HIV/AIDS surveillance in Europe - European Centre for Disease

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SURVEILLANCE REPORT
HIV/AIDS surveillance in Europe
2014
www.ecdc.europa.eu
www.euro.who.int
HIV/AIDS surveillance in Europe
2014
HIV/AIDS surveillance in Europe 2014
Suggested citation for full report:
European Centre for Disease Prevention and Control,
WHO Regional Office for Europe. HIV/AIDS surveillance
in Europe 2014. Stockholm: ECDC; 2015.
Tables and figures should be referenced:
European Centre for Disease Prevention and Control,
WHO Regional Office for Europe. HIV/AIDS surveillance
in Europe 2014.
This publication follows the ECDC terminological practice, which reflects the European Union
Interinstitutional Style Guide with regard to names and
designations of countries. The names and designations
of countries used in this publication should not be
understood as an endorsement by WHO of the terminology used in this publication.
ECDC amended the maps supplied by the WHO Regional
Office for Europe for this publication. The designations
employed and the presentation of this material do not
imply the expression of any opinion whatsoever on the
part of the Secretariat of the World Health Organization
concerning the legal status of any country, territory,
city or area or of its authorities, or concerning the
delimitation of its frontiers and boundaries.
The WHO Regional Office for Europe is responsible for
the accuracy of the translation of the Russian summary.
© World Health Organization, 2015.
Keywords
ACQUIRED IMMUNODEFICIENCY SYNDROME –
EPIDEMIOLOGY
AIDS AND ITS CONTROL
DISEASE OUTBREAKS – STATISTICS
HIV INFECTIONS – EPIDEMIOLOGY
POPULATION SURVEILLANCE
Errata:
The legend of Map 7 was corrected on 4 December 2015.
On 9 February 2016, the following changes were made:
On page 15, paragraph 2, the words ‘decrease may even
out’ replaced the words ‘increase is likely to be reinforced’;
on page 27, some repeated text was deleted; on page 101,
the column heading was corrected to ‘Coverage’.
Cover picture © Stockxpert
ISBN 978-92-9193-731-8
ISSN 2363-3085
doi 10.2900/29461
Catalogue number TQ-AL-15-001-EN-N
© European Centre for Disease Prevention and Control,
2015.
Reproduction is authorised, provided the source is
acknowledged.
ii
SURVEILLANCE REPORT
The report was coordinated by Anastasia Pharris (ECDC)
and Annemarie Stengaard (WHO Regional Office for
Europe). Report review and production support were
provided by Andrew J. Amato-Gauci, Julien Beauté, Mike
Catchpole, Denis Coulombier, Martin Donoghoe, Nedret
Emiroglu, Shahin Khasiyev, Valentina Lazdina, Marc
Rondy, Chantal Quinten and Phillip Zucs.
The European Centre for Disease Prevention and
Control (ECDC) and the WHO Regional Office for Europe
would like to thank the nominated national operational
contact points for HIV/AIDS surveillance from EU/EEA
Member States and the national HIV/AIDS surveillance
focal points from other countries of the WHO European
Region for providing data and valuable comments on
this report:
Albania: Marjeta Dervishi; Andorra: Jennifer Fernández
Garcia; Armenia: Trdat Grigoryan; Austria: Daniela
Schmid; Azerbaijan: Farhad Singatulov, Shahin
Khasiyev; Belarus: Svetlana Sergeenko, Elena Fisenko;
Belgium: Andre Sasse, Dominique Van Beckhoven;
Bosnia and Herzegovina: Zlatko Cardaklija, Stela
Stojisavljevic; Bulgaria: Tonka Varleva; Croatia:
Tatjana Nemeth Blazic; Cyprus: Linos Hadjihannas,
Maria Koliou; Czech Republic: Marek Maly; Denmark:
Susan Cowan; Estonia: Kristi Rüütel; Finland: Kirsi
Liitsola, Mika Salminen; the former Yugoslav Republic
of Macedonia: Zarko Karadzovski, Zvonko Milenkovic;
France: Françoise Cazein, Josiane Pillonel, Florence
Lot; Georgia: Otar Chokoshvili, Maia Tsereteli;
Germany: Barbara Gunsenheimer-Bartmeyer; Greece:
Georgios Nikolopoulos, Dimitra Paraskeva; Hungary:
Maria Dudas; Iceland: Haraldur Briem, Gudrun
Sigmundsdottir; Ireland: Derval Igoe, Kate O’Donnell,
Darina O’Flanagan; Israel: Daniel Chemtob; Italy:
Barbara Suligoi; Kazakhstan: Lolita Ganina, Gulnar
Temirkhanov; Kyrgyzstan: Aigul Solpueva; Latvia:
Šarlote Konova; Liechtenstein: Sabine Erne; Lithuania:
Irma Čaplinskienė; Luxembourg: Jean-Claude Schmit;
Malta: Jackie Maistre Melillo, Tanya Melillo; Moldova:
Stepan Gheorghita, Lucia Pirtina; Monaco: Dominique
De Furst; Montenegro: Boban Mugosa, Alma Cicic;
Netherlands: Eline Op de Coul; Norway: Hans Blystad;
Poland: Magdalena Rosinska; Portugal: Antonio Diniz;
Romania: Mariana Mardarescu; Russia: Natalia Ladnaia;
San Marino: Andrea Gualtieri, Mauro Fiorini; Serbia:
Danijela Simic; Slovakia: Peter Truska; Slovenia: Irena
Klavs; Spain: Mercedes Diez; Sweden: Maria Axelsson;
Switzerland: Martin Gebhardt; Tajikistan: Zukhra
Nurlaminova; Turkey: Ekin Cubukci; Ukraine: Ihor
Kuzin, Violetta Martsynovska; United Kingdom: Valerie
Delpech; Uzbekistan: Vokhid Nurmatov.
SURVEILLANCE REPORT
HIV/AIDS surveillance in Europe 2014
Contents
Abbreviations ............................................................................................................................................................................................................................................ vii
Overview of HIV and AIDS in Europe ........................................................................................................................................................................ viii
European Union and European Economic Area ................................................................................................................................................................. viii
WHO European Region .............................................................................................................................................................................................................................x
Conclusions .................................................................................................................................................................................................................................................. xii
Обзор эпидемиологической ситуации по ВИЧ/СПИДу в Европе ............................................................................... xiv
Европейский союз и Европейская экономическая зона ...................................................................................................................................... xv
Европейский регион ВОЗ ............................................................................................................................................................................................................. x vii
Выводы ..........................................................................................................................................................................................................................................................xix
1 HIV and AIDS in the European Union and European Economic Area ............................................................................ 1
1.1 HIV diagnoses ....................................................................................................................................................................................................................................... 1
1.2 Trends in HIV diagnoses ............................................................................................................................................................................................................... 2
1.3 AIDS cases, morbidity and mortality ................................................................................................................................................................................... 6
1.4 Conclusions ........................................................................................................................................................................................................................................... 8
2 HIV and AIDS in the WHO European Region ............................................................................................................................................... 11
2.1 HIV and AIDS diagnoses in the WHO European Region ........................................................................................................................................ 11
2.2 HIV and AIDS diagnoses in the East .................................................................................................................................................................................. 15
2.3 HIV and AIDS diagnoses in the Centre ............................................................................................................................................................................. 21
2.4 HIV and AIDS diagnoses in the West ................................................................................................................................................................................ 23
2.5 Number of HIV tests performed ............................................................................................................................................................................................24
2.6 Conclusions ......................................................................................................................................................................................................................................... 25
Tables
Table A: Characteristics of new HIV diagnoses reported in the WHO European Region, the EU/EEA, and West, Centre and East of the
WHO European Region, 2014 ............................................................................................................................................................................................................................viii
Table 1: New HIV diagnoses and rates per 100 000 population, by country and year of diagnosis (2005-2014) and cumulative totals, in
EU/EEA and other countries of the WHO European Region ..................................................................................................................................................................... 32
Table 1a: New HIV diagnoses and rates per 100 000 population, by country and year of statistics (2005-2014) and cumulative totals, in
EU/EEA and other countries of the WHO European Region ..................................................................................................................................................................... 34
Table 2: New HIV diagnoses in males and rates per 100 000 population, by country and year of diagnosis (2005-2014) and cumulative
totals, in EU/EEA and other countries of the WHO European Region .................................................................................................................................................. 36
Table 3: New HIV diagnoses in females and rates per 100 000 population, by country and year of diagnosis (2005-2014) and cumulative
totals, in EU/EEA and other countries of the WHO European Region ..................................................................................................................................................38
Table 4: New HIV diagnoses in men infected through sex with men, by country and year of diagnosis (2005-2014) and cumulative
totals, in EU/EEA and other countries of the WHO European Region .................................................................................................................................................. 40
Table 5: New HIV diagnoses in people infected through injecting drug use, by country and year of diagnosis
(2005-2014) and cumulative totals, in EU/EEA and other countries of the WHO European Region .......................................................................................... 41
Table 6: New HIV diagnoses in people infected through heterosexual contact, by country and year of diagnosis
(2005-2014) and cumulative totals, in EU/EEA and other countries of the WHO European Region ........................................................................................... 42
Table 7: New HIV diagnoses in people infected through mother-to-child transmission, by country and year of diagnosis (2005-2014) and
cumulative totals, in EU/EEA and other countries of the WHO European Region ............................................................................................................................ 43
Table 8: New HIV diagnoses, by sex, transmission mode and year of diagnosis (2005–2014) and cumulative totals .................................................... 44
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Table 8a: EU/EEA and non-EU/EEA countries .......................................................................................................................................................................................... 44
Table 8b: West, Centre and East of the WHO European Region ........................................................................................................................................................ 46
Table 9: New HIV diagnoses, by sex, age and year of diagnosis (2005–2014) and cumulative totals ..................................................................................
