Monitoring the EU’s response to the HIV epidemic

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Monitoring the EU’s response to the HIV epidemic Andrea Ammon, ECDC 30 January 2017 St. Julian’s, Malta

Transcript of Monitoring the EU’s response to the HIV epidemic

  • Monitoring the EUs response to the HIV epidemic

    Andrea Ammon, ECDC 30 January 2017St. Julians, Malta

  • 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

  • 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.

  • 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

  • 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

  • Prevention

  • 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

  • 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.

  • Testing

  • Source: Pharris, Quinten, Noori, Amato-Gauci, van Sighem, the ECDC HIV/AIDS Surveillance and Dublin Declaration Monitoring Networks; Euro Surveillance; 2016

  • Source: ECDC/WHO Europe (2016). HIV/AIDS Surveillance in Europe, 2015

    Late diagnosis of HIV is still common

    *CD4

  • 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.

  • Treatment

  • 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

  • Source: ECDC. The status of the HIV response in the European Union/European Economic Area, 2016. Stockholm: ECDC; 2017.

  • Source: ECDC. The status of the HIV response in the European Union/European Economic Area, 2016. Stockholm: ECDC; 2017.

  • What are the key priorities to tackle HIV

    in the EU?

  • 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