One of New Zealand’s leading HIV researchers has called on the New Zealand government to “remove red tape” so new HIV prevention initiatives can be rolled out.
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 (GBM), who account for 80% of HIV transmission in this country.
However, they said Government leadership was 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. Condoms have averted 50 million HIV infections according to UNAIDS and are the mainstay of prevention,” said Dr Peter Saxton of Auckland University’s Gay Men’s Sexual Health research group.
However Dr Saxton says more can and should be done. “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 said five actions needed 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 fueling or limiting the epidemic).
Dr Saxton said that Government leadership is urgently needed as the last three actions require regulatory reform to remove red tape and ensure quality control. Until then, he says there is little those in non governmental agencies can do.
“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.”
“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.”
Article | Levi Joule.