48
Table 9a: EU/EEA and non-EU/EEA countries .......................................................................................................................................................................................... 48
Table 9b: West, Centre and East of the WHO European Region ........................................................................................................................................................
50
Table 10: HIV diagnoses in people infected through heterosexual contact, by country and transmission subcategory, cases diagnosed
in 2014, in EU/EEA and other countries of the WHO European Region ............................................................................................................................................... 53
Table 11: HIV diagnoses, by country of report and region of origin, cases diagnosed in 2014, in EU/EEA and other countries of the WHO
European Region .................................................................................................................................................................................................................................................... 54
Table 12: HIV diagnoses, by geographical area, transmission mode and country or subcontinent of origin, cases reported in 2014 ...................... 56
Table 12a: EU/EEA and non-EU/EEA countries ......................................................................................................................................................................................... 56
Table 12b: West, Centre, East of the WHO European Region .............................................................................................................................................................. 56
Table 13: New HIV diagnoses, by country of report and probable region of infection, in 2014, in EU/EEA and other countries of the WHO
European Region .................................................................................................................................................................................................................................................... 58
Table 14: Percentage of new HIV diagnoses (2014) among persons >14 years reported with information about CD4 cell count, by CD4
cell count level (<200 and <350 cells per mm3 blood) and by transmission mode in cases with CD4 <350, in EU/EEA and other countries
of the WHO European Region ............................................................................................................................................................................................................................
61
Table 15: AIDS diagnoses and rates per 100 000 population, by country and year of diagnosis (2005-2014) and cumulative totals, in EU/
EEA and other countries of the WHO European Region............................................................................................................................................................................ 62
Table 16: AIDS diagnoses in males and rates per 100 000 population, by country and year of diagnosis (2005-2014) and cumulative
totals, in EU/EEA and other countries of the WHO European Region ................................................................................................................................................. 64
Table 17: AIDS diagnoses in females and rates per 100 000 population, by country and year of diagnosis (2005-2014) and cumulative
totals, in EU/EEA and other countries of the WHO European Region ................................................................................................................................................. 66
Table 18: AIDS diagnoses in men infected through sex with men, by country and year of diagnosis (2005-2014) and cumulative totals,
in EU/EEA and other countries of the WHO European Region ............................................................................................................................................................... 68
Table 19: AIDS diagnoses in people infected through injecting drug use, by country and year of diagnosis (2005-2014) and cumulative
totals, in EU/EEA and other countries of the WHO European Region ................................................................................................................................................. 69
Table 20: AIDS diagnoses in people infected through heterosexual contact, by country and year of diagnosis
(2005-2014) and cumulative totals, in EU/EEA and other countries of the WHO European Region ......................................................................................... 70
Table 21: AIDS diagnoses in people infected through mother-to-child transmission, by country and year of diagnosis (2005–2014) and
cumulative totals, in EU/EEA and other countries of the WHO European Region ........................................................................................................................... 71
Table 22: AIDS diagnoses, by sex, transmission mode and year of diagnosis (2005–2014) and cumulative totals ......................................................... 72
72
74
Table 23: AIDS diagnoses, by sex, age and year of diagnosis (2005–2014) and cumulative totals ....................................................................................... 76
Table 23a: EU/EEA and non-EU/EEA countries ........................................................................................................................................................................................ 76
Table 23b: West, Centre, East of the WHO European Region ............................................................................................................................................................ 78
Table 24: The most common AIDS-indicative diseases diagnosed in 2014, ordered by frequency ........................................................................................ 80
Table 24a: EU/EEA and non-EU/EEA countries ........................................................................................................................................................................................ 80
Table 24b: West, Centre, East of the WHO European Region .............................................................................................................................................................80
Table22a: EU/EEA and non-EU/EEA countries .........................................................................................................................................................................................
Table 22b: West, Centre, East of the WHO European Region .............................................................................................................................................................
Table 25: Deaths among people diagnosed with HIV and/or AIDS, by country and year of death (2005–2014) and cumulative totals in
EU/EEA and other countries of the WHO European Region ..................................................................................................................................................................... 81
Table 26: Deaths among AIDS cases, by transmission mode and year of death (2005–2014) and cumulative totals ...................................................... 82
Table 26a: EU/EEA and non-EU/EEA countries ........................................................................................................................................................................................ 82
Table 26b: West, Centre, East of the WHO European Region ............................................................................................................................................................. 84
Table 27: Number of HIV tests performed, excluding unlinked anonymous testing and testing of blood donations, by country and year
(2005–2014) and number of tests per 1 000 population in 2014, in EU/EEA and other countries of the WHO European Region ................................. 86
Figures
Figure A: Rate of new HIV diagnoses per 100 000 population, by year of diagnosis and adjusted for reporting delay, in the EU/EEA and
the WHO European Region, 1984-2014 ........................................................................................................................................................................................................... ix
Figure B: Cumulative number of new HIV diagnoses in the EU/EEA and other countries of the WHO European Region, 1984-2014 .............................. x
Figure C: New HIV diagnoses among non-migrants, European migrants, other migrants, adjusted for reporting delay, WHO European
Region, 2005-2014 ..................................................................................................................................................................................................................................................xi
Figure 1.1: Male-to-female ratio in new HIV diagnoses, by country, EU/EEA, 2014 ......................................................................................................................... 2
Figure 1.2: Age- and gender-specific rates of new HIV diagnoses per 100 000 population, EU/EEA, 2014 ............................................................................ 3
Figure 1.3: Number of new HIV diagnoses by age group and transmission mode, EU/EEA, 2014 ............................................................................................... 3
Figure 1.4: Percentage of new HIV diagnoses in people between 15 and 24 years old, by country, EU/EEA, 2014 ............................................................. 4
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HIV/AIDS surveillance in Europe 2014
Figure 1.5: Percentage of new HIV diagnoses with known mode of transmission, by transmission route and country,
EU/EEA, 2014 ............................................................................................................................................................................................................................................................. 4
Figure 1.6: Percentage of new HIV diagnoses among migrants out of all reported cases with known information on region of origin, by
country of report, EU/EEA, 2014 ......................................................................................................................................................................................................................... 5
Figure 1.7: New HIV diagnoses, by CD4 cell count per mm3 at diagnosis and transmission mode, EU/EEA, 2014 ................................................................ 5
Figure 1.8: New HIV diagnoses, by CD4 cell count per mm3 at diagnosis and region of origin of the case diagnosed,
EU/EEA, 2014 ............................................................................................................................................................................................................................................................. 6
Figure 1.9: New HIV diagnoses, by transmission mode and year of diagnosis, adjusted for reporting delay, EU/EEA, 2005-2014 ............................... 7
Figure 1.10: New HIV diagnoses, by transmission and migration status, EU/EEA, 2005-2014 .................................................................................................... 7
Figure 1.11: Median CD4 cell count per mm3 at HIV diagnosis, by transmission group, EU/EEA, 2005-2014 ........................................................................ 8
Figure 1.12: AIDS diagnoses, by transmission mode, EU/EEA, 2005-2014 (logarithmic scale) ................................................................................................... 8
Figure 1.13: Percentage of AIDS diagnoses made in 2014 which occurred within 90 days of HIV diagnosis, EU/EEA, 2014 ............................................ 9
Figure 2.1: New HIV diagnoses, by CD4 cell count per mm3 at diagnosis and transmission mode, WHO European Region, 2014 ................................12
Figure 2.2a: Rates of new HIV diagnoses, by year of diagnosis, WHO European Region, 2005-2014 (including Russia) .................................................12
Figure 2.2b: Rates of new HIV diagnoses, by year of diagnosis, WHO European Region, 2005-2014 (excluding Russia) ................................................ 12
Figure 2.3: New HIV diagnoses, by transmission mode and year of diagnosis, WHO European Region, 2005-2014 ..........................................................1 4
