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HIV/AIDS surveillance in Europe, 2012 (ECDC, November 27 2013, extract)
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extract.]
SURVEILLANCE REPORT
HIV/AIDS surveillance in Europe, 2012
Suggested citation for full report: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2012. Stockholm: European Centre for Disease Prevention and Control; 2013.
Tables and figures should be referenced: European Centre for Disease Prevention and Control/WHO Regional Office for Europe: HIV/AIDS surveillance in Europe 2012.
This publication follows the ECDC terminological practice which reflects the European Union Interinstitutional Style Guide with regard to names and designations of countries. The names and designations of countries used in this publication should not be understood as an endorsement by WHO of the terminology used in this publication.
The maps are reproduced with the permission of the WHO Regional Office for Europe. The designations employed and the presentation of this material do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers and boundaries.
WHO keywords: ACQUIRED IMMUNODEFICIENCY SYNDROME ? EPIDEMIOLOGY - AIDS AND ITS CONTROL - DISEASE OUTBREAKS ? STATISTICS - HIV INFECTIONS ? EPIDEMIOLOGY - POPULATION SURVEILLANCE
The WHO Regional Office for Europe is responsible for the accuracy of the translation of the Russian summary.
? World Health Organization.
Cover picture ? Stockxpert
ISBN 978-92-9193-541-3 / ISSN 1831-9483 / doi 10.2900/11420 / Catalogue number TQ-AL-13-001-EN-C
? European Centre for Disease Prevention and Control, 2012. Reproduction is authorised, provided the source is acknowledged.
Overview of HIV and AIDS in Europe
HIV infection remains of major public health importance in Europe. In 2012, 131 202 new HIV infections were diagnosed in 52 of the 53 countries of the WHO European Region(1). Of those infections, 55 494 were officially reported to ECDC/WHO Regional Office for Europe by 51 countries; 29 381 of which were from the European Union and European Economic Area (EU/EEA)(2), while 75 708 infections were reported through the database of the Federal Statistics Agency of the Russian Federation[1]. The surveillance data suggest an overall rate of 7.8 diagnoses per 100 000 population for the WHO European Region and 5.8 per 100 000 for the EU/EEA. The rates are highest in the East of the Region (Table A). The main transmission mode varies by geographical area, illustrating the diversity in the epidemiology of HIV in Europe; heterosexual transmission is the main mode of transmission in the WHO European Region, while sexual transmission between men is the most common mode in the EU/EEA and transmission through injecting drug use remains substantial in the East of the Region.
In 2012, 16 534 AIDS cases were diagnosed in 50 countries of the WHO European Region(3), of which 6 461 were officially reported to ECDC/WHO by 49 countries, and 10 073 were obtained through the Ukrainian Centre for Socially Dangerous Disease Control [3] due to incomplete reporting by Ukraine through TESSy(4). Although the number of AIDS cases increased in all reporting countries in the East of the Region, the number of AIDS cases has continued to decline in many countries.
A total of 15 153 592 HIV tests performed for diagnostic purposes were reported by 30 countries for 2012. A majority of countries reported increasing numbers of HIV tests performed annually during the period 2006?2012. Higher testing rates were reported by countries in the East and lower rates by countries in the Centre. Data from countries in the West showed varied levels and trends (Table 27).
European Union and European Economic Area
In 2012, 29 381 HIV diagnoses were reported by 30 EU/EEA countries, with a rate of 5.8 per 100 000 population (Table 1). The five countries with the highest rates of HIV diagnoses in 2012 were Estonia (23.5), Latvia (16.6), Belgium (11.1), the United Kingdom (10.3) and Luxembourg (10.3). The lowest rates were reported by Slovakia (0.9) and Croatia (1.7). Since the start of reporting on the HIV epidemic, 455 757 HIV diagnoses have been reported in the EU/EEA; 324 181 were in men and 128 325 in women (Tables 2 and 3), 3 251 not having gender information available.
In 2012, the male-to-female ratio was 3.2 (Table A). Young people aged 15 to 24 years accounted for 10.6% of all HIV diagnoses reported, but this varied widely from 4.4% in Slovenia to 32.5% in Romania (Figure B).
