With one baby being diagnosed with HIV in Fiji every week, health officials in the Pacific nation are struggling to contain a growing outbreak – and health researchers say New Zealand needs to be better prepared for possible transmission here.
Rapid HIV tests, which can provide results in as little as 60 seconds, have become a key tool in detecting the virus in New Zealand. The tests are available at community clinics and can also be taken home for added privacy.
Mark Fisher, the executive director for HIV/AIDS peer support organisation Body Positive, said community-based testing had helped reach people who may otherwise avoid getting tested.
"We’ve seen 34% of the people who come to our clinic would not have gone anywhere else to get tested," he said.
Fisher believed the same approach could help improve detection rates in Fiji.
"I run a community clinic because it's a little more accessible. It takes away some of those fears and barriers around who's going to know, who's going to see me," he said.
According to the University of Otago HIV Epidemiology Group, 80 people were diagnosed with HIV in New Zealand last year. Of that number, 29% identified as Asian, 25% as Māori, 21% as European and 14% as Pacific peoples.
But Fisher and Dr Jalal Mohammed, a Pacific health researcher from Fiji, believe the true number of HIV cases in the island nation may be far higher than official figures show.
"With Fiji currently gripped by an escalating epidemic, we could be seeing another 45% of that total diagnosed number in Fiji that is yet to be diagnosed," Mohammed said.
There were concerns the outbreak could have implications for New Zealand. Fisher said around a third of AIDS diagnoses in New Zealand are among Pacific people – an indication of late-stage diagnosis.
"We could have an outbreak that we just don't know about because we're not getting to that group in terms of the testing," he said.
Vaiola Fifita – a volunteer with Toitū te Ao, which provides support for Māori and Pasifika people living with HIV – said cultural and religious stigma remained a major barrier preventing Pacific communities from seeking testing.
"Our cultural beliefs and our religious beliefs have made a really strong impact in our community and kind of like the barrier for our people to come in and get tested,” he said. Fifita learned of his HIV status after undergoing an immigration medical examination. He believed he contracted the virus years earlier while at high school in Tonga.
"Growing up, we never get to have that conversation or to feel free to have that conversation," he said.
Health advocates are now calling for HIV testing to become a routine part of general healthcare.
"If you get a diabetes test or cholesterol check, why don't we include a sexual health check?" Fisher said.
Mohammed also wanted stronger public health messaging for travellers arriving from or going to Fiji, including information at airports.
"Whether this be brochures, whether they be posters, it's just saying, hey, there is a HIV epidemic going on in Fiji, it's been fuelled by a drug crisis,” he said.
Health New Zealand said an awareness campaign targeting Pacific communities was currently being developed.
Fifita said he hoped sharing his own story would help challenge the stigma surrounding HIV.
"I am Tongan, I am young and beautiful, and I live with HIV and there's nothing that would take that away from me."
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