Figure 2.4: Rates of new AIDS diagnoses, by geographical area and year of diagnosis, WHO European Region, 2005-2014 ........................................1 4
Figure 2.5: Male-to-female ratio in all new HIV diagnoses and new diagnoses with heterosexual transmission, by country, East, 2014 ................15
Figure 2.6: New HIV diagnoses, by age group and transmission mode, East, 2014 ......................................................................................................................16
Figure 2.7: New HIV diagnoses by country and transmission mode, East, 2014 ............................................................................................................................. 17
Figure 2.8: New HIV diagnoses, by CD4 cell count per mm3 at diagnosis and transmission mode, East, 2014 ...................................................................18
Figure 2.9: New HIV diagnoses, by transmission mode and year of diagnosis, East, 2005-2014 .............................................................................................19
Figure 2.10: New AIDS diagnoses, by transmission mode and year of diagnosis, East, 2005-2014 ...................................................................................... 20
Figure 2.11: Distribution of the three most common AIDS-defining illnesses per transmission mode, East, 2014 ..........................................................20
Figure 2.12: Male-to-female ratio in new HIV diagnoses, by country, Centre, 2014 .....................................................................................................................21
Figure 2.13: New HIV diagnoses by country and transmission mode, Centre, 2014 .................................................................................................................... 23
Figure 2.14: New HIV diagnoses, by CD4 cell count per mm3 category at diagnosis and transmission mode, Centre, 2014 ........................................24
Figure 2.15: New HIV diagnoses, by transmission mode and year of diagnosis, Centre, 2005-2014 ..................................................................................... 25
Figure 2.16: New AIDS diagnoses, by transmission mode and year of diagnosis, Centre, 2005-2014 .................................................................................. 25
Figure 2.17: Distribution of the three most common AIDS-defining illnesses per transmission mode, Centre, 2014 ..................................................... 26
Figure 2.18: New HIV diagnoses, by transmission mode and year of diagnosis, West, 2005-2014 ........................................................................................26
Figure 2.19: New AIDS diagnoses, by transmission mode and year of diagnosis, West, 2005-2014 ..................................................................................... 26
Figure 2.20: Distribution of the three most common AIDS-defining illnesses per transmission mode, West, 2014 ....................................................... 27
Maps .................................................................................................................................................................................................................................................................... 87
Map 1: New HIV diagnoses per 100 000 population, 2014 .....................................................................................................................................................................88
Map 2: New HIV diagnoses in men per 100 000 male population, 2014 ...........................................................................................................................................88
Map 3: New HIV diagnoses in women per 100 000 female population, 2014 ..................................................................................................................................89
Map 4: New HIV diagnoses in men who have sex with men per 100 000 male population, 2014 ............................................................................................89
Map 5: New HIV diagnoses acquired through injecting drug use per 100 000 population, 2014 ............................................................................................ 90
Map 6: New HIV diagnoses acquired through heterosexual transmission per 100 000 population, 2014 ........................................................................... 90
Map 7: Percentage of adult (>14 years) HIV diagnoses with CD4 <350 cells/mm3 at diagnosis, 2014 ..................................................................................... 91
Map 8: AIDS diagnoses reported per 100 000 population, 2014 ......................................................................................................................................................... 91
Annexes .......................................................................................................................................................................................................................................................... 93
Annex 1: Framework for data collection, validation and presentation ............................................................................................................................................... 95
Annex 2: List of variables* for 2014 HIV/AIDS data collection .............................................................................................................................................................. 99
Annex 3: Completeness of variables for data reported in 2013 and 2014 ...................................................................................................................................... 100
Annex 4a: HIV surveillance system overview: data source information .......................................................................................................................................... 101
Annex 4b: AIDS surveillance system overview: data source information ....................................................................................................................................... 102
Annex 5: Country-specific comments regarding national HIV and AIDS reporting ...................................................................................................................... 103
Annex 6: HIV diagnoses and rate per 100 000 population, adjusted for reporting delay and adjustment coefficients, EU/EEA countries,
2011–2014 ............................................................................................................................................................................................................................................................. 104
Annex 7: HIV/AIDS surveillance in Europe: participating countries and national institutions ............................................................................................... 105
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HIV/AIDS surveillance in Europe 2014
Abbreviations
AIDS
Acquired immunodeficiency syndrome
ART
Antiretroviral therapy
ECDC
European Centre for Disease Prevention and Control
EEA
European Economic Area
EU
European Union
HIV
Human immunodeficiency virus
ICJ
International Court of Justice
MSM
Men who have sex with men
TESSy
The European Surveillance System
UN
United Nations
UNSCR United Nations Security Council Resolution
WHO
World Health Organization
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HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Overview of HIV and AIDS in Europe
Although HIV is preventable through effective public
health measures, significant HIV transmission continues
in Europe. In 2014, 142 197 people were newly diagnosed
with HIV in 50 of the 53 countries of the WHO European
Regioni. Of those, 56 945 were officially reported to
the joint ECDC/WHO Regional Office for Europe surveillance system by 49 countries, including 29 992 from
the European Union and European Economic Area (EU/
EEA), while information about 85 252 new diagnoses in
2014 was published by the Russian Federal Scientific
and Methodological Centre for Prevention and Control of
AIDS [1]. In the 50 countries, the rate of newly diagnosed
infections was 16.4 per 100 000 population (Table A).
The cited data source from Russia allowed inclusion of
Russian data within regional HIV annual and cumulative
totals and rates, quotation of country-specific annual
and cumulative HIV totals and rates and data by transmission mode, and inclusion of cumulative total AIDS
diagnoses into regional totals. All other regional HIV figures and all 2014 AIDS data presented in this report are
based on data from the 49 countries reporting to ECDC/
WHO.
Among the 49 officially reporting countriesii the rate was
7.9 per 100 000 population and 5.9 per 100 000 for the
EU/EEA (Figure A). As in recent years, rates and overall
numbers of people diagnosed with HIV were highest in
the East of the Region and lowest in the Centreiii (Table A).
The main transmission mode varied by geographical
area, illustrating the diversity in the epidemiology of
HIV in Europe; sexual transmission between men was
the most common mode in the EU/EEA and heterosexual
transmission was the main transmission mode in the
East of the Region.
31% of new HIV diagnoses in the WHO European Region
were among people originating from outside of the
reporting country, including 22% originating from outside the WHO European Region and 9% originating from
a European country other than the country of report.
Between 2005 and 2014, new HIV diagnoses among
non-natives decreased by 28% overall. Examining this
trend by region of origin reveals that new diagnoses in
migrants originating from outside the WHO European
Region decreased by 41% but increased by 48% among
European migrants (i.e. people originating from a
European country other than the country of report)
(Figure C, Table 11).
In 2014, 16 037 people were diagnosed with AIDS in 47
countriesiv of the WHO European Region and the rate of
new diagnoses for the WHO European Region was 2.3 per
100 000 population and 0.8 per 100 000 for the EU/EEA.
Although the number of AIDS cases continued its steady
decline in the West and the EU/EEA, it has more than
doubled in the East during the last decade.
European Union and European
Economic Area
i No data available from Bosnia and Herzegovina, Turkmenistan or
Uzbekistan. One case from Liechtenstein is included in the total
number of newly diagnosed HIV infections presented in this report
but, since Liechtenstein is not a Member State of the WHO European
Region, data for Liechtenstein are not included in the totals for the
West, Centre and East of the WHO European Region.
In 2014, 29 992 people were diagnosed with HIV in the
31 countries of the EU/EEA, with a rate of 5.9 per 100 000
population (6.4 per 100 000 when adjusted for reporting delay) (Table 1). Countries with the highest rates
ii No data from Bosnia and Herzegovina, Russia, Turkmenistan or
Uzbekistan.
iii The grouping of countries into the West (23 countries), Centre (15
countries) and East (15 countries) of the WHO European Region is
based on epidemiological considerations and follows the division of
countries used in previous reports published by EuroHIV since 1984:
See Annex 1, Figure A1 for details.
iv No data available from Bosnia and Herzegovina, Russia, San Marino,
Sweden, Turkmenistan or Uzbekistan.
Table A: Characteristics of new HIV diagnoses reported in the WHO European Region, the EU/EEA, and West, Centre
and East of the WHO European Region, 2014
Reporting countries/Number of countries
Number of new HIV diagnoses
Rate per 100 000 population
Percentage age 15-24 years
Male-to-female ratio
Transmission mode
Men who have sex with men
Heterosexual
Injecting drug use
Mother to child transmission
Unknown
WHO European Region
49/53 (50/53)
56 972 (142 197)
7.9 (16.4)
10.2%
2.2
West
23/23
27 325
6.4
10.6%
3.3
Centre
14/15
4950
2.6
14.9%
4.4
East
12/15 (13/15)
24 669 (109 930)
22 (43.2)
8.7%
1.4
EU/EEA
31/31
29 992
5.9
11.1%
3.3
24.4%
46.8%
14.0%
1.0%
13.5%
43.9%
33.7%
3.1%
0.8%
18.1%
28.0%
24.3%
5.4%
1.0%
40.9%
2.2%
66.0%
27.8%
1.2%
2.9%
42.3%
32.8%
4.1%
0.8%
19.7%
No data received from Bosnia and Herzegovina, Russia, Turkmenistan, Uzbekistan. All data presented were reported to ECDC/WHO through the European Surveillance
System (TESSy), except for data for Russia which were obtained through the Russian Federal Scientific and Methodological Center for Prevention and Control of AIDS
[1] . Russian data are included in the numbers in parentheses for the European Region and the East.
