More people were diagnosed with HIV in New Zealand last year than in any year since records began in 1985.
Photo: 123RF
The data from AIDS Epidemiology Group released today showed 244 people were diagnosed with HIV in 2016, up 20 from the previous year.
Of last year's newly diagnosed cases, 217 were men and 27 were women.
AIDS Foundation executive director Jason Myers said the rise was disappointing - but not unexpected.
"We know that HIV has been rising in New Zealand since 2011 and not much is changing in terms of the tools that exist being made available to enable us to turn that trend around."
The way to reduce infection rates was a combination of antiretroviral and prophylactic drugs as well as education, he said.
"It's possible to end new HIV transmissions by 2025 in New Zealand" - Jason Myers
"Maintaining condom use, getting pre-exposure prophylaxis into the hands of people who need it and then finding and treating undiagnosed HIV infection.
"That really holds the potential to slow this trend, halt it, reverse it and ultimately end HIV transmission," he said.
Pre-exposure prophylaxis includes drugs that help prevent people who are at substantial risk of contracting the infection from getting it.
Peter Saxton from Auckland University's Gay Men's Sexual Health Research Group agreed more should be spent on prevention.
He said HIV drugs were amazing, but extremely costly.
"For every 20-year-old infected with HIV, it's going to cost the tax payer around $800,000 over their lifetime. Whereas if you frontload that investment into HIV prevention, and in surveys that can help improve prevention, it's incredibly good value for money."
Dr Saxton said the increase in the number diagnosed was particularly frustrating because the disease could be easily stopped.
"We know that we need to keep condom use levels stable, we need to increase the level of HIV testing, we need to promptly offer HIV treatment for people diagnosed."
"We also need to offer HIV pre-exposure prophylaxis to the small number of individuals who are unable to sustain condom use or are at very high risk."
But Dr Saxton said the vital tool in the fight against HIV was knowing more about people's behaviour.
"The HIV data released today tells us what's happening in the epidemic and that it's increasing. What we lack is why."
"Behavioural data on why it's going up, why we're seeing an increase in risk and in whom we're seeing an increased risk is incredibly important right now," he said.
Mark Fisher from HIV support group Body Positive said fear was still a big factor putting people off getting themselves tested.
If testing was a routine part of certain health checks, it would stop many people slipping through the cracks, he said.
"Doctors aren't offering the tests to people because they don't think they're in a risk category and so they won't say maybe you need an HIV test whereas in reality it should just be a routine thing."
"It shouldn't be a judgement call ... it should just be a standard routine test that you do in emergency settings," he said.
The Ministry of Health said while it recognised the significant impact the illness has, the prevalence of HIV infection in the general population remained very low.
It said it would consider the new figures and work with other agencies on improving outcomes.
No need for blanket testing - AIDS Foundation
The AIDS Foundation's Dr Myers said people who were at high risk of contracting HIV should be getting tested, but he did not think a blanket approach was necessary.
"The message really needs to be if you're at high risk of HIV infection, so that in New Zealand is gay and bisexual men who are having unprotected sex, people who are injecting drugs and sharing needles for example, that group of people who are engaged in those behaviours should be testing regularly.
"We wouldn't go out and suggest that everybody in New Zealand should be getting a regular HIV test."
Dr Myers said access to testing could be a barrier for those that needed it. Clinics are open from 9am to 5pm, Monday to Friday, and some people can't get time off work for an appointment.
He said the foundation was looking at different ways to overcome those barriers.
"We use HIV rapid testing, for example, and we go out to community settings where we know we'll be able to access those high risk people. We're also this year looking at piloting a home testing scheme, so that actually we can send HIV test kits out to people's homes and they can administer the test themselves, with us providing them links to care should they get an HIV positive result."
Joshua James, 22, from Wellington, said he and his friends have safe sex and get tested for HIV at least every three months.
"I mean it's terrifying getting tested, especially if you have participated in risky behaviour.
Although they didn't grow up during the 1980s, at the height of the AIDS epidemic, Mr James said there were always lots of young people getting tested for HIV at events like the Big Gay Out.
"I think young people are getting tested regularly and I think that might also be a reason why we're seeing the official [number of cases] going up, so more people getting tested, more people knowing their status."