HIV/AIDS in Europe in 2004
Published: 09.02.06 Updated: 09.02.2006 14:30:29
Department of Infectious Diseases, Institute de Veille Sanitaire, France.
This report is dedicated to the memory of Andrea Infuso, a dear and respected colleague and friend, who died suddenly on September 20, 2005 at the age of 44.
The transmission of HIV/AIDS continues in Europe as indicated by the 2004 annual surveillance data released by EuroHIV (HIV/AIDS Surveillance in Europe, year-end report 2004, number 71; www.eurohiv.org). This document underlines the importance of appropriate and timely surveillance data to support and develop policies for the prevention and control of the HIV epidemic in Europe.
In 2004, a total of 71 755 new diagnoses of HIV and 10 855 AIDS cases were reported in the World Health Organisation (WHO) European Region. Both figures are slightly lower than those reported for 2003 (72 843 and 11 633, respectively). The number of newly diagnosed HIV cases in 2004 is lower than the peak observed in 2001 (113 930), but is nearly twice the number of reports in 1999 (39 602).
Four countries reported rates of more than 200 new HIV diagnoses per million population: Estonia (568), Portugal (280), Russian Federation (239) and Ukraine (212). The HIV epidemic can be characterised according to the three different sub-regions of Europe:
• In eastern Europe, comprising the Baltic and other former Soviet Union countries, the largest burden of disease in the three sub-regions is found. In 2004, 49 929 newly diagnosed HIV cases (a rate of 174 per million) were reported. Whilst AIDS incidence has been declining in Europe, in eastern Europe it has increased continuously and for the first time exceeded that of the West (27.4 versus 19.5 per million) in 2004. The predominant mode of HIV transmission in the East is injecting drug use, although the numbers of newly diagnosed cases has declined from the peak observed in 2001 (18 455 down from 56 664). However, the number of new heterosexually transmitted cases continues to increase from year to year, with a 25% increase observed in 2004 (from 7 687 in 2003 to 9 666 in 2004).
• In western Europe, 20 229 newly diagnosed HIV cases were reported in 2004 (87 per million population), an increase of 38% since 2001. In western Europe, the predominant mode of transmission is heterosexual intercourse, particularly among persons originating from countries with generalised epidemics. Over a quarter of the newly diagnosed HIV cases were among men who have sex with men and represent a continued increase in newly diagnosed infections from the low observed in 2001. It should be noted that these figures do not include data from two countries with past epidemics among injecting drug users (Italy and Spain) due to the lack of a national surveillance system.
• In central Europe, relatively small numbers of new HIV diagnoses were reported with 1 597 new cases in 2004 (9 per million). Different modes of transmission were observed, with transmission through homosexual contact predominant in some countries (e.g. Hungary), injecting drug use in others (e.g. Poland) and heterosexual contact in others (e.g. Romania).
Although the number of newly diagnosed HIV cases in eastern Europe has declined from the epidemic peaks reported in 2001, prevention and care programmes among injecting drug users must be maintained. In western Europe, prevention and care programmes need to be increasingly targeted at heterosexuals and especially migrant communities. Despite continued health promotion campaigns among homosexual and bisexual men, the numbers of newly diagnosed HIV cases have increased since 2001 emphasizing the need for innovative and better-targeted prevention in this community.