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of 6.7 per 100 000 in 2005 (29 129 cases) compared with
6.4 per 100 000 (32 605 cases) in 2014 when adjusted
for reporting delay (Table 1, Annex 6). Trends by transmission mode show that the number of HIV diagnoses
among MSM in countries with consistent reporting has
continued to increase in the EU/EEA as a whole (Table
8; Figure 1.9), with sustained increases over the last
decade reported in all but six EU/EEA countries (Table
4). Cases attributed to MSM increased over this period
both among men born in the country of report and those
born outside it (Figure 1.10). The numbers of HIV diagnoses due to heterosexual transmission decreased by
40% during the last decade, with sharper decreases
seen among people born outside of the country of
report, particularly those coming from countries with
generalised HIV epidemics (Table 8, Figure 1.10). The
number of people who acquired HIV through injecting
drug use has decreased by 44% over the same period
(Table 8). An overall increase among cases attributed to
injecting drug use was observed in 2011 and 2012 due
to localised outbreaks in Greece and Romania (Table 5),
but reported cases in 2013 and 2014 in these countries
show a downward trend. Mother-to-child transmission
and transmission through nosocomial infection or blood
transfusion have decreased steadily between 2005 and
2014 and remain at less than 1% of cases diagnosed
(Table 8).
of new HIV diagnoses reported in 2014 were Estonia
(22.1; 291 cases), Latvia (17.3; 347 cases) and Luxembourg
(12.6; 69 cases). The lowest rates were reported by
Slovakia (1.6; 86 cases), Croatia (2.2; 92 cases) and the
Czech Republic (2.2; 232 cases).
The rate of new HIV diagnoses was higher among men
(9.2 per 100 000 population; Table 2), than women (2.6
per 100 000 population; Table 3). The overall male-tofemale ratio was 3.3 (Table A). This ratio was highest in
Slovenia (15.0), Hungary (10.6), Croatia (9.2), the Czech
Republic (9.1) and Malta (9.0) (Figure 1.1). The predominant mode of transmission in these countries was sex
between men (Figure 1.5).
The highest crude age-specific rate of HIV diagnoses
was observed among 25-to-29-year-olds (14.6 per 100
000 population) with the rates for men and women
peaking in this age group at 22.7 and 6.2 per 100 000,
respectively (Figure 1.2).
Similar to recent years, the highest proportion of HIV
diagnoses was reported to be in men who have sex with
men (MSM) (42%), with heterosexual contact the second
most common transmission mode (33%).Transmission
due to injecting drug use accounted for 4% of HIV diagnoses, and for nearly 20% of new HIV diagnoses the
transmission mode was not reported or was reported
to be unknown (Table A). Of the total number of people
diagnosed, more than one third (37%) originated from
outside of the reporting country (Figure 1.6), although
this varied widely from 82% in Iceland and 78% in
Sweden to less than 5% of cases in Croatia, Estonia,
Hungary, Latvia, Poland, Romania and Slovakia.
In 2014, information on CD4 cell count at the time of
HIV diagnosis was provided by 22 countries (Table 14)
for 18 411 (61%) people (>14 years old) diagnosed with
HIV (Table 14). Nearly half (47%) of all people diagnosed
who had CD4 cell count information available had a
reported CD4 cell count of less than 350 cells per mm3
at diagnosis, including 27% of cases with advanced
HIV infection (CD4 <200 cells/mm3). Among all those
diagnosed for whom CD4 cell count information was
available, 20% had a CD4 cell count of between 350 and
Despite continuing prevention efforts and resources
allocated by countries in the EU/EEA, there has been
only a minimal decline in the number of HIV diagnoses
per 100 000 population over the last decade, with a rate
Figure A: Rate of new HIV diagnoses per 100 000 population, by year of diagnosis and adjusted for reporting delay, in
the EU/EEA and the WHO European Region*, 1984-2014
9
WHO European Region
Cases per 100 000 population
8
EU/EEA
7
6
5
4
3
2
1
0
1984
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
Year of diagnosis
Countries
reporting
*
15 25 27 36 36 39 42 42 42 42 44 43 45 48 48 47 47 49 46 50 52 52 52
51 52 52 53 51
51 49 49
Rates may increase in the coming years due to reporting delays
Data from Russia are not included
ix
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
500 cells per mm3 and 33% had a CD4 cell count of 500
or more per mm3 (Figure 1.7). When analysing CD4 cell
count by transmission mode, the highest proportion of
people presenting at a later stage of HIV infection (CD4
<350 cells/mm3) was observed among people who inject
drugs (61%) (Figure 1.8). The lowest proportion with a
CD4 count lower than 350 cells per mm3 was observed
among people who acquired HIV through sex between
men (37%). The proportion of cases diagnosed at or
below 350 CD4 cells per mm3 increased with age, and
61% of persons aged 50 or older were diagnosed with
HIV at or below 350 cells per mm3. Higher proportions of
persons from sub-Saharan Africa (57%) and south and
south-east Asia (57%) had CD4 counts of less than 350
cells per mm3 at diagnosis than non-migrants (46%) and
other migrant groups (Figure 1.8).
In 2014, 4 020 people were diagnosed with AIDS in
31 EU/EEA countries, which is a rate of 0.8 cases per
100 000 population (Table 15). The highest rates were
reported by Latvia (8.5) and Portugal (2.4). In the EU/
EEA, the number of AIDS cases has consistently declined
since the mid-1990s. Among the 20 EU/EEA countries
where it was possible to fully link HIV and AIDS cases,
69% of AIDS diagnoses occurred at the same time as, or
within 90 days of, the HIV diagnosis. This ranged from
100% of AIDS cases reported (Cyprus, Denmark, Norway
and Slovenia) to around 47% of new AIDS diagnoses in
Austria and Belgium and 26% in Latvia (Figure 1.13).
WHO European Region
With 142 197 people newly diagnosed with HIV in the
WHO European Region in 2014 – the highest annual
number since reporting started in the 1980s – the cumulative number of diagnosed infections in the European
Region increased to 1 840 136. This number includes 995
175 diagnoses officially reported to the joint ECDC and
the WHO Regional Office for Europe surveillance system
(Figure B) and 907 607 infections diagnosed in Russiai
i Minus the 62 581 cases officially reported to ECDC/WHO by Russia in
2010.
[1]. Of the 142 197 people newly diagnosed with HIV in
2014 in the 50 countriesii, 77% were diagnosed in the
East (109 921), 19% in the West (27 325) and 3% in the
Centre of the Region (4 950) (Table A). The rate was also
highest in the East (43.2 per 100 000 population), considerably higher than in the West (6.4 per 100 000) and
the Centre (2.6 per 100 000) (Table A).
Across the 49 countries reporting to ECDC/WHOiii, 43% of
people newly diagnosed (24 669) were reported in the
East with a rate of 22.0 per 100 000, 48% in the West
and 9% in the Centre. For men, the Regional rate was 11.1
per 100 000 population (Table 2) and for women, 4.7 per
100 000 population (Table 3).
Rates of newly diagnosed HIV infections for 2014 varied
widely between countries in the WHO European Region.
In Russia the rate was 58.4 per 100 000 population,
the highest in the Region [1]. Among countries reporting to ECDC/WHO, rates were highest in Ukraine (36.9) iv,
Estonia (22.1), Moldova (20.4), Belarus (19.1), Latvia
(17.3), Kazakhstan (13.5), Georgia (13.3), Luxembourg
(12.6), Tajikistan (11.9) and Kyrgyzstan (11.0) and lowest in the former Yugoslav Republic of Macedonia (1.4),
Serbia (1.4), Slovakia (1.6), Croatia (2.2), the Czech
Republic (2.2), Turkey v (2.3) and Slovenia (2.4) (Table 1).
In the reporting countries the majority of people newly
diagnosed (36%) were in the age group 30–39 years,
while 10% were young people aged 15–24 years. The
male-to-female ratio was 2.2, lowest in the East (1.4.),
higher in the West (3.3) and highest in the Centre (4.4)
(Table A). People had been infected most commonly
through heterosexual contact (47%), including 13% who
originated from countries with generalised epidemics,
ii No data available from Bosnia and Herzegovina, Turkmenistan or
Uzbekistan.
iii No data from Bosnia and Herzegovina, Russia, Turkmenistan or
Uzbekistan.
iv Excluding data from Crimea and Sevastopol City.
v HIV data for Turkey do not include people diagnosed with AIDS at the
time of HIV diagnosis and are therefore not directly comparable with
data for other countries.
Figure B: Cumulative number of new HIV diagnoses in the EU/EEA and other countries of the WHO European Region*,
1984-2014
1000000
EU/EEA
Other countries of the WHO European Region
Number of cases
800000
600000
400000
200000
0
1985
1990
1995
2000
Year of diagnosis
*
x
Data from Russia not included
2005
2010
2014
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure C: New HIV diagnoses among non-migrants, European migrants, other migrants, adjusted for reporting delay,
WHO European Region, 2005-2014
20000
Non-migrants (people originating from
the reporting country)
Other migrants (people originating from
outside the WHO European Region)
Number of cases
15000
European migrants (people originating from
a European country other than the reporting
country)
10000
5000
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Data from Bulgaria, Estonia, Italy, Russia, Spain, Ukraine, Uzbekistan and Turkmenistan excluded due to inconsistent reporting on incomplete reporting on country of
birth and region of origin during the period
while 24% were infected through sex between men,
14% through injecting drug use and 1% through motherto-child transmission. Information about transmission
mode was missing for 13% of new diagnoses.
