Increase in HIV diagnoses among men who have sex with men in New Zealand from a stable low period
Peter J. W. Saxton A B C , Nigel P. Dickson B , Susan M. McAllister B , Katrina Sharples B and Anthony J. Hughes A
+ Author Affiliations
- Author Affiliations
A Research Unit, New Zealand AIDS Foundation, PO Box 6663, Wellesley Street, Auckland 1141, New Zealand.
B AIDS Epidemiology Group, Department of Preventive and Social Medicine, University of Otago Medical School, PO Box 913, Dunedin, New Zealand.
C Corresponding author. Email: peter.saxton@otago.ac.nz
Sexual Health 8(3) 311-318 https://doi.org/10.1071/SH10087
Submitted: 13 July 2010 Accepted: 3 November 2010 Published: 17 August 2011
Journal Compilation © CSIRO Publishing 2011 Open Access CC BY-NC-ND
Abstract
Objectives: To describe trends in HIV diagnoses among men who have sex with men (MSM) in New Zealand 1996–2008, and to identify characteristics associated with HIV diagnoses in the resurgent phase. Methods: Data collected through routine surveillance of HIV infection, where the mode of transmission included homosexual contact, were analysed over the period 1996–2008. Results: Annual HIV diagnoses were low during 1996–2000, rose sharply between 2001 and 2005, and remained at an elevated plateau between 2006 and 2008. Over a quarter were attributed to HIV infection acquired overseas (28.6%). Trends in diagnoses of locally acquired HIV infection closely mirrored the trend of three diagnosis phases. Increases in locally acquired HIV occurred among virtually all characteristics of MSM. However, compared with MSM diagnosed in the low phase 1996–2000, individuals diagnosed in the resurgent phase 2001–05 were more likely to be aged 30–39, to have tested HIV-negative within the previous 2 years, to live in the Northern region encompassing Auckland, and to be of non-European ethnicity. The per capita HIV diagnosis rate among MSM was lowest in 1997, at 22.0 per million males aged 15–64, and highest in 2005 at 66.7 per million. Conclusion: The increase in HIV diagnoses among MSM in New Zealand was primarily due to an increase in locally acquired HIV infection, which disproportionately affected some groups of MSM. Factors driving this change in local epidemic conditions need to be identified. The rate of new HIV diagnoses among MSM remains low by international standards.
Additional keywords: characteristics, epidemic phases, per capita rates, trends.
References
[1] McAllister SM, Dickson NP, Sharples K, Reid MR, Morgan JM, Macdonald EJ, et al Unlinked anonymous HIV prevalence among New Zealand sexual health clinic attenders: 2005–2006. Int J STD AIDS 2008; 19 752–7.| Unlinked anonymous HIV prevalence among New Zealand sexual health clinic attenders: 2005–2006.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1cnnt1yltw%3D%3D&md5=0fff48cbcd6d454a5a5abb93997177ebCAS |
[2] Dickson NP, Paul C, Skegg DC, Sharples KJ, Lyttle PH, Say PJ, et al Unlinked anonymous monitoring of HIV prevalence at sexually transmitted disease clinics. N Z Med J 1993; 106 325–7.
| 1:STN:280:DyaK3szktFOqsw%3D%3D&md5=ba051e69b2d7509b3d11e199d36068e6CAS |
[3] Saxton P, Dickson N, Hughes A. GAPSS 2006: findings from the 2006 Gay Auckland Periodic Sex Survey. Auckland: New Zealand AIDS Foundation; 2006.
[4] Saxton P, Dickson N, McAllister S, Hughes A, Sharples K. Trends in HIV prevalence among homosexual men in New Zealand 1985–2009 [abstract 252]. 22nd Annual Conference of the Australasian Society for HIV Medicine (ASHM); October 20–22 2010; Sydney, Australia.
