Stigma, access and testing: why HIV is still rising in Europe

By | December 12, 2018

Last year ECDC counted 159,420 new diagnoses of HIV in the WHO Europe region, which includes Siberia and the central Asian countries, an increase of 5313 or 3.4% over the previous year.

This increase was largely due to an increase of diagnoses in Russia from 98,177 to 104,402, a 6.5% increase. This now means that Russia accounts for 65.5% of all HIV diagnoses in the European region: last year it was 64%.

There has also been a slight increase in the rate of diagnosis in Ukraine, and significant increases in Belarus, where cases have tripled since 2008, and Georgia, where they have doubled. Russia and Ukraine between them account for three-quarters of all HIV diagnoses in Europe. The largest proportional increase in diagnoses was in Turkey, where diagnoses have risen more than tenfold since 2008, though from a very low base.

The rate of diagnosis per head of population is a better guide to changes in the epidemics of countries in a region with widely differing populations and rates of population change. Last year one in 1406 Russians was diagnosed with HIV, compared with one in 1493 the previous year. 

Ukraine has roughly half this rate with one in 2702 people diagnosed a year. Although numerically Ukraine had only 15% as many new cases as Russia, the number of new diagnoses there has increased by 10% since 2016 and its rate per head has increased by 22%. This is disappointing in a country that has seen some intensive programmes to improve access to treatment.

In contrast the rate in the entire WHO Europe region was one in 12,000 people, and in the European Union plus the countries like Norway and Iceland that comprise the European Economic Area, it was one in 15,000 people.

If Russia is excluded, then the 55018 cases recorded in the rest of the WHO Europe region, despite some other countries seeing increases, represent a 9% decrease in the annual total relative to 2008 and a 6.4% decrease since last year.

This is because the increases in eastern Europe were counterbalanced by decreases in a number of western European countries, especially Portugal, Spain, the United Kingdom, Switzerland and the Netherlands. In these countries, the annual number of new diagnoses has almost halved since 2008.

France saw a smaller decline and there was no clear decline in Italy. There were increases in Ireland and Malta, while data problems prevented Germany reporting this year.

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