New Zealand has experienced a blowout of AIDS diagnoses in the first six months of this year, with figures for January to June more than doubling last year's figures for the same period. It is currently not clear how many gay men are included in the figures, or the latest AIDS figures' relationship to HIV infection rates. The Institute of Environmental and Scientific Research monthly report on disease incidence shows that AIDS diagnoses for the first six months this year totaled 33, compared with just 14 for the same period last year. The IESR figures do not indicate the sexuality or any other demographic data of those newly diagnosed with AIDS. Quarterly figures from the Dunedin-based AIDS Epidemiology Group may shed some light on the IESR data but are not expected to be available until mid- or late-August. AIDS is the most severe form of HIV infection and is characterised by a significant breakdown of the body's immune system. A person is diagnosed with AIDS when they have HIV infection which causes their immune system to be compromised below a specific level and/or they develop other illnesses commonly seen with AIDS such as life-threatening cancers and pneumonias, lymphoma, and Cytomegalovirus retinitis which causes vision loss. Between the mid 1980s and late 1990s HIV/AIDS-related deaths traumatised New Zealand's gay population. However, in recent years progression from HIV infection to having AIDS has slowed due to a range of powerful but toxic medications becoming available. But anecdotal evidence from HIV specialists indicates that an increasing number of gay men with HIV who have enjoyed a respite from the onset of AIDS due to drug treatments are beginning to experience treatment failure. Until recent years approximately 85% of New Zealanders with HIV and/or AIDS have been men who have sex with men. Early in the epidemic the remainder were predominantly intravenous drug users plus a small number of straight women. In recent years new immigrants, generally those from Africa and Asia, have been an increasing group, although they have generally contracted the disease before immigrating to this country. The NZ AIDS Foundation has been viewing with concern feedback from health practitioners that increasing numbers new AIDS diagnoses are occurring at the same time as people's HIV diagnoses. The implication from this is that at-risk people have not been testing for the disease and are only discovering they have HIV when they contract illnesses consistent with an existing HIV infection having already deteriorated to AIDS. “This affirms our concern that up to 33% of people who are HIV positive do not know they are living with the virus, says the Foundation's Executive Director Rachael Le Mesurier. “This is not only very bad for their life expectancy, it works against our efforts to control the spread of HIV. After all just assuming you are HIV negative is not the same as being certain you are because you have tested negative and had safe sex ever since.” The Foundation says there is strong evidence that people who know they have HIV are less likely to engage in sexual behaviours that risk passing the virus on. The doubling of AIDS progression diagnoses is a timely reminder that AIDS is not “yesterday's issue”, Le Mesurier says, adding that the rise in AIDS cases does not mean there has been a doubling of new HIV infections in New Zealand over the same period. However, the increase in AIDS diagnoses does come on top of a record increase in new HIV infections in 2003 and again in 2004. “One of our concerns has been that the improvement in HIV treatment, while good news for people living with HIV, has resulted in complacency. Some people seem to think HIV is not so serious any more because the pills keep people alive for a lot longer. This could well be contributing to some people being prepared to take more risks, sexually, than when HIV was thought of an almost instant death sentence." Le Mesurier says the new AIDS figures are also "a timely reminder that we have not defeated HIV in New Zealand, people still get AIDS, with its serious impact on both the quality and length of their lives." The mainstay of the AIDS Foundation's campaigning to reduce HIV and AIDS prevalence in New Zealand remains promotion of condoms for anal sex. "Regular and correct condom use, not medication, is still by far our best defence against HIV." Jay Bennie - 19th July 2005