I'm Healthy

When living with HIV you can stay healthy and have a good quality of life by engaging with effective treatment. Medication continues to improve but at the moment there is no cure for HIV.

I'm Healthy

Every human being has a fundamental right of the highest attainable standard of health. The right to health must be enjoyed without discrimination on the grounds of race, age, ethnicity or HIV status. When living with HIV you can stay healthy and have a good quality of life by engaging with effective treatment. Medication continues to improve but at the moment there is no cure for HIV.

Quicklinks:

Important steps to stay healthy include:

Educate yourself and ask questions
Get on treatment and take it as prescribed
Have regular check-ups with your whole care team.
Talk honestly with your health care providers (it's confidential and they can support you)

Starting Treatment

Treatment is recommended for everyone as soon after being diagnosed with HIV. Guidelines recommend that you start treatment as soon as possible to control the virus. The question of ‘when to start’ will depend on your readiness, which includes both a desire to maximise your health and reduce your infectiousness.

There are several issues to consider when starting treatment including being ready emotionally as well as physically as it is a life-long commitment.

HIV treatments:

Reduce the amount of HIV in your bodyYou will feel better and it will take longer for you to become sick. Treatment is now recommended for all people with HIV, irrespective of CD4 count, to reduce the risk of disease progression.
Lowers the amount of HIV in your body, often to an undetectable levelThis means you will not pass HIV on to someone else.
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May cause side-effectsThese are usually manageable and short term while your body gets used to the medication. Some people experience no side-effects at all. More serious or long-term side-effects are less common. If you notice any symptoms it is important to talk to your doctor as soon as possible. Many persistent side-effects can be reduced by medication. Do not stop treatment without talking to your doctor beforehand as doing so can have harmful consequences.
Work well, but you need to take your treatment exactly as your doctor tells youThis is known as treatment adherence. Treatment adherence is vital or the drugs will become less effective, even if you start taking them regularly again. You will need to think how to store your drugs, how to fit them in around meals if required, and travelling.
Are a lifelong commitmentOnce you start treatment, you should keep taking it. You should not stop because HIV can become ‘resistant’ to treatment – meaning the HIV treatments won’t work properly when you start taking them again. Stopping can cause significant deterioration in your health.
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How much does treatment cost?

Specialist visits are provided at no cost and are provided at hospitals and sexual health clinics.

All HIV medication in New Zealand is publicly funded for everyone and available from community pharmacies – they usually need 24 hours to get the medicine into stock. A $5 dispensing fee may be charged upon collecting the prescribed medication. The amount of prescription fees charged per year is capped to a maximum of twenty prescriptions. People on low incomes or government financial support receive a Community Services Card which lowers the maximum prescription fee per year as well.

General practice doctor fees are usually reduced if you enrol with that clinic as your primary provider as compared to being a casual patient. These fees are capped at $19.50 per visit to people with a Community Services Card. Body Positive provide the Positive Health Scheme which may assist with medical expenses (GP Visits and Pharmacy fees).

All blood test and other medical services and prescriptions directly related to HIV care are provided free of charge through the Public Hospital System and the I.D. departments/Sexual Health Clinics.

Treatment Options

HIV treatment needs to be approved by Medsafe before it can be made available in New Zealand. Once Medsafe has approved it, Pharmac may fund some medications for public use. Your provider will work with international guidelines to provide the treatment that will work best for you.

Not all HIV treatment regimens are available in NZ. A list of the medications available and their funding status can be found here.

Currently there is only one single pill regimen available in NZ. If you are relocating from overseas you may find you need to change regimens, this will often be a matter of going from a single pill to a multi pill dose of the same medications. In some instances you may need to change to a new regimen.

Discussing which treatment you are currently taking and why with your HIV team will help them find the best medication for you available in NZ. Access to non-funded medication can sometimes be arranged so ask questions if your current treatment option isn’t available. Changing medication does not necessarily mean your health is at risk or that the available medication isn’t as effective. It may just be a matter of a similar drug from a different manufacturer.

Adherence

It’s important to take your medication as prescribed. This includes the amount (number of pills) and timing. Follow any other directions such as with or without food and be aware of any possible complications such as potential interactions with food or other medications.

Using medication adherence strategies like pill boxes, blister packs or drug apps are ways to overcome any challenges you may have keeping up with your medicine and appointments. You can practice before you start with a candy to get you used to the routine. Perhaps link pills with a daily activity – like breakfast.

Keep spare doses available in case of emergencies. Including when travelling. If you find it difficult to take your medication on time speak with your health care team to see what can be done to make it easier.

Working with your HIV Care Team

Your healthcare team has the expertise and knowledge to help you stay healthy. Use their skills to your benefit by maintaining a good relationship with them. Your information is confidential so its okay to share information. You should feel safe, comfortable and respected working with your team. They are your supports to stay healthy.

Stay healthy by understanding your HIV treatment plan; how many pills of each medicine you should take; when to take each medicine; how to take each medicine (with or without food); and how to store medicine (avoid high temperatures).

