HIV prevention in Europe: Action, needs and challenges Stockholm, 2 3 October 2006

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1 ABA Kopiering AB 2007 TQ-X EN-C MEETING Report HIV prevention in Europe: Action, needs and challenges Stockholm, 2 3 October 2006 ecdc.europa.eu

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9 Newly diagnosed cases of HIV infection reported in 2005, WHO European Region * Cases per million < Data unavailable * Estimate based on data for half a year EuroHIV

10 Routes of transmisison of newly diagnosed HIV infections in 25 European countries, 2005 Homo/bisexual 28% Injecting drug use 8% Unknown 18% Update 30 June 2005 Other 1% * No data reported for Austria, Estonia, Italy, Norway and Spain. Mother-to-Child <1% Heterosexual 45% EuroHIV Trends in reported route of HIV transmission, 20 European countries*, ,000 7,000 Heterosexual 6,000 Number of cases 5,000 4,000 3,000 Homo/bisexual Risk not reported 2,000 1,000 Injecting drug use Year of report EuroHIV * Data missing for 10 countries: Austria, Estonia, France, Greece, Italy, Malta, Netherlands, Norway, Portugal, Spain.

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12 PMTCT indicators in 2004 as reported by WHO EURO member states Subregion Pregnancies tested and counselled pregnant women HIV positive pregnant women Had an abortion Had elective Caesarean Section Had a vaginal delivery Received PMTCT Confirmed PMTCT cases (reported in 2004) West (15) 2.70m 1.36m 1, , , Centre (9) 1.23m 0.24m East (10) 1.19m 0.25m Russian F. 2.93m 3.52m 11,105 4,724 1,018 6,365 5, * Total (35) 8.05m 5.36m 13,248 4,971 2,412 6,763 7, * STI/HIV/AIDS Programme * Russian Federation and Ukraine have very limited testing of children born to HIV WHO/Europe positive mothers to confirm HIV diagnosis 17

13 Number people living with an AIDS diagnosis, 26 countries in Europe 30, ,000 25,000 Estimated Living AIDS cases AIDS mortality 120,000 Number AIDS/deaths 20,000 15,000 10,000 5, Year * Countries excluded Cyprus, France, Netherlands and Norway ,000 80,000 60,000 40,000 20,000 0 Number living after AIDS EuroHIV Impact of HAART on prevention Positive effect (decreased morbidity and mortality; increased survival) of HAART continues, including a lower average amount of circulating virus per infected individual since the introduction of HAART A virus concentration below the detection limit is reached in an increasing number of patients on HAART The HIV transmission probability in the population has decreased as a result of the lower amount of HIV circulating Source: HIV Monitoring Foundation, Amsterdam

14 Percentage newly diagnosed HIV infections among young people (15-24 years), 2005 Update 30 June % 50% 40% 30% 20% 10% 0% * No data reported by Austria, Italy, Spain EST ROM LVA LTU POL BUL HUN MAT CZH CYP LUX FIN CRO SWE NET POR DEU BEL UNK IRE SVK SWI DEN GRE FRA EuroHIV SVN ICE

15 Average incidence of syphilis, gonorrhoea and hepatitis B in western Europe, Annual cases per population Syphilis Gonorrhoea Hepatitis B Year STI/HIV/AIDS Programme WHO/Europe 5

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18 Year of diagnosis Number of cases

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23 Percentage change in number of reported HIV cases among MSM, % Update 30 June % 100% 0% -100% Italy* Poland Sweden Finland Estonia* Belgium Switzerland Portugal* Denmark Cyprus Czech UK Germany Latvia Hungary Slovenia Lithuania Iceland Ireland Luxembourg Netherlands* Slovakia Greece *Estonia comparision 2000/2003; *Netherlands - comparision 2002/05, *Italy data for 7 regions only and latest data in 2004; *Portugal comparision 2001/05 EuroHIV

24 Western and Central Europe 100 All hetero Hetero males Hetero females MSM IDU 80 % BEL DEN SWE CRO NET GER GRE SLO HUN UNK FRA SWI IRE POR POL ITA ESP Mainly sexual transmission in the west and centre, 25-65% of all cases are among MSM Significant or historical IDU epidemics in ESP, POR, FRA, IRL, ITA, SWI, POL Up to 75% of all heterosexual cases are among immigrants from high prevalence countries and women are >50% of all heterosexual cases Vulnerable Groups: MSM, IDU & immigrants (specially immigrant women) STI/HIV/AIDS Programme WHO/Europe 3

25 Acute HIV and STD episodes (Cohen and Pilcher, JID, 2005 HIV RNA in Semen (Log 10 copies/ml) Acute Infection 3 wks STD Episode STD Episode AIDS

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33 Lithuania Latv ia Estonia

34 absolute number of new cases July 1, injecting drug users other clients Male Female >=50 age unknown

35 P o la n d C z e c h R e p Ic ela n d It aly N e t h e rla n d s L it h u a n ia D e n m a rk N o rw ay S p a in S w itz e r la n d S w ed e n E s t o n ia N a t io n a l G F A T M

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39 Percentage of HIV diagnoses in heterosexuals originating from a country with a generalised epidemic* in selected European countries (2005) Percentage heterosexual HIV cases Update 30 June % 80% 70% 60% 50% 40% 30% 20% 10% 0% Iceland Sweden Belgium Ireland Malta UK Luxembourg Germany France Greece Switzerland Finland Denmark * HIV prevalence consistently >1% in pregnant women; mostly sub-saharan Africa Hungary Portugal Czech EuroHIV

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43 System product services quality capacity/access Individual health literate appropriate demand engagement in health Environment community participation political will and policies social norms

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55 This report was prepared by World Health Communication Associates. ISBN

56 ABA Kopiering AB 2007 TQ-X EN-C Postal address: ECDC Stockholm, Sweden ecdc.europa.eu An agency of the European Union europa.eu