn more about U=U.

There are a range of treatment options, so if you are experiencing issues it is very likely that there will be another treatment that is better for you. This is something you will want to discuss with your HIV specialist. Always keep in mind that not adhering to your treatment carries the risk of developing resistance to certain HIV drugs – meaning your treatment options may be reduced. Any changes to medication need to be managed carefully under the guidance of your specialist.

Learn more about HIV treatments.

Being undetectable does not protect you or your partner(s) from other STIs and if an HIV-negative person has an STI they are at higher risk of getting HIV. There is also evidence that STIs can increase the viral load of someone living with HIV who is not on treatment. However, the presence of an STI does not increase the possibility of transmission if the HIV-positive person is on effective antiretroviral therapy.

Learn more about HIV treatments.

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

Not everyone who gets HIV will experience any short-term symptoms. So, symptoms or not, it's important to test twice a year - or more often if you haven't been playing safe.  In some people, symptoms may occur from two to four weeks after HIV infection and may include flu-like symptoms that are easily confused with other infections, such as fatigue, fever, night sweats, sore throat, swollen lymph nodes, headache, loss of appetite or skin rash. These symptoms usually last less than two weeks although they can last as long as 10 weeks. If you‘ve recently had unprotected anal sex and experience any of these symptoms, you should have an HIV test with NZAF, your emergency room, GP or sexual health service.

Also, keep in mind that not all doctors will recognise the symptoms of HIV. If you see a doctor because you have one of the symptoms listed above, it’s important to explain that you feel at risk of HIV and ask to be tested, even if they don't suggest it. Don't assume you will be tested for HIV just because they take your blood. Ask to be sent a copy of the results.

If you're using daily PrEP to provide protection during anal sex, you need to take it daily for 7 days prior to any sex without condoms to ensure that the levels of the drug have built up to provide enough protection.  You also need to continue taking it daily for 28 days following the last episode of anal sex without condoms for maximum protection.

Cisgender gay and bisexual guys can also start it with a double dose (two pills at once, and continue with single pill every 24 hours), and the protective effect should kick in after two hours. Learn more about how to take non-daily PrEP. If you keep having sex then keep taking a PrEP pill each day. After you’re done having sex, keep taking a pill each for two days after the last episode of sex.  

Learn more about PrEP

It's great that he's taking action to reduce his risk of getting HIV by using PrEP, but him being on PrEP is not a 100% guarantee that he hasn't got HIV.

He may, for example, have stopped taking it for a period of time and unknowingly acquired HIV. So you're still at risk unless you're taking action to protect yourself either by using condoms or taking PrEP yourself.

Keep in mind that PrEP doesn't protect against other STIs like syphilis, gonorrhoea or Hep C, and you won't always know if someone has another STI because they can have no symptoms. Using condoms is the best option for protecting against both HIV and other STIs, but if you struggle with condoms then PrEP at least will provide protection from HIV.

That's an interesting question as piercings are quite common these days. The best advice we can give on this is that you or your partner should remove the piercings before having anal sex. This is because there is a chance that the metal might break through the latex of the condom. Some might argue that the jewellery is smooth and won't tear the condom, but we reckon with metal against latex it's not worth the risk. Be aware too that piercings need time to heal after you first get them so sexual activity during the healing period should be avoided.

Oral sex is very low risk for HIV transmission, find out more about why here. It's important to manage the risks as much as possible, and still enjoy sex.

A couple of things to consider to keep that risk to a minimum is not letting them cum in your mouth and checking for cuts or ulcers either in the mouth or on the penis, as they become potential entry points for HIV to enter into your blood stream. So yes, if you have ulcers in your mouth and you get his cum or pre-cum on those ulcers there is some risk.

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

Ouch! Any trauma should be checked out by a medical professional.

It is really important to remember that everybody is different when it comes to sex. What is 'normal' for one person doesn't necessarily relate to everyone, and the guys on the screen are the exception and not the rule. Bodies will produce different amounts of cum and can take time in 'refilling'.

The use of lube can increase the sensation and sensitivity and ultimately the level of arousal, so experiment with different amounts. Try not to measure yourself on the quantity to determine your quality. 

Firstly, go buy some lube or get us to send you some. The shower gel you're using could have harsh chemicals in it which might be why your asshole feels irritated - soaps can interfere with natural bacteria and irritate sensitive membranes.You should get some pleasure from rubbing around the anus, and then from the prostate, which is about a thumb's length inside your ass towards your bellybutton.

Read more about cleaning your butt 

Relying on negative HIV status to prevent HIV is risky. It requires constant, open communication with your partner(s), and regular testing. And even then, it won't necessarily work.

If you're HIV negative and struggle with consistent condom use, you could consider taking PrEP to stay safe. But remember that while PrEP is great at preventing HIV transmission, it won't protect you against other STIs like gonorrhoea, syphilis or chlamydia.

The short answer is that it's not very safe - because you can never be 100% sure of somebody's HIV status (or even your own status), for the following reasons: First, it can take up to three months from the date of infection for HIV to show up in a test. So, even if you both tested negative yesterday, it's possible that one of you does have HIV and it hasn't shown up on the test. Second, HIV is most infectious in the few weeks after somebody catches it. So if a guy caught HIV a few weeks ago he won't know it yet because it often has no symptoms and it my not show up that early on a test. He'll also be highly infectious at this stage, with a very high chance of passing it on. This is actually how most HIV in New Zealand is passed on - from guys who don't know yet that they have it yet. 

There are lots of ways to help with this; number one, have you got the right size?

We have 49mm, 56mm (standard size) and 60mm condoms we can send out, so if you would like to try some different kinds for free, flick us an email or dm.

Secondly, thickness can play a part. Have a play around with some non-latex condoms, as they're super thin and may make a difference for you. The final thing to do is simply put a small bit of lube on the head of your penis before rolling on the condom. Better lubricating the inside can make a huge difference; just have a play around first before you fuck, as you want to make sure you don't use too much and risk your condom slipping off.  If you're still struggling after trying these options you could consider PrEP, the daily pill that prevents HIV. It's as effective as condoms for preventing HIV but it doesn't provide any protection from other STIs like gonorrhoea or syphilis.

HIV is not spread through saliva, even when used as lubricant for anal sex. However, if he had oral herpes this could be transmitted to your anus.

Spit is generally not a great lubricant though, so this could lead to anal bleeding. We'd recommend getting a water-based lube from the pharmacy or supermarket or we can mail them to you for free!

Worried about the risk of an event? You can use our tool to find out your risk & best next steps.

No. Kissing on the mouth is extremely low risk for HIV transmission; The only time it would be possible is if both people had open wounds in their mouths that were bleeding and kissed for a long, long time

Worried about the risk of an event? You can use our tool to find out your risk & best next steps..

Yes. Condoms and water based lube, when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV. 

Also, people living with HIV who are on antiretroviral treatment and maintain an undetectable viral load (U=U) for at least six months do not sexually transmit HIV.

Learn more about U=U

The condoms available in our free condom and lube packs are:

49mm – Moment
53mm – Moments
56mm - Gold Knight Ultra Thin
60mm – Gold Knight

Learn more about condom sizes (r16)

It's totally normal to feel anxious about telling someone you have an STI. To help, we have made a tool to make it easier! This Tool write the message for you, it lets you pick from a range of options such as what STI you've been diagnosed with and if you'd like to hook up with them again and It will generate a message for you to copy and send.

If you test at our clinic anything you share is completely confidential. You don’t even need to tell us your real name.

You can also order a self-test which will arrive in discreet packaging so you can test privately. 

Book or order a self-test here.

We promise you, it’s better to know. If the result is positive, your life isn’t over. You will be connected to care and support and can live your life with the same dreams and goals. You’ll also likely get to an undetectable viral load and then HIV won’t be transmitted through sex – even without condoms.

