The rate of newly diagnosed HIV infection in the European Union (EU) has almost doubled since 1999, according to EuroHIV data from the European Centre for Disease Prevention and Control.
The 20 Member States that consistently reported data between 1999 and 2006 showed that new diagnosis had increased from 28.8 per million inhabitants to 57.5 per million inhabitants. In the 25 member states reporting in 2006 (Italy and Spain were excluded) 26,220 new diagnoses were recorded.
In the EU, Estonia reported the highest rate of new diagnosis (504.2 per million), followed by Portugal (205 per million), the UK (148.8 per million) and Latvia (130.3 per million). The lowest rate was in Slovakia, where 27 new HIV cases (five per million people) were reported last year.
Men accounted for the majority of EU diagnosis (66%) with 11% of cases in young people aged 15-24. The predominant route of transmission was heterosexual contact (53%) with a large proportion of those infected originating from countries with generalised epidemic (e.g. countries in sub-Sahara Africa). ECDC spokesperson, Ben Duncan, said that in Western European countries, such as the UK and France, one of the main drivers of new cases is people migrating from other areas of the world.
With over a third of the cases diagnosed and a relatively small population size, men who have sex with men remain at greater risk of infection than heterosexuals. Less than 10% of the total cases reported were among injecting drug users.
ECDC director Zsuzsanna Jakab said that the true European figures are likely to be much higher; it is estimated that almost one third of people living with HIV in Europe are unaware they are infected.
"These people are less likely to take precautions against transmitting the virus, and are also unable to access treatment, and addressing this hidden epidemic is a priority for the ECDC," she said.
While Estonia showed the highest rates of new HIV diagnosis, the EU report praised Estonia's efforts to tackle the epidemic. At the launch of the HIV/AIDS Surveillance in Europe report in Tallinn, Estonia, Zsuzsanna Jakab said, “In response to the high levels of HIV infection being reported, Estonia has launched an ambitious long-term plan for 2006-2015. This plan includes new initiatives on surveillance, prevention and treatment. We at ECDC are supportive of the work being done by the Estonian government to reverse the trend of increasing HIV infection rates. On behalf of ECDC, I have pledged to support Estonia in a number of priority areas, including on surveillance, sharing country experiences and providing European guidance on HIV testing”.
In non-EU areas of Europe, the number of cases is also continuing to rise, with particularly high rates in Ukraine (288 per million) and Russia (275 per million). The data showed that in 2006, a total of 86,912 new HIV infections were reported across 50 of the 53 countries of the WHO European Region.
Eastern and western WHO European regions
In 2006, over two thirds of the new HIV diagnoses in Europe were reported in the former Soviet Union countries (the East of Europe) with 59,866 new cases or 211 new diagnoses per million inhabitants). Of these, 41% were female and 27% were young people aged 15-24. The predominant mode of HIV transmission was injecting drug use (22,185 cases) although there has been a five-fold increase in heterosexually-acquired cases since 1999.
In western Europe 25,241 new HIV diagnoses were reported in 2006 (82.5 per million inhabitants) of which 35% were female and 10% aged 15-24 years old. The predominant mode of transmission was heterosexual (10,722) but approximately 43% of cases originated from countries with a generalised epidemic (e.g. sub-Saharan Africa).
Between 2002 and 2006, 32 countries in the WHO European region reported an increase in HIV testing, with nine countries reporting a decrease. The greater uptake of testing accounts for some of the increase in diagnoses.
Herida M et al. HIV/AIDS in Europe: epidemiological situation in 2007 and a new framework for surveillance. Eurosurveillance Weekly Release: 12, 11, November 22nd 2007.