The Management of HIV Care Services in Central and Eastern Europe: Data from the Euroguidelines in Central and Eastern Europe Network Group

PrEP Scale-Up and PEP in Central and Eastern Europe: Changes in Time and the Challenges We Face with No Expected HIV Vaccine in the near Future

With no expected vaccine for HIV in the near future, we aimed to define the current situation and challenges for pre- and post-exposure prophylaxis (PrEP and PEP) in Central and Eastern Europe (CEE). The Euroguidelines CEE Network Group members were invited to respond to a 27-item survey including questions on PrEP (response rate 91.6%). PrEP was licensed in 68.2%; 95 centers offered PrEP and the estimated number on PrEP was around 9000. It was available in daily (40.1%), on-demand (13.3%), or both forms (33.3%). The access rate was <1−80%. Three major barriers for access were lack of knowledge/awareness among people who are in need (59.1%), not being reimbursed (50.0%), and low perception of HIV risk (45.5%). Non-occupational PEP was available in 86.4% and was recommended in the guidelines in 54.5%. It was fully reimbursed in 36.4%, only for accidental exposures in 40.9%, and was not reimbursed in 22.72%. Occupational PEP was available in 95.5% and was reimbursed fully. Although PrEP scale-up in the region has gained momentum, a huge gap exists between those who are in need of and those who can access PrEP. Prompt action is required to address the urgent need for PrEP scale-up in the CEE region.

Integrated use of laboratory services for multiple infectious diseases in the WHO European Region during the COVID-19 pandemic and beyond

Technical advances in diagnostic techniques have permitted the possibility of multi-disease-based approaches for diagnosis and treatment monitoring of several infectious diseases, including tuberculosis (TB), human immunodeficiency virus (HIV), viral hepatitis and sexually transmitted infections (STI). However, in many countries, diagnosis and monitoring, as well as disease response programs, still operate as vertical systems, potentially causing delay in diagnosis and burden to patients and preventing the optimal use of available resources. With countries facing both human and financial resource constraints, during the COVID-19 pandemic even more than before, it is important that available resources are used as efficiently as possible, potential synergies are leveraged to maximise benefit for patients, continued provision of essential health services is ensured. For the infectious diseases, TB, HIV, hepatitis C (HCV) and STI, sharing devices and integrated services starting with rapid, quality-assured, and complete diagnostic services is beneficial for the continued development of adequate, efficient and effective treatment strategies. Here we explore the current and future potential (as well as some concerns), importance, implications and necessary implementation steps for the use of platforms for multi-disease testing for TB, HIV, HCV, STI and potentially other infectious diseases, including emerging pathogens, using the example of the COVID-19 pandemic.

HIV infections and AIDS in Poland in 2020

PURPOSE

The aim of the study was to assess the epidemiological situation of newly diagnosed HIV infections and AIDS cases and death among AIDS cases in Poland in 2020 in comparison to the changes in preceding years.

MATERIAL AND METHODS

Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases received from doctors and laboratories and the results of the annual survey of HIV testing conducted among the laboratories throughout the country. A dataset on clients from anonymous Voluntary Testing and Counselling (VCT) network was also used. The activities of the VCT are coordinated by the National AIDS Center, which anonymously collects epidemiological and behavior data on people who come for testing.

RESULTS

In 2020 there were 934 HIV cases newly diagnosed in Poland (diagnosis rate 2.44 per 100,000), including 100 among non-Polish citizens. The number of newly detected HIV infections decreased by 39.9% compared to the previous year and was lower by 26.9% compared to the median in 2014-2018 years. Similarly, among VCT clients, number of HIV diagnoses decreased by 42%, from 536 in 2019 to 308 in 2020 year, what was connected with 44% decreased in number of HIV tests. The total number of AIDS cases was 50 (incidence 0.13 per 100,000). The HIV infection was most often detected in the age group between 30 and 39 (35.7%) and among men (83.5%). Among cases with known transmission route, 68.5% concerned among men who had sexual contact with men (MSM). The percentage of AIDS cases diagnosed at the same time with HIV diagnosis decreased by almost 14 percent points in comparison to 2019 (from 75.8% to 62% of all incident AIDS cases).

CONCLUSION

In 2020, the number of newly detected HIV infections decreased compared to the previous year, however, this is not only due to a decrease in the number of infections, but rather to a lack of continuity in the diagnostic and reporting system during the COVID-19 pandemic, as indicated by a smaller number of tests and greater delays in data reporting. Due to the chronic course of HIV infection, a full assessment of the impact of the COVID-19 pandemic will be possible in the future.