Stay in control by asking about possible side effects from your HIV medication and what you should do if you experience them.

Use your GP or other health services that can help you manage anything which may affect your overall health like mental health or addiction. Include things like housing, food assistance or any other resources you might need to maintain good overall health.

By asking questions you will understand your blood tests, CD4 counts and viral load and how they indicate your health status as well as understanding any other medical conditions you may have. These may be adversely affected by HIV. Being actively involved in your treatment means living a healthier life.

Anything you discuss with all members of your Healthcare Team, including your HIV status is completely confidential. Privacy restrictions are in place preventing unauthorised access to your health records. If you feel your privacy has been compromised there are processes available to investigate any concerns you may have.

POZQOL - The PozQoL Scale is a brief quality of life scale that helps service providers improve care quality and health outcomes for people with HIV. Taking part helps people with HIV shape the type and extent of care available to maintain the best possibly quality of life.

How do I access healthcare?

Treatment in NZ is provided through the Infectious Diseases (ID) departments at Public Hospitals or through Sexual Health Clinics in each region. A referral can be made to the HIV team by a General Practice Doctor, Body Positive or any other HIV support organisation. In some areas, the ID Department or Sexual Health Clinic can be contacted directly.

Treatment and Service Providers

Treatment for people with HIV in NZ is only available via Infectious Disease departments within regional hospitals or Sexual Health Clinics. Not all cities and towns in NZ have these facilities and not all facilities offer all services. Depending on your location you may need to travel to receive the care you need. This is particularly true for the South Island which has a smaller population spread over a large geographical area. Not all services are available at all locations, some are only available on a limited basis or infrequently. Telehealth appointments may be available to reduce the travel requirements once you have a relationship with the clinic.

North Island (North)

Northland Region has services provided by the Sexual Health clinic in Whangarei

Auckland Region has services in Auckland Hospital, Greenlane Sexual Health Clinic, Middlemore Hospital and Mangere Sexual Health Clinic

North Island (Central)

Waikato Region has services at Hamilton Sexual Health Clinic

Bay of Plenty has services provided by the Tauranga Sexual Health Clinic

Hauora Tairawhiti Region has services provided at Gisbourne Sexual Health Clinic

Lakes Region has services provided by the Sexual Health Clinic in Rotorua

Taranaki Region has services provided by the Sexual Health Clinic in New Plymouth

North Island (South)

Hawkes Bay Region has services provided by Napier Hospital and the Hastings Sexual Health Clinic

Whanganui Region has services provided by the Sexual Health Clinic in Whanganui

Mid Central Region has services provided by the Sexual Health Clinic in Palmerston North

Wairapa Region has services provided by the Sexual Health Clinic in Wairoa

Hutt Valley Region has services provided by the Wellington Sexual Health clinics in Upper Hutt, Hutt Valley and Lower Hutt

Capital and Coast Region has services provided by Wellington Sexual Health Clinic in Wellington

South Island

Nelson Marlborough Region has services provided by the Sexual Health Clinic in Nelson

West Coast Region has services provided by the Sexual Health Clinic in Greymouth

Canterbury Region has services provided by the Sexual Health Clinic in Christchurch

South Canterbury Region has alternating clinic services provided through the South Canterbury Sexual Health in Temuka, Timaru, Twizel and Waimate once a week.

Southern Region has services provided by Dunedin Hospital and Sexual Health Clinic in Dunedin. Some Registered Service Providers (GPs) hold specialist clinics in other cities/towns on a weekly or monthly basis.

Healthcare for non-residents

Specialist providers, HIV treatment and Antiretroviral Medication is free of charge in New Zealand to everyone, regardless of their residence or visa status. People legally in New Zealand on all visas including Tourist, Student, Working Holiday, Work, Residence or Permanent Residence are entitled to free HIV Care. This is provided through the Infectious Diseases Departments at public hospitals as well as regional Sexual Health Clinics. General Practitioners (GP's) in New Zealand are not authorised to prescribe HIV Antiretroviral Medication.

HIV treatment works by stopping the virus reproducing and suppresses the viral load to an undetectable level. Suppressing the virus maintains your immune system and keeps you healthy. In terms of preventing HIV transmission undetectable is defined as anything less than 200 copies/ml. When the viral load is <200 copies/ml there is a zero risk of HIV transmission to sexual partners.

Having a child

Having children can raise questions for people living with HIV. The origins of the U=U movement came from fertility clinics and identified that when undetectable there is zero risk of transmission of HIV through sex. If someone cannot reach undetectable, strategies such as sperm washing and PrEP can facilitate having a child. In 2019, New Zealand launched Sperm Positive, the first ever sperm bank for HIV positive men to donate their sperm to have biological children with their partner or others wanting children.

Mental Health

Mental Health is an important part of staying healthy and concerns can arise from external and internal stigma, depression, anxiety to name some. Looking after your mental health can seem daunting but Body Positive has a really good guide to looking after yourself, linking in with other agencies for support and how to talk with your medical staff. More Information

Smoking

Smoking, in itself, does not make HIV infection worse. However, smoking damages your heart and blood circulation, increasing your risk of cardiovascular (heart) disease, high blood pressure, heart attack, and stroke.

