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Guidelines for Medical Assessors:
HIV
Version 1 June 2023
Contents
Purpose of this document ......................................................................................................... 2
Background ............................................................................................................................... 2
Assessing HIV for ASH requirements ......................................................................................... 2
Making further information requests (FIRs) to applicants with HIV ..................................... 2
Wording FIRs for applicants with [medical condition] .......................................................... 2
ASH outcomes for applicants with HIV ..................................................................................... 2
Temporary entry visas ........................................................................................................... 2
Residence visas ...................................................................................................................... 3
ASH outcomes for applicants taking PrEP ................................................................................. 4
Appendices ................................................................................................................................ 4
1
PURPOSE OF THIS DOCUMENT
This document provides information and guidance to assist with assessing applicants with HIV
or taking PrEP to prevent HIV.
BACKGROUND
Some of the anti-retroviral medications used for the treatment of HIV in New Zealand changed
to generics (or are subject to a confidential pricing rebate) in July 2018. This resulted in a
change to the outcomes for visa applicants with HIV because the majority of the anti-
retrovirals used for HIV are no longer considered high cost.
HIV medications that became generics in 2018 are:
• Truvada – Tenofovir disoproxil fumarate and Emtricitabine
• Atripla – Tenofovir disoproxil fumarate, Emtricitabine and Efavirenz
ASSESSING HIV FOR ASH REQUIREMENTS
Making further information requests (FIRs) to applicants with HIV
If an applicant with HIV is taking non-generic medication make a FIR for an HIV specialist to:
• confirm the cost of the medication in NZ,
• comment on whether the applicant could be changed to a generic NZ medication at
any time in the future.
• Comment on the applicant’s compliance with their treatment and monitoring
ASH OUTCOMES FOR APPLICANTS WITH HIV
Temporary entry visas
AWC
Your opinion will be likely AWC if the applicant has HIV with no complications – that is,
HIV
which is stable, with no history of, or current associated complications, is compliant with
treatment and with a favourable Specialists report.
The AWC conditional FIR should include the following:
• A recent report from an infectious disease specialist is required regarding the
applicant’s HIV. This should include – history, diagnosis, current clinical examination
findings, information about the applicant's HIV status including viral load, CD4 and
2
AIDS defining conditions, the results of any additional investigations performed,
ongoing management needs, compliance with treatment and the applicant’s long term
prognosis.
NOT ASH
Your opinion will be like
ly NOT ASH if the applicant has HIV and:
• is taking non-g eneric medication (or taking medication not subject to the Pharmac
confidential pricing rebate) which remains high cost, or
• is non-compliant with treatment or their monitoring requirements as outlined by their
specialist, or
• is considered to be a public health risk, or
• has or has previously had, secondary complications to their HIV.
Residence visas
ASH
Your opinion will be likely ASH if the applicant has HIV with no complications – that is,
HIV
which is stable, with no history of, or current associated complications, is compliant with
treatment and with a favourable Specialists report.
Before an ASH opinion the following information is required:
• A recent or updated report from an infectious disease specialist is required regarding
the applicant’s HIV. This should include – history, diagnosis, current clinical
examination findings, information about the applicant's HIV status including viral load,
CD4 and AIDS defining conditions, the results of any additional investigations
performed, ongoing management needs, compliance with treatment and the
applicant’s long term prognosis.
NOT ASH
Your opinion will be likely NOT ASH if the applicant has HIV and:
• is taking non-generic medication (or taking medication not subject to the Pharmac
confidential pricing rebate) which remain high cost, or
• Is non-compliant with treatment or their monitoring requirements as outlined by their
specialist, or
• is considered to be a public health risk, or
• has or has previously had, complications secondary to their HIV.
3
ASH OUTCOMES FOR APPLICANTS TAKING PREP
Some applicants are taking PrEP to prevent them from contracting HIV. This medication is not
a generic medication in New Zealand and still costs approximately $830 per month. This means
it is high cost for any visa type. However, as this medication is a preventative medication and
an applicant is not takin
g it to treat a medical condition, this medication can be disregarded
when assessing a health case.
APPENDICES
Funded
antiretrovirals.docx
Funded Antiretrovirals
4