In the East, heterosexual contact and injecting drug use
were the main modes of HIV transmission (66% and 28%
of new diagnoses, respectively) while reported transmission through sex between men remained very low
(2% of cases). In Russia, of people newly diagnosed
with a known mode of HIV transmissioni (which amounts
to about half of cases [2]), 57% were infected through
injecting drug use, 40% through heterosexual transmission, 1% through sex between men and 0.1% through
mother-to-child transmission [1]). The large number of
new diagnoses in Russia of people infected through
injecting drug use increases the significance of that
mode of transmission in the East of the Region. In the
Centre, sex between men (28%) and heterosexual contact (24%) were the main transmission modes, with sex
between men predominating in 10 of the 14 countries,
while information about transmission mode was lacking for 41% of new diagnoses. In the West, sex between
men remained the main transmission mode (44% of new
diagnoses), followed by heterosexual transmission (34%
of new diagnoses).
Overall, between 2005 and 2014, the rate of newly diagnosed HIV infections increased by 59% from 10.3 per 100
000 population (80 652 cases) to 16.4 per 100 000 population (142 197 cases) for 50 countries (Russia included
[1]). The increase is mainly driven by an upward trend
in the East where the rate continued to rise with a 115%
increase from 20.1 per 100 000 in 2005 (51 058 cases)
to 43.2 per 100 000 in 2014 (109 921 cases). In the 49
countriesii that provided data to ECDC and WHO, the rate
for the Region increased by 11%, from 7.1 in 2005 (45 251
cases) to 7.9 in 2014 (56 945 cases); and in the East the
rate increased by 59%, from 14.1 in 2005 (15 657 cases)
to 22.3 in 2014 (24 669 cases). In the Centre, the rate
increased by 117%, the largest relative increase of the
three geographical areas, from 1.2 (2 165 cases) to 2.6
(4 950 cases) whereas in the West the rate decreased by
20%, from 8.0 (27 429 cases) in 2005 to 6.4 (27 325) in
2014.
Trends by transmission mode in 44 countries with consistent dataiii showed increases in the number of people
infected through heterosexual contact (28% increase)
and sex between men (28% increase), whereas infections due to injecting drug use decreased by 22%. In
the East, sexual transmission increased (by 171% for
heterosexual transmission and 10-fold for transmission through sex between men), while transmission
through injecting drug decreased by 17% in comparison with 2005. At the same time, the number of women
newly diagnosed increased by 74%, and the number of
men newly diagnosed increased by 49%. In the Centre,
people infected through sex between men more than tripled, heterosexual transmission increased by 26% and
transmission through injecting drug use increased sixfold due to an outbreak in Romania that started in 2011,
peaked in 2012 and has since slowed. In the West, transmission through sex between men increased by 15%
whereas heterosexual transmission decreased by 44%,
with an even steeper decline among people originating
from generalised epidemic countries, and transmission
through injecting drug use decreased by 60%.
ii No data from Bosnia and Herzegovina, Russia, Turkmenistan or
Uzbekistan.
i This analysis approach is different from the rest of the report where
cases with unknown transmission mode are shown separately
and included in the denominator for percentage calculations. The
percentages for Russia are therefore not directly comparable with
those of other countries or groups of countries in this report.
iii Data from Estonia, Poland and Turkey were excluded because more
than 50% of their data on transmission mode was missing; data
from Spain and Italy were excluded because coverage of the national
surveillance system increased over this time period; and data from
Bosnia and Herzegovina, Russia, Turkmenistan and Uzbekistan were
not reported.
xi
HIV/AIDS surveillance in Europe 2014
Close to half (48%) of people (>14 years old) newly diagnosed for whom information about CD4 cell count at
the time of HIV diagnoses was available, were late presenters with CD4 cell counts below 350 cells per mm3,
including 28% with advanced HIV infection (CD4 <200
cells/mm3). 20% had a CD4 cell count of between 350
and 500 cells per mm3 and 32% had a CD4 cell count of
500 or more cells per mm3. The percentage of late presenters varied across transmission categories and was
highest for people infected through injecting drug use
(64%), lower for people infected through heterosexual
contact (56%) and lowest for men infected through sex
with men (37%). The percentage of people diagnosed at
or below 350 CD4 cells per mm3 increased with age, and
61% of persons aged 50 or older were diagnosed with
HIV with CD4 cell counts at or below 350 cells per mm3.
In 2014, 16 037 people were newly diagnosed with AIDS
in 47 countries of the WHO European Regioni with a rate
of 2.3 per 100 000 population. 74% of people (11 890)
were diagnosed in the East, 20% (3 214) in the West and
6% (932) in the Centre of the Region. The rate was also
highest in the East (10.7 per 100 000 population), thirteen times higher than in the West (0.8 per 100 000) and
21 times higher than in the Centre (0.5 per 100 000).
Between 2005 and 2014, the rate of new AIDS diagnoses
decreased by 4% in the Region from 2.3 (14 294 cases) to
2.2 (16 037 cases). There was, however, great variation
between the three geographical areas: a 143% increase
in the East from 4.4 per 100 000 in 2005 (4 926 cases)
to 10.7 (11 890 cases), a 25% rate increase in the Centre
from 0.4 (751 cases) to 0.5 (932 cases) and a steady 69%
decline in the West from 2.6 per 100 000 (8 617 cases) to
0.8 (3 214 cases).
Conclusions
HIV transmission remains of major concern in Europe,
in particular in the eastern part of the WHO European
Region. In 2014, more than 142 000 people were diagnosed with HIV, the highest number of newly diagnosed
infections ever reported in one year. Of these, 77% were
diagnosed in the East of the Region and 21% in the EU/
EEA. The most recent surveillance data indicate that,
despite significant efforts dedicated to the prevention
and control of HIV, the number of new HIV diagnoses
has not declined substantially in the western part of the
Region and the EU/EEA and has more than doubled over
the last decade in the East. In the Centre, while remaining lower than in the East and West, the number of new
diagnoses has also more than doubled over the last
decade.
While epidemic patterns and trends vary widely
across European countries, there have been sustained
increases in the number of infections among men who
have sex with men in the western and central parts of
the Region and among people infected heterosexually, notably women, in the eastern part of the Region.
i No data available from Bosnia and Herzegovina, Russia, San Marino,
Sweden, Turkmenistan or Uzbekistan.
xii
SURVEILLANCE REPORT
Transmission through injecting drug use has continued
to decrease but still accounted for more than a quarter of reported new diagnoses in the East. At the same
time, new diagnoses among persons born outside the
reporting country, particularly people originating from
countries outside the European Region, are decreasing.
In 2015, new WHO HIV treatment guidelines were issued
recommending that antiretroviral therapy (ART) should
be initiated in all people living with HIV, irrespective of
CD4 count [3]. There is now evidence that early treatment is beneficial both to the health of the treated
individual and in preventing onward HIV transmission [4,
5]. However, too many people throughout the European
Region are diagnosed late (48%), with implications for
greater risks for ill health, death and onward HIV transmission. The high and alarming increases in the number
of AIDS cases in the East also suggest that late HIV
diagnosis, delayed initiation of ART and low treatment
coverage remain major challenges.
To decrease the number of people who are diagnosed
late, new strategies are required for the delivery of
expanded targeted HIV testing services. New WHO
consolidated guidance for HIV testing services [6] provides new recommendations that support HIV testing
by trained lay providers (community-based HIV testing)
in addition to provider-initiated testing; considers the
potential of HIV self-testing to increase access to, and
coverage of, HIV testing; and outlines focused and strategic approaches to HIV testing services that are needed
to support the first of the three 90-90-90 targets (90%
of people living with HIV know their HIV status) [7]. These
services should focus on reaching the most affected
population groups in the local epidemic context, be
tailored to the specific needs of these groups and support timely linkage to HIV prevention, treatment and
care. This will ensure earlier diagnoses and treatment
initiation and result in improved treatment outcomes,
reduced morbidity, mortality and HIV incidence in support of the second and third 90-90-90 targets (90% of
diagnosed people living with HIV receive treatment and
90% of people on treatment achieve viral suppression).
Interventions to control the epidemic should be based
on evidence and adapted to the national and local epidemiology. From the comprehensive epidemiological data
presented in this report, the following can be concluded:
• For the countries in the EU/EEA and West, considering
the persistent increase in cases diagnosed in MSM
over the last decade, it would appear that current prevention and control interventions need to be scaled
up and strengthened and should remain the priority
cornerstone of the HIV response. Multi-component
interventions, including the consideration of new
strategies such as the inclusion of pre-exposure
prophylaxis for HIV into the package of prevention
interventions, could help to curb this increased trend
[8, 9, 10]. The observed increases in HIV cases among
people who inject drugs in a number of countries [2, 3]
in recent years demonstrates the need to maintain or
scale up harm reduction programmes.
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
• For the countries in the Centre, the epidemic remains
at a low level but with a higher relative increase than
in any other part of Europe. With the increase being
driven by sexual transmission, mainly among MSM
but also through heterosexual contact and with 4 in
5 new diagnoses being among men, the priority is to
strengthen and target a mix of interventions to prevent, test and treat HIV in this relatively broad group.
