HIV infection continues to rise in across European countries.
HIV infection is still a cause for concern worldwide, as cases reached more than 2 million for the first time in Europe, according to the World Health Organization (WHO) Regional Office for Europe.
In 2015, more than 153,000 new cases of HIV contributed to this figure, a 7% increase compared with the previous year, and represents the highest annual number since reporting first started in the 1980s, the WHO reported.
The findings come from a new report called HIV/AIDS surveillance in Europe 2015, which was jointly released by the WHO Regional Office for Europe and the European Center for Disease Prevention and Control (ECDC).
“Despite significant efforts, HIV remains among the main public health concerns in the WHO European Region, in particular in its eastern part,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe, as reported by the WHO. “2015 recorded the highest number of new cases in 1 year, contributing to an appalling 2 million cumulative cases.
“To address this critical situation, we have made available a new action plan that all European countries endorsed in September 2016. We no call on countries’ leaders to use this plan for an urgent, accelerated and innovative response to HIV in the Region, to reverse the AIDS epidemics immediately and end it by 2030.”
Effective HIV surveillance brings challenges, however, since figures of the epidemic are based on the number of new diagnoses reported each year, according to the WHO. But these figures do not reflect the true number.
“ECDC estimates that currently more than 122,000 people in the [European Union/European Economic Area (EU/EEA)] are infected with HIV but are not aware of their infection — that is every 1 in 7 people living with HIV in the EU/EEA,” said Andrea Ammon, ECDC Acting Director, as reported by the WHO. “To reach the estimated 15% who are not aware of their infection, we need to increase efforts to promote and facilitate more testing for HIV, and link those diagnosed with care.”
Trends in the HIV epidemic vary widely across the region. In western European countries, 27,022 new HIV cases were diagnosed, which did not reflect a decline over the last decade. In central European countries, 5297 new cases were diagnosed. Although the intensity of the epidemic remains relatively low in this area, it is still a substantial increase compared with 10 years ago, according to the report.
In eastern European countries, there were 121,088 new cases of HIV diagnosed, a number that more than doubled over a decade. According to the report, the number of AIDS cases in this area increased by 80% in 10 years.
Transmission also varied by geographical area, with HIV increasing consistently among men who have sex with men (MSM) in the western and central parts of the region, while heterosexual transmission increased in the eastern part. Additionally, transmission through injection drug use still accounted for one-third of new cases in eastern European countries.
The report recommends that to help achieve the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 HIV treatment targets by 2030, each country should define and implement an essential package of prevention, treatment, and care interventions that are contextualized to each individual local epidemic, resources, and capacity, the WHO reported.
In western European countries, prevention and control interventions that are targeted to MSM should remain the cornerstone of the HIV response, according to the report. Pre-exposure prophylaxis should become part of the comprehensive prevention strategy, while harm-reduction programs need to be strengthened or maintained, the WHO noted.
Since the HIV epidemic is low in central European countries, the main priority is to further decrease it by focusing on prevention in MSM, who are the main drivers of the recent increases. The key to achieving this is community involvement and efforts to reduce stigma, the report stated.
There is an urgent need to deliver integrated services through health systems in eastern European countries that better address the social determinants of health. According to the report, these interventions include prevention for individuals who are at risk of sexual and drug-related HIV transmission, targeted HIV testing, community involvement in design and delivery of services, and a treat-all approach within the WHO-recommended regimen.
The large amount of new infections in injection drug users further proves the importance of basing policies on evidence, and to target key populations while strengthening harm reduction programs, the report concluded.