Similar to recent years, the highest proportion of HIV diagnoses was reported in men who have sex with men (MSM) (40.4%), followed by heterosexual transmission (33.8%) including heterosexually-acquired cases originating from sub-Saharan African countries. For 18.7% of the cases, the transmission mode was unknown. (Table A).
The rate of HIV diagnoses per 100 000 population appears to have remained fairly stable over time, with a rate of 6.4 per 100 000 in 2006 (28 318 cases) compared to 6.2 per 100 000 (30 900 cases) in 2012 when adjusted for reporting delay (Table 1, Annex 6). Trends by transmission mode show that the number of HIV diagnoses among MSM has increased by 11% since 2006 (Table 8). In contrast, the number of cases among people who inject drugs (PWID) has decreased by 7% (Table 8), although a slight increase compared to recent years was observed in 2012 due to ongoing outbreaks in Greece and Romania (Table 5). The numbers of HIV diagnoses due to heterosexual transmission, mother-to-child transmission and blood transfusion have decreased continuously between 2006 and 2012 (Table 8).
In 2012, information on CD4 cell counts at the time of diagnosis was available in 20 countries for 16 150 cases (55% of all cases reported in 2012) (Table 14). Half of these cases (49%) were reported as late presenters (CD4 cell count <350/mm3), including the 30% of cases with advanced HIV infection (CD4 <200/mm3). The proportion of late presenters was highest among heterosexually acquired cases reported as originating from sub-Saharan African countries (62%) and among PWID (56%). The lowest proportions of late presenters were observed in MSM (38%) and in cases of mother-to-child transmission (23%) (Table 14, Figure F).
In 2012, 4 313 AIDS cases were diagnosed and reported by 29 EU/EEA countries(5), which is a rate of 0.8 cases per 100 000 population (Table 15). The highest rates were reported by Latvia (6.8), Estonia (2.7), Portugal (2.4) and Spain (1.7). In the EU/EEA, the number of AIDS cases has consistently declined since the mid-1990s.
WHO European Region
In 2012, 131 202 new HIV infections were diagnosed in 52 of the 53 countries of the WHO European Region6. Of those infections, 55 494 were officially reported to ECDC/WHO Regional Office for Europe by 51 countries while 75 708 infections were reported through the database of the Federal Statistics Agency of the Russian Federation[1]. Since the beginning of the epidemic and up to 31 December 2012, there have been a cumulative total of at least 1 496 201 diagnoses of HIV infection in the WHO European Region. This number includes a cumulative total of 839 337 infections officially reported to ECDC and the WHO Regional Office for Europe and 719 445 infections reported in Russia as of 31 December 2012 [2] minus the 62 581 cases officially reported to ECDC/WHO by Russia in 2010.
Forty-four percent of newly diagnosed infections (24 464 cases) were reported in the East, 49% (27 315 cases) in the West and 7% (3 715 cases) in the Centre of the Region, while the rate (cases per 100 000 population) was highest in the East at 22.0, over three times higher than in the West (6.6 per 100 000) and almost twelve times higher than in the Centre (1.9 per 100 000). The highest rates were reported by Ukraine (37.1), Estonia (23.5) and Moldova (21.3).
The majority of new HIV infections (37%) were reported in the age group 30?39 years old, while 10% were reported among 15?24 year-olds. The male-to-female ratio was 2.1; lowest in the East (1.4) and highest in the Centre (4.5) (Table A). Most frequently, reported cases were acquired through heterosexual transmission (46%), although the picture is more heterogeneous at sub-regional level, illustrating the wide diversity in the epidemiology of HIV in Europe. Eighteen percent of the new HIV cases were infected through injecting drug use, 23% through sex between men and 1% were due to mother-to-child transmission (MTCT). For 12% of cases the transmission mode was reported as unknown.
In the West, sexual transmission between men remains the main transmission mode, followed by heterosexual transmission, together accounting for 77% of all infections.
