Migrants Focus of HIV Alert

By DAVIS, Joanna

GPs need to be more proactive in carrying out HIV tests on migrants from countries with high rates of the disease, a Christchurch infectious diseases specialist says.

From Monday, people coming to New Zealand for more than 12 months must be HIV tested, but there is no such requirement for migrants already living here.

Christchurch Hospital infectious diseases specialist Alan Pithie said he was concerned about the high proportion of his immigrant patients who were diagnosed only when they became very sick with HIV.

Pithie said it was both a personal and public health issue.

“Clearly, if someone (with HIV) presents later, they may die or be in a hospital for a long time. Secondly, there’s a concern about potential transmission to other people,” he said.

Half of new HIV infections in New Zealand last year were heterosexually acquired, according to National Aids Epidemiology Group figures, and 90 per cent of those were acquired overseas.

The call for testing was backed by Christchurch GP Doug Smith, who said migrants deserved to know their HIV status.

“We ought to give them the opportunity to have reasonable, proactive preventable health screening for a disease that’s very prevalent in their country,” he said.

“It can stop them getting terribly devastating diseases, wasting away, and passing it to their families.”

Smith said many immigrants believed they were clear of HIV as they had a blood test before coming to New Zealand.

However, he said that test was for syphilis.

Pregnant women, in particular, should be tested for HIV as a diagnosis in pregnancy could cut the likelihood of transmission to the baby from 30% to about 2%.

This year, the Health Ministry announced it would introduce routine pregnancy HIV screening after an untested Thai mother infected her baby.

However, a nationwide roll-out of the testing was expected to take at least another two years, a delay Smith said could not be justified.

Pithie said he did not want to stigmatise migrants from particular countries.

However, he said: “The message to GPs is they should just be aware of the possibility of HIV in anyone who comes from high- prevalence countries. That’s many African and some Asian countries.”

In parts of Sub-Saharan Africa, more than 35% of the adult population is infected with HIV.

New Zealand Aids Foundation executive director Rachael Le Mesurier said GPs needed to know that high-prevalence countries were increasingly diverse and included China, India, Russia, Thailand, Indonesia and Africa.

Le Mesurier agreed GPs should offer HIV testing to people from high-prevalence countries, but she said the offer should not be confined to migrants.

“It’s not just migrants, but returning New Zealanders who’ve been living overseas and also those coming back from holidays in high- prevalence countries,” she said.

“We’re a great population for going overseas and we, like everybody else, are having sex while we’re there.”

She said that any request to a GP or sexual health doctor for a sexually transmitted infection check should be taken as an opportunity to offer HIV testing.