ecdc.europa.eu epidemiological situation of hiv/aids in the eu and its neighbouring countries german...
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“Total media coverage of HIV/AIDS increased during the early 1980's, peaked in 1987, and declined steadily through 2001.” From Kaiser Family Foundation 2004 press release on AIDS at 21: media coverage of the HIV Epidemic * [* Following US based media] 25 years into the HIV epidemicTRANSCRIPT
ecdc.europa.eu
Epidemiological Situation of HIV/AIDS in the EU and its
Neighbouring CountriesGerman Presidency Conference
Responsibility & Partnership – Together Against HIV/AIDS 13 March 2007
Zsuzsanna JakabDirector, ECDC
Mid – late 1980s: HIV response in western Europe
25 years into the HIV epidemic
1981: first AIDS cases described
0
5 000
10 000
15 000
20 000
25 000
1986 1988 1990 1992 1994 1996 1998 2000 2002 2004
AIDSDeaths
1996: Highly active antiretroviral treatment (HAART)
“Total media coverage of HIV/AIDS increased during the early 1980's, peaked in 1987, and declined steadily through 2001.”
From Kaiser Family Foundation 2004 press release on AIDS at 21:
media coverage of the HIV Epidemic 1981-2002*
[* Following US based media]
25 years into the HIV epidemic
Presentation outline
• Geographic and time trends• Populations at highest risk• Implications for public health
Total: 39.5 (34.1–47.1) million Source: UNAIDS/WHO
Adults and children estimated to be living with HIV in 2006
0
5,000
10,000
15,000
20,000
25,000
1986 1988 1990 1992 1994 1996 1998 2000 2002 2004Year
AID
S &
Dea
ths
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
Living with A
IDS
AIDS Deaths Living with AIDS
New AIDS Cases, deaths among personswith AIDS & people living with AIDS,1986–2005, EU
Data adjusted for reporting delays* Excluding Andorra, Netherlands and Norway: data not available for the whole period
0
5000
10000
15000
20000
2001 2002 2003 2004 2005
New HIV diagnoses in the EU & EEA/EFTA countries, 2001-05
10
77
3
11
15
9
467
54
11
13035
6
127
17
9
247
418
243
14
HIV cases per million< 2020 - 99100 - 199200+
251
99
77
148
27
4326
52
10275 30
55
50
52
5
Not available
100
Source: EuroHIV
New HIV diagnoses reported in 2005per million population, Europe
0
50
100
150
200
250
300
2000 2001 2002 2003 2004 2005
PortugalUKBelgiumFranceIrelandNetherlandsAustriaGreeceGermany
New HIV diagnoses in the EU15 and EEA/EFTA countries, 2000-05
0
10
20
30
40
50
60
70
2000 2001 2002 2003 2004 2005
DenmarkNorwaySwedenIcelandFinland
Note: the graphs are on a different scale!
0
10
20
30
40
50
60
2000 2001 2002 2003 2004 2005
CyprusMaltaSloveniaPolandHungaryCzech R.Slovakia
New HIV diagnoses in new EU Member States, 2000-05
0
200
400
600
800
1000
1200
2000 2001 2002 2003 2004 2005
EstoniaLatviaLithuania
Note: the graphs are on a different scale!
New HIV diagnoses in EU neighbouring countries 2000-05
0
10
20
30
2000 2001 2001 2002 2003 2004 2005
Croatia
Serbia &MontenegroBulgaria
Albania
Romania
FYROM
Turkey 0
200
400
600
2000 2001 2002 2003 2004 2005
Russian F.UkraineMoldova, R.Georgia
Note: the graphs are on a different scale!
Source: EuroHIV
Predominant mode of HIV transmission, cases reported in 2005
Heterosexual contactMen having sex with menInjecting drug usersData not available
0
2500
5000
750019
96
1997
1998
1999
2000
2001
2002
2003
2004
2005
HeterosexualMen having sex with menInjecting drug users
New HIV diagnoses by mode of transmission, EU, 1996-2005
* Countries with data available for the whole period: Belgium, Cyprus, Czech Republic, Denmark, Finland, Germany, Greece, Hungary, Ireland, Latvia, Lithuania, Luxembourg, Poland, Slovakia, Slovenia, Sweden, United Kingdom.
0
2500
5000
7500
1997
1998
1999
2000
2001
2002
2003
2004
2005
All
Originating from countries withgeneralised HIV epidemicOthers
* Countries with data available for the whole period: Belgium, Cyprus, Czech Republic, Denmark, Finland, Germany, Greece, Hungary, Ireland, Latvia, Lithuania, Luxembourg, Poland, Slovakia, Slovenia, Sweden, United Kingdom.
New HIV diagnoses in persons infected through heterosexual contact, EU, 1996-2005
Age at HIV diagnosis by sexCases reported in the EU in 2005
0
1000
2000
3000
4000
5000
6000
7000
<20 20-29 30-39 40-49 50+ Age (years)
FemaleMale
Median age at HIV diagnosisby country
20 25 30 35 40
FranceDenmarSloveniaSwitzerlBelgiumGermanFinlandGreece
PortugalSweden
UKMalta
IrelandCzech
HungaryLuxembPoland
LithuaniSlovakia
Latvia
Age (years)
Median age at HIV diagnosis in the EU: 35 years
Men having sex with men
• MSM are the group at highest risk for acquiring HIV in many countries;
• HIV prevalence: 5 - 15%;• HIV incidence: ~3% per
year;• Multiple epidemics of other
STI (syphilis, gonorrhoea, LGV);
• Resurgence of high risk sexual behaviours.
New drugs & new technologies influencing high risk sexual behaviours in men having sex with men
ViagraCrystal methamphetamin Internet
Injecting Drug Users
• Steady declines in unsafe injection practices and HIV prevalence in most western European countries;BUT
• HIV prevalence remains very high (>25%) in eastern Europe and in some cities of western Europe;
• Very high prevalence of hepatitis C (>60%).
Sex workers
• Major transformation in the sex industry worldwide;• Western Europe:
• Relatively low HIV prevalence, <2%; • Little effect on the initial spread of HIV;• HIV remains highly associated with drug use;• Shift to a primarily migrant workforce;
• Eastern Europe:• Close relationship between sex work and IDU.
People living with HIV
• The number of people living with HIV keeps increasing;
• In the EU, an estimated 30% of people living with HIV are not aware of their infection;
• These people disproportionately contribute to the spread of HIV.
Awareness of Serostatus Among People with HIV and Estimates of Transmission
~25% Unaware
of Infection
~75% Aware of Infection
People Living with HIV/AIDS: 1,039,000-1,185,000
New Sexual Infections Each Year: ~32,000
Accounting for: ~54% of New
Infections
~46% of New
Infections
Marks G, Crepaz N, Janssen RS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS.
2006 Jun 26;20(10):1447-50.
% from a country with a originating generalised epidemic among heterosexually infected persons diagnosed with HIV in 2005
0%10%20%30%40%50%60%70%80%90%
Icelan
d
Sweden
Belgium
Irelan
d UK
Luxembourg
German
y
France
Greece
Switzerl
and
Finland
Denmark
Portugal
Source: EuroHIV
Conclusions
• HIV remains a major public health problem both in the EU and in neighbouring countries;
• Priorities for prevention in the EU– Increasing uptake of HIV testing and counselling;– Strengthening prevention and care in high-burden
countries;– Developing innovative prevention approaches for
men having sex with men;– Providing specific services for migrant
communities;• HIV is a global epidemic and the EU response needs
to be seen in this context.