In the Centre, levels of HIV remain low and stable, though there is evidence of increasing sexual transmission between men in many countries. In 2011 and 2012, there was a marked increase in the number of cases infected through injecting drug use compared with 2010, mainly due to an outbreak in Romania. In the East, the number of HIV infections continued to increase. Heterosexual contact, followed by injecting drug use, is reported to be the dominant mode of transmission.
Heterosexual transmission among PWID is known to be of significant importance, but the proportion of independent versus PWID-related heterosexual transmission is unknown as information on the probable source of infection is missing for the majority of cases.
Between 2006 and 2012, the rate of newly diagnosed HIV infections per 100 000 population increased by 7%, from 7.3 (49 424 cases) to 7.8 (55 494 cases) in the 51 countries that have reported consistently. Trends by transmission mode show increases in infections acquired due to heterosexual contact (19% increase), sex between men (14% increase) and mother-to-child transmission (61% increase), whereas infections due to injecting drug use decreased by 14%.
In 2012, 30 countries in the WHO European Region provided information on CD4 cell count at the time of diagnosis for 18 369 (33%) cases (Table 14). Half of these cases were reported as late presenters (CD4 cell count <350/mm3), including 30% of cases with advanced HIV infection (CD4 <200/mm3).
In 2012, 16 534 AIDS cases were diagnosed in 50 countries of the WHO European Region7, of which 6 461 were officially reported to ECDC/WHO by 49 countries, and 10 073 were obtained through the Ukrainian Centre for Socially Dangerous Disease Control [3] due to incomplete reporting by Ukraine through The European Surveillance System. Seventy-three percent (12 132 cases) of the total 16 534 AIDS cases were reported by countries in the East, 22% (3 564 cases) in the West and 5% (838 cases) in the Centre of the Region. The number of cases per 100 000 population was 10.9 in the East, over thirteen times higher than in the West (0.9 per 100 000) and 27 times higher than in the Centre (0.4 per 100 000). Due to incomplete reporting, the number of AIDS cases is underestimated, particularly in the East.
Between 2006 and 2012, among the 49 countries with consistent official data8, the rate of reported AIDS diagnoses declined by 29%, from 1.4 per 100 000 population (9 311 cases) in 2006 to 1.0 per 100 000 population (6 461 cases) in 2012. If the complete number of AIDS cases diagnosed in Ukraine is included, the pattern reverses to show a slight increase from a rate of 2.0 per 100 000 (14 089 cases) in 2006 to 2.3 per 100 000 (16 534 cases) in 2012. In the East, the number of AIDS cases is increasing rapidly and has more than doubled over the same period, from 5 699 cases (5.6 per 100 000) to 12 132 cases (10.9 per 100 000 population).
Conclusions
The most recent surveillance data indicate that the number of people living with HIV in Europe continues to increase and that HIV is concentrated in key populations at higher risk of HIV infection such as men who have sex with men; people originating from high-endemic countries, mainly sub-Saharan Africa; and people who inject drugs and their sexual partners. Recent increases of HIV among PWID in the EU/EEA and West indicate that even low numbers can rapidly evolve into an outbreak when public health interventions are insufficient.
The relatively high proportion of late diagnoses in many countries indicates a delay in HIV testing and many cases are already eligible for treatment when they are diagnosed. The high and increasing number of AIDS cases in the East is indicative of late HIV diagnosis, low treatment coverage and delayed initiation of life-saving HIV treatment. The wide availability of treatment and recommendations for earlier initiation [4] has widened the scope of HIV surveillance to include monitoring of access to care and treatment. Improved access to and earlier initiation of treatment, particularly for key populations, is of importance throughout Europe but needs to be urgently addressed in the East.
Throughout Europe, HIV counselling and testing services need to be continuously promoted and accessible and targeted at key populations that are at higher risk in order to ensure earlier diagnosis and initiation of HIV treatment and linkage to care. This will result in improved treatment outcomes and clinical benefits, as well as contribute to preventing or further reducing HIV transmission. Equal access to HIV prevention, testing, treatment and care for all population groups should be ensured in order for countries to reach the global goal of universal access [5] for all in need.
