Sexual and reproductive health

Find out about the work being progressed in sexual and reproductive health, including strategies and plans.

What’s being done to improve sexual and reproductive health

The Government funds a broad range of sexual and reproductive health services, programmes and initiatives. Services are delivered through general practice, hospitals, pharmacies and other community-based service providers such as Sexual Wellbeing Aotearoa (previously called New Zealand Family Planning), laboratories, specialist fertility services, and health promotion providers.

Schools and other government agencies also undertake work in this area.

Sexual and reproductive health covers a broad range of topics and issues. Some of the key services, and work being progressed, are outlined below.

Sexually Transmitted and Blood Borne Infections Strategy

The Sexually Transmitted and Blood Borne Infections Strategy, was published by the Ministry of Health in March 2023.

The vision of the Sexually Transmitted and Blood Borne Infection (STBBI) strategy is to achieve ‘An Aotearoa New Zealand where STBBI are prevented and where all people living with STBBI live long and healthy lives free from stigma and discrimination.’

This is the first combined strategy for STBBI such as syphilis, gonorrhoea, chlamydia, human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS), human papilloma virus (HPV), Hepatitis C and Hepatitis B.

Aotearoa New Zealand’s rates of sexually transmitted infections are high and there are inequities in health outcomes particularly for Māori, Pacific peoples, young people, men who have sex with men (MSM), migrants and people who inject drugs.

The STBBI Strategy is designed to improve collaboration, support collective action and set a unified strategic direction across the health sector in response to these infections. It aims to achieve a reduction in infection rates and get better outcomes for people living with sexually transmitted and blood borne infections.

The Strategy sits across and supports the delivery of the HIV Action Plan, Hepatitis C Action Plan and National Syphilis Action Plan, to eliminate the transmission of these infections by 2030.

Aotearoa New Zealand’s HIV Action Plan

In March 2023, Ministry of Health published the National HIV Action Plan for Aotearoa New Zealand 2023-2030. This Action Plan was drafted with the support of community organisations representing people living with and affected by human immunodeficiency virus (HIV) as well as health professionals and researchers.

The HIV Action Plan aims to eliminate both local HIV transmission and deaths due to acquired immunodeficiency syndrome (AIDS) and ensure people living with HIV have healthy lives free from stigma and discrimination.

The Action Plan sets out a roadmap to achieve this vision by 2030 and is aligned with global targets set by UNAIDS.

Aotearoa New Zealand’s HIV Action Plan has five goals:

reduce the number of new and locally acquired HIV infections
improve Māori health and wellbeing in relation to HIV by delivering on our Te Tiriti o Waitangi obligations
decrease mortality and negative consequences of HIV on health and wellbeing
decrease experiences of stigma and discrimination for people living with HIV
increase equity in relation to all HIV goals and objectives.

Priority groups include people living with HIV; gay, bisexual and other men who have sex with men; Māori at risk of and living with HIV; sex workers; people who inject drugs, people who have migrated from high HIV prevalence countries; transgender and non-binary people.

These priority groups are not fixed over time and may change following a future review of the epidemiology and plan. Priority settings include primary health care, community-led HIV health promotion, services and outreach, prisons, Kaupapa Māori services and specialised healthcare.

The Action Plan has four focus areas:

surveillance, information and knowledge systems
combination prevention and health promotion
testing and linkage to care
support for people living with HIV, including addressing stigma and discrimination.

The HIV Action Plan sits under, and is supported by, the Sexually Transmitted and Blood Borne Infections (STBBI) Strategy. The STBBI Strategy was published by the Ministry of Health in March 2023, with the vision of achieving an Aotearoa New Zealand where STBBI are prevented and where all people living with STBBI live long and healthy lives free from stigma and discrimination.

This is the first combined strategy for STBBI such as syphilis, gonorrhoea, chlamydia, HIV and AIDS, human papilloma virus (HPV), Hepatitis C and Hepatitis B.

The STBBI strategy is designed to improve collaboration, support collective action and set a unified strategic direction across the health sector in response to these infections. It aims to achieve a reduction in infection rates and get better outcomes for people living with sexually transmitted and blood borne infections.

Progress on implementation of National HIV Action Paln

Health New Zealand | Te Whatu Ora is responsible for leading the delivery of the HIV Action Plan supported by the Ministry of Health | Manatū Hauora.

