The Euro HIV Index 2009 – a reality check of public policy and best practice in 29 countries.

At the end of 2007 it was estimated that around 800,000 people were living with HIV in Western and Central Europe. This represents 8.1 % increase over the estimated 740,000 in 2006. Although the number of people living with HIV and AIDS in Europe is relatively small when compared to the number of people living with HIV in areas such as Asia and sub-Saharan Africa, HIV/AIDS in Western and Central Europe is still considered a major public health issue. The highest rates were reported from Estonia, Portugal and Latvia; the lowest rates were reported by Slovakia, the Czech Republic and Romania. The number of people dying from AIDS in this region has significantly decreased since the introduction of combination antiretroviral treatment in the mid-1990s. Most Western and Central European countries benefit from wealthy economies, stable infrastructures and developed healthcare systems, making significant progress in scaling up towards universal access, including access to antiretroviral therapy and prevention of mother-child transmission. HIV is now often considered a chronic disease, instead of a death sentence. Heterosexual intercourse has become the predominant mode of transmission in persons diagnosed with HIV in recent years in most countries and accounted for over 50% of the cases reported in 2006. Most of the increase in HIV diagnoses among heterosexuals is among persons originating from infected high-prevalence countries outside Europe, primarily in sub-Saharan Africa. Data from several countries suggest that the majority of these persons have been infected in their country of origin, although transmission within the host EU country does occur. The number of reported HIV diagnoses among MSM has nearly doubled over the past 5 years. MSM (Men having sex with men) account for the largest number of new diagnoses in a number of countries including Germany, The Netherlands and Greece. The spread of HIV among Injecting drug users (“IDU”) has declined substantially in Western Europe, following a peak in incidence in the mid- to late 1980s which could be explained by the increasing availability of harm reduction measures, such as needle exchange programmes. However, the transmission of HIV among IDUs is still an important factor in some countries of the EU, including Italy, Portugal, Spain and Poland