Efforts to reduce stigma and discrimination will be key
to achieving this.
• For the countries in the East, there is an urgent need
to scale up bold evidence-based actions and deliver
more effective, integrated services through health
systems that better address the social determinants
of health. Comprehensive coverage with effective
prevention for people at risk of heterosexual transmission and people who inject drugs, effective targeted
HIV testing, and access to counselling and integrated
care should be provided to all in need. In couples
where one partner is engaged in a high-risk behaviour
(injecting drug use, purchased sex, bisexual relations
or is working abroad for long periods of time) bolder
prevention interventions should address the risk of
heterosexual transmission, including through the
use of pre-exposure prophylaxis where relevant and
according to WHO recommendations [3, 11]. Evidencebased policies targeting key populations, particularly
people who inject drugs, and including harm reduction programmes, need to remain central in the HIV
response. Access to antiretroviral therapy needs to be
scaled up to treat and prevent HIV transmission and
reduce the growing number of AIDS cases.
• Although HIV diagnoses among migrants have
decreased considerably since 2005, 31% of diagnoses are among persons born abroad, including 22%
originating from outside the WHO European Region.
New diagnoses among all migrants decreased by 28%
overall and by 41% in people originating from countries outside Europe since 2005. There is evidence
that a significant proportion of migrants acquire HIV
after migrating to the European Region [12, 13, 14]. It
therefore remains crucial that countries ensure that
HIV prevention, treatment and care are accessible to
migrants.
References
1
Federal Scientific and Methodological Center for Prevention and 1
Russian Federal Scientific and Methodological Center for Prevention
and Control of AIDS. Information note ”Spravka” on HIV infection in
the Russian Federation as of 31 December 2014. Moscow: Russian
Federal Scientific and Methodological Center for Prevention and
Control of AIDS; 2015. Available at: http://hivrussia.org/files/
spravkaHIV2014.pdf.
2
Hedrich D, Kalamara E, Sfetcu O, Pharris A, Noor A, Wiessing L, et
al. Human immunodeficiency virus among people who inject drugs:
Is risk increasing in Europe? Euro Surveill. 2013;18(48):pii=20648.
Available online: http://www.eurosurveillance.org/ViewArticle.
aspx?ArticleId=20648
3 World Health Organization. Guidelines on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva:
World Health Organization; 2015. http://apps.who.int/iris/bitstr
eam/10665/186275/1/9789241509565_eng.pdf
4 INSIGHT START Study Group. Initiation of antiretrovial therapy in
early asymptomatic HIV infection. N Engl J Med. 2015;373(9):795-807.
5 Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC,
Kumarasamy N, et al. Prevention of HIV-1 infection with early
antiretroviral therapy. N Engl J Med. 2011;365(6):493-505.
6
World Health Organization. Consolidated guidelines on HIV testing
services. Geneva: World Health Organization; 2015.
7 UNAIDS. Ambitious treatment targets: Writing the final
chapter of the AIDS epidemic. Geneva; 2014. Available at:
h t t p://w w w. u n a i d s .o r g /s i te s/d e f a u l t /f i l e s/m e d i a _ a s s e t /
JC2670_UNAIDS_Treatment_Targets_en.pdf
8
European Centre for Disease Prevention and Control. HIV and STI
prevention among men who have sex with men. ECDC Guidance.
Stockholm: ECDC; 2014. Available at: http://ecdc.europa.eu/en/
publications/Publications/hiv-sti-prevention-among-men-whohave-sex-with-men-guidance.pdf
9
World Health Organization. Consolidated guidelines on the use
of antiretroviral drugs for treating and preventing HIV infection.
Recommendations for a public health approach. Geneva: World
Health Organization; 2013.
10 McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et
al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1
infection (PROUD): effectiveness results from the pilot phase of
a pragmatic open-label randomised trial. Lancet. 2015 Sep 9. pii:
S0140-6736(15)00056-2 [Epub ahead of print].
11 World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Geneva:
World Health Organization; 2014.
12. Rice BD, Elford J, Yin Z, Delpech VC. A new method to assign country
of HIV infection among heterosexuals born abroad and diagnosed
with HIV. AIDS. 2012;26(15):1961-1966.
13. Fakoya I, Alvarez-del Arco D, Woode-Owusu M, Monge S, RiveroMontesdeoca Y, Delpech V, et al. A systematic review of postmigration acquisition of HIV among migrants from countries with
generalised HIV epidemics living in Europe: implications for effectively managing HIV prevention programmes and policy. BMC Public
Health. 2015; 15: 561.
14. Alvarez-del Arco D, Fakoya I, Monge S, Gennotte AF, Touloumi G,
Zuure F, et al; aMASE. HIV Acquisition among migrants living in
Europe: Results from aMASE (Advancing Migrant Access to Health
Services in Europe). Paper presented at: European AIDS Clinical
Society Conference. 15th European AIDS Conference; 2015 October
21-24; Barcelona, Spain.
Finally, robust surveillance data are critical to monitor
and inform the public health response to the European
HIV epidemic in an accurate and timely fashion. The
number of countries conducting enhanced HIV surveillance and reporting surveillance data at European level
has gradually increased over time. For the first time in
2014, 33 countries submitted linked HIV and AIDS data,
enabling greater understanding of the clinical status of
persons diagnosed with HIV. This approach increases
possibilities for longer-term monitoring of outcomes of
the HIV continuum of care such as linkage to care, treatment and viral suppression following diagnosis and can
support national and global efforts to monitor progress
towards the 90-90-90 targets.
xiii
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SURVEILLANCE REPORT
Обзор эпидемиологической ситуации по
ВИЧ/СПИДу в Европе
Несмотря на возможность предотвращения ВИЧ путем
проведения эффективных мер общественного здравоохранения, в Европе продолжается значительное
распространение вируса иммунодефицита человека.
В 2014 году в 50 из 53 стран Европейского региона
ВОЗ было зарегистрировано 142 197 новых случаев
ВИЧ-инфекцииi. Сорок девять стран официально
предоставили ЕЦКЗ/Европейскому региональному
бюро ВОЗ сведения о 56 945 случаях, в том числе о
29 992 случаях из стран-членов Европейского союза
и Европейской экономической зоны (ЕС/ЕЭЗ). Данные
еще о 85 252 новых случаях в 2014 г. были опубликованы Российским федеральным научно-методическим
центром по профилактике и борьбе со СПИДом [1].
В 50 странах частота новых случаев ВИЧ-инфекции
составила 16,4 на 100 000 населения (Таблица А).
Наличие источника приведенных данных по России
позволило включить российские сведения в ежегодные и сводные региональные итоговые значения и
показатели по ВИЧ-инфекции, в ссылки на ежегодные
и сводные итоговые значения и показатели стран, в
данные о путях передачи вируса, а также включить
сводные итоговые данные по диагностике СПИДа в
общие региональные показатели. Все другие региональные показатели по ВИЧ и все данные по СПИДу за
2014 г., представленные в этом докладе, основаны на
информации, полученной от 49 стран, предоставляющих свои сведения в ЕЦКЗ/ВОЗ.
i Нет данных от Боснии и Герцеговины, Туркменистана и
Узбекистана. Один случай из Лихтенштейна включен в общее
число новых случаев ВИЧ-инфекции, представленных в этом
докладе, но поскольку Лихтенштейн не является государствомчленом Европейского региона ВОЗ, данные от этой страны не
вошли в состав итоговых значений по западной, центральной и
восточной частям Европейского региона ВОЗ.
Среди 49 странii, официально предоставивших отчетные данные, частота случаев составила 7,9 на 100 000
населения и 5,9 на 100 000 населения для стран ЕС/
ЕЭЗ (Рис. А). Как и за последние годы, показатели и
общее число людей с установленным диагнозом ВИЧ
были самыми высокими в восточной части Региона,
а самыми низкими – в центральнойiii (Таблица A).
Основной путь передачи вируса различается по
географическим зонам, что указывает на широкое
разнообразие эпидемиологической ситуации с ВИЧинфекцией в Европе. В странах ЕС/ЕЭЗ доминирует
передача ВИЧ при сексуальных контактах между
мужчинами, а основным путем передачи вируса в восточной части Региона является гетеросексуальный.
В Европейском регионе ВОЗ 31% новых случаев
ВИЧ был зарегистрирован среди людей, которые не
являлись выходцами из страны, включившей их в
отчетные данные, из них 22% людей были рождены
за пределами Европейского региона ВОЗ, а 9% - были
выходцами из европейской страны, отличной от
той, что включила их в отчет. В период между 2005
и 2014 годами число новых случаев ВИЧ-инфекции
среди неместного населения сократилось в целом
на 28%. Анализ этой тенденции по региону происхождения указывает на то, что число новых случаев
ВИЧ-инфекции среди мигрантов, рожденных за
пределами Европейского региона ВОЗ, сократилось
на 41%, но увеличилось на 48% среди европейских
мигрантов (т.е. людей, рожденных в одной из стран
ii Нет данных от Боснии и Герцеговины, России, Туркменистана и
Узбекистана.
iii Группировка стран Региона по принципу «Запад» (23 страны),
«Центр» (15 стран) и «Восток» (15 стран) основана на
эпидемиологических данных и следует делению стран на группы,
которое использовалось в предыдущих докладах, публикуемых
EuroHIV с 1984 года: Для получения более подробной
информации смотрите Приложение 1, Рис. A1.
