In 2023, 97 people were first diagnosed with HIV in Aotearoa New Zealand. Of the 97 diagnosed, 65 gay, bisexual or other men who have sex with men (GBM), 17 acquired HIV through heterosexual contact, and for the remaining 15 the means of acquisition was reported as other or unknown. This represents a slight increase on 2022 figures, however in general, HIV diagnoses have been on the decline since their peak in 2016. This general downward trend is promising, but continued resourcing is needed to meet our 2030 goal of ending local HIV transmission.
43 GBM were thought to have acquired HIV in Aotearoa New Zealand in 2023. While this is also slightly higher than in 2021 and 2023, in general the numbers are still declining. This is a 55% decrease from the peak in 2016. The steady decline in the number of people with locally-acquired HIV means we are seeing the continued impact of local HIV prevention, like PrEP and condom use, and HIV testing efforts that allow for people to be diagnosed early and access medication to live healthy lives without the risk of passing HIV to their sexual partners (see U=U). This is great news.
Unfortunately, a significant number are still being diagnosed with low CD4 counts (35% of new local cases among GBM in 2023), which suggests that these cases have been living with undiagnosed HIV for some time. Seeing a higher proportion of late diagnoses highlights the need for our communities to be in regular systems of testing for HIV and other STIs suitable to their sexual needs. The earlier a person living with HIV is diagnosed, the sooner they can get on treatment and live a healthier life.
A total of 235 cases were notified for 2023 – an increase from the 135 reported in 2022. This was largely driven by a notable increase in people living with HIV who were first diagnosed with HIV overseas and who have moved to Aotearoa New Zealand, and it reflects not only overall increases in immigration, but also our ongoing advocacy to remove discriminatory HIV-specific policies preventing migrants with HIV to move here.
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 2023, 13 Māori GBM were diagnosed in New Zealand, and 12 of these men acquired their HIV here. The most significant decreases in number of new infections have been seen among European gay and bisexual men. At the same time, the numbers for other ethnic groups are decreasing at a slower rate. This means we need to do better to ensure equitable access to the benefits of combination HIV prevention.
With Kiwis’ heightened awareness of public health in light of COVID-19, it is now more important than ever for all New Zealanders to understand HIV prevention and the realities of HIV stigma for Aotearoa to continue to be a world leader in infectious disease response.
While we don’t know the exact number of people living with HIV in New Zealand, we know that, currently, 3272 people in New Zealand are receiving treatment for HIV.
The infections continue to disproportionately affect gay and bisexual men. Recent research shows that this population continues to have a 348x greater risk of HIV than heterosexual people in Aotearoa!
Despite the increased rates of HIV among gay and bisexual men, overall, New Zealand has a relatively low prevalence of HIV by international standards. This is largely due to the consistent promotion of condom and lube use for anal sex between men, since 1987. A robust legislative environment based on a strong human rights approach is also a key reason for this.
Gay, Bisexual and Other Men Who Have Sex With Men
Of the 97 new HIV notifications in New Zealand in 2023, 65 were gay, bisexual and other men who have sex with men (GBM).
43 GBM were thought to have acquired HIV in Aotearoa New Zealand in 2023.
While gay and bisexual men account for only 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 2023, there were 17 people found to have acquired HIV from heterosexual sexual contact.
This included 10 women and 7 men, and 9 of the cases were acquired locally. The number of heterosexual men and women diagnosed with locally acquired HIV has in general remained stable with an average of 12 people per year over the past five years.
While the number of heterosexual men and women infected in New Zealand in 2023 remained relatively stable, the numbers of people who acquire HIV heterosexually each year are small and therefore subject to year-by-year fluctuations.
Among the heterosexually-acquired cases in New Zealand in 2023, almost half had a low CD4 count at the time of diagnosis indicative of a relatively late-diagnosed infection.
People who inject drugs
Low numbers of people who inject drugs (PWID) and the successful operation of an effective national needle exchange programme since 1988 has meant that PWID account for very few HIV infections in New Zealand.
In 2023, three people diagnosed with HIV were also people who injected drugs, and two of these acquisitions occurred locally.
We are proud that blood to blood transmission continues to be rare in New Zealand due to the work of the Needle Exchange Programme across the country. This is a great example of the effectiveness of rational, community-focused, and science-led public health policy.
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.
Perinatal transmission
Between 1998-2023, there were 215 births to people known to be living with HIV in New Zealand. However, the AEG says, for children born in 2023 it is too soon to be sure about this as acquired HIV cannot be definitively ruled out until the child is slightly older.
Widespread pregnancy screening and effective treatment for pregnant people means that the transmission of HIV from parents to babies has been at very low levels.
HIV and Migration
People living with HIV are able to migrate to New Zealand as HIV is not deemed to be a restrictive health condition. The AIDS Epidemiology Group record when people living with HIV first enter care in New Zealand. It is important to know how many people are living with HIV in Aotearoa so we can provide quality care, ensure access to treatment, and to support positive health outcomes.
In 2023, 123 people were notified with HIV in New Zealand who had first been diagnosed overseas. This represents less than 0.1% of all migrants to New Zealand in 2023.
AIDS in Aotearoa
AIDS stands for Acquired Immune Deficiency Syndrome. It is an advanced form of HIV. Not everyone that has HIV develops AIDS, largely thanks to advances in medications.
AIDS can develop when HIV is untreated, as the virus weakens a person’s immune system so their body is no longer able to protect itself against infections and diseases that a normal immune system would fight off.
In Aotearoa, there were 14 people (nine men and 5 women) diagnosed with AIDS in 2023. Eleven (79%) had their AIDS diagnosis within three months of being diagnosed with HIV which means they were late diagnosed and would not have had the opportunity for treatment to control progression of their HIV infection.
Six deaths from AIDS-related illnesses were also reported in 2023, but this number could rise due to delayed reports.