Book or order a self-test here.

Testing is one of the most important things you can do to help end HIV transmissions in New Zealand. Most new HIV transmissions occur when people don’t know they are living with HIV and aren’t on treatment.

Book or order a self-test here.

Testing should be a part of a regular sexual-health schedule, not just something you do when things hurt or pustules pop up. Not having any symptoms is pretty common with HIV and a lot of other STIs – you should still be testing regularly.

Book or order a self-test here. (we even have self-STI test kits)

Yes. Being on PrEP (both daily and 2-1-1) still requires three monthly check-ins for HIV and STI testing as well as tests to ensure PrEP continues to be safe for you. These other tests include things like checking your kidneys.

Yes, basically, as long as you are HIV-negative and are eligible for publicly funded healthcare in Aotearoa, you should now have access to funded PrEP.

The cost to be on publicly-funded PrEP should be $5 plus the cost of a GP visit every three months. This cost isn’t different for folks who were on already PrEP before the rules changed. But it does mean more people who are now eligible can get PrEP for much cheaper than they would have previously.

Yes. Both PrEP and PEP can be prescribed by any ‘relevant prescriber’. This simply means all GPs, sexual health physicians, infectious disease specialists, and many nurse practitioners are now able to prescribe funded PrEP and PEP.

You may not have to share it to qualify for funded PrEP under the new criteria. However, it is really important to be open and honest with your prescriber about any drugs you may be using in order to make sure that PrEP is safe for you to use, and that the recreational drugs don’t interact badly with your prescription drugs, so that you get the best health outcomes possible. Remember, prescribers have to keep what you share confidential.

If your doctor hasn’t heard about PrEP or doesn’t know how to safely prescribe it for you, you download a letter to take to your doctor here. You can also direct them to us at Burnett Foundation Aotearoa. We have resources that can support prescribers to learn about PrEP. If they are open to learning then we can help them get up to speed so they can support you.

Otherwise, you have the right to see another provider that does know about PrEP. Check out this map of PrEP-friendly providers around Aotearoa.

Below are some of the standard tests your prescriber should be doing when you go on PrEP and timelines we’d expect for follow-up/ongoing testing. It’s important to remember, PrEP isn’t just a pill – it's a health programme – think of it as a journey rather than a destination. Everybody’s health journey on PrEP might look slightly different, and that’s okay! So the tests and monitoring your prescriber thinks are right for you may look slightly different than what is listed here.

Before starting PrEP, we would expect your prescriber to carry out the following checks:

• HIV testing
• Full blood count
• Hepatitis A, B, and C
• Liver function tests
• STIs: syphilis, gonorrhoea, chlamydia
• Kidney function tests
• Pregnancy testing (for those who may become pregnant)
  

After the first three months on PrEP, we would expect your prescriber to carry out the following checks:

• HIV testing
• Assess side effects
• Hepatitis B (if you are not immune)
• STIs: syphilis, gonorrhoea, chlamydia
• Kidney function tests
• Pregnancy testing (for those who may become pregnant)
  

Every subsequent three months, we would expect your prescriber to carry out the following checks:

• HIV testing
• Assess side effects
• Hepatitis B (if you are not immune)
• STIs: syphilis, gonorrhoea, chlamydia
• Pregnancy testing (for those who may become pregnant)
  

Every six months, we would expect your prescriber to carry out the following checks:

• Liver function tests
• Kidney function tests
• Every twelve months, we would expect your prescriber to carry out the following checks:
• Phosphate
• Hepatitis C

Yes, the new rules enable your prescription for a three-month supply of PrEP to be provided all at once.

Even if you are on PrEP 2-1-1, the recommendation to test every three months for HIV, STIs and kidney function remains the same. The fact that you might not need a new prescription because you have plenty of tablets using PrEP 2-1-1 does not mean you should delay your PrEP follow-ups – these check-ups are about your ongoing health, not just to get more PrEP. We strongly recommend that you do get the required testing every three months, even if you still have PrEP pills left.

It is unlikely that you will be able to get access to more than three months of PrEP to take with you if you are going to be out of the country for more than three months. Many countries impose limits on the quantity of medication you may bring with you for your personal use, and quite often this restriction is up to 90 days. If you are travelling for a long time, it is a good idea to find out how to access PrEP in the country you are visiting.

If you are a work visa holder who’s eligible to be in New Zealand for two years or more, then you are likely eligible for publicly-funded PrEP. Unfortunately, most other temporary migrants are still not eligible for publicly-funded PrEP. Click here to find out if you are eligible to access publicly funded health services in Aotearoa.

However, even if you are not eligible, you can still consider paying for PrEP yourself. This involves getting a prescription from a local prescriber as well as other costs you will need to be able to cover ongoing.

Potential costs include:

• Consultation fees with the prescriber
• Three-monthly HIV and STI testing
• Prescription renewal fees
• The cost of importing or buying PrEP directly from a local pharmacy

Burnett Foundation Aotearoa continues to advocate for decision-makers to improve access to HIV prevention, including PrEP, for those who are not otherwise eligible for publicly funded healthcare in Aotearoa.

While the risk of HIV transmission is highest for those having anal sex, there are some other scenarios in which PrEP might be beneficial.

For example, if you have condomless vaginal sex, there is still some risk of HIV transmission from infected semen, pre-cum or vaginal fluids. PrEP would likely be of significant benefit to you if you are having vaginal sex with gay, bisexual, or other men who have sex with men outside of a monogamous/exclusive sexual relationship. 

PrEP would also likely benefit:

• People having vaginal sex with partners who are living with HIV where the HIV-positive partner does not maintain an undetectable viral load.
• People intending to travel overseas and anticipating condomless vaginal sex with partners in regions of high HIV-prevalence.

If you are only engaging in oral sex, then you will likely not benefit from PrEP, as oral sex presents an extremely low risk of HIV transmission. Having an open and bleeding wound in your mouth does increase the risk of oral HIV transmission slightly, but there would need to be a significant amount of semen containing a high HIV viral load coming into direct contact with the wound. You cannot acquire or pass on HIV by rimming (licking or eating out someone's ass) and you cannot acquire HIV by receiving oral sex.

People who have shared needles in the past or anticipate sharing needles during injecting drug use in the future, especially in the context of chemsex, may also benefit from PrEP.

Yes, generally speaking. Tenofovir disoproxyl and emtricitabine (the active ingredients of PrEP) are generally considered very well-tolerated (which means you are not likely to experience unpleasant or dangerous side effects) and safe for most people to use, including most older people. That being said, it’s important to remember there may be individual health issues that can make PrEP use less safe. Which is why, when taking PrEP – like any other medication – it is best to have an open and honest discussion with your prescriber about your health, as this will help them to give you appropriate advice on whether PrEP is safe and suitable for you to take.

While most people will breeze through taking PrEP without noticing any day-to-day side-effects, some may experience them. Some people experience: gas, bloating, diarrhoea, low energy and nausea. However, these side-effects are usually mild and go away after the first few days or weeks on PrEP. Your doctor should also offer you regular check-ups to make sure PrEP continues to be safe for you in the long run.

Read more about potential side effects here.

When taken as prescribed, PrEP offers nearly full protection from acquiring HIV. The cases where PrEP has failed to prevent HIV transmission when used correctly are very rare but these have been covered in medical reports.

This is why everyone using PrEP needs to be tested for HIV every three months. You should also remember that PrEP does not reduce your risk of contracting other STIs.

These days, approvals should be instantaneous, and you should be able to get your script without delay.

These approvals, called an Electronic Special Authority are basically an electronic form that your prescriber fills out. The system should return a response instantly and this is a process that typically doesn’t involve you – it's just admin for your prescriber. There are still Paper Special Authority application forms, which are processed within 10 working days, but the vast majority of practices use electronic forms so you shouldn’t usually need to wait.