Таблица A: Характеристики случаев ВИЧ-инфекции, зарегистрированных в Европейском регионе ВОЗ, в ЕС/ЕЭЗ,
в западной, центральной и восточной частях Европейского региона ВОЗ, 2014
Европейский регион
ВОЗ
Страны, предоставившие отчетные данные/Число
стран
Число новых случаев ВИЧ-инфекции
Частота случаев на 100 000 населения
Процент случаев у людей в возрасте 15-24 лет
Соотношение мужчины/женщины
Путь передачи инфекции
Сексуальные контакты между мужчинами
Гетеросексуальные контакты
Употребление инъекционных наркотиков
От матери ребенку
Путь неизвестен
Западная часть
Центральная часть
Восточная часть
ЕС/ЕЭЗ
49/53 (50/53)
23/23
14/15
12/15 (13/15)
31/31
56 972 (142 197)
7.9 (16.4)
10.2%
2.2
27 325
6.4
10.6%
3.3
4950
2.6
14.9%
4.4
24 669 (109 930)
22 (43.2)
8.7%
1.4
29 992
5.9
11.1%
3.3
24.4%
46.8%
14.0%
1.0%
13.5%
43.9%
33.7%
3.1%
0.8%
18.1%
28.0%
24.3%
5.4%
1.0%
40.9%
2.2%
66.0%
27.8%
1.2%
2.9%
42.3%
32.8%
4.1%
0.8%
19.7%
Данные не были получены от Боснии и Герцеговины, России, Туркменистана и Узбекистана. Все представленные данные поступили в ЕЦКЗ/ВОЗ через
Европейскую систему эпиднадзора (TESSy), за исключением данных по России, которые были получены от Российского федерального научно-методического
центра по профилактике и борьбе со СПИДом [1]. Российские данные включены в цифры по Европейскому региону и его восточной части, они указаны в
круглых скобках.
* Цифры, включающие данные по России, представлены в скобках в колонках по Европейскому региону ВОЗ и по его восточной части
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HIV/AIDS surveillance in Europe 2014
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Европы, отличной от той, что включила их в отчет)
(Рис. C, Таблица 11).
соотношения отмечают в Словении (15,0), Венгрии
(10,6), Хорватии (9,2), Чешской Республике (9,1) и на
Мальте (9,0) (Рис. 1.1). Преобладающим путем передачи вируса в этих странах являются сексуальные
контакты между мужчинами (Рис. 1.5).
В 2014 году в 47 странах i Европейского региона ВОЗ
было диагностировано 16 037 случаев СПИДа (данные по России отсутствуют), а частота новых случаев
составила 2,3 на 100 000 населения для Европейского
региона ВОЗ и 0,8 на 100 000 населения для ЕС/ЕЭЗ.
Несмотря на то, что в западной части Региона и в
ЕС/ЕЭЗ число случаев СПИДа продолжает устойчиво
снижаться, на востоке Региона за последнее десятилетие оно увеличилось почти вдвое.
Наивысший общий показатель диагностики ВИЧинфекции по отдельным возрастным группам
наблюдался среди людей в возрасте 25-29 лет (14,6
на 100 000 населения), при этом пиковые значения
у мужчин и женщин в этой возрастной группе составили 22,7 и 6,2 на 100 000 населения, соответственно
(Рис. 1.2).
Европейский союз и
Европейская экономическая
зона
Как и в предыдущие годы, самая высокая доля
случаев ВИЧ-инфекции зарегистрирована среди
мужчин, практикующих секс с мужчинами (МСМ) –
42%, а вторым наиболее распространенным путем
передачи ВИЧ стали гетеросексуальные контакты
(33%). Распространение ВИЧ-инфекции вследствие
потребления инъекционных наркотиков привело к
появлению 4% новых случаев ВИЧ-инфекции, и почти
в 20% случаев путь передачи вируса был неизвестен
(Таблица А). От общего числа диагностированных
людей, более трети (37%) зарегистрировано среди
тех, кто был рожден за пределами страны, предоставившей отчетные данные (Рис.1.6). Однако здесь
наблюдаются широкие колебания от 82% в Исландии
и 78% в Швеции до менее 5% случаев в Венгрии,
Латвии, Польше, Румынии, Словацкой Республике,
Хорватии и Эстонии.
В 2014 году диагноз ВИЧ был установлен у 29 992
человек в 31 стране ЕС/ЕЭЗ, что составляет 5,9 случаев на 100 000 населения (6,4 на 100 000 населения
с поправкой на задержки в предоставлении данных)
(Таблица 1). Страны с самой высокой частотой новых
случаев ВИЧ-инфекции, зарегистрированных в 2014
году, это Эстония (22,1; 291 случай), Латвия (17,3; 347
случаев) и Люксембург (12,6; 69 случаев). Самые
низкие показатели ВИЧ-инфицирования были зарегистрированы в Словакии (1,6; 86 случаев), Хорватии
(2,2; 92 случая) и Чешской Республике (2,2; 232
случая).
Частота новых случаев ВИЧ-инфекции была выше
среди мужчин (9,2 на 100 000 населения; Таблица 2),
чем у женщин (2,6 на 100 000 населения; Таблица 3).
В целом соотношение случаев у мужчин и женщин
составило 3,3 (Таблица A). Наивысшее значение этого
Несмотря на постоянную работу по профилактике и
ресурсы, выделяемые странами ЕС/ЕЭЗ, за последнее
десятилетие было отмечено лишь весьма незначительное снижение числа случаев ВИЧ-инфекции на
100 000 населения, частота которых в 2005 году
составил 6,7 на 100 000 населения (29 129 случаев)
по сравнению с 6,4 на 100 000 населения (32 605
i Нет данных от Боснии и Герцеговины, России, Сан-Марино,
Швеции, Туркменистана и Узбекистана.
Рис. A: Частота зарегистрированных новых случаев ВИЧ-инфекции на 100 000 населения, с разбивкой по году
постановки диагноза, в ЕС/ЕЭЗ и в Европейском регионе ВОЗ*, 1984–2013 гг. – с поправкой на задержки в
предоставлении данных
9
Европейский регион ВОЗ
случаи на 100 000 населения
8
ЕС/ЕЭЗ
7
6
5
4
3
2
1
0
1984
Количест
во стран,
которые
подали 15
отчет
1986
1988
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
Год постановки диагноза
25 27 36 36 39 42 42 42 42 44 43 45 48 48 47 47 49 46 50 52 52 52
51 52 52 53 51
51 49 49
Из-за задержки сообщения в ближайшие годы частота может увеличиться.
* Данные по Российской Федерации не включены.
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случаев) в 2014 году - с поправкой на задержки в
предоставлении данных (Таблица 1, Приложение 6).
Тенденции в отношении путей передачи инфекции
указывают на то, что число случаев ВИЧ-инфекции
среди МСМ в странах с систематической отчетностью увеличилось в ЕС/ЕЭЗ в целом (Таблица 8; Рис.
1.9). При этом за последнее десятилетие устойчивый
рост наблюдался во всех кроме шести стран ЕС/ЕЭЗ
(Таблица 4). Число случаев, относимых к МСМ, увеличилось за этот период как среди мужчин, рожденных
в стране, предоставившей отчетные данные, так и
среди мужчин, рожденных за ее пределами (Рис.
1.10). Число случаев ВИЧ-инфекции, возникших в
результате гетеросексуальных контактов, за последнее десятилетие сократилось на 40%, при этом более
резкое снижение наблюдалось среди людей, рожденных за пределами страны, предоставившей отчетные
данные, в особенности среди выходцев из стран с
генерализованной эпидемией ВИЧ (Таблица 8, Рис.
1.10). Число случаев среди людей, инфицированных
ВИЧ вследствие потребления инъекционных наркотиков, за этот период сократилось на 44% (Таблица
8). Общий рост числа случаев, отнесенных к потреблению инъекционных наркотиков, наблюдался в
2011 и 2012 годах и был вызван локальными вспышками в Греции и Румынии (Таблица 5). Однако число
случаев, зарегистрированных в этих странах в 2013
и 2014 гг., указывает на продолжающуюся тенденцию к снижению. В период с 2005 по 2014 годы число
случаев передачи ВИЧ-инфекции от матери ребенку,
а также число случаев нозокомиального заражения
или заражения путем переливания крови постоянно
снижалось, оставаясь на уровне менее 1% диагностированных случаев (Таблица 8).
В 2014 г. информация о числе клеток CD4 на момент
постановки диагноза ВИЧ была получена от 22 стран
(Таблица 14) для 18 411 (61%) диагностированных
людей в возрасте >14 лет и старше (Таблица 14).