[5] Sharples K, Dickson NP, Paul C, Skegg DCG. HIV/AIDS in New Zealand: an epidemic in decline? AIDS 1996; 10 1273–8.
| HIV/AIDS in New Zealand: an epidemic in decline?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s%2Fjsl2lsA%3D%3D&md5=5cead384adb798a00a8b6d388a100f11CAS |
[6] AIDS Epidemiology Group. AIDS – New Zealand. University of Otago, Dunedin; 2009. Available online at: http://dnmeds.otago.ac.nz/departments/psm/research/aids/pdf/63 AIDS-NZ March 2009.pdf [verified November 2010].
[7] Likatavicius G, Klavs I, Devaux I, Alix J, Nardone A. An increase in newly diagnosed HIV cases reported among men who have sex with men in Europe, 2000–6: implications for a European public health strategy. Sex Transm Infect 2008; 84 499–505.
| An increase in newly diagnosed HIV cases reported among men who have sex with men in Europe, 2000–6: implications for a European public health strategy.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1cjmtFCitg%3D%3D&md5=0018686838151c2898c59912980dca0aCAS |
[8] Sullivan PS, Hamouda O, Delpech V, Geduld JE, Prejean J, Semaille C, et al Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996–2005. Ann Epidemiol 2009; 19 423–31.
| Reemergence of the HIV epidemic among men who have sex with men in North America, Western Europe, and Australia, 1996–2005.Crossref | GoogleScholarGoogle Scholar |
[9] Grulich AE, Kaldor JM. Trends in HIV incidence in homosexual men in developed countries. Sex Health 2008; 5 113–8.
| Trends in HIV incidence in homosexual men in developed countries.Crossref | GoogleScholarGoogle Scholar |
[10] Guy RJ, McDonald AM, Bartlett MJ, Murray JC, Giele CM, Davey TM, et al Characteristics of HIV diagnoses in Australia, 1993–2006. Sex Health 2008; 5 91–6.
| Characteristics of HIV diagnoses in Australia, 1993–2006.Crossref | GoogleScholarGoogle Scholar |
[11] Hall HI, Song R, Rhodes P, Prejean J, An Q, Lee LM, et al Estimation of HIV incidence in the United States. JAMA 2008; 300 520–9.
| Estimation of HIV incidence in the United States.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXps1ygtrY%3D&md5=b6e75dc419f0e499ee16005080f97c32CAS |
[12] Stall R, Hart G. The continuing evolution of research on sexually transmitted infections among men who have sex with men. Sex Transm Infect 2008; 84 407–9.
| The continuing evolution of research on sexually transmitted infections among men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[13] van Griensven F, de Lind van Wijngaarden JW, Baral S, Grulich A. The global epidemic of HIV infection among men who have sex with men. Curr Opin HIV AIDS 2009; 4 300–7.
| The global epidemic of HIV infection among men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[14] Paul C, Wilson M, Dickson N, Sharples K, Skegg DC. Enhanced surveillance of HIV infections in New Zealand, 1996–1998. N Z Med J 2000; 113 390–4.
| 1:STN:280:DC%2BD3crhtVehtg%3D%3D&md5=2ddf96b33fab73b458bab13e4f160054CAS |
[15] AIDS Epidemiology Group. AIDS – New Zealand. University of Otago, Dunedin; 2002. Available online at: http://dnmeds.otago.ac.nz/departments/psm/research/aids/pdf/49 AIDS-NZ February 2002.pdf [verified November 2010].
[16] Statistics New Zealand. National population estimates, mean year ended 31 December. Wellington: Statistics New Zealand; 2006. Available online at: www.stats.govt.nz/methods_and_services/access-data/tables/national-pop-estimates.aspx [verified August 2009].
[17] Hughes A, Saxton P. Geographic micro-clustering of homosexual men: implications for research and social policy. Soc Pol J New Zealand 2006; 28 158–78.
[18] Saxton P, Hughes A, Segedin R, Robinson E, Aspin C. Male Call/Waea Mai, Tane Ma report Six: Regions. Auckland: New Zealand AIDS Foundation; 1998.
[19] Anderson RM, May RM. Infectious diseases of humans: dynamics and control. Oxford: Oxford University Press; 1992.
