Please note: This edition of the bulletin was published by MEDFASH. Click here to view the original format.
Welcome to the December MEDFASH Sexual Health & HIV Policy EUROBulletin. In this World AIDS Day issue we have an eFeature interview with EATG’s Tamás Bereczky, who looks at the impact of stigma and discrimination on HIV prevention and testing and also considers the influence patient organisations and people living with HIV have had on HIV policy in Europe.
Earlier this week, the WHO Regional Office for Europe and the European Centre for Disease Control (ECDC) released the HIV/AIDS surveillance report for Europe for 2015. The data presented indicate that, despite significant efforts dedicated to the prevention and control of HIV in Europe, the number of new HIV diagnoses has not declined substantially over the last decade in the western part of the Region and the EU/EEA, and has more than doubled in the East. In the Centre, while remaining at a low level overall, the number of new diagnoses has increased more than anywhere else in the Region. See the full item in the evidence section below.
Other items to look out for in this month’s round-up include: a new report from UNAIDS warning that people are more vulnerable to HIV at certain points of their lives and calling for a life cycle approach to HIV; a consensus statement from the Ministries of Health of Eastern Europe and Central Asia on expanding access to HIV and TB treatment; new WHO guidelines on HIV self-testing and partner notification; a new multi-language website for people living with HIV and for healthcare professionals in Eastern Europe and Central Asia and the latest report from the Resource Tracking for HIV Prevention R&D Working Group (RTWG) looking at funding trends for HIV prevention research and development.
This is the final issue of the MEDFASH Sexual Health & HIV Policy EUROBulletin, as MEDFASH will close at the end of December. We are delighted to announce, however, that the EUROBulletin will continue to be produced in 2017 by NAM aidsmap. Click here or see the MEDFASH section at the end of the bulletin for more information on the transfer of the EUROBulletin and other MEDFASH publications and resources.
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Tamás Bereczky currently works as Communications Advisor for the European AIDS Treatment Group (EATG), the largest European network of individuals living with HIV. He has served as a member on the board of directors of EATG for four years and was co-chair of the European Commission’s Civil Society Forum on HIV/AIDS between 2013 and 2015. He also works as an advisor to the European AIDS Clinical Society (EACS), UNAIDS and the European Centre for Disease Prevention and Control (ECDC) in matters concerning HIV, hepatitis C, men having sex with men, substance use, and health policy. In this eFeature interview, Tamás speaks about his personal and professional experiences of HIV and the impact of stigma and discrimination on HIV prevention and testing. He discusses the role and achievements of people living with HIV in the areas of peer support and advocacy and also considers the influence patient organisations have had on HIV policy in Europe.
>Tamás Bereczky – eFeature interview
Policy development & guidance
Get on the Fast-Track: the life cycle approach to HIV
A new report launched by UNAIDS in the run up to World AIDS Day shows that countries are getting on the Fast-Track, with 18.2 million people now accessing HIV treatment. If these efforts are sustained and increased, the world will be on track to achieve the target of 30 million people on treatment by 2020. The report however also warns that people are particularly vulnerable to HIV at certain points in their lives and calls for a life-cycle approach to find solutions for everyone at every stage of life. Click the links to access the report and to see a World AIDS Day message from Michel Sidibé, Executive Director of UNAIDS.
Global & Regional HIV statistics
UNAIDS has also released a new factsheet with up-to-date global and regional HIV statistics, including European regions.
Minsk Statement from Ministries of Health of Eastern Europe and Central Asia
Health ministers from Eastern Europe and Central Asia adopted a Consensus Statement HIV and TB treatment for all on expanded and rapidly scaled-up access to affordable, quality-assured antiretroviral and TB drugs at the conclusion of the two-day Regional Consultation in Minsk, Belarus, at the beginning of last month. Click the link for more information and to access the Minsk Statement.
WHO: New guidelines on HIV self-testing and partner notification
Yesterday (30 Nov) WHO released new guidelines on HIV self-testing and assisted HIV partner notification services to improve access to and uptake of HIV diagnosis. According to WHO, lack of an HIV diagnosis is a major obstacle to implementing the Organization’s recommendation that everyone with HIV should be offered antiretroviral therapy (ART). These new guidelines are a supplement to the consolidated guidelines on HIV testing services issued in 2015.
