Kiwis Living With HIV Need More Support To Meet Govt’s 2030 Elimination Goal - Advocate

More needs to be done to support Kiwis living with HIV if New Zealand is to reach its goal of being the first country in the world to eliminate HIV transmissions by 2030, according to a leading patient advocate.[3]

Advocates are also calling for more support for those ageing with HIV with research showing many have concerns around financial security, housing and health care for their unique needs.

Latest annual data from the University of Otago’s AIDs Epidemiology Group shows the number of people in Aotearoa living with HIV in 2023 increased by 235 - up 74% on the previous year, to an estimated total of 3,272. This total was made up of 97 people diagnosed with HIV in NZ and the remaining 138 were diagnosed overseas and immigrated to this country. Maori and Pacific peoples make up 15% of this number however research shows they are more likely to be diagnosed late and have advanced infection.[4][5][6][7]

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV is not treated, it can progress to AIDS (acquired immunodeficiency syndrome). There is currently no cure and once people contract HIV, they have it for life; however, with proper medical care, HIV can be controlled and remain untransmittable.[8]

A recent Nga Taipakeke o te Uruta HIV Ageing with HIV report found that the proportion of Kiwis living with HIV who are aged 50+ is expected to rise from 61% to 72% by 2030.[9]

The report found that poapoataunutanga, or the impact of stigma and discrimination, is widespread with 60% of respondents having experienced homophobia and 50% having experienced HIV stigma. The internalised stigma can lead to feelings of shame, fear of disclosure, isolation, and despair and over 80% of respondents spoke of themselves in a stigmatised way.[10]

The research also found rangirua or uncertainty around a future living with HIV was the most common concern for those in the study. Future housing and financial security were a concern for over 30% of respondents while over 40% said they were worried aged care facilities may not be able to meet their unique needs.[11]

Jane Bruning of Positive Women says the study provides culturally relevant insight into ageing with HIV with participants sharing their needs and experiences.

“What we have is a new frontier which we have to navigate with the largest group of people living with HIV now ageing. The research shows that in their experience the current health care and aged care system is not designed to meet their needs and more needs to be done to prepare for these people in their later years,” she says.

“The study showed gaps where many aged care providers lacked the education on how to manage the health requirements of these patients. Similarly, these facilities have a largely heterosexual environment with respondents from the rainbow community nervous about how they might fit in so there was an extra layer of concern for them,” she says.[12]

Bruning says a new interactive website has been designed to act as a resource to better educate both consumers and healthcare professionals on HIV.

“What we also need to see is an ongoing commitment to raising awareness and the de-stigmatisation of HIV if we are to help to control HIV transmission,” she says.

In 2023 the Ministry of Health HIV action plan outlined a pathway for Aotearoa New Zealand to eliminate locally acquired HIV transmissions, to decrease stigma and discrimination for those living with HIV and to improve Maori health and well-being in relation to HIV by delivering on Te Tiriti o Waitangi obligations.[13]

Patient advocate and Maori wahine Milly Stewart, founder of Toitu Te Ao, says more needs to be done to bring Maori and Pasifika on the journey if we are to achieve the goals outlined in the Action Plan.

Stewart says she founded Toitu Te Ao to offer tangata whenua living with HIV and their whanau better support and help through a cultural lens.

“I wanted to provide a service where Maori, Pasifika and indigenous people felt heard and their concerns and rights were respected. I also wanted to ensure that there was an organisation that was communicating these needs to the wider community in a way that is mana-enhancing for Maori.

“If we are to meet the goal of destigmatising HIV and having zero transmissions by 2030 then we need to ensure that we adopt a hauroa Maori approach. That means aside from improving access to testing and treatment we need to have a culturally appropriate way to talk about sexual health, a subject that is still tapu to many of our people,” she says.

“There is a lot of korero about inequity but what is also missing from this conversation is the approach. We need to see the provision of more health professionals and materials that are sensitive and mana-enhancing so we can educate not just our takatapui but also our heterosexual people and our rangatahi who are also at risk,” she says.

The call for greater support for Maori and older people living with HIV comes as a recently funded treatment for the virus is made available in New Zealand.

The single-tablet combination antiretroviral treatment, dolutegravir with lamivudine (branded as Dovato), is now funded for people with HIV and is used to treat HIV infection. While it is not a cure for the virus, the medicine reduces the amount of virus in the body and keeps it at a low level, meaning it’s sexually untransmittable to HIV negative individuals.[14][15]

Brett Marett, GSK NZ medical director says, providing a funded therapy for HIV that requires fewer antiretroviral medicines is an important step forward in supporting those living with the virus.

“While we know that there is no cure for HIV, with treatment those living with HIV can live long, healthy lives.

