Pātiki and Waharua Kōpito patterns
Human Immunodeficiency Virus (HIV) can be transmitted through condomless vaginal and anal sex, sharing needles, through pregnancy, childbirth and breastfeeding, and direct blood-to-blood contact with someone living with HIV.
Without treatment, HIV causes a chronic progressive immune deficiency, leading to Acquired Immunodeficiency Syndrome (AIDS).
There is no cure for HIV, but for those living with HIV in New Zealand (regardless of residency status), excellent treatment is available and funded.
With early and effective treatment, people with HIV will stay well and will not progress to AIDS. With treatment, people living with HIV are expected to have a similar life expectancy to people without HIV.
Once a person is stable on treatment, with an undetectable viral load for at least 6 months, there is zero risk of sexual transmission. This is known as U=U (undetectable = untransmittable).
Testing is recommended:
- At a patient’s request
- For people with signs or symptoms which could be consistent with HIV (HIV clinical indicator conditions (external link)), even if the person is considered to be low risk
- As a routine part of a sexual health check (external link)
- For people with possible signs or symptoms of a sexually transmitted infection (STI) as part of a sexual health check (external link)
- For sexual contacts of people with STIs as part of a sexual health check (external link)
- In pregnancy
- In persons with a recent change in sexual contact, or multiple sexual contacts as part of a sexual health check (external link)
- For men who have sex with men (MSM) (external link)– at least annually as part of a sexual health check (external link); every 3 months if frequent partner change or on PrEP (external link) [PDF]
- For people using HIV Pre- or Post-Exposure Prophylaxis (PrEP (external link) [PDF] or PEP (external link) [PDF])
- After a non-consenting sexual encounter
- For people who inject drugs (external link)
People should know what they are being tested for, and give verbal consent to testing, but extensive pre- and post-test counselling is not required (unless the person indicates that this is needed, or the result is positive).
If a person is asymptomatic and is concerned about a specific recent risk event, the recommended testing interval is 6 weeks from time of last risk.
Where possible, testing for HIV should be combined with testing for other infections with similar routes of transmission, for example chlamydia, gonorrhoea, and syphilis. Consider testing for Hepatitis B and C.
A negative HIV test offers an opportunity to discuss HIV prevention as indicated, for example condom use, HIV Pre-Exposure Prophylaxis (PrEP) or needle exchange services.
A positive test result should ideally be given in person. A result is only considered positive if confirmatory testing has been done. It is useful to discuss a positive result with an infectious diseases or sexual health specialist before speaking with the patient, to ensure that you have all the necessary information.
The following organisations can provide peer support:
- Body Positive Inc (external link)
- Burnett Foundation (external link)
- Positive Women Inc (external link)
- Toitu te Ao (external link) (external link)
The New Zealand Sexual Health Society HIV Guideline (external link) provides further information for clinicians.