Launch of SDG Watch Europe
SDG Watch Europe is a new, EU-level, cross-sectoral alliance of civil society organisations and NGOs from development, environment, social, human rights and other sectors. Its goal is to hold the EU and governments to account for the implementation of the 2030 Agenda for Sustainable Development (SDGs), including those in the area of HIV and sexual and reproductive health. Alliance members include the European NGOs for Sexual and Reproductive Health and Rights, Population and Development (EuroNGOs) and the IPPF European Network.
HIV Prevention Research & Development Investments, 2000-2015
This latest annual report from the Resource Tracking for HIV Prevention R&D Working Group (RTWG) looks at global investment into biomedical HIV prevention. It highlights that overall funding for HIV prevention research and development has remained essentially flat for over a decade and looks at the potential impact on continued innovation in the HIV prevention research and development field.
Parliament & other European institutions
Health at a Glance: Europe 2016
This joint report from the European Commission and the Organisation for Economic Co-operation and Development (OECD) presents key indicators of health and health systems in the 28 EU countries, 5 candidate countries and 3 EFTA countries. According to the report, better public health and prevention policies, as well as more effective healthcare could save hundreds of thousands of lives and billions of euros each year in Europe. The report includes health status sections on HIV, tuberculosis and sexually transmitted infections and also looks at late-diagnosed HIV and tuberculosis treatment outcomes.
International Day for the Elimination of Violence against Women – 25 Nov 2016
The EC released a joint statement on 24 November to mark this day and to launch a series of actions for 2017 to combat violence against women and girls in all its forms. Click the link below to see the statement and for more information on the actions the EC is taking in this area.
Evidence, data & research
HIV/AIDS surveillance in Europe 2015 (2016)
A new surveillance report released this week (29 Nov) by the WHO Regional Office for Europe and ECDC confirms that HIV transmission is still a major concern in Europe, in particular in the eastern part of the European Region. In 2015, more than 153 000 people were diagnosed with HIV in the WHO European Region, the highest number of newly diagnosed infections ever reported in one year. Of these, 79% were diagnosed in the East of the Region and 19% in the European Union and European Economic Area (EU/EEA). Newly diagnosed infections from Russia represented 64% of all cases in the WHO European Region and 81% of cases in the East of the Region. Click the links to see the relevant news releases and to access the full surveillance report.
ECDC evidence brief: Pre-exposure prophylaxis (PrEP) for HIV prevention in Europe
This ECDC evidence brief summarises key issues and priorities for action with regard to PrEP in Europe. It draws on country data reported to ECDC for Dublin Declaration monitoring in 2016. In addition, it draws on data from a collaborative ECDC and Hornet Gay Social Network rapid survey of a non-representative sample of men who have sex with men in Europe about PrEP use.
Communication strategies for the prevention of HIV, STI and hepatitis among MSM in Europe
This document provides guidance for developing innovative and effective communication strategies to promote a culture of lower risk behaviour in the MSM community, supporting men who have sex with men (MSM) to make decisions that reduce their risk of HIV, STI and viral hepatitis transmission. It is intended as a practical tool for selecting and locally adapting appropriate communication interventions to a variety of contexts in the European Union and European Economic Area.
HIV Testing in Europe – Evaluation of the impact of the ECDC guidance on HIV Testing: increasing uptake and effectiveness in the European Union
This technical report from ECDC evaluates the use and impact of ECDC’s 2010 HIV testing guidance in the EU/EEA. The report will inform future action in this area, including the potential of new updated guidance.
ECDC: Systematic review on hepatitis B and C prevalence in EU/EEA
ECDC conducted a systematic review of the literature published between 2005–2015, with the aim to provide current estimates of the prevalence of HBV and HCV in the general population and specific population subgroups in the EU/EEA Member States, and to identify gaps in the available information. This review is an update of a previous systematic review covering the period 2000–2009.
OptTEST: Barring the way to health
This new searchable database shows the most common legal and regulatory barriers to HIV testing, linkage to care and treatment access across Europe and Central Asia. An accompanying toolkit is being developed and will be available in full by spring 2017.