Interventions to control the epidemic need to be based on evidence and adapted to national and local epidemiology.
From the surveillance data presented in this report the following can be concluded:
Although the number of countries conducting enhanced HIV surveillance and reporting surveillance data at European level has gradually increased over time, the overall picture is still incomplete; in 2012, 51 of the 53 countries submitted data. Data quality and completeness of such key variables as transmission mode and CD4 cell count at time of diagnosis is still to be improved in many countries. This is of vital importance to allow monitoring the HIV epidemic and the response to HIV, in particular the access to and uptake of HIV testing services.
(?)
References
_________
(1) No data available from Uzbekistan.
(2) Liechtenstein is not presented separately in the tables as their data are included in the data reported by Switzerland (see Annex 5).
(3) No data available from Russia, Sweden or Uzbekistan.
(4) No data available from Russia, Sweden or Uzbekistan.
(5) No data available from Sweden.
(6) No data available from Uzbekistan.
(7) No data available from Russia, Sweden or Uzbekistan.
(8) Russia, Sweden, Ukraine and Uzbekistan not included.
-
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SURVEILLANCE REPORT
HIV/AIDS surveillance in Europe, 2012
Suggested citation for full report: European Centre for Disease Prevention and Control/WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2012. Stockholm: European Centre for Disease Prevention and Control; 2013.
Tables and figures should be referenced: European Centre for Disease Prevention and Control/WHO Regional Office for Europe: HIV/AIDS surveillance in Europe 2012.
This publication follows the ECDC terminological practice which reflects the European Union Interinstitutional Style Guide with regard to names and designations of countries. The names and designations of countries used in this publication should not be understood as an endorsement by WHO of the terminology used in this publication.
The maps are reproduced with the permission of the WHO Regional Office for Europe. The designations employed and the presentation of this material do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers and boundaries.
WHO keywords: ACQUIRED IMMUNODEFICIENCY SYNDROME ? EPIDEMIOLOGY - AIDS AND ITS CONTROL - DISEASE OUTBREAKS ? STATISTICS - HIV INFECTIONS ? EPIDEMIOLOGY - POPULATION SURVEILLANCE
The WHO Regional Office for Europe is responsible for the accuracy of the translation of the Russian summary.
? World Health Organization.
Cover picture ? Stockxpert
ISBN 978-92-9193-541-3 / ISSN 1831-9483 / doi 10.2900/11420 / Catalogue number TQ-AL-13-001-EN-C
? European Centre for Disease Prevention and Control, 2012. Reproduction is authorised, provided the source is acknowledged.
Overview of HIV and AIDS in Europe
HIV infection remains of major public health importance in Europe. In 2012, 131 202 new HIV infections were diagnosed in 52 of the 53 countries of the WHO European Region(1). Of those infections, 55 494 were officially reported to ECDC/WHO Regional Office for Europe by 51 countries; 29 381 of which were from the European Union and European Economic Area (EU/EEA)(2), while 75 708 infections were reported through the database of the Federal Statistics Agency of the Russian Federation[1]. The surveillance data suggest an overall rate of 7.8 diagnoses per 100 000 population for the WHO European Region and 5.8 per 100 000 for the EU/EEA. The rates are highest in the East of the Region (Table A). The main transmission mode varies by geographical area, illustrating the diversity in the epidemiology of HIV in Europe; heterosexual transmission is the main mode of transmission in the WHO European Region, while sexual transmission between men is the most common mode in the EU/EEA and transmission through injecting drug use remains substantial in the East of the Region.
In 2012, 16 534 AIDS cases were diagnosed in 50 countries of the WHO European Region(3), of which 6 461 were officially reported to ECDC/WHO by 49 countries, and 10 073 were obtained through the Ukrainian Centre for Socially Dangerous Disease Control [3] due to incomplete reporting by Ukraine through TESSy(4). Although the number of AIDS cases increased in all reporting countries in the East of the Region, the number of AIDS cases has continued to decline in many countries.