[20] May RM, Gupta S, McLean AR. Infectious disease dynamics: what characterizes a successful invader? Philos Trans R Soc Lond B Biol Sci 2001; 356 901–10.
| Infectious disease dynamics: what characterizes a successful invader?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MzktlCqsw%3D%3D&md5=5dbafeb35d53109227c0ca9151637a8fCAS |
[21] Ginige S, Chen MY, Hocking JS, Grulich AE, Fairley CK. Rising HIV notifications in Australia: accounting for the increase in people living with HIV and implications for the HIV transmission rate. Sex Health 2007; 4 31–3.
| Rising HIV notifications in Australia: accounting for the increase in people living with HIV and implications for the HIV transmission rate.Crossref | GoogleScholarGoogle Scholar |
[22] White PJ, Ward H, Garnett GP. Is HIV out of control in the UK? An example of analysing patterns of HIV spreading using incidence-to-prevalence ratios. AIDS 2006; 20 1898–901.
| Is HIV out of control in the UK? An example of analysing patterns of HIV spreading using incidence-to-prevalence ratios.Crossref | GoogleScholarGoogle Scholar |
[23] Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS 2006; 20 1447–50.
| Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA.Crossref | GoogleScholarGoogle Scholar |
[24] Pinkerton SD. How many sexually-acquired HIV infections in the USA are due to acute-phase HIV transmission? AIDS 2007; 21 1625–9.
| How many sexually-acquired HIV infections in the USA are due to acute-phase HIV transmission?Crossref | GoogleScholarGoogle Scholar |
[25] Wilson DP, Hoare A, Regan DG, Law MG. Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men. Sex Health 2009; 6 19–33.
| Importance of promoting HIV testing for preventing secondary transmissions: modelling the Australian HIV epidemic among men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[26] Grierson J, Thorpe R, Pitts M, Hughes T, Saxton P, Smith J, et al. HIV Futures New Zealand 2 [Mate āraikore a muri ake nei (Tuarua)]. Monograph Series Number 66. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University; 2008.
[27] Dickson N, Davidson O. HIV prevention in New Zealand – still room for improvement. N Z Med J 2006; 119 1243
[28] Health Protection Agency. Sexually transmitted infections and men who have sex with men in the UK: 2008 report. London: Health Protection Agency; 2009.
[29] Arneborn A, Blaxhuit A. Increase of reported HIV infections in Sweden. Eurosurveill 2007; 12 3214
[30] Koblin BA, Husnik MJ, Colfax G, Huang Y, Madison M, Mayer K, et al Risk factors for HIV infection among men who have sex with men. AIDS 2006; 20 731–9.
| Risk factors for HIV infection among men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[31] Volk JE, Prestage G, Jin F, Kaldor J, Ellard J, Kippax S, et al Risk factors for HIV seroconversion in homosexual men in Australia. Sex Health 2006; 3 45–51.
| Risk factors for HIV seroconversion in homosexual men in Australia.Crossref | GoogleScholarGoogle Scholar |
[32] Read TR, Hocking J, Sinnott V, Hellard M. Risk factors for incident HIV infection in men having sex with men: a case-control study. Sex Health 2007; 4 35–9.
| Risk factors for incident HIV infection in men having sex with men: a case-control study.Crossref | GoogleScholarGoogle Scholar |
[33] Macdonald N, Elam G, Hickson F, Imrie J, McGarrigle CA, Fenton KA, et al Factors associated with HIV seroconversion in gay men in England at the start of the 21st century. Sex Transm Infect 2008; 84 8–13.
| Factors associated with HIV seroconversion in gay men in England at the start of the 21st century.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c%2FlsFKqsg%3D%3D&md5=4ffe149c67f2c57ff4e09cf69d870898CAS |
[34] Prestage GP, Hudson J, Down I, Bradley J, Corrigan N, Hurley M, et al Gay men who engage in group sex are at increased risk of HIV infection and onward transmission. AIDS Behav 2009; 13 724–30.