As part of starting PrEP kidney and liver function are tested. If they are too low, you will not be able to take the standard PrEP medication supplied in New Zealand. This may have already happened to you.

In some cases, there is an alternative medicine containing Tenofovir alafenamide and Emtricitabine (called TAF for short) that can be used as daily PrEP instead. This cannot be purchased in NZ from a local chemist. But with a prescription you can import this drug for personal use from overseas. You will need a local doctor to support you and ensure your safety. 

If you would like more information on TAF importation please email [email protected] or speak to one of our peer testers.

It depends, but some level of testing should be carried out every three months. The testing schedule is quite complex and, in some cases, may be tailored to your individual health circumstances. It’s important to have regular check-ups while taking PrEP, so your kidneys and liver can be monitored when appropriate and you should be doing HIV and STI tests every three months when you refill your prescription. While it is not common, PrEP can interfere with kidney function, and your prescriber may advise you to stop taking PrEP. The drugs in PrEP also suppress the hepatitis B virus, so starting and stopping PrEP can cause virus flare-ups and liver inflammation if you have a chronic hepatitis B infection.

We don’t know yet. We would love for folks in Aotearoa to be able to access PrEP in as many ways as possible, but this will be conditional on PHARMAC providing public funding for it. This process may take time and the end outcome depends on how the price stacks up against other alternatives (including oral PrEP which is currently much cheaper than injectable options globally).

Mpox is an ongoing health risk that our communities must be aware of. While mpox is a self-limiting illness (i.e., can resolve on its own) and most people recover in a few weeks, some symptoms can be very uncomfortable, and it currently requires an isolation period to prevent transmission.

Symptoms can be more severe in immunocompromised people.

A reminder: most people living with HIV and receiving treatment in Aotearoa are not considered immunocompromised.

People living with HIV are overrepresented in the number of mpox cases, but the reasons for this are not certain. It appears that people living with HIV who are on effective treatment are typically experiencing infection in a very similar way to their HIV-negative counterparts, which means it is most often mild and self-limiting. However, those who are not on treatment or have low CD4 cell counts may be more vulnerable to more severe mpox disease.

The JYNNEOS vaccine is safe for people living with HIV. It has been tested among people living with HIV with CD4 counts >100. It can be used in people with lower CD4 counts, but we are not yet sure if it will be as effective.

Right now, the best thing you can do is arrange an mpox consultation with your GP or local sexual health clinic, who will work with you to determine if a vaccine is appropriate.

Otherwise, keep an eye out for symptoms. Look out for any skin changes, new lesions/spots/scabs or any new pain and discomfort in the genital, anal or rectal areas (around your butt and butthole).

Other symptoms include fever, swollen lymph nodes, fatigue, muscle ache, headache and flu like symptoms (keep in mind that these do not appear in all mpox cases and can often be symptoms of other illnesses).

If you are concerned, stay home and get in touch with your local sexual health clinic or GP and follow their instructions.

Being alert and getting tested if you experience symptoms will be the easiest way to know what you might be dealing with.

Mpox is primarily transmitted through skin-to-skin contact and direct contact with skin rashes, lesions or scabs, and may be transmitted through bodily fluids. In this global outbreak, the most common and efficient way mpox is spreading is through sexual contact.

Gay, bisexual, and other men who have sex with men make up a small portion of the population. So, when we’re meeting another person for sex, the pool of people we are choosing from is much smaller. That makes us quite closely connected sexually, which can allow mpox to spread more quickly among us.

Not necessarily. Symptoms can start with just some spots/lesions (usually around the face, arms or legs). In this global outbreak, we are seeing more rashes/lesions on the mouth, genitals and anus where they may not be easily spotted by the individual. Because of this, it’s important that if you are at risk and you notice any new symptoms, that you get them checked out early. For example, there have been reports of people experiencing proctitis, rectal pain discharge, or constipation) as the only symptom of mpox, so make sure to see your doctor if you have pain in or around your anus (butt) and genitals.  

Yes, mpox is contagious if you have close or skin to skin contact with an infected person. But by following public health advice, you can avoid passing it on to other people. In the current outbreak, most infections are thought to have occurred through sexual contact. Mpox is not spread the same as illnesses like COVID-19. Mpox can be passed on through breathing in droplets exhaled by someone who has the virus, but this is very rare.  

Mpox can spread to those you live with as direct contact is also a mode of mpox transmission, but in general the risk of this happening is low.

If you want to reduce the risk to your friends and whānau make sure to do the following:

• Avoid physical contact with others, cover any lesions, and regularly clean common spaces.
• While symptoms persist, use your own towels and sheets and avoid contact with pets.
• Sleep in a separate room where possible.
• Use a separate bathroom where possible, otherwise clean the bathroom in between different people using it.

If any of your whānau are identified as close contacts, they should also follow instructions from Public Health officials. They will not be required to isolate unless they start showing symptoms.

You will also be provided with specific guidance and advice from Public Health about how to keep others safe.

Our communities have a right to know about issues that could affect our health and wellbeing. 

Talking about a global public health issue that has had cases within New Zealand is not what we would call fear mongering. We are raising awareness, encouraging government to protect those most at risk, and giving people information they need to be safe and make informed choices about their own health. Prevention is the best medicine – the more people who know what to look out for, what to do and where to get help, the less likely it is we’ll see a larger outbreak disrupting people’s lives and the health system here.

This is complicated. It is not classified as a sexually transmitted infection (STI), BUT, in this global outbreak it is primarily spreading through sexual contact (the majority of cases have been associated with sexual contacts!). This is because of the role that close skin to skin contact has in transmission.

Using condoms is important as we are seeing that the first mpox lesions may often appear where the person has had contact with infected lesions or skin to skin contact. If this is while having oral sex, you could get lesions in your mouth. If this is after anal sex, you can develop lesions on the penis, scrotum or in the anus and rectum (inside your butt or around your butthole – ouch!), which are more sensitive than other areas. This can be very painful or can cause complications.

Essentially, while unlikely to eliminate the risk of mpox transmission, using condoms can prevent you getting mpox where it might be more painful or sensitive.

Plus, (and this applies to everyone, even if you are using PrEP or relying on U=U as HIV prevention), condoms are effective at reducing the risk of other sexually transmitted infections which can appear similar to monkeypox and can also be associated with unpleasant symptoms.

Some people will need to know so that they can protect themselves or support you, but you won’t have to tell anyone who doesn’t need to know:

Close Contacts (including sexual partners)

Yes, people who have had close contact with you while you have been infectious do need to know. Public Health will work with you to inform your contacts. Unless you tell them yourself, public health will not tell your contacts that you have mpox, just that they have been in contact with someone who has mpox.

Whānau

The people you live with may need to know so that you can protect each other. You don’t need to tell anyone else in your whānau or anyone else you don’t want to know. Having mpox is nothing to be ashamed of, so if you need any help, consider reaching out to those around you for support.

Employers

Public Health will work with you to do this. Your healthcare provider can provide you with a medical certificate to give to your employer as evidence that you are required to isolate and cannot attend your place of work. This certificate will not include clarification of an mpox diagnosis unless you have asked for it to. Instead, it will just give a general explanation that you cannot attend work due to medical reasons. Your employer would only be told of your mpox diagnosis if Public Health needed to manage potential exposure to mpox in your workplace, but this is unlikely.

Yes. You must isolate at minimum for 7 days from when the lesions first appeared. After this, your isolation requirements will be reviewed by Public Health. Your time to isolate depends on the stage of healing for your lesions, where they’re located, and how you’re feeling. This is likely to be a two-to-four-week timeframe depending on when you tested positive. Public Health will assist with ensuring you are safe to leave isolation as soon as possible.