“It is hoped that this combination of two funded antiretroviral medicines will reduce barriers to receiving treatment for around 900 people in the first year,” he says.[16]

Note:

References

[1] Ageing with HIV Report | Positive Women. (n.d.). https://positivewomen.org.nz/research/ageing-hiv-report

[2] Ageing with HIV Report | Positive Women. (n.d.). https://positivewomen.org.nz/research/ageing-hiv-report

[3] National HIV Action Plan for Aotearoa New Zealand 2023-2030. (n.d.). Ministry of Health NZ. https://www.health.govt.nz/publication/national-hiv-action-plan-aotearoa-new-zealand-2023-2030

[4] Otago University AIDS Epidemiology Group. (2024, May). Retrieved May 24, 2024, from https://www.otago.ac.nz/__data/assets/pdf_file/0019/570610/83.-AIDS-NZ-May-2024.pdf

[5] Bateman JP, Saxton PJW, de Gouw A, Kolodziej J, Priest PC, McAllister SM. Late presentation of HIV infection among adults in New Zealand from 2011 to 2020. International Journal of STD & AIDS. 2023;34(5):332-337. doi:10.1177/09564624231151458

[6] University of Otago. (2024, May 8). New Zealand HIV diagnoses for 2023 released – downward trend overall. https://www.otago.ac.nz/news/newsroom/new-zealand-hiv-diagnoses-for-2023-released-downward-trend-overall#:~:text=Figures%20released%20today%20by%20the,preceding%202016%20to%202020%20period.< /FONT>

[7] Otago University AIDS Epidemiology Group. (2023, May). Otago University. Retrieved June 13, 2024, from ttps://www.otago.ac.nz/__data/assets/pdf_file/0018/307233/aids-new-zealand-newsletter-issue-82-may-2023-0244567.pdf

[8] About HIV/AIDS | HIV Basics | HIV/AIDS | CDC. (n.d.). https://www.cdc.gov/hiv/basics/whatishiv.html

[9] Ageing with HIV Report | Positive Women. (n.d.). https://positivewomen.org.nz/research/ageing-hiv-report

[10] Ageing with HIV Report | Positive Women. (n.d.). https://positivewomen.org.nz/research/ageing-hiv-report

[11] Ageing with HIV Report | Positive Women. (n.d.). https://positivewomen.org.nz/research/ageing-hiv-report

[12] Ageing with HIV Report | Positive Women. (n.d.). https://positivewomen.org.nz/research/ageing-hiv-report

[13] National HIV Action Plan for Aotearoa New Zealand 2023-2030. (n.d.). Ministry of Health NZ. https://www.health.govt.nz/publication/national-hiv-action-plan-aotearoa-new-zealand-2023-2030

[14] Pharmac. (2024b, April 12). Summary of decision: combination treatment for HIV - Pharmac | New Zealand Government. Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/news/summary-of-decision-combination-treatment-for-hiv

[15] Medsafe Dovato Datasheet. (n.d.). Medsafe. Retrieved May 15, 2024, from https://www.medsafe.govt.nz/consumers/cmi/d/dovato.pdf

[16] Pharmac. (2024b, April 12). Summary of decision: combination treatment for HIV - Pharmac | New Zealand Government. Pharmac | New Zealand Government. https://pharmac.govt.nz/news-and-resources/news/summary-of-decision-combination-treatment-for-hiv

[17] Medsafe Dovato Datasheet. (n.d.). Medsafe. Retrieved May 15, 2024, from https://www.medsafe.govt.nz/consumers/cmi/d/dovato.pdf

[18] Medsafe Dovato Datasheet. (n.d.). Medsafe. Retrieved May 15, 2024, from https://www.medsafe.govt.nz/consumers/cmi/d/dovato.pdf

Important Safety Information: Avoid Dovato if you have any known allergies (hypersensitivity) to dolutegravir or lamivudine, or to any other ingredients listed in the Dovato Consumer Medicine Information leaflet.[17] 

About GSK
GSK is a global biopharma company with a purpose to unite science, technology, and talent to get ahead of disease together. GlaxoSmithKline NZ Limited, Auckland

About Dovato
Dovato is indicated for the treatment of Human Immunodeficiency Virus (HIV-1) infection in adults and adolescents (from 12 years of age weighing at least 40 kg) who have no known or suspected resistance to either antiretroviral component.[18]

DOVATO (dolutegravir and lamivudine) is a film coated tablet containing 50 mg of dolutegravir (as dolutegravir sodium) and 300 mg of lamivudine, which is used for the treatment of Human Immunodeficiency Virus (HIV-1) infection in adults and adolescents (from 12 years of age weighing at least 40 kg) who have no known or suspected resistance to either antiretroviral component. DOVATO is a Prescription Medicine. Dovato has risks and benefits and should be initiated by a doctor experienced in the management of HIV infection. DOVATO is a funded medicine; Special Authority criteria apply. Ask your doctor if DOVATO is right for you. Use strictly as directed. If you have concerns or if you have side effects, see your doctor, pharmacist or healthcare professional. Normal doctor’s consultation fees apply.

Trademarks are owned by or licensed to the ViiV Healthcare group of companies. ©2024 ViiV Healthcare group of companies or its licensor. Marketed on behalf of ViiV Healthcare by GlaxoSmithKline NZ Limited, Auckland. Adverse Events involving GlaxoSmithKline products should be reported to GSK Medical Information on 0800 808 500.

Date of Approval: 11 2024 | Date of Expiry: 11 2024 | TAPS-NP21879 | PM-NZ-DLL-PRSR-240001

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