A total of 15 153 592 HIV tests performed for diagnostic purposes were reported by 30 countries for 2012. A majority of countries reported increasing numbers of HIV tests performed annually during the period 2006?2012. Higher testing rates were reported by countries in the East and lower rates by countries in the Centre. Data from countries in the West showed varied levels and trends (Table 27).
European Union and European Economic Area
In 2012, 29 381 HIV diagnoses were reported by 30 EU/EEA countries, with a rate of 5.8 per 100 000 population (Table 1). The five countries with the highest rates of HIV diagnoses in 2012 were Estonia (23.5), Latvia (16.6), Belgium (11.1), the United Kingdom (10.3) and Luxembourg (10.3). The lowest rates were reported by Slovakia (0.9) and Croatia (1.7). Since the start of reporting on the HIV epidemic, 455 757 HIV diagnoses have been reported in the EU/EEA; 324 181 were in men and 128 325 in women (Tables 2 and 3), 3 251 not having gender information available.
In 2012, the male-to-female ratio was 3.2 (Table A). Young people aged 15 to 24 years accounted for 10.6% of all HIV diagnoses reported, but this varied widely from 4.4% in Slovenia to 32.5% in Romania (Figure B).
Similar to recent years, the highest proportion of HIV diagnoses was reported in men who have sex with men (MSM) (40.4%), followed by heterosexual transmission (33.8%) including heterosexually-acquired cases originating from sub-Saharan African countries. For 18.7% of the cases, the transmission mode was unknown. (Table A).
The rate of HIV diagnoses per 100 000 population appears to have remained fairly stable over time, with a rate of 6.4 per 100 000 in 2006 (28 318 cases) compared to 6.2 per 100 000 (30 900 cases) in 2012 when adjusted for reporting delay (Table 1, Annex 6). Trends by transmission mode show that the number of HIV diagnoses among MSM has increased by 11% since 2006 (Table 8). In contrast, the number of cases among people who inject drugs (PWID) has decreased by 7% (Table 8), although a slight increase compared to recent years was observed in 2012 due to ongoing outbreaks in Greece and Romania (Table 5). The numbers of HIV diagnoses due to heterosexual transmission, mother-to-child transmission and blood transfusion have decreased continuously between 2006 and 2012 (Table 8).
In 2012, information on CD4 cell counts at the time of diagnosis was available in 20 countries for 16 150 cases (55% of all cases reported in 2012) (Table 14). Half of these cases (49%) were reported as late presenters (CD4 cell count <350/mm3), including the 30% of cases with advanced HIV infection (CD4 <200/mm3). The proportion of late presenters was highest among heterosexually acquired cases reported as originating from sub-Saharan African countries (62%) and among PWID (56%). The lowest proportions of late presenters were observed in MSM (38%) and in cases of mother-to-child transmission (23%) (Table 14, Figure F).
In 2012, 4 313 AIDS cases were diagnosed and reported by 29 EU/EEA countries(5), which is a rate of 0.8 cases per 100 000 population (Table 15). The highest rates were reported by Latvia (6.8), Estonia (2.7), Portugal (2.4) and Spain (1.7). In the EU/EEA, the number of AIDS cases has consistently declined since the mid-1990s.
WHO European Region
In 2012, 131 202 new HIV infections were diagnosed in 52 of the 53 countries of the WHO European Region6. Of those infections, 55 494 were officially reported to ECDC/WHO Regional Office for Europe by 51 countries while 75 708 infections were reported through the database of the Federal Statistics Agency of the Russian Federation[1]. Since the beginning of the epidemic and up to 31 December 2012, there have been a cumulative total of at least 1 496 201 diagnoses of HIV infection in the WHO European Region. This number includes a cumulative total of 839 337 infections officially reported to ECDC and the WHO Regional Office for Europe and 719 445 infections reported in Russia as of 31 December 2012 [2] minus the 62 581 cases officially reported to ECDC/WHO by Russia in 2010.
Forty-four percent of newly diagnosed infections (24 464 cases) were reported in the East, 49% (27 315 cases) in the West and 7% (3 715 cases) in the Centre of the Region, while the rate (cases per 100 000 population) was highest in the East at 22.0, over three times higher than in the West (6.6 per 100 000) and almost twelve times higher than in the Centre (1.9 per 100 000). The highest rates were reported by Ukraine (37.1), Estonia (23.5) and Moldova (21.3).