We have compiled a handy list of things you can do here.

Globally, there are vaccines that can be used to prevent mpox. The JYNNEOS vaccine has been used internationally and shows good safety and efficacy. Mpox vaccines can be used to prevent mpox before you have been exposed or after you have been exposed to prevent mpox from developing.

The supply of the mpox vaccine has touched down in Aotearoa, and is available via select GPs and sexual health clinics to:

• Gay, bisexual and other men who have sex with men (MSM) who have multiple sexual partners;
• Trans and non-binary people who have sex with MSM, and;
• Anyone who is a close contact of someone who has been infected with mpox.

The vaccine itself is free, however consultation fees may apply. 

Once you have received a vaccine, you will be eligible for a second dose after 4 weeks.

We expect you should be able to access the vaccine in a way that offers you as much privacy as possible. Our understanding is that this vaccine does get documented on your medical record. As it is a two-dose schedule that's spaced apart, documentation in this way will help you and your provider make sure this is done correctly.

You can find the latest information regarding local case numbers on Te Whatu Ora’s website.

Most of us will be familiar with the effects of alcohol (aka booze, liquor, drink etc), which is the most common but also the least likely to be associated with drugs. Yes, alcohol is technically a drug, so if you drink but “don’t do drugs”, guess what – this page is still very relevant for you 😉

Often underestimated in its dangers, alcohol can be really problematic for some people and it does some pretty nasty damage to the body over time. For others, it's a manageable way to loosen up and have some fun.

Know what you’re in for:

• A feeling of relaxation
• Trouble concentrating
• Reduced reflexes
• Increased confidence
• Heightened mood: feeling happier or more depressed than usual
• Lowered inhibitions

Most of us will be aware that the comedown from alcohol (the hangover) can be an unpleasant and painful experience. Rehydration is the key here and if you can keep food down, that's a bonus. Grab a sports drink and prepare for a day of Netflix under a duvet, depending on the severity.

Abuse of alcohol over time could result in:

• Erectile dysfunction and infertility
• Memory loss and/or brain damage
• Difficulties with pregnancy and becoming pregnant
• Depression
• Chronic liver disease
• Drug dependency
• Reduced kidney and liver function
• An increased risk of heart disease

Methods of taking:

• Ingested/Drunk

Mixing:

Alcohol has reported negative interactions with most other drugs.

• Alcohol + other drugs classified as depressants (GHB, Ketamine and certain prescription medications) are a dangerous combination. Together, they may increase the risk of overdose by reducing heart rate and breathing to dangerously low levels.
• Alcohol + Cannabis may cause nausea and vomiting. Feelings of anxiety and paranoia may also occur when the drugs are taken in combination.
• Alcohol + Cocaine will strengthen the stimulant effect of cocaine and places the heart under extreme stress. This condition has been linked to sudden death.
• Alcohol + Ecstasy generally lessens the overall effect of ecstasy. It can, however, dangerously increase these effects, speeding up the process of dehydration.

Cocaine is a stimulant derived from the leaves of the coca bush, widely known by many street names, including coke, snow, blow, nose candy, crack, freebase etc.

Sought out for its quick onset of a euphoric state, reduced inhibitions, and increased energy and motivation, cocaine has quite a short sharp high and is highly addictive. It's easy to build a tolerance to cocaine, meaning continued use can require larger doses to achieve the same results.

Coke can give you more confidence and enhance your libido, but it can also cause you to be self-centered and pay less attention to your partner, so knowing boundaries from the outset and checking in with them regularly during sex is important. Some folks might use coke to keep them going when their body would ordinarily want to crash, so is more common in long sex sessions (or can turn a regular sex session into a long session).

Harder to get a hold of here in Aotearoa, coke is notably expensive - meaning cheap/affordable "coke" is likely methamphetamine.

Effects:

• Increased confidence and motivation
• Feelings of euphoria
• Reduced inhibitions
• Dilated pupils
• A dry or pasty mouth
• Increase in heart rate
• A reduced appetite
• Excess sweating
• Increase in libido

Snorting cocaine may result in nose bleeds, infections of the nasal passage, a perforated septum, and long-term damage to the nasal cavity and sinus.

Also, the comedown is no cakewalk! Try and look after yourself when coming down; do something relaxing with people you trust, as you're likely to experience the below:

• Restlessness/irritability
• Paranoia
• Radical mood swings
• Lethargy/exhaustion
• Anger

Methods of taking:

• Snorted/sniffed
• Injected
• Ingested/rubbed into gums
• Smoked (Crack and Freebase)
• Most commonly snorted, cocaine is the original line on the mirror.

Dosage info:

• Active dose: 20-50mg
• Common dose: 50-100mg
• Risk of overdose: It is hard to pinpoint the cocaine dose that will cause an overdose - tolerance, weight and purity of the drug all confuse this number. One thing to remember is that cocaine use often promotes compulsive redosing - making it harder to track how much is in your system as the night goes on

Prolonged use can badly damage the tissues in your nose, even eating away at your septum - use alternate nostrils where possible. Make sure you're not sharing snorting equipment as cuts and irritations could result in blood passing from one nose to another. It's a good idea to rinse your nostrils out after a hit kicks in to avoid the drug damaging tissue.

If you are injecting, it’s important to use clean injecting equipment and to avoid sharing needles or other injecting equipment.

Mixing:

• Cocaine + Alcohol will strengthen the stimulant effect of cocaine and places the heart under extreme stress. This condition has been linked to sudden death.
• Cocaine + other stimulants (ecstasy, amphetamines) will put the heart under pressure and will increase the risk of overdose.

GHB/GBL (both commonly referred to as ‘G’, despite being different drugs) are depressants that slow down the body’s functions with effects of euphoria, disinhibition and relaxation lasting up to 2.5 hours with after effects of up to 4 hours. They have a lot of different street names, so you may encounter the street names G, Fantasy, Waz, G-riffic, Goop and Liquid G.

The major risk for G is that the active dose is very small - 0.3ml - and it’s easy to accidentally use too much. It is also common to lose track of time and not be aware of when you last used.

Effects:

• Feelings of euphoria
• Increased libido
• Lowered inhibitions
• Relaxed muscles - especially in the anus
• Memory lapses
• Clumsiness and or loss of motor control
• Dizziness or headache
• Lowered body temperature and heart rate
• Nausea, diarrhoea or difficulties urinating.

The effects of GHB/GBL are felt within 15 to 20 minutes and may last up to 3 or 4 hours depending on the strength of the substance and quantity consumed.

Little is known about the long-term effects that G has on the body. This is because the chemical composition of GHB/GBL varies, largely due to the method in which it is manufactured. What we do know though is this - it’s very easy to take too much G. The difference between the amount needed for a high to that of a fatal dose can be difficult to judge.

The effect of G depends on a couple of factors. For starters, you need to be sure whether you have GHB or GBL on your hands, as GBL (which is converted to GHB in your body) actually has a faster onset and is often more potent. Next, think about your body weight: if you are lighter, use less. Matching a playmate or friend’s dose is not the way to go, as bodyweight and tolerance could mean they are taking way more than you should. People often feel effects at very low doses, so remember to start with less.

Methods of taking:

• Measured and drunk (usually diluted)
• Not injected
• Not sniffed or snorted
• Not shafted/booty bumped

Use a syringe (without a needle) to measure the dose rather than guessing or swigging from a bottle. Don't let others dose you - stay in control of your own doses. Diluting in a small amount of water or soft-drink can help avoid chemical burns from G.

Dosing info:

• Active dose: 0.3 – 0.9ml
• Common dose: 0.6 – 1.5 ml
• Risk of overdose: 1.5ml or more

At 2ml or more of GHB, unconsciousness is likely, and death is likely at 5ml or more. If people are unresponsive, they need immediate medical attention, so dial 111 and request an ambulance. Remember that GBL can be more potent, so start with a smaller dose if you know you're using GBL.