Since publication of the HIV Action Plan in March 2023, community-based HIV service providers, including a new kaupapa Māori HIV service, have been funded to:

scale up peer and community-led programmes and resources that focus on connecting and empowering people living with HIV
deliver programmes that increase knowledge and access to combination prevention for communities that have migrated from high HIV prevalence countries
scale up innovative HIV testing and provide workforce training to conduct testing.

Other areas of progress for implementing the HIV Action Plan have included

publishing updated clinical guidance for combination prevention for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) prescribing in primary care
commissioning behavioural surveillance research to monitor modifiable behaviours driving HIV transmission for gay and bisexual men who have sex with men
developing and publishing an HIV Monitoring Plan to support and measure progress.

Hepatitis C Action Plan

The National Hepatitis C Action Plan was published by the Ministry of Health in July 2021. The action plan aims to guide the health sector and services working in hepatitis prevention or treatment. It provides a framework for working towards the World Health Organization’s goal to eliminate viral hepatitis by 2030.

Refer here for more information about the action plan and work underway to improve hepatitis prevention and treatment services in New Zealand Hepatitis C – Health New Zealand | Te Whatu Ora

National Syphilis Action Plan

In 2019, the Ministry of Health published the National Syphilis Action Plan to guide a systematic and coordinated health sector response to stop the increase in syphilis, eliminate inequities, eliminate congenital syphilis, improve testing and treatment, and ensure high quality surveillance.

The action plan was developed in consultation with the wider sexual health community and takes a comprehensive approach to addressing the increase in syphilis, focussing on both prevention and treatment. Four priority areas have been identified:

prevention and health promotion
testing and management
antenatal care
surveillance and monitoring.

The implementation of the Syphilis Action Plan was impacted by the reprioritisation of resources to respond to the COVID-19 pandemic. In November 2021, a working group supporting the development of the STBBI Strategy prioritised actions within the Syphilis Action Plan for implementation.

Progress is underway on the prioritised actions including:

work that has been commissioned to develop a teaching package for midwives on syphilis and other sexually transmitted infections
preparations to pilot a social marketing campaign to raise awareness of syphilis in affected communities in Auckland
second trimester screening for syphilis during pregnancy that has been rolled out by the Northern region and in much of Te Manawa Taki region.

Reproductive health and abortion

New long-acting reversible contraception (LARC) training standard and national contraceptive guidance to support high quality, safe and consistent practice across Aotearoa/New Zealand.
Services to manage fertility
A wide range of safe, effective, acceptable funded contraception.
Affordable sexual and reproductive health services for young and low-income people including youth one stop shops, school-based health services and family planning services.
The Contraceptive Access Programme provides low cost contraceptive cunselling and free procedures to insert and remove LARCs are available for women on very low incomes.

Sexuality education

Health promotion and sexuality education services in school and community settings.

Sexual violence prevention

A national Violence Intervention Programme (VIP) supports protocols and training for health practitioners to provide support and referrals for victims of family violence, sexual violence and child abuse.
Information, resources and support for sex workers who have experienced sexual violence.
Prevention of female genital mutilation (FGM) in collaboration with communities affected by the practice.

Gender-affirming care

Budget 2019 earmarked an additional $2.992 million over the next four years to increase access to gender-affirming genital surgeries.

Cross-agency collaborative work

Sexuality education in schools, led by the Ministry of Education.
Cross-government work on harms associated with online pornography.
Stats NZ is conducting a review of its statistical standard for gender identity.
A cross-government joint venture leading the Government's work on family violence and sexual violence, including the development of a National Strategy and Action Plan.
The Sexual Abuse and Assessment Treatment Service (SAATS) provides health care and forensic examinations for any person who has experienced sexual assault or abuse.

Sexual and reproductive health services

Heath New Zealand | Te Whatu Ora provides a range of sexual and reproductive health services, including sexual health clinics, health promotion and community education.

Sexual and reproductive health services

Publications

STI guidelines and surveillance reports

STI management guidelines

Sexually transmitted infections (STIs) are common in New Zealand.

Associated complications include chronic pain, infertility, neonatal morbidity and genital tract cancer.

Surveillance data regularly indicates that those aged less than 25 years and non-Europeans show a disproportionate burden of STIs, the highest numbers and rates for each STI are almost always seen in the 15 to 19 years and 20 to 24 years age groups.

Sexual Health Services, Primary care practitioners and community based providers diagnose and treat the majority of STI cases in New Zealand.

Best practice guidelines on the management of STIs are an essential component of effective management of STIs in order to: