Epidemiological Challenges in Europe

Dr Anastasia Pharris from ECDC in Stockholm gave a detailed and insightful presentation on the state of HIV in Europe.

Current situation 

• Globally HIV incidence is decreasing due to ART and viral suppression, but Europe is still increasing, mainly in the east
• 80% of new HIV infections in Europe in 2015 were in Eastern Europe and mostly attributable to IDU but this is declining over time
• MSM may be under-reported in the East
• Mother to child transmission is very low in virtually all countries

Is Europe's response to HIV sufficient?

• Probably not as many people are diagnosed too late
• There is a big move now to test and treat regardless of CD4 but in undocumented migrants this falls short
• Viral suppression is achieved in many countries, but Russia and the East are well below targets

Challenges and opportunities moving forwards

• Europe needs to implement what they already know works
• Harm reduction coverage remains low in parts of Europe and should be improved
• Changing the culture of testing to community based, home sampling and non-medical staff will expand in the next 10 years
• Many countries are still on the fence about PrEP, particularly in the East
• 2/3 countries in Europe report that funds for HIV prevention are insufficient to implement the necessary prevention strategies
• Low cost interventions should be utilised to target populations at risk e.g. Health promotion through apps (I will discuss an interesting poster about this in a later post)

Stigma remains an issue and Europe is not addressing this adequately

This was a very interesting discussion and there are points to consider in the Australian context – the use of mobile technologies and partnering with the private sector in this space; maximising access to harm reduction strategies as we know this works; and looking at expanded opportunities for testing outside the medical model to engage high risk populations.