Publications by authors named "Peter J W Saxton"
Pre-exposure prophylaxis (PrEP) minimises HIV risk and New Zealand was one of the first countries to publicly fund PrEP in 2018. However, no studies have explored in-depth the experience and meaning of living 'on PrEP' among individuals at elevated risk of HIV, such as gay and bisexual men. This qualitative study builds on findings from the NZPrEP demonstration project of early PrEP-adopting gay and bisexual men in Auckland, New Zealand.
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- Early diagnosis of HIV is crucial for effective treatment and controlling its spread; the study focused on late diagnoses in New Zealand from 2011-2020.
- Out of 1145 adults analyzed, 40.5% were diagnosed late, with 24.9% having advanced HIV disease; the majority of late presenters were men-who-have-sex-with-men (MSM).
- Factors contributing to late presentation included older age, being of non-European ethnicity, and testing due to symptoms, highlighting the need to identify barriers to testing and create strategies to encourage earlier diagnosis, especially among heterosexuals and diverse ethnic groups.
Inequities in pre-exposure prophylaxis (PrEP) experiences will impede HIV epidemic elimination among gay and bisexual men (GBM). Ethnicity is a strong marker of inequity in the United States, but evidence from other countries is lacking. We investigated experiences on-PrEP to 12 months follow-up in a prospective cohort of 150 GBM in Auckland, New Zealand with an equity quota of 50% non-Europeans.
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- Gay and bisexual men (GBM) represent a significantly higher percentage of HIV, syphilis, and gonorrhoea cases in New Zealand, with rates calculated for the first time by sexual orientation.
- In 2019, GBM accounted for 76.3% of HIV, 65.7% of syphilis, and 39.4% of gonorrhoea notifications, showing stark disparities in case rates compared to heterosexual individuals.
- The study highlights serious inequities in STIs among GBM in New Zealand, emphasizing the need for targeted surveillance and interventions based on sexual orientation.
Objectives: To assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity.
Design: Repeated cross-sectional.
Setting: Behavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand.
Background: Race and ethnicity classification systems have considerable implications for public health, including the potential to reveal or mask inequities. Given increasing "super-diversity" and multiple racial/ethnic identities in many global settings, especially among younger generations, different ethnicity classification systems can underrepresent population heterogeneity and can misallocate and render invisible Indigenous people and ethnic minorities. We investigated three ethnicity classification methods and their relationship to sample size, socio-demographics and sexual health indicators.
View Article and Find Full Text PDFIntroduction And Aims: Gay and bisexual men (GBM) who inject drugs are disproportionately affected by human immunodeficiency virus (HIV) because of dual transmission risks. New Zealand has a progressive history of harm reduction and was the first country to publicly fund needle exchange programs in 1988 for people who inject drugs (PWID). We combine national HIV epidemiological and bio-behavioural surveillance data to understand HIV risk among this subpopulation.
View Article and Find Full Text PDFPre-exposure prophylaxis (PrEP) became publicly funded in New Zealand (NZ) on 1 March 2018. PrEP could have a substantial population-level effect on HIV transmission if scaled up rapidly. An accurate estimate of the size of the PrEP-eligible population would guide implementation.
View Article and Find Full Text PDFUnlabelled: Background Pre-exposure prophylaxis (PrEP) became publicly funded in New Zealand (NZ) on 1 March 2018. PrEP could have a substantial population-level effect on HIV transmission if scaled up rapidly. An accurate estimate of the size of the PrEP-eligible population would guide implementation.
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- The study focused on gay and bisexual men (GBM) in New Zealand, evaluating those offered pre-exposure prophylaxis (PrEP) with an emphasis on equity, particularly including non-European participants.
- A total of 150 GBM were recruited, with over half being non-European; many reported high-risk sexual behaviors, such as multiple condomless partners and a significant STI prevalence, indicating they are at high risk for HIV.
- The findings suggest that early PrEP users face considerable HIV risk and highlight the need for equity initiatives to ensure minority groups can effectively participate in PrEP programs.
Background: Respondent-driven sampling (RDS) is a method of approximating random sampling of populations that are difficult to locate and engage in research such as gay, bisexual and other men who have sex with men (GBM). However, its effectiveness among established urban gay communities in high-income countries is largely unexplored outside North America. We conducted a pilot study of RDS among urban GBM in Auckland, New Zealand to assess its local applicability for sexual health research.
View Article and Find Full Text PDFMost HIV behavioural surveillance programmes for gay, bisexual and other men who have sex with men (MSM) sample from location-based (offline) or web-based (online) populations, but few combine these two streams. MSM sampled online have been found to differ demographically and behaviourally from those sampled offline, meaning trends identified in one system may not hold for the other. The aim was to examine trends among MSM responding to supplementary repeat online behavioural surveillance surveys who had not participated in offline surveillance earlier that year in the same city, to see whether trends were parallel, converged or diverged.
View Article and Find Full Text PDFBackground: Understanding HIV testing behaviour is vital to developing evidence-based policy and programming that supports optimal HIV care, support, and prevention. This has not been investigated among younger gay, bisexual, and other men who have sex with men (YMSM, aged 16-29) in New Zealand.
Methods: National HIV sociobehavioural surveillance data from 2006, 2008, and 2011 was pooled to determine the prevalence of recent HIV testing (in the last 12 months) among YMSM.
Objectives: Over the last decade, annual HIV diagnoses among men who have sex with men (MSM) in New Zealand increased, then stabilised in 2006 and have not increased further. The aim was to examine trends in behaviours in order to better understand this pattern and inform community-based prevention.
Methods: From 2002 to 2011, we conducted five repeat cross-sectional behavioural surveillance surveys among MSM at community locations in Auckland (fair day, gay bars, sex-on-site venues; n=6091).
Background: The prevalence of HIV infection and how this varies between subgroups is a fundamental indicator of epidemic control. While there has been a rise in the number of HIV diagnoses among men who have sex with men (MSM) in New Zealand over the last decade, the actual prevalence of HIV and the proportion undiagnosed is not known. We measured these outcomes in a community sample of MSM in Auckland, New Zealand.
View Article and Find Full Text PDFObjectives: To describe trends in HIV diagnoses among men who have sex with men (MSM) in New Zealand 1996-2008, and to identify characteristics associated with HIV diagnoses in the resurgent phase.
Methods: Data collected through routine surveillance of HIV infection, where the mode of transmission included homosexual contact, were analysed over the period 1996-2008.
Results: Annual HIV diagnoses were low during 1996-2000, rose sharply between 2001 and 2005, and remained at an elevated plateau between 2006 and 2008.
Background: This paper is drawn from the first comprehensive study in New Zealand of the health and social experiences of HIV positive people and specifically addresses the experiences of HIV positive Maori.
Methods: A total of 226 HIV positive men and women completed an anonymous, self-administered HIV Futures New Zealand questionnaire. Twenty-five Maori completed the survey (17 male, 7 female, 1 transgendered).
Aims: To investigate the lifetime self-reported incidence of sexually transmitted diseases and hepatitis A, B and C in a national sample of men who have sex with men (MSM) in New Zealand.
Methods: A national telephone survey of MSM was conducted in 1996 with the aim of collecting baseline information on the sexual behaviour, safe sex practices, socio-sexual milieu and HIV knowledge of a broad range of MSM.
Results: Of the 1852 respondents, 37.