UPDATE OF HIV & AIDS
EPIDEMIOLOGY IN NEW ZEALAND
Sue McAllister
AIDS Epidemiology Group
University of Otago, Dunedin
HIV Treatments Update
Auckland
30 August 2019
1
HIV notification process
Laboratories
Public Health
Units via
EpiSurv (ESR)
AEG
Health care
providers
2
• Non-identifiable data
• HIV “diagnosis” could have
been first diagnosed in NZ or
overseas
• Year of diagnosis may not
reflect the year of infection
AEG=AIDS(Epidemiology(Group
ESR=Environmental(Science(&(Research
Annual numbers “diagnosed” with HIV in New Zealand
by mode of transmission - 1985-2018
Number of people diagnosed with HIV in New Zealand through Western blot (WB) antibody test by year of diagnosis and means
of infection, and since 2002 the number reported through viral load (VL) test. (* It is important to appreciate that infection might
have occurred some time before diagnosis)
3
0
20
40
60
80
100
120
140
160
180
200
220
240
260
85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04+ 05+ 06 07+ 08+ 09 10 11 12 13 14 15 16 17 18
No.
Ye a r
Unknown+
Other
Perinatal
People+ who+ inject+ drugs
Het erosexual**
Men+ who+have+sex+wit h+men*+
2013-17
16%
2018
Total - 178
156 Males
19 Females
3 Transgender
41 previously
diagnosed
overseas
Annual HIV diagnoses in NZ: mode of
transmission
4
0
20
40
60
80
100
120
140
160
180
85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18
Number
Men who have sex with men (includes MSM/IDU)
Heterosexual
People who inject drugs
Perinatal
Other
Men who have sex with men (MSM)
(n=111)
5
Includes(HIV(cases(diagnosed(by(Western(Blot(antibody(test(and(viral(load(testing
Annual number MSM diagnosed with HIV in New
Zealand, by place of infection: 1996-2018
6
0
10
20
30
40
50
60
70
80
90
100
110
96
97
98
99
00
01
02
03
04
05
06
07+
08
09
10
11
12
13
14
15
16
17
18
No.
Ye a r
NZ
Overseas
Unkn ow n
2013-17
27%
Reason for testing for MSM diagnosed &
infected in NZ (n=60)
7
Ro uti ne(
screen
34%
History(of(risk(
contact/behaviour
30%
Symptoms
17%
Risk(&(
symptoms
3%
Contact(tracing
3%
Work-up( f or(PrEP
5%
Other
5%
Unk.
Initial CD4 count of MSM diagnosed and infected
in New Zealand: 2014-2018
8
37%
23%
28%
2
3 3
5
7
22
32
27
19
17
21
16
24
11
14
43
36
44
34
22
0
10
20
30
40
50
60
70
80
90
100
2014 2015 2016 2017 2018
Unknown
<350 350-499 500+
Age of MSM diagnosed and infected in
New Zealand: 2014-2018
9
0
5
10
15
20
25
30
35
2014 2015 2016 2017 2018
Numb er
<30 30-39 40-49 50+
Ethnicity of MSM diagnosed and infected in
New Zealand: 2014-2018
10
0
10
20
30
40
50
60
70
2014 2015 2016 2017 2018
Number
European Māori Pacific Asian African Other/Unk.
Residence of MSM diagnosed & infected
in New Zealand: 2014-2018
11
0
10
20
30
40
50
60
70
80
2014 2015 2016 2017 2018
Number
Northern Midland Central Southern Unknown> NZ Overseas/Unk.
Men and women heterosexually infected
(n=27: 18 men; 9 women)
12
Annual number heterosexually acquired HIV diagnosed in
New Zealand, by place of infection: 1996-2018
.Includes(HIV(cases(dia gnose d(by(Western(Blot(antibody(te st(and(viral(load(testing
13
0
10
20
30
40
50
60
70
80
96 97 98 99 00 01 02 03 04 05+ 06 07+ 08 09 10 11 12 13 14 15 16 17 18
No.
Ye a r
NZ
Overseas
Unkn ow n
Initial CD4 count of heterosexual men and women
diagnosed and infected in New Zealand: 2014-2018
14
39% 52% 52%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014-2018
Unknown
>500
350.to.<500
<350
52%
33%
6%
MSM
30%
Age of heterosexual men and women
diagnosed in New Zealand: 2014-2018
15
0
5
10
15
20
25
30
35
40
45
50
2014 2015 2016 2017 2018
Number
<30 30-39 40-49 50+
Ethnicity of heterosexual men and women diagnosed in
New Zealand: 2014-2018
16
0
5
10
15
20
25
30
35
40
45
50
2014 2015 2016 2017 2018
Number
Europea n Māori Pacific Asian African Other/Unk.
People who inject drugs (PWID): 1996 – 2018
(Includes IDU only + MSM/IDU + Hetero/IDU)
!
"
#
$
%
&
'
(
)
*
"!
*' *( *) ** !! !" !# !$ !% !& !' !( !) !* "! "" "# "$ "% "& "' "( ")
+,-./0
123/45/67827+9 123/45/67:;/0</=<
Children diagnosed in NZ through mother-to-
child transmission (MTCT)
• One child notified in 2018 infected through MTCT (born
overseas)
• 5 births to women with diagnosed HIV in 2018
• No child with diagnosed perinatal HIV born in NZ since
2007
Annual number of diagnoses of AIDS and
deaths among people notified with AIDS
19
0
10
20
30
40
50
60
70
80
85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07+ 08 09 10 11 +12 13 14 15 16 17 18
No.
Year
AIDS,diagnoses Deaths
13
3
Summary
MSM#diagnosed
- ↓(Infected(in(NZ
- ↓European;(↑ Māori
- ↓Auckland
- ↑ MSM/IDU
- Late(diagnoses
Heterosexual#men#and#women#diagnosed
Acknowledgements
21
• Organisers and sponsors of today’s meeting
• Ministry of Health
• Infectious disease and sexual health clinicians and their support staff,
& GPs Laboratory staff
• Ms. Hedwig van Asten, Dr Andy Anglemyer - AIDS Epidemiology Group