Post on 19-Jan-2016
ecdc.europa.eu
Estonian Ministry of Social Affairs 23 November 2007
Zsuzsanna JakabDirector, ECDC
Press Briefing on HIV/AIDS
Purpose of today’s press conference
• To celebrate World AIDS Day and remember the millions of people suffering from HIV/AIDS across the globe;
• To focus attention on Estonia, which is the country with the highest infection rate in the EU;
• To launch the annual EuroHIV Report on HIV/AIDS surveillance in Europe.
Why was ECDC established?
•Emerging and re-emerging communicable diseases revitalised through globalisation, bioterrorism, interconnectivity, and EU without internal borders
•Health implications of enlarging EU•Strengthen EU Public health capacity to help
meet EU citizen’s concerns
• EU level disease surveillance
• Scientific opinions and studies
• Early Warning system and
response
• Technical assistance and training
• Epidemic intelligence
• Communication to scientificcommunity
• Communication to the public
What does ECDC do?
Identify, assess & communicate current & emerging health threats to human health from communicable diseases
How is ECDC organised?
Administrative
Services
Healthcommunication
Preparedness &
response
SurveillanceScientificadvice
Director and Director's CabinetManagement Governance External relations Country
cooperation
Antimicrobial resistance & healthcare-associated infections
Food- & waterborne diseases
HIV, STI & Hepatitis
Influenza
Other diseases of environmental & zoonotic origin
Tuberculosis
Vaccine preventable diseases & invasive bacterial infections
ECDC role in HIV/AIDS prevention
• Despite many EU & national initiatives, HIV infection remains a major public health concern across the EU;
• ECDC called on by EU Health Commissioner to evaluate and assess national control programmes, and provide support to Member States, particularly to strengthen prevention and care in high burden countries;
• ECDC/WHO-EURO to take over the European HIV surveillance activities as from 2008, crucial for informing prevention efforts and health care planning;
• ECDC priority to reduce barriers to HIV testing - we estimate that 30% of people living with HIV in EU are unaware of infection - and will be working on scientific guidance to achieve this;
• HIV/AIDS will be a HIGH priority in the years to come.
Total: 33.2 (30.6–36.1) million Source: UNAIDS/WHO
Adults and children estimated to be living with HIV in 2007
75 000
1.3 million
1.6 million
230 000
22.5 million
380 000
760 0001.6 million
800 000
4.0 million
10
76
4
12
14
9
504
62
8
13029
8
148
20
8
275
5
17
288
14
HIV cases per million
< 20
20 - 99
100 - 199
200+
205
92
80
149
37
4137
45
9565 33
53
51
72
4
Not available
104
Source: EuroHIV
New HIV diagnoses reported in 2006per million population, Europe
0
5000
10000
15000
20000
25000
2001 2002 2003 2004 2005 2006
New HIV diagnoses 2001-2006EU & EEA/EFTA countries
0
50
100
150
200
250
300
2000
2001
2002
2003
2004
2005
2006
PortugalUKLux Belgium FranceIreland NetherAustria Greece
New HIV diagnoses 2001-2006per million pop, EU15 and EEA/EFTA countries
Note: the graphs are on a different scale!
0
10
20
30
40
50
60
70
2000
2001
2002
2003
2004
2005
2006
Norway Denmark Sweden Finland Iceland Germany
0
200
400
600
800
1000
1200
2000
2001
2002
2003
2004
2005
2006
Estonia Latvia Lithuania
New HIV diagnoses 2001-2006per million pop, Member States which have joined EU since 2004
Note: the graphs are on a different scale!
0
10
20
30
40
50
60
70
80
2000
2001
2002
2003
2004
2005
2006
MaltaCyprus Poland Slovenia Bulgaria Czech RRomania Hungary Slovakia
New HIV diagnoses 2001-2006per million pop, EU neighbourhood
0
100
200
300
400
500
600
2000 2001 2002 2003 2004 2005 2006
Ukraine
RussianFedMoldova,RepKazakhstan
Uzbekistan
Belarus 0
10
20
30
40
50
60
2000 2001 2002 2003 2004 2005 2006
Georgia
Kyrgyzstan
Tajikistan
Azerbaijan
Armenia
Croatia
Serbia
Albania
FYROM. Note: the graphs are on a different scale!
Source: EuroHIV
Predominant mode of HIV transmission, cases reported in 2006
Heterosexual contact
Men having sex with men
Injecting drug users
Data not available
0
2500
5000
7500
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
Heterosexual
Men having sex with men
Injecting drug users
New HIV diagnoses by mode of transmission, EU, 1996-2006
* 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.
Median age at HIV diagnosisby country (2005)
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%).
• 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.
Sex workers
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 2006
0%
10%
20%
30%
40%
50%
60%
70%
Icel
and
Swed
en
Belgiu
m
Irela
nd UK
Luxem
bourg
Ger
man
y
France
Gre
ece
Switz
erla
nd
Finla
nd
Denm
ark
Portuga
l
Source: EuroHIV
0
200
400
600
800
1000
1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Year of report
Latvia
Estonia
Cases per
million
HIV infections newly diagnosed 1996-06per million pop, Baltic States
EuroHIV
Lithuania
Upd
ate
at 3
1 D
ecem
ber
2006
0
10
20
30
40
50
60
1988 1990 1992 1994 1996 1998 2000 2002 2004 2006
Year of diagnosis
Cases per million
Latvia
AIDS incidence 1988-2006per million pop, EU as a whole compared to Baltic States
Data adjusted for reporting delays
Upd
ate
at 3
1 D
ecem
ber
2006
Estonia
Lithuania
Situation in Estonia
•Estonia has the highest rate of new HIV diagnoses in Europe (504 new cases per million inhabitants);
•Spread of HIV associated with injecting drug use- Young males;- High infection rate;- Most are non-Estonian ethnic background
•However, HIV is increasingly spread through heterosexual contact
•The proportion of women has increased from 20% in 2000 to 36% in 2006.
ECDC supporting Estonia
•ECDC delegation first visited Estonia in April 2007 to review, together with the country experts, the status of HIV & STI surveillance, prevention and control;
•As a result, we agreed a number of areas for ECDC support, including
−Sharing good practice and providing technical support in surveillance;
−Assisting with reviews of HIV estimates;−Providing advice on development of prevention and
media campaigns;−Scientific guidelines on HIV/AIDS & STI testing.
Conclusions
• Priorities for prevention in the EU− Securing HIV surveillance activities to inform prevention &
healthcare planning;− Reducing barriers to HIV testing, including scientific
guidance to achieve this; − Developing innovative prevention approaches for MSM;− Providing specific services for migrant communities;− Strengthening prevention and care in high-burden
countries such as Estonia• ECDC is supportive of the work being done by the
Estonian government to reverse the trend of increasing HIV infection rates;
• Political commitment is key – what happens in Estonia is important for whole EU.
ecdc.europa.eu
Thank you ! Zsuzsanna JakabDirector, ECDC
info@ecdc.eu.int