This presentation on New Zealand's approach to HIV prevention was given by Shaun Robinson, Executive Director NZ AIDS Foundation, at the AFAO Members Forum - May 2015.

1. Shaun Robinson
Executive Director NZAF

2. NZ an Epidemic under Control but not in Decline
Incidence Below the Prevalence Trend
MSM Incidence Below Prevalence Trend

3. NZ an Epidemic under Control but not in Decline

4. Success Story for Māori Health
Testing rates lower but
increasing

5. Challenges in Prevention
New Biomedical Tools – TASP and PrEP
+
Long Standing Public Health Tools – Condoms, Needle Exchange
How do they Fit together in the NZ Context?
Need clinical and community collaboration and co-ordination
Need a National Strategy
Strategy
please

6. Strategy
Condoms
Test
PrEP
Sexual Health Context
Support for PLHIV/ Stigma Elimination
Cultural Responsiveness
Legal and Human Rights
Treat

7. NZ an Epidemic under Control but not in Decline

8. NZ an Epidemic under Control but not in Decline
Testing /Clinical Challenge
20% of MSM and of Africans in NZ who have HIV are undiagnosed
50% of all HIV diagnoses are late
200? People Diagnosed but lost to Care since 2005.

9. NZ an Epidemic under Control but not in Decline
Testing Challenge
Rapid testing at NZAF since 2006
Increased from 250 pa – 2500 pa
No policy or national consistency
Health system has not adopted rapid testing

10. NZ an Epidemic under Control but not in Decline
Testing Tactics
Outreach to :
• Venues
• Events
• Suburbs
Partnering with others to support rapid testing
• Marae
• GPs
• Body positive
• Asian
• Pacific

11. NZ an Epidemic under Control but not in Decline
Testing Tactics
Home Testing pilot
Exploring other models
Working towards national strategy

12. New Zealand 30 Years into the Epidemic…
A Lot to Loose …
Low Prevalence
A Lot to Gain …
Persistent Incidence

13. NZ an Epidemic under Control but not in Decline
Condom Use Challenges
95% positive attitudes to condom use (GAPSS GOSS research)
Close the GAP
80% high condom use

14. New Science New Opportunities
PARTNER Study - TASP
PROUD and IPERGAY - PrEP

15. No one
uses
Condoms
Most
people use
Condoms
A new
medication
Day to Day Focus Can Pull Us Apart

16. PrEP
A small targeted role
For people who resist condom use and are able to manage adherence
Requires Clinical Oversight – HIV testing, STI testing, Adherence
monitoring, Condom promotion, Support
Best managed by sexual health physicians as people using PrEP will
definitely risk repeated STI infections

17. PrEP Project New Zealand
No funding
Voluntary project being developed with Auckland Sexual Health
Need to put definition around PrEP in NZ
• Access Criteria
• Clinical Protocols/ Guidelines
Test demand and effectiveness in real world in NZ
Gain experience which will guide future developments

18. Clinical and Community Collaboration