Tue 22 Jul 2014 In: New Zealand Daily News View at Wayback View at NDHA
HIV prevention workers from a number of countries have attended a presentation by New Zealand researchers and safe-sex promoters this afternoon, keen to learn from this country's success in keeping the HIV epidemic from re-exploding as it has in other countries. The sixty delegates to the AIDS 2014 conference in Melbourne who attended the session came from a variety of countries including South Africa, Germany, England, Venezuela and several Asian and African countries. Peter Saxton They heard HIV and gay men's health researcher Dr Peter Saxton of Otago University Medical School advise that New Zealand has had no overall infection rate increase across the last ten years, despite a slowly increasing pool of HIV-positive men and the increased prevalence of HIV testing amongst men who have sex with men. Saxton said that understanding the sexual behaviour of gay and bi men at risk of contracting HIV is vital. He noted that there are highly sexually active groups within the gay community with close networks of sexually active men and high partner turnovers. He also advised HIV workers to keep their incidence of condom use data in mind rather than only focusing on non-use. "How much condom use there is represents potential infections averted", he said, "and that reminds us of what we've got to lose if we backtrack on condom promotion." He said that research in this country shows that attitudes to condom use "are overall positive but we've got to work to maintain that." Tony Hughes, the NZ AIDS Foundation's scientific director, spoke on prevention strategy, underscoring that the sexual culture of men who have sex with men is different to the general, or straight, population while communications and marketing manager Joe Rich explained the Love Your Condom campaign and how NZ has achieved excellent results on a very small budget. Massey University's Jeff Adams presented an independent valuation of the NZAF's social marketing approach which underscores that it has had significant success in helping avert the spread of HIV amongst gay and bi New Zealanders. After the presentation Saxton told GayNZ.com Daily News that he was pleased to see that attendees "were challenged to avoid nihilism, to not turn their backs on condom promotion as whatever condom use they are achieving is still actually preventing infections." Saxton says blowouts amongst young men who have sex with men in places as varied as New York and Bangkok "show how quickly HIV can spread given the right conditions." Many countries are beginning to rely increasingly on pre-exposure prophylaxis (PrEP), a method of taking HIV drugs prior to unsafe sex encounters, to lower the chances of contracting the debilitating virus. This 'bio-medical' prevention technique "provides a high degree of protection against HIV infection, even for individuals who miss some daily doses," according to new data from the iPrEx OLE study released at the conference today. Shaun Robinson The NZAF's Executive Director, Shaun Robinson, relaxing in a bar near the conference centre with the session's presenters this evening after a strenuous day, said he was gratified by "a very positive response" to NZAF's presentation on retaining condom use as primary prevention and that people expressed concern about over-reliance on bio-medical on prevention approaches such as PrEP and 'treatment as prevention.' He says he particularly noted an observation by Dr Valerie Delpech of the English public health system that her country has more or less reached UNAIDS' new 90-90-90 target - whereby it says having 90% of people tested, 90% of HIV-positive people on treatment and 90% of those achieving undetectable viral levels - will see the end of AIDS - and it hasn't stopped the HIV epidemic there. "That reinforces that biomedical intervention alone won't work," Robinson says, adding that he finds today's report of the iPrEx OLE study "not particularly encouraging. "It is probably effective at an individual level but how do you make it effective at a community-wide level?" he asks. New Zealand's total adherence to condoms as the first and main line of defence against HIV infection is in contrast to most Australian states where the bio-medical approaches have been more roundly embraced. Despite this difference of opinion Robinson says relations between New Zealand delegates and those from some states of Australia and other countries with diverging approaches are cordial. "There has been a mixed response to us, many people are envious that our base of condom use is so high and they acknowledge it makes sense for us to continue with that as the cornerstone of our programmes," he says. He acknowledges that his strongly voiced view has not been popular in all areas of HIV prevention work around the world. "But when people make a song and dance about treatment as prevention, that has an influence around the world. I've sometimes felt I have to put our case out there as well. Everyone involved in HIV prevention work must remember to concentrate on the 94% of people who don't have HIV, not just the 6% who already have it. Body Positive boss Bruce Kilmister had a slightly different take on the results of the iPrEx OLE study, saying it added to the "mounting evidence for PrEP to be used by some people and that there is a clear connection between adherence and efficacy Kilmister says today was his first opportunity to go through the trade hall, which is dominated by displays by HIV medication manufacturing companies. He particularly noted two new medications that might prove advantgeous to people living with HIV in New Zealand, one of which is already going through the approvals process. "They would provide another option for people having problems with their available drug combinations," he says. But, overall, he believes "we have pretty good access to HIV treatments in New Zealand" and he is "comfortable that we have most of what we need." Richard Branson New Zealand MP Peter Dunne made a presentation at the conference today, on issues surrounding psycho-active recreational drugs, part of a conference theme which saw liberalisation campaigner Richard Branson claim that the global war on drugs has failed "both in terms of drug and public health outcomes, particularly in relation to HIV." However, a delegate from Singapore mentioned that methamphetamine use there is significant and is often reported as a factor in not using condoms and subsequent transmission of HIV. Robinson says the NZAF knows there are people with HIV who have had behavioural issues with drugs. And, he says, "There is some indication that highly sexualised men who have sex with men have higher drug use and lower condom use." He says harm minimisation is the best approach to dealing with drug use. Kilmister also expressed concern regarding any links between recreational drug use and HIV infection and describes the synthetic cannabis products, which were until recently widely available, as "highly dangerous." The candlelight vigil in Federation Square Meanwhile, hundreds of people bearing candles gathered in Melbourne's Federation Square this evening to acknowledge the millions of deaths around the world as a result of the HIV and AIDS epidemic. Of the loss of six conference delegates in the destruction of flight MH17 MC Richard Taki, originally of Auckland, said "we are particularly saddened by the loss of the delegates who were traveling to Australia to participate in the AIDS 2014 conference... their contribution to the cause has been outstanding. We thank you."
Credit: GayNZ.com Daily News staff
First published: Tuesday, 22nd July 2014 - 11:55pm