The majority of new HIV infections (37%) were reported in the age group 30?39 years old, while 10% were reported among 15?24 year-olds. The male-to-female ratio was 2.1; lowest in the East (1.4) and highest in the Centre (4.5) (Table A). Most frequently, reported cases were acquired through heterosexual transmission (46%), although the picture is more heterogeneous at sub-regional level, illustrating the wide diversity in the epidemiology of HIV in Europe. Eighteen percent of the new HIV cases were infected through injecting drug use, 23% through sex between men and 1% were due to mother-to-child transmission (MTCT). For 12% of cases the transmission mode was reported as unknown.
In the West, sexual transmission between men remains the main transmission mode, followed by heterosexual transmission, together accounting for 77% of all infections.
In the Centre, levels of HIV remain low and stable, though there is evidence of increasing sexual transmission between men in many countries. In 2011 and 2012, there was a marked increase in the number of cases infected through injecting drug use compared with 2010, mainly due to an outbreak in Romania. In the East, the number of HIV infections continued to increase. Heterosexual contact, followed by injecting drug use, is reported to be the dominant mode of transmission.
Heterosexual transmission among PWID is known to be of significant importance, but the proportion of independent versus PWID-related heterosexual transmission is unknown as information on the probable source of infection is missing for the majority of cases.
Between 2006 and 2012, the rate of newly diagnosed HIV infections per 100 000 population increased by 7%, from 7.3 (49 424 cases) to 7.8 (55 494 cases) in the 51 countries that have reported consistently. Trends by transmission mode show increases in infections acquired due to heterosexual contact (19% increase), sex between men (14% increase) and mother-to-child transmission (61% increase), whereas infections due to injecting drug use decreased by 14%.
In 2012, 30 countries in the WHO European Region provided information on CD4 cell count at the time of diagnosis for 18 369 (33%) cases (Table 14). Half of these cases were reported as late presenters (CD4 cell count <350/mm3), including 30% of cases with advanced HIV infection (CD4 <200/mm3).
In 2012, 16 534 AIDS cases were diagnosed in 50 countries of the WHO European Region7, of which 6 461 were officially reported to ECDC/WHO by 49 countries, and 10 073 were obtained through the Ukrainian Centre for Socially Dangerous Disease Control [3] due to incomplete reporting by Ukraine through The European Surveillance System. Seventy-three percent (12 132 cases) of the total 16 534 AIDS cases were reported by countries in the East, 22% (3 564 cases) in the West and 5% (838 cases) in the Centre of the Region. The number of cases per 100 000 population was 10.9 in the East, over thirteen times higher than in the West (0.9 per 100 000) and 27 times higher than in the Centre (0.4 per 100 000). Due to incomplete reporting, the number of AIDS cases is underestimated, particularly in the East.
Between 2006 and 2012, among the 49 countries with consistent official data8, the rate of reported AIDS diagnoses declined by 29%, from 1.4 per 100 000 population (9 311 cases) in 2006 to 1.0 per 100 000 population (6 461 cases) in 2012. If the complete number of AIDS cases diagnosed in Ukraine is included, the pattern reverses to show a slight increase from a rate of 2.0 per 100 000 (14 089 cases) in 2006 to 2.3 per 100 000 (16 534 cases) in 2012. In the East, the number of AIDS cases is increasing rapidly and has more than doubled over the same period, from 5 699 cases (5.6 per 100 000) to 12 132 cases (10.9 per 100 000 population).
Conclusions
The most recent surveillance data indicate that the number of people living with HIV in Europe continues to increase and that HIV is concentrated in key populations at higher risk of HIV infection such as men who have sex with men; people originating from high-endemic countries, mainly sub-Saharan Africa; and people who inject drugs and their sexual partners. Recent increases of HIV among PWID in the EU/EEA and West indicate that even low numbers can rapidly evolve into an outbreak when public health interventions are insufficient.