Keeping track of how much you have used and when is very important. You can set a timer on your own phone to wait at least 3 hours before using again. Remember - it's VERY easy to overdose on G. It's not uncommon to assign a "G mama" or "tripsitter" to help people keep track of doses and timing. You may even be organised enough to create a little spreadsheet or timetable that could be stuck to the fridge (or anywhere obvious) to track who's had what doses and when.

Another handy tip; G is a clear liquid that could easily be mistaken for something else. Consider storing it in a container that isn't a drinking receptacle to avoid someone else (or yourself) picking it up and taking a massive dose by mistake. You could also use a food colouring to avoid this.

Mixing:

The effect of G in combination with other drugs, including over-the-counter or prescribed medication, is unpredictable. Here are some of the known interactions between GHB/GBL and other drugs including prescription medications:

• GHB/GBL + Alcohol - Do not take GHB with alcohol. Just don't do it. If you have been drinking alcohol and use GHB the risk of overdose is very high. Both these drugs are depressants and the effects compound which can lead to unconsciousness, coma or death.
• GHB/GBL + Benzodiazepines greatly increases the chance of overdose.
• GHB/GBL + Amphetamines or Ecstasy places strain on the body and increases the risk of seizure. Using GHB/GBL to help with the come down of stimulants may lead to a cycle of dependence on both drugs.

Often represented as 🐎 due to ketamine’s traditional use as a horse tranquilizer, ketamine, or simply K, is an anaesthetic that has hallucinogenic properties and produces increased feelings of happiness.

However, too much K can pull you into a K-hole where you may not have full control over your body. For this reason, having a sober friend or experienced user that you trust with you to tripsit in case the state becomes overwhelming, or your dissociation becomes dangerous (i.e. not seeing a staircase, pool or road, etc.).

Ketamine is often found in a crystalline powder form, and sometimes found as a pill or liquid. It's known to be hugely dissociative, which means people using ketamine may find themselves completely disconnected from their surroundings and bodies as strong hallucinations affect sense of sight, smell, taste and feeling.

Effects:

• Increased feeling of happiness
• A sense of detachment from your body – falling into the "K-hole"
• Hallucinations
• Confusion, clumsiness and lowered pain sensitivity
• Increased heart rate and/or blood pressure
• Slurred or slow speech
• Anxiety and panic attacks

Ketamine bladder syndrome: Taken in large, repeated doses, ketamine may cause a painful ongoing condition known as ketamine bladder syndrome. Symptoms include incontinence and ultimately ulceration to the bladder.

Coming down from a ketamine session can be pretty disorienting. You may experience memory loss, clumsiness, and have your judgement/reasoning impaired.

Methods of taking:

• Snorted
• Injected (into muscle rather than a vein)
• Shafted/Booty-bumped
• Most commonly injected.

Dosage info:

• Active dose: 5-10mg
• Common dose: 50-125mg
• Risk of overdose: Ketamine is not as easy to overdose on as with some other drugs, but the dissociative and numbing effects mean harm to the user can be from being injured by interactions with their environment in this state - e.g. drowning.

Mixing:

• Ketamine + Alcohol or Opiates may lead to a reduced awareness of the amount of combined depressants being taken. This could result in overdose. Signs of overdose may include nausea and vomiting, slowed heart rate and breathing, coma and possibly even result in death.
• Ketamine + Amphetamines, Ecstasy and Cocaine place an enormous strain on the body, leading to an increased heart rate and the possibility of heart failure and/or stroke.

Whether you snort it, swallow it, dissolve it, or shelve it, Molly is likely to be at most parties. MDMA is affectionately known as the love drug, so can lower your inhibitions when it comes to sex and intimate connection.

Molly is often found in pill, capsule or powdered form - and is usually taken to induce a euphoric state and heighten sensory awareness.

Sometimes, people think they’ve had MDMA when they’ve actually had something else, so it’s a great idea to test your drugs beforehand.

Effects:

The desired effects of MDMA are felt somewhere between 20 minutes to an hour after the drug has been taken and can last upwards of 6 hours in the body.

• Increased confidence and feelings of euphoria
• Dilated pupils
• Reduced inhibitions
• Clenching/grinding of the jaw and teeth
• Heightened sensory awareness
• Excessive sweating
• Nausea and reduction in appetite
• Increased heart rate
• Increased risk of dehydration
• Restless sleep patterns and or insomnia
• Heat stroke
• Long-term use may eventually cause depression, memory loss or cognitive impairment, dependency, anxiety or reduced kidney and liver function

Come downs from MDMA can be quite intense and sometimes emotional. Monitor your feelings - having a cry is totally fine, but if you're feeling super low, call a trusted friend to come and give you some support.

It's important to stay hydrated when you've taken MDMA, as it will help regulate your body temperature. MDMA also introduces a risk of overhydration - so make sure to enjoy your water slowly rather than chugging constantly. Having an electrolyte-heavy beverage like a sports drink can help with this too. Also, remember to pee!

Methods of taking:

• Ingested/swallowed
• Snorted
• Rarely injected
• Most commonly encountered in pill form.

Dosage info:

• Active dose: 40-75mg
• Common dose: 75-125mg
• Risk of overdose: It is hard to pinpoint the MDMA dose that will cause an overdose - tolerance, weight and other compounds present in the pill all confuse this number

Mixing:

• MDMA + Alcohol may increase your risk of dehydration or consequently it may result in the drinking of too much water.
• MDMA + Amphetamine may increase the potential for anxiety and reduced brain functioning. This is due to the depletion of dopamine in the brain. Enormous strain is also placed on the heart and body and this has the potential to lead to stroke.
• MDMA + SSRIs (anti-depressants/anti-anxieties) can be risky as with mixing any drugs, as it is hard to predict how one drug will interact with another. Avoid using MDMA if you are on anti-depressants (MAOIs or SSRIs) as they act on the same areas in the brain making the effects unpredictable and dangerous.

Methamphetamine is a stimulant that has effects of intense alertness, energy and, in this setting, increased sex-drive and euphoria. It's also known as Crystal Meth, P, Tina and Meth. The main effects last up to 8 hours with after-effects up to three days later. Using larger doses over longer periods can result in agitation, mood swings, paranoia, hallucinations or seizures.

Effects:

• Increased confidence and motivation
• Feelings of euphoria
• Reduced inhibitions
• Dilated pupils
• A dry or pasty mouth
• Increase in heart rate
• A reduced appetite
• Excess sweating
• Increase in libido

Like with many chems, using meth (particularly if using regularly) may result in unwanted or detrimental effects:

• Agitation and mood swings
• Paranoia and hallucinations (you may have heard of this as meth psychosis)
• A reduced appetite
• Seizures
• Extreme weight loss
• Restless sleep patterns and or insomnia
• Ongoing dental problems
• Difficulty concentrating
• Respiratory issues
• Muscle stiffness
• Snorting meth can damage the nasal passage and cause nose bleeds

Methods of taking:

• Smoked
• Injected (slammed)
• Shafted (inserted rectally)
• Snorted

Methamphetamine is more commonly smoked, which is the safer way to use it when it comes to risk of HIV transmission. Some people shaft meth, which means inserting it into the anus. Shafting meth can increase the risk of acquiring HIV because it can damage the lining of the anus, creating a potential entry point for HIV. If injecting (also known as slamming), always use sterile equipment (spoon, needle and syringe) and never reuse or share.

Remember, you can get free sterile needles and syringes from Needle Exchanges and some pharmacies, as well as return used equipment to be safely disposed of.

