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Saturday 10 October 2015

HIV prevention: We risk being left behind

Posted in: Health & HIV, Features
By Jacqui Stanford - 22nd September 2015

A leading New Zealand HIV researcher believes we can dramatically alter the trajectory of the epidemic among gay and bi men by adding enhanced testing, immediate treatment and targeted use of PrEP to condom use.

Dr Peter Saxton says adding enhanced testing, immediate treatment and targeted use of PrEP to condom use could dramatically alter the trajectory of the epidemic here.

Dr Peter Saxton from Auckland University’s Gay Men’s Sexual Health research group says New Zealand delegates have returned from the World STI Congress and Australasian HIV Conference in Brisbane excited by the possibility of reversing new HIV infections in gay and bisexual men, who account for 80 per cent of HIV transmission in this country.

They say Government leadership is needed more than ever to remove red-tape so new initiatives can be rolled out.

“New Zealand can still make incremental gains in HIV control by continuing to improve condom promotion,” Dr Saxton says.

“Condoms have averted 50 million HIV infections according to UNAIDS and are the mainstay of prevention.

“But we can dramatically alter the trajectory of the epidemic if we add onto condoms enhanced testing, immediate treatment if HIV positive, and targeted pre-exposure prophylaxis (PrEP) for the small number most at risk.”

Dr Saxton says five actions need to be prioritised to achieve this:

(1) Increasingly sophisticated promotion of the multiple advantages of condoms against HIV and STIs during anal intercourse (to stop transmission);

(2) Improved access to comprehensive STI screening and vaccination (to control resurgent STI epidemics);

(3) Prompt HIV testing following anal intercourse without a condom by rapid testing and potentially home HIV testing or home HIV sampling (to reduce the number with undiagnosed infection);

(4) Immediate access to HIV treatment post diagnosis (to reduce immune system damage and infectivity);

(5) A Govt-funded programme of voluntary pre-exposure prophylaxis (PrEP) and quarterly STI screening for the minority of GBM who are unable to sustain consistent and correct condom use during anal intercourse (to target the most at risk community members who play a disproportionate role in either fuelling or limiting the epidemic).

Dr Peter Saxton
Dr Saxton says Government leadership is urgently needed as the last three actions require regulatory reform to remove red tape and ensure quality control. Until then, he suggests clinicians, NGOs, researchers and community members have their hands tied.

“New Zealand has an excellent international record in HIV prevention but that is now at stake. We risk being left behind.

“We can do this if Government acts decisively. Our small scale means we can act nimbly. New Zealand’s strong existing condom culture, supportive environment on sexuality and commitment to equity provide an excellent platform to launch this next phase in the epidemic response. We can maximise the gains and make sure they’re equitably distributed.”

Dr Saxton says this is a once in a generation opportunity for Government to take a more active role and preside over a sustained decline in new infections, saving millions in healthcare costs and also winning the political right to trumpet their own success.

He will raise these issues at the bi-annual national HIV Forum this Thursday. On Friday, he will discuss HIV epidemiology at Body Positive’s HIV Treatments Update and Dr Massimo Giola will discuss findings on PrEP. has asked the Health Minister to respond to his suggestions.

Jacqui Stanford - 22nd September 2015

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