Research raises hope for ending HIV by 2030

Ending HIV transmission in Aotearoa New Zealand is in sight, but trends in testing and prevention suggest more needs to be done.

Associate professor Peter Saxton.
New Zealand is heading in the right direction to meet the government's HIV Action Plan goal of eliminating HIV transmission by 2030, says Associate Professor Peter Saxton in the School of Population Health.

New research out of Waipapa Taumata Rau, University of Auckland shows encouraging trends for HIV testing and prevention, with testing at the highest level for 20 years and prevention increasing after an earlier decline.

“More gay, bisexual and other men who have sex with men (GBM) are adopting different HIV prevention options that make sense for them,” says lead researcher Associate Professor Peter Saxton. See Research Brief.

Their findings just released help explain data also released today by the AIDS Epidemiology Group at the University of Otago, which show a 30 percent drop in new HIV diagnoses in New Zealand in 2023, compared with the average over the 2016-2020 period before COVID-19. See AIDS – New Zealand

Together, these data point to New Zealand heading in the right direction to meet the government's HIV Action Plan goal of eliminating HIV transmission by 2030. However, data also show that uptake of prevention and testing is not quite high enough to stop transmission at the community level, Saxton says. See HIV Action Plan.

Further, not everyone is able to access the benefits of new testing and prevention options equally, with data pointing to less uptake outside of Auckland, Wellington and Canterbury, and among Māori and Pacific people.

The report draws on surveys over the past 20 years, which were conducted regularly until 2014, then followed up by the Sex and Prevention of Transmission (SPOTS) survey, led by the University of Auckland, in 2022. See SPOTS website

In total, 18,679 responses from GBM were examined between 2002 and 2022, the largest dataset of its kind in the country.

Key findings were HIV testing was at an all-time high among GBM in 2022, with 87 percent of participants saying they had tested in their lifetime and 60 percent having tested in the previous 12 months.

“There’s also been a big change in where GBM get tested for HIV,” Saxton says.

“The proportion of participants using self-tests at home and rapid HIV tests at events has increased from 7.5 percent in 2014 to 23.4 percent in 2022.”

Not only have testing behaviours changed, but the availability of biomedical tools since 2015 has increased the overall uptake of effective HIV prevention approaches.  

“In the previous 2014 survey and earlier, condoms were the most common form of prevention with casual partners.”

“By 2022, in addition to condoms, many GBM are using biomedical tools such as pre-exposure prophylaxis (PrEP) if they’re HIV negative, or HIV antiretroviral treatments.”

Antiretroviral treatments make people living with diagnosed HIV, who are virally suppressed, unable to transmit HIV to their sexual partners.

The next step will be a shortened SPOTS survey in 2025, so researchers can monitor whether the progress has continued, for whom and whether this is happening fast enough to reach the goal of HIV elimination by 2030.

Read Research Brief: Trends in combination HIV prevention and HIV testing 2002-2022.

The 2022 SPOTS survey was funded by the Ministry of Health and Health Research Council of NZ.

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FMHS media adviser Jodi Yeats
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