Dosage info:

• Active dose: 5 – 10mg (half – one point)
• Common dose: 10 – 30mg (one point – three points)
• Risk of overdose: More than 30mg (more than three points)

Mixing:

• Amphetamines + Antidepressants or Alcohol/Cannabis/Benzos - Because amphetamine speeds up the body, when it’s combined with depressants it may increase your risk of heart attack or stroke. Use of uppers and downers at the same time places the body under a high degree of stress. As your body attempts to deal with the conflicting chemical messages produced by different drugs, you significantly increase the negative side effects and this could result in overdose.

Poppers are the most common name for a type of inhalant – usually Amyl or Butyl Nitrite – that are used for their dilatory, muscle-relaxing effects and short-term euphoria. Renowned for their effects on anal sex, poppers may be quite a common encounter.

Most safely used by inhaling the vapour (and the vapour only!). This can be done by placing the bottle near the nose and inhaling for a maximum of five seconds. If you want an extra huffer-buffer you can drop some on a tissue or cotton and inhale from this to further reduce the chance of accidentally having the liquid enter your nose.

Effects:

• Pretty much instant effects
• Sense of warmth and euphoria lasting 2-3 minutes
• Relaxed muscles – especially the anus
• Lowered blood-pressure – which can cause light-headaches and increased heart-rate

Swallowing poppers is extremely dangerous and potentially fatal - they should only ever be inhaled as they can potentially cause users to fall unconscious or slip into a coma.

If you, or someone around you, swallows poppers - you should immediately call 111 as urgent medical care is required.

If you've got heart problems – it’s best not to play with poppers

Methods of taking:

• Huffed/inhaled
• Never drunk
• Never injected

Mixing:

• Avoid using poppers with drugs like Viagra or blood pressure medication as this can be dangerous. It lowers the blood pressure, which can cause fainting, or even fatal drops in blood pressure. When mixed with stimulants such as speed, meth or cocaine, Viagra increases the stress levels on your heart and puts the body under a lot of pressure. GHB also lowers blood pressure, so mixing with poppers can be dangerous as it increases the chance of losing consciousness or respiratory issues.

Viagra is a prescription medication used in the treatment of erectile dysfunction. It acts by increasing blood flow to the genitals and, voilà; you've got a somewhat instant boner (you'll still need to be aroused, of course).

Viagra is simply a brand name - the active ingredient in Viagra is sildenafil citrate. Other medications such as Cialis have similarly acting active constituent, produce the same result and will affect the long and short-term health of users similarly.

Viagra is found in tablet form. All sildenafil citrate products are manufactured either as a pill or an oral jelly.

Effects:

• Relaxed blood vessels in the penis resulting in long-lasting erections
• We’re talking 2-5 hours where you may have more than one prolonged boner
• Overdoing Viagra or any similar product can result in priapism (which is doctor-speak for a painful erection that won’t go away)
• Impotence and permanent penile damage can occur if you maintain an erection for more than four hours

Methods of taking:

• Ingested (pill or jelly)

Yes – however, each application will need to be for separate kaupapa, and cannot be combined for a total value of more than $10,000.

Within the context of this application process and fund, we are looking for events, wānanga, or other kaupapa that engage and support takatāpui and diverse Māori communities. We are not limiting applicants to particular types of kaupapa and encourage you to apply if you meet our criteria! Find out more about some of the previous kaupapa we have funded here.

We will only accept applications led, or in partnership with Takatāpui and rainbow Māori. However, we will consider applications from individuals and organisations who don't identify as Takatāpui or rainbow Māori, provided the kaupapa serves these communities. 

The Marketing Team lead and Pouwhakahaere Māori will make the assessments in line with the Hononga Takatāpui criteria and funding guidelines available here, though staff with additional lived experience (such as staff living with HIV) may be involved in the decision making if it's important to the kaupapa. All applicants will be contacted to advise the outcome of their application, regardless of the decision. Some applicants may be required to submit further information before a final decision is made.

Hononga Takatāpui will not fund the purchase of alcohol, cigarettes, or other harmful substances. However, we may still fund kaupapa that include alcohol (i.e. a catered event).

There is no set timeframe for fund expenditure as every kaupapa is different. However, pūtea should be spent by the expected conclusion of the kaupapa as set out in your application. If this is delayed, kei te pai; we simply ask that you keep us in the loop and advise a new deadline for completion.

Please note, however, that funding applications Pūtea Kaupapa will only have the last 20% of funds released upon completion of an approved wrap-up report, submitted within 6 weeks of the kaupapa ending.

Applications can be submitted any time after the funding round has opened (5 August 2024), until the fund is fully allocated. After this date, our website will be updated accordingly.

Any of the following bank account evidence will be accepted by Burnett Foundation Aotearoa:

1. A pre-printed deposit slip which includes the full bank account number (bank, branch, account number and suffix) and the account holder’s name.
2. A bank statement which includes the full bank account number (bank, branch, account number and suffix) and the account holder’s name.
3. A letter from the bank which includes the full bank account number (bank, branch, account number and suffix) and the account holder’s name. This must be signed and stamped by the bank.
4. An internet printout which includes the full bank account number (bank, branch, account number and suffix) and the account holder’s name and the web address along the top or bottom of the page. This does not need to be signed and stamped by the bank unless all of the above is not provided on the printout.
5. ATM printout must show the bank logo and the full bank account number (bank, branch, account number and suffix) and the account holder’s full name.
6. Hand-written bank account evidence as long as it includes the full bank account number (bank, branch, account number and suffix) and the account holder’s name. This must be signed and stamped by the bank.

If you have any further questions or if you require our assistance in completing the application for our fund please email and let us know at [email protected]

A legal entity includes incorporated societies, charitable trusts, and companies with a charitable status. Only a legal entity can apply for funding above $5,000. You will need to provide one or more of the following document as proof, which includes, but is not limited to:

• Current constitution or trust deed and certificate of incorporation,
• Letter from your district Māori Council/appropriate iwi authority
• Copy of a Māori Land Court Order
• Bank account details
• Proof of organisational structure
• Copies of minutes of meetings/annual general meetings.

Applications are reviewed every two weeks. Some applications may be able to be fully assessed, in which case a decision will be communicated within 48 hours of assessment. However, some applications may require further information before being assessed, in which case they may need to wait until the following review date.

Anyone can apply for applications up to $5,000. However, for applications over $5,000, applicants must be from an approved representative of a legal entity. For more information, please see our funding programme guidelines.

The map can appear quite busy, so you have the option to only show the following:

• Cruisers: Only shows profiles. This can be further segmented for registered accounts to specify things like people who are currently online, are hosting at specific types of places (i.e. a gloryhole) or people who you have recorded chat history with.
• Places: Only shows popular cruising spots. This can be further segmented for registered accounts to specify things like location type (i.e. bathhouse), popularity (based on historic number of users at the location), and whether or not it’s currently active.
• Groups: Only shows groups that have been set up by users.

The Sniffies logo at the top of the page has a variety of options in the drop-down, including:

• Online safety tips
• A fetish wiki
• Hush (a culture and lifestyle resource focused on sex, love, hookups, and holistic sexual health for men into men)
• Resources on topics such as sex ed, mental wellbeing, and mpox.

Here, you can do things like view and edit your profile (even anonymous profiles), view and edit your account, access vanilla mode (blocks explicit content), and turn on the location randomizer.

One key difference between Sniffies and other apps is that users have a lot of profile options to choose from, including sexual position preference, expression (i.e. tribe), fetishes, clothing you find sexy, what you’re into, how you prefer to interact, and your HIV and STI prevention method(s) of choice. You can often select multiple options, which means you can be very specific about what you’re after.

One important thing to note – unlike other options, there is no ethnicity listing on Sniffies.