One of the best things you can do for your health is to quit smoking. There are a number of programmes that are aimed at helping to quit smoking to improve your health.

Immunisations & Vaccines

The purpose of vaccinations and immunisations is to protect a person from infectious diseases. Compared to HIV-negative people, people living with HIV have increased vulnerability to diseases that could be prevented by vaccines. Some live vaccines are risky for people living with HIV and should be avoided.

For a full list of immunisations which are recommended for people living with HIV, along with their current funding/eligibility status in NZ, click here.

Staying Healthy

Eating a balanced nutritional diet will help maintain a healthy weight, combined with exercise it will reduce the risks of many health conditions. While watching your alcohol and recreational drug intake, will make sure you have a better sleep, improving your overall mood and energy levels.

Tips for a Healthy Diet

Good nutrition supports overall health and helps maintain the immune system. It also helps people with HIV maintain a healthy weight and absorb HIV medicines.

In general, the basics of a healthy diet are the same for everyone, including people with HIV.

Eat a variety of foods from the five food groups: fruits, vegetables, grains, protein foods, and dairy.
Eat the right amount of food to maintain a healthy weight.
Choose foods low in saturated fat, sodium (salt), and added sugars.

Side effects from HIV medicines, such as loss of appetite, nausea, or diarrhoea, can make it hard to stick to an HIV regimen. If you have HIV and are having a nutrition-related problem, talk to your health care provider.

To avoid nutrition-related problems, people with HIV must also pay attention to food safety. Food safety is about how to select, handle, prepare, and store food to prevent food-borne illnesses.

Because HIV damages the immune system, food-borne illnesses are likely to be more serious and last longer in people with HIV than in people with a healthy immune system. Following food safety guidelines reduces the risk of food-borne illnesses.

If you have HIV, follow these food safety guidelines to reduce your risk of food-borne illnesses:

Do not eat or drink the following foods:

Raw eggs or foods that contain raw eggs, for example, homemade cookie dough
Raw or undercooked poultry, meat, and seafood
Unpasteurised milk or dairy products and fruit juices

Follow the four basic steps to food safety: clean, separate, cook, and chill.

Clean: Wash your hands, cooking utensils, and countertops often when preparing foods.
Separate: Separate foods to prevent the spread of any germs from one food to another. For example, keep raw meat, poultry, seafood, and eggs separate from foods that are ready to eat, including fruits, vegetables, and breads.
Cook: Use a food thermometer to make sure that foods are cooked to safe temperatures.
Chill: Refrigerate or freeze meat, poultry, eggs, seafood, or other foods that are likely to spoil within 2 hours of cooking or purchasing.

A Healthy diet should include a variety of vitamin and mineral rich foods. Fruits, vegetables, whole grains, low-fat dairy and lean protein choices contain vitamins and minerals that help the body function. Zinc and vitamin C are used by the immune system and iron and vitamin B12 are essential for healthy blood cells.

Helpful links for Healthy Diets:
Eating Tips - A Nutrition Guide for People Living with HIV/AIDS
Nutrition and HIV/AIDS
Healthy eating for people living with HIV

Tips for Exercising

Exercise benefits for HIV patients

Maintains or builds muscle mass and decreases fat, helping to maintain a healthy body weight
Reduces cholesterol and triglyceride levels (less risk of heart disease)
Increases energy
Regulates bowel function
Strengthens bones (less risk of osteoporosis)
Improves blood circulation
Increases lung capacity
Helps with sound, restful sleep
Lowers stress and can improve depression
Improves appetite
Reduces the risk of high blood pressure, diabetes, and some kinds of cancer

People living with HIV can do the same types of physical activity and exercise as individuals who do not have HIV. The Physical Activity Guidelines advise at least 150-300 minutes per week of moderate-intensity aerobic activity that increase the heart rate such as brisk walking, cycling, or jogging.

Helpful links:
Physical Activity, Exercise, and HIV

Green prescription

A Green Prescription (GRx) is a health professional's written advice to a patient to be physically active, as part of the patient's health management. It's a smart and cost-effective way to help people stay healthy.

'GRx' is a referral based health and wellbeing service for adults 18 years and over. It is best suited for adults who would like encouragement and motivation to become active and improve their lifestyle, help with a long term medical condition, or those who may be feeling stressed, depressed or anxious.

The service is delivered through face to face, phone or virtual consultations, group-based community nutrition and wellbeing programmes, online webinars, online live exercise sessions as well as pre and post-natal activity advice and guidance.

Referral Criteria:

18 years and over
Ready to make changes to lifestyle
May have a medical condition as a result of a sedentary lifestyle

All Health Professionals can refer their patient or client to Green Prescription, or people can also choose to Self Refer themselves by calling 0800 228 483 or online.

Helpful links:
Self Referral - Health & Wellbeing Programme
Health NZ - Green Prescriptions

Media Downloads

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