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Today is World AIDS Day, and the New Zealand AIDS Foundation and the AIDS Epidemiology Group at Otago University are passing on the safe sex message – use condoms and lube, and get tested regularly.

The Theme of this year’s World Aids Day “Getting to Zero” echoes UNAIDS’ vision of a world with “Zero new HIV infections, Zero discrimination, Zero AIDS-related deaths”. One strategy to achieve this aspirational goal is through the early detection of people infected with HIV.

The shorter the time between HIV infection being acquired and it being diagnosed, makes it better for the individual through being able to access antiretroviral treatment in a timely manner. It is also better for the community through effective treatments andcounselling resulting in people being less infectious and hopefully acting in a safer manner.

New Zealand information just published – reported in the current issue of AIDS – New Zealand – shows that half of all people diagnosed with HIV infection in the past six years presented late – that is, past the ideal stage for starting treatment. Very late presentation (Advanced HIV disease) was more common among heterosexuals, among Māori and Pacific men who had sex with men (MSM), and among people 40 years or older. This is probably contributing to the ongoing spread of HIV in New Zealand.

Associate professor Nigel Dickson, from the AIDS Epidemiology Group based at the University of Otago that ran this study, says, “These findings indicate that HIV testing needs to be encouraged among those who may have been at risk, and this means it has to be available at a range of sites and in a way that people don’t fear being stigmatised.”

He does add, “However a problem of relying solely on this approach for the control of new infections is that people are particularly infectious soon after infection occurs. Even with widespread and frequent testing, not all cases will be picked up in these early weeks. Some risks will exist while people engage in unsafe sex, particular anal sex among men who have sex with men without condoms. Therefore consistent condom use is a also needed to achieve “Zero New Infections”.

NZAF executive director Shaun Robinson agrees.

Shaun Robinson, Executive Director of the NZAF says, “The epidemic is in a resurgent phase due to changes in treatment, community perceptions and sexual networking. As the epidemic has become less visible over the years, a certain complacency around sexual safety has crept in. A clear and determined focus on HIV prevention strategies is needed now, more than ever before.

“The key to ending the HIV epidemic is increasing rates of condom use in the communities most affected by HIV.”

Condoms remain the single most effective tool in reducing the onward transmission of HIV. The National Institutes for Health in the US confirm that condoms reduce the probability of transmission per sex act by 95 per cent when used correctly and consistently; a figure supported by the World Health Organisation.

Robinson says, “The best estimate of the number of people living with HIV in New Zealand in 2010 is 1800. The majority of these will be gay and bisexual men. That’s 1800 people who have been needlessly infected. While New Zealand has one of the best records in the world for controlling the HIV epidemic, World AIDS Day is a sobering reminder that there are many people we still need to reach. An increased focus on safe sexual behaviour will be the driving force behind the NZAF’s initiatives for 2012.”