monitoring the eu’s response to the hiv epidemic
TRANSCRIPT
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Monitoring the EUs response to the HIV epidemic
Andrea Ammon, ECDC 30 January 2017St. Julians, Malta
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20152000 2004
Dublin Declaration
2001 2016
2017
EU Commission Communications and
Action plans on HIV/AIDS
2006-2009 2009-2013 2014-2016
2006 2009 2014
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New HIV diagnoses reported in the EU/EEA, 2015
Not included
10 to 20 per 100 000
5 to 9 per 100 000
2 to 5 per 100 000
< 2 per 100 000
20 per 100 000
29 747 persons diagnosed in 31 EU/EEA countries
Notification rate of 6.3 per 100 000 population*
Source: ECDC/WHO Europe (2016). HIV/AIDS Surveillance in Europe, 2015 *adjusted for reporting delay.
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Rate of new HIV diagnoses EU/EEA vs. non-EU/EEA countries, 20062015
+105%
Source: ECDC/WHO Europe (2016). HIV/AIDS Surveillance in Europe, 2015
Chart1
16.96.6
18.96.8
22.46.9
23.56.6
23.76.6
256.5
27.46.8
30.26.6
32.86.5
34.66.3
Non-EU/EEA
EU/EEA
Year of diagnosis
Rate per 100 000 population
Rate EU vs non-EU incl Russia
Table 1: HIV infections newly diagnosed and rates per 100 000 population by country and year of diagnosis (20062015) and cumulative totals, in EU/EEA and other countries of WHO European Region
Non-EU/EEAEU/EEA
200616.96.6
200718.96.8
200822.46.9
200923.56.6
201023.76.6
2011256.5
201227.46.8
201330.26.6
201432.86.5
201534.66.3
Author:Including Russian data obtained from their Sprakva
Anastasia Pharris:These are corrected for reporting delay; the non-EU numbers are not, however the difference would be a very slight increase for non-EU and it wouldn't really be apparent
Rate EU vs non-EU incl Russia
Non-EU/EEA
EU/EEA
Year of diagnosis
Rate per 100 000 population
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HIV trends by reported mode of transmission, EU/EEA, 2006-2015
Source: ECDC/WHO Europe (2016). HIV/AIDS Surveillance in Europe, 2015
Data is adjusted for reporting delay. Cases from Estonia, Italy, Poland, Spain excluded due to inconsistent reporting over the period
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Prevention
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Current level of prevention appears insufficient to reduce the number of new HIV infections
2 out of 3 EU/EEA countries report gaps in funding for HIV prevention
Source: ECDC. The status of the HIV response in the European union/European economic Area, 2016. Stockholm. ECDC: 2017.
Gaps in funding for HIV prevention interventions
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Pre-exposure prophylaxis implementation in the EU/EEA (as of October 2016)
Countries should give consideration to integrating PrEP into their existing HIV prevention package for those most at-risk
Key barrier for provision of PrEP: the cost of drugs and the cost associated with service delivery
Source: ECDC. Evidence brief: Pre-exposure prophylaxis for HIV prevention in Europe. Stockholm: ECDC; 2016.
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Testing
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Source: Pharris, Quinten, Noori, Amato-Gauci, van Sighem, the ECDC HIV/AIDS Surveillance and Dublin Declaration Monitoring Networks; Euro Surveillance; 2016
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Source: ECDC/WHO Europe (2016). HIV/AIDS Surveillance in Europe, 2015
Late diagnosis of HIV is still common
*CD4
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Are new testing approaches included in EU/EEA countries guidelines?
Testing types Yes No No guidelines
Community-based testing delivered by trained medical staff 20 4 6
Community-based testing delivered by non-medical staff (e.g. trained lay people) 8 16 6
Home-sampling kits 1 23 6
Self-testing kits 2 22 6
Source: Data reported to ECDC in 2016 as part of Dublin Declaration monitoring. To be published in Spring 2017.
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Treatment
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Policies on antiretroviral initiation in EU/EEA countries, 2014 and 2016
2015
Source: ECDC. The status of the HIV response in the European Union/European Economic Area, 2016. Stockholm: ECDC; 2017.
Chart1
411141
24330
Initiation regardless of CD4 count
500 cells/mm3
350 cells/mm3
200 cells/mm3
Number of EU/EEA countries/ART policy
Sheet1
201420162016
Initiation regardless of CD4 count424Initiation regardless of CD4 count24
500 cells/mm3113500 cells/mm33
350 cells/mm3143350 cells/mm3
200 cells/mm310200 cells/mm0
Sheet1
2014
Sheet2
2016
Initiation regardless of CD4 count
500 cells/mm3
350 cells/mm3
200 cells/mm3
Numbers of EU/EEA countries/ART policy
Initiation regardless of CD4 count
500 cells/mm3
350 cells/mm3
200 cells/mm3
Number of EU/EEA countries/ART policy
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Source: ECDC. The status of the HIV response in the European Union/European Economic Area, 2016. Stockholm: ECDC; 2017.
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Source: ECDC. The status of the HIV response in the European Union/European Economic Area, 2016. Stockholm: ECDC; 2017.
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What are the key priorities to tackle HIV
in the EU?
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PREVENTMore primary HIV
prevention for those most at-risk
TESTStrengthen efforts
to reach the undiagnosed
TREATLink those
diagnosed to care and early treatment
Slide Number 1Declarations and commitments on HIV/AIDSNew HIV diagnoses reported in the EU/EEA, 2015Rate of new HIV diagnoses EU/EEA vs. non-EU/EEA countries, 20062015HIV trends by reported mode of transmission, EU/EEA, 2006-2015Slide Number 6Gaps in funding for HIV prevention interventionsPre-exposure prophylaxis implementation in the EU/EEA (as of October 2016)Slide Number 9Slide Number 10Late diagnosis of HIV is still commonAre new testing approaches included in EU/EEA countries guidelines? Slide Number 13Policies on antiretroviral initiation in EU/EEA countries, 2014 and 2016Slide Number 15Slide Number 16Slide Number 17Slide Number 18