Coalition of community advocates demand halt to Gilead DISCOVER study
A coalition of US, Canadian and European community advocates and HIV NGOs have released a public sign-on letter to Gilead expressing deep concerns that it has failed to follow Good Participatory Practice (GPP) guidelines in the design and implementation of its new PrEP trial, DISCOVER. The coalition is making a number of demands on Gilead including that it consults with organisations experienced in GPP to help conduct DISCOVER, creates two new Community Advisory Groups for North America and Europe and temporarily halts the trial until full engagement can take place to address enrolment, marketing and other key issues. Click the links to see the letter and for more information on the trial.
Reports & resources
Challenges and opportunities in improving access to medicines through efficient public procurement in the WHO European Region (2016)
A new WHO report provides insight into how countries in the WHO European Region can improve access and reduce medicine prices through strategic and well-planned procurement processes. It also addresses collaboration within and across countries to improve availability of affordable medicines for patients in the Region.
Global State of Harm Reduction 2016
This biennial report from Harm Reduction International (HRI) provides a global overview of harm reduction policy and programming and also contains regional updates, including for Central and Eastern Europe and Western Europe. The 2016 report concludes that services to reduce drug-related harms are failing to keep up with growing need, despite pledges to combat HIV among people who inject drugs.
Drug-related infectious diseases in Europe: update from the EMCDDA expert network
This report provides an update on infectious diseases related to injecting drug use in Europe. It covers the EMCDDA Drug-related infectious diseases indicator and the responses in the area. The report is based on the indicator’s annual expert meeting, held in Lisbon in June 2016, which brought together national experts from the 28 EU Member States, Norway and Turkey.
Tina & Slamming: MSM, crystal meth and intravenous drug use in a sexual setting
This report from Mainline and SOA AIDS Netherlands describes two relatively new trends regarding chemsex in the Netherlands: the use of crystal meth (Tina) and the practice of injecting drugs (slamming). It is based on a desk review of Dutch statistical data, a literature review and 27 in-depth interviews with MSM who use crystal meth.
Health4LGBTI: Reducing health inequalities experienced by LGBTI people
This project has been funded by the European Commission to explore the particular health needs and challenges faced by LGBTI people and analyse the key barriers faced by health professionals when providing care for LGBTI people. The aim is to raise awareness of the challenges and provide European health professionals with the tools that give them the right skills and knowledge to overcome these barriers and contribute to the reduction of health inequalities. The project is well underway and is being managed by a consortium of Verona University Hospital (AOUI-Verona ,Italy), ILGA-Europe (Belgium), University of Brighton (UK), the National Institute of Public Health-National Institute of Hygiene (Poland) and EuroHealthNet (Belgium). Click the link for more information
HIV booklets for European healthcare professionals
MEDFASH and JUSTRI are today jointly launching adapted versions of the MEDFASH booklets HIV in Primary Care and HIV for non-HIV specialists: diagnosing the undiagnosed for use by healthcare professionals across Europe. The booklet HIV in Primary Care - a practical guide for primary healthcare professionals in Europe aims to help general practitioners and the primary healthcare team to improve rates of HIV diagnosis and provide high quality care for their patients diagnosed with HIV. HIV for non-HIV specialists – diagnosing the undiagnosed offers guidance to non-HIV specialist clinicians in secondary care settings who are likely to encounter patients with undiagnosed HIV. Both booklets provide essential information about HIV and its presentation with a range of indicator conditions (with photos), as well as case studies and concrete strategies to help non-HIV specialists implement HIV testing in their daily practice. The booklets can be downloaded free of charge from http://justri.org/hivinprimarycare and www.justri.org/hivforthenonspecialist or www.medfash.org.uk/publications
NAM aidsmap provided science news reporting from several HIV conferences recently. Click the links to access the reports.
Sexual health rights & advocacy
Action against legislative developments restricting access to sexual and reproductive rights
Attempts earlier this year in Poland to make its sexual and reproductive health laws more restrictive was debated in the European Parliament in October. MEPs focused on Poland’s national bill to ban all abortions, with some arguing that such action strikes a severe blow against women’s rights. A coalition of youth advocates has also met with MEPs to stress that the European Parliament needs to do more to monitor legislative developments which restrict sexual and reproductive rights and services across Europe.
