Transcript The HIV/AIDS epidemic in the WHO European Region

The HIV/AIDS epidemic in the
WHO European Region
1986-2004
EuroHIV
update 30 June 2005
INSTITUT DE
VEILLE SANITAIRE
WHO & UNAIDS Collaborating Centre
Adults and children estimated to be living
with HIV at end 2004
Eastern Europe
& Central Asia
Western & Central
Europe
610 000
North America
[480 000 – 760 000]
1.0 million
1.4 million
[920 000 – 2.1 million]
[540 000 – 1.6 million]
Caribbean
440 000
[270 000 – 780 000]
Latin America
1.7 million
[1.3– 2.2 million]
East Asia
1.1 million
North Africa & Middle East
540 000
[230 000 – 1.5 million]
[560 000 – 1.8 million]
South & South - East Asia
7.1 million
Sub -Saharan Africa
25.4 million
[23.4 – 28.4 million]
[4.4 – 10.6 million]
Oceania
35 000
[25 000 – 48 000]
Total: 39.4 (35.9 – 44.3) million
Definition of geographic areas: West, Centre, East
used in this presentation
East
West
Centre
EuroHIV
Date of initiation and coverage of reporting of
diagnosed HIV infections, WHO European Region
Reporting of HIV infection
Year of start (range)
Country coverage in 2004
1984 (UK) – 2003 (France)
No national reporting in Spain
and Italy; no information on
transmission group in Austria
Centre
1985 – 1992
100%
East
1987 – 1989
100%
Update at 31 December 2004
West
EuroHIV
HIV infections newly diagnosed, reported in 2004:
characteristics of cases by geographic area
WHO European Region
West*
Centre
East
23 246
1 585
49 929
Rate per million population
77.9
8.5
174.2
Aged 15-24 years old (%)
10%
21%
36%
Females (%)
36%
30%
40%
Heterosexual
Low level
epidemic†
Drug injection
Update 30 June 2005
Number of diagnosed cases
Predominant
transmission mode
EuroHIV
* No data for Italy, Norway, Spain
† Except Romania (nosocomial epidemic ~1990) & Poland (IDU epidemic); heterosexual in Balkan countries, homosexual
elsewhere
HIV infections newly diagnosed per million population
by year of report (1994-2004) and geographic area
WHO European Region*
350
Cases
per million
300
250
200
East
150
Update at 31 December 2004
100
West *
50
Centre *
0
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
Year of report
* Countries excluded (data not available for the whole period):
West: Andorra, Austria, France, Italy, Malta, Netherlands, Norway, Portugal, San Marino, Spain;
Centre: Bulgaria, Croatia
EuroHIV
HIV infections newly diagnosed:
cases reported in 2004 per million population
WHO European Region
HIV cases per million
17
200 +
100 - 199
25
20 - 99
48
89
59
126
78
25
95
84
108
278
Update 30 June 2005
NA
NA: data not available
131
7
58 3
13 7
12
4 10
Not available
45
79
17
30
212
84
76
32
16 14
3
40
43
31
13
NA
9
< 20
239
568
141
39
0
3
31
48
EuroHIV
HIV infections newly diagnosed:
cases reported among homo/bisexual men in 2004
per million population, WHO European Region
HIV cases per million
7
50 +
30 - 49
8
10 - 29
9
16
30
36
12
Update 30 June 2005
NA: data not available
0
0.5
44
0
3
25
8
6
14 NA
0.1
1
18
31
Not available
3
35
17
< 10
0.8
2
4
0.2
0.2 3
NA
0.3
0
1
0 0.5
0
0.1
0.3 12
5
0.3
0
10
10
EuroHIV
HIV infections newly diagnosed:
cases reported among injecting drug users in 2004
per million population, WHO European Region
HIV cases per million
3
50 +
30 - 49
2
10 - 29
3
18
3
63
30
2
3
2
1
12
98
Update 30 June 2005
14 NA
NA: data not available
24
0.7
0
0 0.2
0.9
0.7 1
NA
120
31
43
17
0
21
11 7
0
0
0.8
5
Not available
28
36
5
7
3
< 10
72
0
0.1
0
9
EuroHIV
HIV infections newly diagnosed:
