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Expert Group on HIV/STI

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Expert Group on HIV/STI
Report 22.4 2008
Meeting in Tallinn 3.-4.4 2008
•
•
•
•
•
Approval of thematic report
Evaluation of country reports
Evaluation of projects (ongoing and planned)
Development of indicators
Site visit to Narva
Registered new HIV cases per million inhabitants in
selected European countries in 2006
600
504,2
500
400
275,1
300
288,3
200
130,3
19,5
37,1
41,6
45,0
Sweden
Denmark
75,6
Finland
29,3
Poland
100
Belorussia
Lithuania
Latvia
Ukraine
Russia
Estonia
0
(Data source: www.eurohiv.org)
Reported cases of HIV-infection among injecting drug
users Nordic countries1990-2007
No. of notified cases
100
Denmark
Sweden
Finland
Norway
Iceland
80
60
40
20
0
1990
1992
1994
1996
1998
2000
2002
2004
2006
1800
450
1600
400
1400
350
1200
300
1000
250
800
200
600
150
400
100
200
50
0
0
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
number of newly diagnosed HIV infections/ IDU, HET, HPR
number of newly diagnosed HIV infections/ MSM
Trends in newly diagnosed HIV infections
by mode of transmission and year of
diagnosis
MSM
IDU
Hetero
HPR
Thematic report/Priority topics
for projects:
• Regional collaboration
• Integration of social and health care for
HIV-infected individuals
• Prevention of HIV among drug users
• Enhancing cross-border bilateral activities
• Promoting harm reduction policies among
drug users
Thematic report/Priority topics
for projects/2:
•
•
•
•
Prevention of HIV/TB dual infections
Prevention of HIV among MSM
Prevention of MTCT
Enhancing implementation of common best
practices
Other areas to be covered:
• Surveillance and analysis of risk factors
• HIV prevention in prisons
• Prevention of social exclusion of people
living with HIV
• Integration of social and health care for
people living with HIV
• Laboratory collaboration
Example of a successful project
following the priorities
• Development of low-treshold services for
injecting drug users to prevent the spread of
HIV in Murmansk and adoption and
implementation of the principles and
experience to Leningrad oblast
Реализация международных проектов по профилактике ВИЧ/СПИДа в
Мурманской области
Дозорные
Норвегия
Финляндия
Швеция
исследования
2002- 200…
1999-2001
2002-200…
2004
2005- 200…
2007-2000…
472
500
400
300
200
100
0
1999
2000
2001
2002
2003
2004
2005
2006
р е ги стр а ци я н овы х случа е в ВИЧ - и н ф е кци и в Мур м а н ской обла сти с 1 9 9 9 п о 2 0 0 6 гг.
Legacy for LTCS
• Properly implemented non-discriminating
LTCS is challenging but could demonstrate
the heritage of promoting social well-being
and solidarity in the society
Project status in the end of 2007
• Ongoing projects - 21
–
–
–
–
–
Projects involving Russia - 18
Projects involving Norway – 12
Projects involving Finland – 6
Projects involving Sweden – 1
Projects involving Estonia, Latvia and
Lithuania – 3
– Projects involving France - 1
Project status 2
• Project proposals – 15
• Completed projects - 4
Financing
• ITA and coordination financed through a
project in 2008-2010 by the Ministry for
Foreign Affairs, Finland
• Chairmanship financed by the Ministry of
Social Affairs and Health at least through
2008
• Additional possibilities offered by the
Finnish financing in the project pipeline
Indicators/Important targets
•
•
•
•
Epidemiological situation
Changes in risk behaviour
Impact of interventions
Coverage in risk groups
Suggestions for indicators in the
NDPHS HIV
1. Annually reported HIV cases by transmission
category
2. Annual newly reported AIDS cases
3. Annual deaths among HIV-infected
4. Annual reported HIV-cases in 15-19 years old
and 20-24 years old
5. Annual HIV and TB cases in correctional
facilities
Suggestions for indicators in the NDPHS HIV/2
6. Percentage of estimated HIVpositive incident
TB cases that received treatment for HIV and
TB
7. Percent of HIV-positive pregnant women who
received antiretrovirals to reduce the risk of
mother-to-child transmission
8. Percent of adults and children with advanced
HIV infection receiving ART
Regional differences
New HIV cases per 100,000 population in 2006
50
%
66
181
242
271
0
50
Kohtla-Järve
100
Narva
150
200
Ida-Virumaa
Tallinn
250
300
Estonia
HIV prevalence among adult population (15-49 years) in 2006
%
0,8
1
3,7
4,7
4,9
(Data sources:
Statistics Estonia,
National HIV Reference Laboratory)
0
1
Kohtla-Järve
2
Narva
3
Ida-Virumaa
4
Tallinn
5
Estonia
6
TB Incidence and TB+HIV cases by Year,
Estonia, 1989–2007
55
49
50
50
38
40
33
45
40
30
22
35
20
30
17
13
25
1
2
1
10
7
HIV cases among TB patients
Incidence + relapses
20
07
20
06
20
05
20
04
20
03
20
02
20
01
20
00
19
99
19
98
19
97
19
96
19
95
19
94
19
93
19
92
19
91
0
19
90
20
No of HIV cases among TB patients
60
19
89
TB cases per 100 000 population
60
Incidence
(Data source: National TB Registry)
Observations from Narva
• Extremely high prevalence (7% of young
adult population, 15-39) and incidence
• Strong link with injecting drug use
• Little understanding of the role of CSW
• Little information about the situation and
developments in Ivangorod
• Strong interest in developing collaboration
accross the border
Observations from Narva/2
• What is needed:
• Common meeting between the health authorities
(and other stakeholders?) in both cities. More
permanent structures in the future?
• Support to projects dealing with CSW vs HIV
• Support to projects implementing low-treshold
services on both sides of the border
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