‘Alarming’ HIV rates in Eastern Europe

More than 130,000 people were newly infected with HIV in Eastern Europe in 2017, the highest number ever recorded. The data signals yet another year of rising new infections in the region – bucking the worldwide trend which has seen HIV rates plummet.

While new infections are growing in Eastern Europe, the rate of increase, at least, is falling. In 2016, the rate of increase was reported at 95% in the decade from 2007-2016. From 2008-2017, the observed rate of increase was 68%. In the central part of the region, the increase was 121% (2008-2017) compared with 142% (2007-2016).

Newly diagnosed infections from two countries alone (the Russian Federation and Ukraine) contributed 75% of all cases in the WHO European Region and 92% of cases in Eastern Europe.

Across the WHO region, where there is a known mode of HIV transmission, heterosexual transmission accounted for 56% of new diagnoses, injecting drug use for 30%, sex between men for 14%, and mother-to child transmission for 0.6%.

In the East, heterosexual transmission accounted for 59% of new diagnoses, transmission through injecting drug use for 37%, sex between men for 3%, and mother-to-child transmission for 0.5%.

The findings were published in the World Health Organization (WHO) and European Centre for Disease Prevention and Control (ECDC) annual HIV/AIDS surveillance in Europe report. It reveals data from the WHO European region which is made up of 53 countries, covering a vast geographical region from the Atlantic to the Pacific oceans – including the 31 countries in the European Union.

In Western Europe, new HIV infections have declined by 20%, thanks to declines in new infections among gay men and other men who have sex with men – which make up 38% of all transmission routes here.  

Programmes that promote frequent and targeted testing of this group was highlighted as a reason for the decline. ECDC Director Andrea Ammon said, “This allows rapid linkage to care and immediate start of antiretroviral treatment for those who tested positive and wider uptake of evidence-based prevention such as pre-exposure prophylaxis. This decline also shows that a stronger focus on addressing and including vulnerable populations in the HIV response, as outlined in new ECDC testing guidance, makes a difference.”

However, one in five people living with HIV across the whole WHO region are unaware of their status. Just over half (53%) of those diagnosed with HIV were diagnosed at a late stage of infection (CD4 cell count < 350 cells/mm3 at diagnosis).

This percentage was highest in the East (57%), the Centre (53%), and lowest in the West (49%), while 49% were diagnosed late in the EU/EEA.

The number of AIDS cases has continued to decline steadily in the West and the EU/EEA during the last decade, and while it has nearly doubled in the East over that period, it has begun to stabilize and even declined by a slight 7% between 2012 and 2017.

The report emphasised the scale up of bold, evidence-based interventions to better deliver more effective, integrated services through health systems that better address the social determinants of health.

Vytenis Andriukaitis, the European Commissioner for Health and Food Safety commented, “We must overcome the stigma of HIV infection and treatment and continue our efforts in dispelling false beliefs about how HIV and AIDS are spread. It is important for our public health services to support easy and affordable access to testing and medical care for vulnerable groups at risk of HIV infection.”