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HIV/AIDS in New Zealand: an epidemic in decline?
K J Sharples1, N P Dickson, C Paul
1Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin, New Zealand.
Objective:
To describe the AIDS epidemic in New Zealand, and to discuss the reasons for an apparent decline in incidence.
Methods:
The AIDS Epidemiology Group collects information on persons diagnosed with AIDS through a compulsory notification system. Data were presented on people diagnosed to the end of 1994, and reported by the end of September 1995.
Results:
The cumulative incidence of AIDS in New Zealand was similar to that in some other Western countries, such as the United Kingdom, Germany and Sweden, before 1989, but has been declining since 1989. The epidemic is concentrated among men who have sex with men (89%). The median survival after diagnosis with AIDS is 13 months.
Conclusions:
The observed decline is not likely to be due to reporting delays or changes in reporting or diagnostic practices. The major factor was probably a rapid decline in HIV incidence among homosexual men a decade ago, and the effective prevention of epidemics in other subgroups. The epidemic in New Zealand started later than in other countries, enabling an earlier response, and there is evidence of behaviour change in high risk groups. Preventive efforts and monitoring must be maintained in order to ensure there is no reversal of this decline.