Recent chats, including:

• Pinned chats (only for paid users)
• Location chats (you need to be registered, but not necessarily paying)
• Groups – only paying users can add groups though if you’ve been added to a group by someone else you can see group chats here

Chats are deleted after 2 months unless you keep the chat going, or if they’re pinned.

This is a public message board, where any paid cruiser can give a cruising update i.e. ‘I’m cruising now, doors unlocked’ – you would then shift the conversation to private chats to provide more info, for safety reasons. Non-paying users can still view cruising updates.

You have the option to:

• Enable travel mode: This allows you to choose a place to browse in, but it will only load for paid users
• Hide me – this is clickable but you can’t actually use the map unless you’re a paid member
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The Privacy Act regulates the collection, storage, use, and disclosure of personal information. It prohibits disclosure of medical information without signed consent, and therefore protects the privacy of people living with HIV regarding their HIV status.

This Act becomes particularly relevant in the workplace; even though it is blatantly illegal, the Aotearoa New Zealand People Living with HIV Stigma Index reported 4% of respondents had their HIV status disclosed to an employer without their consent, and 8% had their HIV status disclosed to a colleague. 4% had been refused employment or lost a source of income because of their HIV status.

Workers in precarious employment or with other vulnerabilities, particularly migrant workers, often wonder if the protections of The Privacy Act and the Human Rights Act (see below) apply to them as well, even before they have secured a visa. The simple answer is yes: discrimination is illegal regardless of someone’s immigration or visa status.

There are a few limited exceptions to the protections against mandatory disclosure in The Privacy Act. If you want to donate blood, organs, semen, or eggs, obtain life insurance, or have sex with anyone without a condom, you are legally mandated to disclose your HIV positive status (even if you have an undetectable viral load). Sex workers are not obligated to disclose their HIV/STI status, as it is illegal to provide or receive commercial sex services without a condom or dental dam for penetrative or oral sex. It is illegal for the operator of a commercial sexual business to state or imply that a medical examination of a worker has taken place, or that they are free of HIV/STIs (PRA 8.1.d).

Similarly, your privacy is legally protected in employment, with the exception of military personnel, aviation workers, and healthcare workers. The Aotearoa New Zealand HIV Stigma Index reported particularly high rates of non-disclosure among healthcare workers, due to anticipating stigma and negative reactions from colleagues. It’s important to note that although disclosure to specific authorities is mandated for the jobs named above, that does not mean all jobs within that sector are unavailable to people living with HIV, or that someone must disclose their status to their colleagues.

We do not want the possibility of disclosure at work to be discouraging to anyone living with HIV. Some of these regulations (particularly in healthcare) were developed over a decade ago, when the HIV epidemic looked very different, so their ongoing relevance is under debate and something Burnett Foundation Aotearoa is raising. These decisions are also often made by people within an organisation who understand bureaucratic risk exposure, but not HIV epidemiology or human rights protections for people living with HIV. Even if you fall into one of the few exceptional categories in which disclosure is mandated and discrimination seems lawful, please reach out to Burnett Foundation Aotearoa to at least discuss whether we can be of some help.

The Human Rights Act prohibits discrimination due to (among other things) disability, which includes, “the presence in the body of organisms capable of causing illness” (Sec 21.h.vii); it is consequently illegal to discriminate against someone due to their HIV positive status.

People living with HIV have the same human rights as everyone else, including the right to health, privacy, non-interference from the state and non-discrimination. No one can refuse you a job, housing, medical services, or dental services because of your HIV diagnosis. This right to non-discrimination extends to your partners, family, friends, colleagues, and other people associated with you. No one can treat people unfairly because of their relationship with you. 

Unfortunately, the HRA allows insurance companies to discriminate against people living with HIV. Most insurance providers currently exclude coverage of any costs relating to HIV for health insurance, and exclude people living with HIV from life insurance products. Acknowledging the advances in HIV medications, some insurance companies will now offer life insurance to people living with HIV. However, these policies often have limited terms (5-7 years) and higher premiums. This discrimination is also allowed for under the Fair Trading Act (1986) provision of ‘unfair contract terms.’

Fortunately, we are familiar with at least one exception: Rainbow Lifestyle Protection (insurance broker in Christchurch) have been providing life insurance to people living with HIV through Fidelity Life. We are also in contact with someone living with HIV who has obtained health insurance through Southern Cross.

If obtaining private health insurance is something you are interested in, make sure you are very clear about what is covered: some companies will provide health insurance to people living with HIV, but will not cover any care that is directly related to HIV itself. The premiums and coverage in both health and life insurance can be highly variable, so it is not possible to determine what someone might offer you personally without a thorough assessment.  

Section 201 of the Crimes Act states, “Every one is liable to imprisonment for a term not exceeding 14 years who, willfully and without lawful justification or excuse, causes or produces in any other person any disease or sickness” (201.1). Although HIV is not specifically mentioned, in practice it is the only infectious disease to which this law is applied. Disclosure with sexual partners is not required if condoms are used as this is recognised as “taking reasonable precautions,” (156) and consequently cannot meet the standard for “willfully” causing or producing illness in another.

The law has not been tested in people living with HIV with a suppressed or undetectable viral load (UVL), meaning even if there is zero risk of transmission, it is still possible you could be prosecuted for having sex without a condom if you do not disclose your HIV positive status. We are unaware of any legislation or case law regarding sharing needles or other injecting equipment.

Burnett Foundation Aotearoa explicitly recognises this as discrimination, and also notes that it is likely counter-productive: you can only be criminally prosecuted for non-disclosure if you know your status, so criminalising non-disclosure simply incentivises people to avoid testing. Criminalising non-disclosure is consequently not only a human rights violation, it is ineffective in preventing onward transmission of HIV. This legislation negatively impacts everyone living with HIV, as it institutionalises and perpetuates HIV stigma. This stigma contributes to self-isolation, affects mental wellbeing, and can negatively impact people’s willingness to seek and maintain effective HIV treatment.

We are actively involved in advocacy to decriminalise HIV in Aotearoa New Zealand, as decriminalisation is a necessary step on the path to creating a society where people living with HIV are safe, fully supported, and free from stigma.

The first principle of the Harmful Digital Communications Act states “A digital communication should not disclose sensitive personal facts about an individual” (6.1). Your HIV status is sensitive, personal information, so even though anti-discrimination laws do not generally protect against disclosure in private relationships, it does mean you can file a complaint if someone in your private life discloses your status on social media, for instance, without consent.

The Health Regulatory Authorities of New Zealand (HRANZ) is an informal group made up of 16 registering authorities that oversee and manage matters of interest among healthcare organisations. HRANZ issued joint guidelines for registered healthcare workers with a transmissible major viral infection (TMVI), which they restrict to HIV, Hepatitis C (HCV), and Hepatitis B (HBV). The guidelines are clear that broad restrictions on people living with HIV working within healthcare are inappropriate; instead, they focus on exposure-prone procedures, which “are characterized by the potential for direct contact between the skin (usually finger or thumb of the health care worker) and sharp surgical instruments or needles in body cavities or in poorly visualized or confined body sites including the mouth.”

Mandatory screening for HIV and HCV is not recommended as the risk does not warrant it; mandatory screening of HBV is recommended for those performing exposure-prone procedures. However, HRANZ says workers who perform exposure-prone procedures must know their HIV/HCV status.

If you know you have HIV/HCV/HBV, you must not continue with clinical practice based on your own assessment of safety; you must seek outside counsel for advice. Each registration authority should maintain a list of health care workers who are qualified to act as consultants in these matters. Section 45 of the HPCAA confirms that if someone knows a healthcare worker has been counselled to modify practice because of their HIV/HCV/HBV status but they do not do so, mandatory reporting to the appropriate registration authority is required.

