Despite decades of global efforts, HIV remains a significant public health issue in many parts of the world, including Papua New Guinea (PNG). The country faces a complex HIV epidemic shaped by social, cultural, and economic factors that influence transmission dynamics and access to prevention and treatment services. As scientific advances open new doors for prevention and treatment, a comprehensive and context-sensitive approach is essential to curb new infections and improve the lives of those living with HIV.
This article explores the latest developments in HIV prevention, the importance of regular testing, advances in treatment and health management, the challenge of myths and misconceptions, and the critical role of support systems and counselling for people living with HIV.
Latest Advances in HIV Prevention: PrEP and PEP
Biomedical innovations have expanded the HIV prevention toolbox significantly over the last decade. Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) represent two of the most promising advances, offering additional options beyond traditional prevention methods like condoms and behavioural interventions.
PrEP involves HIV-negative individuals taking antiretroviral medication daily to prevent HIV infection. Clinical trials and real-world studies have demonstrated that when taken consistently, PrEP reduces the risk of sexual transmission by over 90 percent. This is particularly important for populations at higher risk, including sex workers, men who have sex with men (MSM), transgender individuals, and serodiscordant couples where one partner is HIV-positive. In PNG, pilot projects introducing PrEP have been initiated in urban centres and among key populations, with encouraging but cautious uptake. However, challenges remain around awareness, stigma, consistent access, and adherence, especially in rural and remote areas. Expanding PrEP availability requires investment in education, healthcare infrastructure, and culturally appropriate messaging.
PEP, on the other hand, is an emergency prevention strategy taken after potential exposure to HIV, such as unprotected sex, sexual assault, or needle-stick injuries. When started within 72 hours and taken for 28 days, PEP can significantly reduce the risk of HIV infection. In PNG, PEP services exist primarily in major hospitals and clinics, but public awareness remains low, and access in rural communities is limited. Promoting knowledge about PEP and ensuring health facilities stock and provide it promptly is vital to preventing new infections.
Together, PrEP and PEP complement traditional prevention measures. However, their success hinges on integrating these tools into broader HIV prevention strategies tailored to PNG’s social and cultural landscape.
How to Get Tested and Why Regular Testing Matters
Testing is the foundation of HIV prevention and care. Knowing one’s HIV status is the critical first step that enables access to prevention, treatment, and reduces onward transmission. In PNG, HIV testing services have expanded over the years, yet many barriers hinder widespread testing, including stigma, fear of discrimination, limited healthcare access, and misinformation.
Several testing options are available, ranging from facility-based blood tests to rapid diagnostic tests that deliver results within minutes. More recently, HIV self-testing kits have been introduced, allowing individuals to privately and conveniently test themselves at home. Self-testing is especially useful for reaching populations reluctant to visit clinics due to stigma or logistical challenges.
Regular testing is essential because HIV can remain asymptomatic for years, and early diagnosis enables timely treatment that improves health outcomes and reduces the risk of transmission. For those at higher risk, such as sex workers or partners of people living with HIV, testing every three to six months is advisable. For the broader population, regular testing should become a normalized part of healthcare.
In PNG, increasing testing coverage requires targeted outreach, mobile clinics, and community-led initiatives that address cultural sensitivities and myths. Engaging local leaders and peer educators has proven effective in reducing stigma and encouraging people to know their status.
Living Positively with HIV: Treatment Options and Managing Health
The landscape for people living with HIV in PNG has improved dramatically with the scale-up of antiretroviral therapy (ART). ART involves daily medication that suppresses the virus, reduces viral load to undetectable levels, and prevents progression to AIDS. More importantly, sustained viral suppression eliminates the risk of sexual transmission—a concept known as Undetectable = Untransmittable (U=U).
PNG’s public health system provides free ART through government clinics, but challenges persist in ensuring consistent drug supply, retention in care, and adherence, especially outside urban centres. Healthcare infrastructure constraints, stigma, and economic barriers can disrupt treatment continuity, increasing the risk of resistance and poor health outcomes.
Effective management of HIV extends beyond medication. Regular clinical monitoring, management of opportunistic infections, mental health care, and addressing social determinants such as nutrition and housing are critical components. Support from healthcare workers, community organisations, and family networks significantly improves adherence and quality of life.
Innovations such as long-acting injectable ART, which can reduce pill burden and improve adherence, are on the horizon and could be transformative for PNG if made accessible.
Myths and Facts About HIV Transmission
Stigma and discrimination against people living with HIV in PNG are deeply rooted in misinformation and cultural misconceptions about how the virus is transmitted. Dispelling these myths is essential to reducing fear, encouraging testing, and promoting compassionate care.
A pervasive myth is that HIV can be transmitted through casual contact such as hugging, sharing food or utensils, or using the same toilet. In reality, HIV transmission requires the exchange of specific body fluids—blood, semen, vaginal or rectal fluids, and breast milk—through sexual contact, sharing contaminated needles, or from mother to child during childbirth or breastfeeding.
Another misconception is that HIV only affects certain groups or “immoral” behaviour, which fuels stigma against key populations such as sex workers, MSM, and transgender people. HIV risk depends on behaviours, not identities, and affects diverse communities across PNG.
There is also misunderstanding around disease progression, with some believing that an HIV diagnosis means immediate illness or death. With early diagnosis and proper treatment, many people live long, healthy lives without developing AIDS.
Education campaigns that incorporate local languages, cultural contexts, and respected community figures are vital to correcting misinformation. Engaging faith leaders, traditional authorities, and peer educators has helped break down barriers in many PNG communities.
Support Systems and Counselling for People Living with HIV
Living with HIV poses not only physical health challenges but also emotional, social, and economic burdens. Stigma and discrimination can lead to isolation, depression, and barriers to accessing care. Support systems and counselling services are therefore indispensable components of a comprehensive HIV response in PNG.
Psychosocial support provided through peer support groups, community organisations, and counselling services helps people living with HIV cope with the emotional impacts of diagnosis, adhere to treatment, and maintain overall well-being. These networks foster a sense of belonging and reduce feelings of shame and isolation.
Counselling before and after testing provides crucial information and emotional preparation, while ongoing adherence counselling supports patients in managing medication schedules and side effects.
In PNG, community-based organisations, often led by people living with HIV, have been at the forefront of providing culturally sensitive support services. These groups also play an advocacy role, promoting the rights of people living with HIV and combating stigma.
Expanding these support networks, integrating mental health services into HIV care, and training healthcare workers in stigma reduction are priorities for strengthening PNG’s HIV response.
Conclusion
Papua New Guinea stands at a pivotal moment in its HIV response. The promise of biomedical prevention tools like PrEP and PEP offers new opportunities to reduce transmission, but these must be paired with expanded access, education, and culturally relevant outreach.
Regular testing remains the cornerstone of HIV prevention and care, enabling early diagnosis and timely treatment initiation. For people living with HIV, effective antiretroviral therapy combined with comprehensive health management and psychosocial support improves survival and quality of life.
Dispelling myths about HIV transmission is critical to reducing stigma and discrimination, which continue to undermine prevention and treatment efforts. Strengthening support systems and counselling services enhances resilience and empowers people living with HIV to live positively.
Ultimately, sustaining political commitment, investment, and collaboration between government, communities, and international partners is essential to accelerate progress toward ending HIV as a public health threat in PNG. Scientific advances provide tools, but it is the social and cultural integration of these tools that will determine success.