A new study has found harm reduction measures have been incredibly successful at lowering the rates of HIV in New Zealand, even among the most vulnerable drug users.
Just over 1650 people were diagnosed with the virus in New Zealand between 1996 and 2018, but only 2.9 percent of them used needles to inject drugs.
Auckland University senior research fellow Peter Saxton says it was surprising to see how well needle exchange programmes worked, even among gay and bisexual men who inject drugs.
"Although the rates of HIV amongst that group were higher and the levels of unprotected sex were a little bit higher, they weren't nearly as high as we've found in other countries when we've looked at that group."
The study found only one heterosexual person who injects drugs was diagnosed with HIV each year on average, and one gay or bisexual person.
Dr Saxton says the low rates come down to early intervention.
"The key to that success is this early, rational harm-reduction approach that New Zealand took in the 1980s. That's when we decriminalised the possession of needles, and we were the first country in the world to fund needle exchange programmes."
The needle exchange programme, established in the late 1980s, provides advice and sterile needles for free.
"There is no question that the inception 30 years ago of a national needle exchange programme, a world first, has allowed New Zealand to maintain one of the lowest rates globally of HIV infection among people who inject drugs: consistently below 1 percent," said co-author Geoff Noller.
"But we have to remain on our toes. HIV is transmitted very easily by sharing unsterilised injecting equipment, and the potential for clusters of infection to occur quickly is always there. Ongoing resourcing of harm reduction strategies such as needle exchange, safe sex options and HIV surveillance in at-risk populations is vital."
The research was published Thursday in journal Drug and Alcohol Review.