cases reported among heterosexuals in 2004
per million population, WHO European Region
HIV cases per million
7
50 +
30 - 49
11
10 - 29
29
45
24
74
7
76
Update 30 June 2005
39
0.9
6
3
60
3
4
27 NA
NA: data not available
13
7
39
140
Not available
29
30
40
< 10
31
NA
0.4
1
2 3
8
84
2
8
10
3
9
20
8
40
0
5 4
2
21
23
EuroHIV
AIDS incidence per million population, by
geographic area, 1986-2004, WHO European Region
Cases per
million
60
40
East *
Update at 31 December 2004
20
0
1986
West *
Centre *
1988
1990
1992
1994
1996
1998
2000
2002
2004
Year of diagnosis
Data adjusted for reporting delays
* Countries excluded (data not available for the whole period):
West: France, Norway; Centre: Bulgaria; East: Kyrgyzstan, Russian Federation, Uzbekistan
EuroHIV
AIDS cases diagnosed in 2004 per million population
WHO European Region
10
AIDS cases per million
50 +
8
7
10
14
12
11
6
26
20
29
43
0 NA
Update 30 June 2005
80
42
5
1
10 0.4
43 2
0.7 5
4
20 - 49
20
40
6
8
5 - 19
Not available
17
53
0
11
NA
2
20
7 3
1
7
3
<5
5
0
0.7
NA
5
Data adjusted for reporting delays
NA: data not available
EuroHIV
AIDS cases diagnosed among homosexual men
in 2004, per million population, WHO European Region
7
AIDS cases per million
20 +
5 - 19
1
1- 4
2
0.6
3
4
3
11
10
6
0 NA
Update 30 June 2005
7
<1
0
2
5
2
5
2
3
3
Not available
0
0.6
0.3
3
2
1
NA
0.2
1
0 0.7
0 0
2
0
0.3
0
0
1
0
0 0
0.03
0
0.3
Data adjusted for reporting delays
NA: data not available
EuroHIV
AIDS cases diagnosed among injecting drug users
in 2004, per million population, WHO European Region
0
AIDS cases per million
20 +
5 - 19
0.8
0.9
1
0.5
0.2 0.4
0.3
0.5
2
2
8
31
9
Update 30 June 2005
20
0 NA
2
0.2
1 0
0.5 0
0.3
0 1
NA
1- 4
13
30
1
5
<1
4
40
12
0
0.1
14
5 2
0
0
0.1
0
0
0
NA
1
1
Data adjusted for reporting delays
NA: data not available
Not available
EuroHIV
AIDS cases diagnosed among heterosexuals
in 2004, per million population, WHO European Region
3
AIDS cases per million
20 +
2
5 - 19
4
6
9
2
13
11
22
11
12
0.7
1
8
42
<1
6
4
0 NA
Update 30 June 2005
1- 4
4
3
0.9
0.2
4 0.2
1 0.4
1
0.7 1
11
3
0
5
NA
2
1
2 0.5
0.5
NA
3
Data adjusted for reporting delays
NA: data not available
0
5
2
3
Not available
3
EuroHIV
The four most common AIDS indicative diseases (%)
among AIDS cases diagnosed in 2004
West, Centre and East, WHO European Region
% of cases
60
Tuberculosis
PCP
45
Oesophageal candidiasis
HIV wasting syndrome
Update at 31 December 2004
30
HIV encephalopathy
15
0
West
Centre
East
EuroHIV
AIDS cases (%) diagnosed with TB as initial
opportunistic illness by transmission group and
geographic area, WHO European Region, 2004
% cases
100
Extra-pulmonary TB
Pulmonary TB
75
East
Update at 31 December 2004
50
West
Centre
25
0
IDU
HC MSM
IDU
HC MSM
IDU
HC MSM
Conclusions





HIV infection remains a problem of major public health importance
in the WHO European Region
In western Europe, prevention and care must be adapted to reach
migrant populations; renewed safer sex campaigns targeted at MSM
are needed
In eastern Europe, HIV prevention among IDU should be the
cornerstone of HIV prevention strategies; at the same time,
preventing further heterosexual transmission is critical; prevention
amongst young people is also essential
In the centre, prevention should be adapted according to the
country to maintain their epidemiological advantages
Epidemiological surveillance must be maintained to inform public
health prevention and control
EuroHIV