| Gay men who engage in group sex are at increased risk of HIV infection and onward transmission.Crossref | GoogleScholarGoogle Scholar |
[35] Williamson LM, Dodds JP, Mercey DE, Hart GJ, Johnson AM. Sexual risk behaviour and knowledge of HIV status among community samples of gay men in the UK. AIDS 2008; 22 1063–70.
| Sexual risk behaviour and knowledge of HIV status among community samples of gay men in the UK.Crossref | GoogleScholarGoogle Scholar |
[36] Rehle T, Lazzari S, Dallabetta G, Asamoah-Odei E. Second-generation HIV surveillance: better data for decision-making. Bull World Health Organ 2004; 82 121–7.
[37] Elford J. Changing patterns of sexual behaviour in the era of highly active antiretroviral therapy. Curr Opin Infect Dis 2006; 19 26–32.
| Changing patterns of sexual behaviour in the era of highly active antiretroviral therapy.Crossref | GoogleScholarGoogle Scholar |
[38] Romeril KR. Acute HTLV III infection. N Z Med J 1985; 98 401
| 1:STN:280:DyaL2M7ovFSrsA%3D%3D&md5=543f134176d792f8dd45c92c1013fdc6CAS |
[39] Fraser AG, Henley JW, Ellis-Pegler RB, Benjamin CS, Childs WJ, Harvey VJ. The acquired immunodeficiency syndrome in Auckland in 1985. N Z Med J 1986; 99 485–8.
| 1:STN:280:DyaL283osFyhtw%3D%3D&md5=14977398eac42aa55e5634c4b377a06eCAS |
[40] Carlson RV, Skegg DC, Paul C, Spears GF. Occurrence of AIDS in New Zealand: the first seven years. N Z Med J 1991; 104 131–4.
| 1:STN:280:DyaK3M7oslejsQ%3D%3D&md5=f7a440c6e018fc9043854794c14908fbCAS |
[41] Parkinson P, Hughes T. The gay community and the response to AIDS in New Zealand. N Z Med J 1987; 100 77–9.
| 1:STN:280:DyaL2s7ksFelsw%3D%3D&md5=f9c5c609cadfc44a192727cc6d4a7624CAS |
[42] Crofts N, Ballard J, Chetwynd J, Dickson N, Lindberg W, Watson C. Involving the communities: AIDS in Australia and New Zealand. AIDS 1994; 8 S45–53.
[43] Davis P, Lichtenstein B. AIDS, sexuality and the social order in New Zealand. In: Davis P, editor. Intimate details and vital statistics: AIDS, sexuality and the social order in New Zealand. Auckland: Auckland University Press; 1996. pp. 1–10.
[44] Lindberg W, McMorland J. ‘From grassroots to business suits’: the gay community response to AIDS. In: Davis P, editor. Intimate details and vital statistics: AIDS, sexuality and the social order in New Zealand. Auckland: Auckland University Press; 1996. pp. 102–119.
[45] Plumridge E, Chetwynd J. AIDS policy response in New Zealand: consensus in crisis. Health Care Anal 1994; 2 287–95.
| AIDS policy response in New Zealand: consensus in crisis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M7ivVGjsw%3D%3D&md5=19019321e9354ba2fa7fd027714b9f06CAS |
[46] Lichtenstein B. Tradition and experiment in New Zealand AIDS policy. AIDS Public Policy J 1997; 12 79–88.
| 1:STN:280:DC%2BD3cvhvFGnuw%3D%3D&md5=7b0ea53b13c5956d33c6525e34debac2CAS |
[47] Davis P, Lichtenstein B. A viable partnership? In: Davis P, editor. Intimate details and vital statistics: AIDS, sexuality and the social order in New Zealand. Auckland: Auckland University Press; 1996. pp. 221–227.
[48] Fairley C, Grulich AE, Imrie JC, Pitts M. Investment in HIV prevention works: a natural experiment. Sex Health 2008; 5 207–10.
| Investment in HIV prevention works: a natural experiment.Crossref | GoogleScholarGoogle Scholar |
