Breakthrough Survey Illuminates the Realities of HIV Criminalisation in Aotearoa New Zealand

In a landmark development for public health and legal reform discussions, the first national survey on HIV criminalisation experiences in Aotearoa New Zealand has been released, shedding light on how outdated laws continue to impact the lives of people living with HIV (PLHIV). Conducted collaboratively by Positive Women Inc., Burnett Foundation Aotearoa, Body Positive, and Toitū te Ao, the study gathered insights from 247 diverse participants across the country. This research underscores the tension between modern HIV science—such as Undetectable = Untransmittable (U=U), where effective treatment prevents transmission—and lingering criminal liabilities under the Crimes Act 1961.

The survey reveals profound effects on mental health, relationships, and healthcare access, even though prosecutions remain rare. With New Zealand boasting one of the world's lowest HIV prevalence rates at around 3,272 cases among 5 million people, and a 31% drop in local diagnoses since 2010, these findings highlight how legal fears undermine progress toward eliminating transmission.

Understanding HIV Criminalisation: No Specific Law, Yet High Global Ranking

HIV criminalisation refers to the use of criminal law to prosecute individuals for alleged non-disclosure, exposure, or transmission of HIV, often without transmission occurring. In Aotearoa, there is no dedicated HIV-specific legislation; instead, charges arise under general provisions of the Crimes Act 1961, such as section 145 (criminal nuisance), section 188 (wounding with intent), or section 201 (wilfully infecting with disease). These can lead to sentences up to 14 years.

Despite condom use being recognized as a 'reasonable precaution' since a 2005 ruling, and the government's recent endorsement of U=U in February 2026, PLHIV may still face prosecution for non-disclosure unless using condoms—even if undetectable. This misalignment with science, where viral loads below 200 copies/mL pose zero sexual transmission risk, creates uncertainty. Globally, New Zealand ranks among the top 15 HIV criminalisation hotspots per capita, with at least 14 prosecutions since 1993, resulting in 10 convictions—all involving men.

Historical cases include a 2010 conviction for intentional transmission via injection (eight-year sentence) and a 2018 Court of Appeal decision reducing a sentence by recognizing antiretrovirals mitigate harm. Yet, the threat persists, deterring testing and treatment.

Survey Methodology: Community-Led Insights from 247 Diverse Voices

Launched in June 2025, the anonymous online survey ran until August, using a mix of closed and open-ended questions adapted from established tools like HIV Futures. Recruitment via social media, clinics, and peer networks ensured representation: 86% male, 13% female, 1% other; 69% Pākehā/NZ European, 15% Māori, 11% Asian; 74% gay/lesbian; ages 18-75+; 53% living with HIV 11+ years, 11% recent diagnoses.

Quantitative data was analyzed with statistical tests (chi-square), qualitative via thematic coding in NVivo. Limitations include self-selected convenience sampling, but diversity captured inequities across groups. Participants shared raw experiences, like one stating, "HIV is a public health thing, not a criminal one."

Awareness Gaps: 74% Know Disclosure Rules, But Confusion Reigns

Most (74%) understood disclosure is required absent condom use, and 65% knew exposure alone can lead to charges—even without transmission. However, only 36% recognized the Health Act 1956's public health pathway over criminal routes, with women less aware (17% vs. 38% men). This ambiguity fuels distress, as laws don't clearly incorporate U=U despite scientific consensus.

For those interested in public health careers, resources like research assistant roles in epidemiology offer ways to contribute to HIV studies.

Nuanced Attitudes: 87% Reject Police Role, Favor Public Health

Overwhelmingly (87%), participants opposed police managing HIV, viewing it as a health issue: "It is a medical condition it should be managed by health professionals." 72% endorsed public health authorities, 81% supported criminalisation only for intentional harm, and 64% deemed current laws unfair, often citing homophobia/stigma.

"Do we criminalise cancer?" one asked, highlighting inconsistencies. Community/peer support was valued for nuanced handling.

Lived Impacts: 60% Fear Prosecution, 45% Avoid Intimacy

The law's shadow looms large: 60% worried about charges, over half about disclosure. Behavioral shifts included 45% avoiding sex (nearly half strongly agreed), 30% boosting condom use despite treatment efficacy. One shared, "I have for years been reluctant to even go near another potential relationship due to fear of rejection." Relationships suffered (30% affected), with isolation and abuse linked to fears.

Healthcare access faltered: 38% hesitated discussing sex with providers, fearing reports. For university researchers, explore research jobs advancing stigma reduction.

Disparities Exposed: Migrants, Māori/Pacific, Women Hit Hardest

Inequities were stark. Recent migrants (<5 years) showed double fear/avoidance (57% strongly worried, 48% avoid sex). Māori/Pacific: higher avoidance (33% strongly), provider discussion worries (53%). Women twice as likely to up condom use (47% vs. 20% men). Under-55s: 63% prosecution concern. These align with stigma intersecting marginalization.

• Migrants: Legal unfamiliarity amplifies risks.
• Māori/Pacific: Cultural stigma compounds.
• Women: Disclosure burdens heavier.
• Youth: Future relationship fears dominate.

Public Health Ramifications: Undermining U=U and Elimination Goals

Legal fears deter testing/treatment, hindering New Zealand's HIV Action Plan 2023-2030 aiming for zero transmission. With 95%+ on antiretrovirals undetectable, criminalisation ignores science, fostering stigma that blocks disclosure and peer support. Experts like Burnett CEO Liz Gibbs note: "We have one of the highest rates of HIV criminalisation per capita globally."

Link to the full survey report for deeper analysis.

Path Forward: Recommendations for Reform and Equity

Participants urge: police guidelines science-based; public health primacy; U=U training; community-led education; peer support expansion. Targeted for Māori, migrants, women. Gibbs adds: "HIV transmission managed by Public Health authorities, not Police."

Academics can engage via postdoc opportunities in public health law.

Global Context and NZ's Unique Position

While many nations reform (e.g., Canada, Europe recognizing U=U), NZ lags despite low prevalence. High per-capita cases signal urgency. Future: policy shifts post-U=U endorsement, monitoring impacts.

Explore NZ uni jobs at AcademicJobs NZ.

Photo by Niranjan Lamichhane on Unsplash

Empowering Change: Actionable Steps for Stakeholders

For PLHIV: peer support, know rights via Body Positive. Policymakers: review Crimes Act. Healthcare: U=U messaging. Researchers: stigma studies. Visit career advice for public health paths; job seekers, check higher ed jobs, university jobs, rate my professor.