The relatively high proportion of late diagnoses in many countries indicates a delay in HIV testing and many cases are already eligible for treatment when they are diagnosed. The high and increasing number of AIDS cases in the East is indicative of late HIV diagnosis, low treatment coverage and delayed initiation of life-saving HIV treatment. The wide availability of treatment and recommendations for earlier initiation [4] has widened the scope of HIV surveillance to include monitoring of access to care and treatment. Improved access to and earlier initiation of treatment, particularly for key populations, is of importance throughout Europe but needs to be urgently addressed in the East.
Throughout Europe, HIV counselling and testing services need to be continuously promoted and accessible and targeted at key populations that are at higher risk in order to ensure earlier diagnosis and initiation of HIV treatment and linkage to care. This will result in improved treatment outcomes and clinical benefits, as well as contribute to preventing or further reducing HIV transmission. Equal access to HIV prevention, testing, treatment and care for all population groups should be ensured in order for countries to reach the global goal of universal access [5] for all in need.
Interventions to control the epidemic need to be based on evidence and adapted to national and local epidemiology.
From the surveillance data presented in this report the following can be concluded:
- For the countries in the EU/EEA and West, interventions to prevent and control HIV among MSM are the cornerstones of the HIV response. In addition, as more than one third of the heterosexually acquired HIV cases were reported as originating from high endemic countries (mainly from sub-Saharan Africa), countries need to ensure that interventions for prevention, treatment and care are accessible to these migrant populations. The observed increase in HIV cases among people who inject drugs in a number of countries [6] demonstrates the need to maintain or scale up harm reduction programmes in the EU/EEA.
- For the countries in the Centre, as the epidemic among MSM is increasing, the priority is to strengthen interventions to prevent and treat HIV in this group.
- For the countries in the East, interventions to prevent and treat HIV among people who inject drugs, including harm reduction programmes and improved access to treatment, need to continue to form the cornerstone of the HIV response. In couples where one of the partners is engaged in a high-risk behaviour, such as injecting drug use, prevention interventions should address the risk of heterosexual transmission.
Although the number of countries conducting enhanced HIV surveillance and reporting surveillance data at European level has gradually increased over time, the overall picture is still incomplete; in 2012, 51 of the 53 countries submitted data. Data quality and completeness of such key variables as transmission mode and CD4 cell count at time of diagnosis is still to be improved in many countries. This is of vital importance to allow monitoring the HIV epidemic and the response to HIV, in particular the access to and uptake of HIV testing services.
(?)
References
- Unified Interagency Information-statistics System of the Federal Statistics Agency of the Russian Federation. Number of registered patients newly diagnosed with HIV. Available from: http://www.fedstat.ru/indicator/data.do?id=41719&referrerType=0&referrerId=946905 [Accessed 10 October 2013].
- Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor). National Report on the implementing the National Project ?Health?. Moscow: Federal Surveillance Service of the Russian Federation; 2013.
- Ukrainian Centre for socially dangerous disease control. Available from: http://ucdc.gov.ua/uk/statystyka/informatsijnibyuleteni[ Accessed 10 October 2013].
- World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Recommendations for a public health approach. Geneva: World Health Organization; 2013.
- Pharris A, Wiessing L, Sfetcu O, Hedrich D, Botescu A, Fotiou A, et al. Human immunodeficiency virus in injecting drug users in Europe following a reported increase of cases in Greece and Romania, 2011.
- Euro Surveill. 2011;16(48):pii=20032. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20032
- United Nations. Political Declaration on HIV/AIDS ? United Nations General Assembly Resolution 60/262. New York: United Nations; 2006.
_________
(1) No data available from Uzbekistan.
(2) Liechtenstein is not presented separately in the tables as their data are included in the data reported by Switzerland (see Annex 5).
(3) No data available from Russia, Sweden or Uzbekistan.
(4) No data available from Russia, Sweden or Uzbekistan.
(5) No data available from Sweden.
(6) No data available from Uzbekistan.
(7) No data available from Russia, Sweden or Uzbekistan.
(8) Russia, Sweden, Ukraine and Uzbekistan not included.
-
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