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Advances in HIV-treatment could finally wipe out the stigma of Aids

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Kiwis’ attitudes towards patients don’t need to be stuck in the 1980s thanks to HIV-treatment advances.

When Rodrigo Olin was diagnosed with HIV at 20, he thought he’d be dead by the time he was 40.

But 15 years later, Olin – who is originally from Mexico and moved to New Zealand eight years ago – knows that, thanks to advances in the drugs used to treat HIV, he has the same life expectancy as if he were HIV-negative.

“It is quite life-changing to realise that I’m not going to die – at least of HIV,” says Olin, who works as a senior project officer for the New Zealand Aids Foundation.

Equally life-changing is knowing that as long as he keeps taking the antiretroviral drugs used to treat HIV, he can’t pass the virus on to any sexual partners. Like most people who take the drugs as prescribed, Olin has what’s known as an undetectable viral load.

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That doesn’t mean he’s cured in the traditional sense of the word; if he stopped treatment, he would eventually develop the symptoms of what is known as Aids-defining illness. But it does mean the virus can’t be detected in blood tests and cannot be transmitted to another person.

“I can start a meaningful relationship with someone knowing that I can’t pass the virus on. Knowing that is such a relief for both partners – not just for me as a gay man, but also for other people living with HIV, such as women who want to have children.”

The fact that it is now easy to achieve an undetectable viral load is great news for the estimated 3500 New Zealanders living with HIV. Aids Foundation chief executive Jason Myers hopes it will also help break down the stigma that continues to be associated with the virus.

“It pushes against the narrative that people living with HIV are these frightening vectors of disease roaming around.”

A recent foundation survey found that 88% of Kiwis would be uncomfortable having a sexual relationship with someone with HIV, 46% would be uncomfortable letting a child play with a child with HIV and 38% would be uncomfortable having a flatmate with HIV.

New Zealand Aids Foundation chief executive Jason Myers. Photo/Supplied

Myers says those attitudes are a legacy of the days when being diagnosed with HIV was pretty much a death sentence. “HIV in 2018 is very different to what it was in the 1980s.”

New Zealand was the first country in the world to see a decline in deaths from Aids-defining illness, which now sit at just a couple a year compared with almost 70 in the early 90s. Myers hopes we may now also be on track to achieve the foundation’s goal of eliminating new HIV diagnoses by 2025.

In 2017, New Zealand recorded the first drop in the number of new diagnoses since 2011 – from 244 in 2016 to 197. Of those, 128 were among gay and bisexual men, compared with 164 in 2016.

Gay and bisexual men are most at risk of being infected with HIV. That’s partly because the virus is 18 times more likely to be transmitted through unprotected anal sex than through unprotected vaginal sex. It also reflects higher historical infection rates among gay men, and the fact that they’re more likely to encounter someone living with the virus.

But although Myers hopes the 2018 figures will show another drop in new diagnoses, he knows there’s still work to do if we are to eliminate them altogether. Along with similar organisations around the world, the foundation – which on February 10 will hold its 20th anniversary Ending HIV Big Gay Out event at Coyle Park in Auckland – has traditionally focused on regular testing and the use of condoms to provide protection.

High-risk New Zealanders now have another preventive option available – a drug known as a pre-exposure prophylaxis (PrEP), which, if taken daily, provides almost 100% protection from infection with HIV. About 1300 people have been prescribed the drug since Pharmac started funding it in February last year.

Says Myers, “As long as we can get the message to the right people that they need to protect themselves in whatever way is right for them, and they are also getting tested regularly, there’s no reason the 2017 data point can’t turn into a trend.”

This article was first published in the January 19, 2019 issue of the New Zealand Listener.