Factsheet: Access to safe and legal abortion – a European perspective
ASTRA Network, ASTRA Youth, You Act and CHOICE for Youth and Sexuality developed this factsheet that aims to raise awareness about women’s and girls’ rights to safe and legal abortion and to encourage further debate on this issue.
Campaigns & other news
European Test Finder
During last month’s European HIV-Hepatitis Testing Week (18-25 Nov), almost 500 organisations across Europe hosted activities to increase awareness of the benefits of HIV and hepatitis testing. To support the week ECDC worked closely with NAM aidsmap and others to produce an updated version of the European Test Finder, making it easier to locate testing sites for HIV, sexually transmitted infections and viral hepatitis in all countries in the wider WHO European region. A widget has also been developed which enables organisations to embed the Test Finder on their own websites. Click the links for more information on the Test Finder and the widget.
About HIV / Pro VICH website
The ‘About HIV / Pro VICH’ website has been designed for healthcare professionals, patient groups and people living with HIV in Eastern Europe and Central Asia (EECA) and features a series of factsheets about key HIV topics, currently available in Armenian, English, Georgian, Kazakh, Russian and Ukrainian. This project is a collaboration between six HIV agencies: EATG, International Treatment Preparedness Coalition (ITPCRu), East Europe & Central Asia Union of PLWH (ECUO), AIDS Action Europe (AAE), Eurasian Union of Youth and Adolescents "Teenergizer!" and NAM aidsmap. Click the links for more information.
Norway provides HIV PrEP free to all those at risk of HIV
Norway has become the first country in the world to offer PrEP free under its national health service. PrEP will be offered to groups at higher risk of HIV, including gay and bisexual men and transgender women. There are around 5,800 people living with HIV in Norway, with just over 220 new infections diagnosed in 2015.
Czech Republic: Criminal charges dropped against 30 gay men living with HIV
Earlier this year, Prague’s Public Health Authority initiated criminal investigations against 30 gay men living with HIV who had been diagnosed with an STI in the previous year. The men had been indicted for potential HIV transmission (under a law criminalising the ‘spread of infectious diseases’) but prosecuting authorities withdrew the charges due to lack of evidence. The Prague Public Health Authority was widely condemned for this action by community activists and human rights defenders.
eFeature by MEDFASH Chief Executive
MEDFASH is to close at the end of 2016. In this farewell eFeature, written for its Sexual Health & HIV eBulletin (England), MEDFASH’s Chief Executive Ruth Lowbury considers the challenges faced by small charitable (non-governmental) organisations in securing new and sustainable income streams in an increasingly competitive funding environment and in a sector that is being squeezed. She also reflects on the many ways in which MEDFASH has collaborated with others to influence policy and practice over the years and ultimately benefit people living with HIV and those with other sexual health related needs.
Transfer of MEDFASH publications and resources post December 2016
Despite MEDFASH’s closure at the end of the year, some key publications and resources will continue to be available from the following organisations: the Sexual Health & HIV Policy eBulletin (England) and HIV TIPs online educational tool on HIV testing for general practice will be managed by the Faculty of Sexual and Reproductive Healthcare; this Sexual Health & HIV Policy EUROBulletin by NAM aidsmap; the booklets HIV in primary care and HIV for non-HIV specialists by the British HIV Association and adapted pdf versions of these two booklets for a European audience by JUSTRI (see the full item on the launch of the HIV booklets for European healthcare professionals in the resources section above). Click the links for fuller details and to see a statement from MEDFASH and the other organisations.
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All readers (current and new) will need to re-subscribe/subscribe to ensure they receive any future issues of this Sexual Health & HIV Policy EUROBulletin from NAM aidsmap. Click the link below to do this.
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All readers (current and new) will need to re-subscribe/subscribe to ensure they receive any future issues of the Sexual Health & HIV Policy eBulletin from the Faculty of Sexual and Reproductive Healthcare (FSRH). Click the link below to do this.