The New Zealand Defense Force requires its members to be “medically and physically fit,” as determined by a number of tests throughout the recruitment process. Although HIV is not explicitly mentioned as a long-term condition that would limit or prohibit enrollment in the military, Burnett Foundation Aotearoa is in contact with individuals who have been denied entry into the NZDF due to their HIV positive status, despite having an undetectable viral load.

This guidance is based on outdated misinformation about the management of HIV. As of May 2024, the New Zealand Defense Force confirmed the policy regarding service from people living with HIV is under review. Burnett Foundation Aotearoa will continue to advocate for changes that are both scientifically accurate and support the rights of people living with HIV. We will update this page with information when any changes become public.

The Civil Aviation Authority (CAA) of New Zealand currently has no publicly published guidelines for pilots or air traffic controllers who live with HIV, but in correspondence with Burnett Foundation Aotearoa, CAA confirmed that someone living with HIV does not meet CAA’s part 67 medical standards and certification, and is thus of aeromedical significance. This means that in order to work in this capacity, someone living with HIV would need to make an application for flexibility with the Director of the CAA. The power of the Director to grant this flexibility is given directly to the Director in the Civil Aviation Act (1990) (27B.2). Rather than have a blanket policy, CAA assesses the suitability of people who might require a medical exception (which includes people living with HIV) on a case-by-case basis, often taking into account certification guidelines from other authorities such as CASA in Australia and FAA in the United States.

CAA confirmed they have issued Class 1 and 2 medical certificates to a number of pilots living with HIV, with restrictions and surveillances measures applied to these medical certificates to ensure piles and air traffic controllers remain safe to operate.

If you think you have been discriminated against, you can file a complaint with the Human Rights Commission (www.tikatangata.org.nz). The first step is to contact the Commission’s InfoLine team: freephone 0800 496 877 or email [email protected] to be connected to a case advisor. These case advisors are not able to investigate complaints or determine if the law has been breached, but they can offer free advice on the kinds of discrimination that is unlawful, and how to file a complaint should you choose to do so.

If you have faced discrimination related to a health or disability service (HIV is considered a disability), then you have a right to make a complaint. The Health and Disability Commissioner’s website (www.hdc.org.nz) has a step-by-step guide on the process, and can connect you with a free health and disability advocate to help in formulating your concerns.

The Employment Relations Act (2000) confirms an employee’s right to raise a personal grievance with the Employment Relations Authority (www.era.govt.nz) if they have been treated unfairly. It is important to remember that ‘unfair’ treatment is not restricted to being fired, but can include things like poor treatment at work, or changing your hours or pay without consultation. If you have received any unfair or discriminatory treatment from your employer (or if they have failed to protect you from mistreatment from your coworkers) due to your HIV status (or refusal to disclose it), you might be able to raise a grievance. The ERA’s webpage on personal grievances further explains what can be considered unfair treatment, and how to raise a grievance.

A personal grievance must be raised within 90 days of the offending incident, or from when the employee first became aware of the incident (whichever is later). You have 3 years to proceed with your grievance after it is first filed, but you are only able to raise a personal grievance after the 90 days if: 1) your employer consents OR 2) you are filing a sexual harassment complaint (these have a 12-month window to file).

Independent contractors do not have these protections, but are still protected by the human rights laws that apply to everyone. If you are a contractor who was discriminated against, you cannot raise a grievance with the ERA, but can refer to the other applicable sections in this website.

If you have been discriminated against by a healthcare worker (or in any healthcare setting), the best course of action is to send a complaint to the Health and Disability Commissioner (see above). You may also wish to send a supplementary letter to one of the relevant regulatory authorities listed here:

The Medical Council of New Zealand (www.mcnz.org.nz) oversees 16 health professional regulation bodies, which can be contacted directly.

Concerns about a nurse’s behaviour can be made to the Nursing Council of New Zealand (www.nursingcouncil.org.nz) here.

If your dentist is a member of the New Zealand Dental Association (www.nzda.org.nz), they might be able to help with any complaints of discrimination. Their website has a hotline where you can call to determine whether your dentist is a member of the NZDA, and offers a guide to filing complaints.

There are many other professional roles that are accountable to larger regulatory authorities. We have compiled a list here, but it is not meant to be exhaustive; if you are in doubt as to whether you have faced discrimination, please do not hesitate to contact Burnett Foundation Aotearoa for some initial guidance.

Immigration advisors may not discriminate against you because of your HIV status, nor may they disclose any personal information about you without your permission. Licensed advisors are overseen by the Immigration Advisors Authority (www.iaa.govt.nz). It is important to read the fine print on any contract you sign when engaging an immigration advisor’s services, as some might say you consent to them releasing any pertinent information about you. Guidance on how to raise a complaint about either a licensed or unlicensed advisor can be found here.

The Police are not allowed to discriminate against you based on your HIV status; this includes directly treating you poorly or differently because you are living with HIV, or refusing you assistance because of it. They are overseen by the Independent Police Conduct Authority (www.ipca.govt.nz). Further explanation of what kind of conduct you can complain about can be found here. The procedure on how to file a complaint can be found here.

DoxyPEP can be quite effective for cisgender MSM and transgender and non-binary people assigned male at birth who are having sex with MSM. It can reduce your chance of acquiring syphilis by 70-80% and chlamydia by 70-90%. There are limited studies of DoxyPEP, therefore, our understanding of how effective it is may change as we learn more.

Most gonorrhoea in Aotearoa is already resistant to doxycycline. We do not expect DoxyPEP to prevent gonorrhoea and it is not recommended for this purpose.

DoxyPEP is relatively new, and so not every prescriber may be familiar with, or happy to prescribe DoxyPEP.

However, you could speak to your local GP; we have a letter you can take to guide them to the best evidence to discuss DoxyPEP with you. Some sexual health clinics across the country have also started supplying DoxyPEP; call your local clinic to see if they are supplying DoxyPEP and to book an appointment.

DoxyPEP has only be studied so far among cisgender MSM and transgender and non-binary people assigned male at birth who are having sex with MSM.

One study of cisgender women taking DoxyPEP did not find it was effective but further studies are needed to understand why. There have been no other studies on people assigned female at birth, and this is why it is not currently recommended for these people.

Given the limited evidence, DoxyPEP is only for people assigned male at birth having sex with men so far. We continue to look for new evidence as it emerges to keep this recommendation as up to date as possible.

Studies so far suggest that DoxyPEP does work for cisgender MSM who are living with HIV. It may be slightly less effective at preventing STIs but we need more research to understand this difference. If you are living with HIV, you can use DoxyPEP.  

Doxycycline has two main side effects.

Firstly, taking doxycycline can make you more sensitive to the sun. It is important to be sun-smart when using DoxyPEP as you may burn more easily.

Secondly, it is important you take DoxyPEP with water, and remain upright for half an hour after you take a dose. This is because doxycycline can damage your throat if not swallowed properly, and needs to be digested in your stomach to avoid this. 

DoxyPEP also interacts with antacids (like Mylanta or Gaviscon), as well as supplements with calcium, iron, and magnesium. So if you take these supplements take them 2 hours before or after your DoxyPEP to make sure it works.  

Yes! Definitely. It is important if you test for STIs as DoxyPEP is not 100% effective. Regular testing every three months is still recommended.

Condoms are a really effective option to prevent syphilis, chlamydia and gonorrhoea. You can order some here.

If you aren’t using condoms, you may be at risk of HIV depending on your sexual activity; find out more about PrEP for HIV here.  

NZ Consensus Statement:  

https://www.nzshs.org/site_files/38652/upload_files/AoNZfinaldoxyPEPstatement(1).pdf?dl=1  

ASHM Consensus Statement  

https://ashm.org.au/about/news/doxy-pep-statement/  

CDC Guidelines:   

https://www.cdc.gov/mmwr/volumes/73/rr/rr7302a1.htm?s_cid=rr7302a1_w