Почти половина (47%) всех людей с установленным
диагнозом и информацией об уровне клеток CD4 на
момент постановки диагноза имела зарегистрированное число клеток CD4 менее 350 на мм3, из них
27% случаев находились на продвинутой стадии
ВИЧ-инфекции (CD4 <200 клеток/мм3). Среди всех
диагностированных случаев с данными о числе клеток CD4, у 20% уровень CD4 был в диапазоне от 350
до 500 клеток на мм3, а у 33% - от 500 и более клеток
CD4 на мм3 (Рис. 1.7).
При анализе уровня клеток CD4 и путей передачи
инфекции доля диагнозов, поставленных на более
поздней стадии (CD4 <350 клеток/мм), была самой
высокой у людей, потребляющих инъекционные наркотики (61%) (Рис. 1.8). Самая низкая доля диагнозов,
поставленных при уровне CD4 ниже 350 клеток на
мм3, была зарегистрирована среди тех, кто инфицировался в результате сексуальных контактов между
мужчинами (37%). Доля случаев, диагностированных
при количестве клеток CD4 на уровне 350 на мм3 и
менее, увеличивается с возрастом - шестидесяти
одному проценту людей в возрасте 50 лет и старше
диагноз ВИЧ был установлен, когда число клеток CD4
составляло 350 клеток на мм3 и ниже. По сравнению
с коренными жителями (46%) или другими группами
мигрантов (Рис. 1.8), более высокие доли людей из
стран Африки, расположенных к югу от Сахары (57%),
из Южной и Юго-Восточной Азии (57%) на момент
постановки диагноза имели число клеток CD4 менее
350 на мм3.
В 2014 году в 31 стране ЕС/ЕЭЗ было диагностировано
4 020 случаев СПИДа. Таким образом, частота случаев составила 0,8 на 100 000 населения (Таблица
15). Данные о самых высоких показателях поступили из Латвии (8,5) и Португалии (2,4). С середины
1990-х годов число случаев СПИДа в ЕС/ЕЭЗ последовательно снижается. Среди 20 стран ЕС/ЕЭЗ, где
удалось полностью установить связь между случаями
ВИЧ-инфекции и СПИДа в 2014 г., 69% случаев СПИДа
возникли во время или в течение 90 дней после
поставки диагноза ВИЧ. При этом процентное значение варьировалось от 100% зарегистрированных
Рис. B: Совокупное число новых случаев ВИЧ-инфекции в ЕС/ЕЭЗ и других странах Европейского Региона ВОЗ*,
1984-2014
1000000
ЕС/ЕЭЗ
Другие страны Европейского
региона ВОЗ
Число случаев
800000
600000
400000
200000
0
1985
1990
1995
2000
Год постановки диагноза
Данные по Российской Федерации не включены.
xvi
2005
2010
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HIV/AIDS surveillance in Europe 2014
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Рис. C: Новые случаи ВИЧ-инфекции среди людей, не являющихся мигрантами, а также среди европейских и
других мигрантов с поправкой на задержки в предоставлении данных, Европейский регион ВОЗ, 2005-2014
Люди, не являющиеся мигрантами
( выходцы из страны, предоставившей
отчетные данные)
15000
Другие мигранты (выходцы из стран за
пределами Европейского региона ВОЗ)
Число случаев
20000
Европейские мигранты (выходцы из
европейской страны, отличной от той,
что предоставила отчетные данные)
10000
5000
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Год постановки диагноза
Данные из Болгарии, Италии, Испании, России, Узбекистана, Украины Туркменистана и Эстонии исключены вследствие непоследовательной или неполной
отчетности по данным о стране происхождения или регионе происхождения за указанный период времени.
случаев СПИДа (Дания, Кипр, Норвегия и Словакия)
до почти 47% впервые установленных диагнозов
СПИДа в Австрии и Бельгии и 26% - в Латвии (Рис.
1.13).
Европейский регион ВОЗ
В 2014 г. в Европейском регионе ВОЗ было зарегистрировано 142 197 новых случаев ВИЧ-инфекции
– это самое высокое годовое значение, зарегистрированное с момента начала отчетности в 1980-х.
Таким образом, совокупное число диагностированных случаев ВИЧ-инфекции в Европейском регионе
ВОЗ увеличилось до 1 840 136. В это число вошло
995 175 диагностированных случаев, о которых было
официально сообщено в объединенную систему эпиднадзора ЕЦКЗ и Европейского регионального бюро
ВОЗ (Рис. В), и 907 607 случаев инфекции, диагностированных в Россииi [1]. Из 142 197 человек с впервые
установленным диагнозом ВИЧ-инфекции в 2014 г. в
50 странах ii, 77% было диагностировано в восточной
части (109 921), 19% - в западной (27 325) и 3% - в центральной части Региона (4 950) (Таблица A). Частота
случаев была также самой высокой в восточной
части (43,2 на 100 000 населения), что значительно
выше, чем в западной (6,4 на 100 000) и центральной
части (2,6 на 100 000) (Таблица A).
В 49 странах, предоставляющих данные отчетности
в ЕЦКЗ/ВОЗiii, 43% новых диагностированных случаев (24 669) было зарегистрировано на востоке
Региона, при этом частота случаев составила 22,0 на
100 000 населения, 48% - в западной части и 9% - в
центральной части Региона. У мужчин региональная
частота случаев составила 11,1 на 100 000 населения
i Минус 62 581 случай, официально представленный в ЕЦКЗ/ВОЗ
Россией в 2010 г.
ii Нет данных от Боснии и Герцеговины, Туркменистана и
Узбекистана
iii Нет данных от Боснии и Герцеговины, России, Туркменистана и
Узбекистана.
(Таблица 2), а у женщин - 4,7 на 100 000 населения
(Таблица 3).
Показатели новых диагностированных случаев ВИЧинфекции в 2014 году значительно варьируются по
странам Европейского региона ВОЗ. В России этот
показатель составил 58,4 на 100 000 населения
и стал самым высоким в Регионе [1]. Среди стран,
предоставляющих отчетные данные в ЕЦКЗ/ВОЗ,
самые высокие показатели были зарегистрированы
в Украине (36,9)iv, Эстонии (22,1), Молдове (20,4),
Беларуси (19,1), Латвии (17,3), Казахстане (13,5), Грузии
(13,3), Люксембурге (12,6), Таджикистане (11,9) и
Кыргызстане (11,0), а самые низкие – в бывшей югославской Республике Македония (1,4), Сербии (1,4),
Словакии (1,6), Хорватии (2,2), Чешской Республике
(2,2), Турцииv (2,3) и Словении (2,4) (Таблица 1).
В странах, предоставляющих свои отчетные данные,
большая часть новых случаев ВИЧ-инфекции (36%)
зарегистрирована в возрастной группе 30–39 лет, а
10% – в возрастной группе 15–24 года. Соотношение
случаев у мужчин и женщин составило 2,2 – с самым
низким значением в восточной части Региона (1,4),
выше - на западе (3,3) и с самым высоким значением
в центральной части Региона (4,4) (Таблица А). Чаще
всего инфицирование происходило при гетеросексуальных контактах (47%), включая 13% случаев среди
выходцев из стран с генерализованной эпидемией. У
24% случаев заражение произошло при сексуальных
контактах между мужчинами, у 14% - при употреблении инъекционных наркотиков, и 1% новых случаев
инфицирования был обусловлен передачей вируса
от матери ребенку. Информация о пути заражения
отсутствовала у 13% новых случаев ВИЧ-инфекции.
iv За исключением данных по Крыму и г. Севастополю v Данные по ВИЧ в Турции не включают случаи СПИДа,
диагностированные на момент постановки диагноза ВИЧ,
поэтому они не являются полностью совместимыми с данными
по другим странам.
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В восточной части Региона основными путями распространения ВИЧ-инфекции были гетеросексуальные
контакты и потребление инъекционных наркотиков (66% и 28% новых случаев, соответственно), а
зарегистрированный уровень распространения ВИЧ
посредством сексуальных контактов между мужчинами остается очень низким (2% случаев). В России
среди новых случаев ВИЧ-инфекции с известным
путем передачи вирусаi (это около половины случаев [2]), 57% были инфицированы в результате
потребления инъекционных наркотиков, 40% - через
гетеросексуальные контакты, 1% - в результате
сексуальных контактов между мужчинами и 0,1%
- вследствие передачи вируса от матери ребенку
[1]). Большое число новых случаев ВИЧ-инфекции в
России среди людей, инфицированных в результате
потребления инъекционных наркотиков, подчеркивает значимую роль этого пути передачи вируса
в восточной части Региона. В центральной части
Региона сексуальные контакты между мужчинами
(28%) и гетеросексуальные контакты (24%) были
основными путями передачи ВИЧ-инфекции, при
этом преобладающим путем в 10 из 14 стран были
сексуальные контакты между мужчинами, в то время
как у 41% новых случаев путь передачи вируса был
неизвестен. В западной части Региона сексуальные
контакты между мужчинами оставались основным
путем передачи ВИЧ-инфекции (44% новых случаев),
за которым следовал гетеросексуальный путь (34%
новых случаев).
В целом, в период с 2005 по 2014 год в 50 странах
(включая Россию [1]) частота впервые диагностированных случаев ВИЧ-инфекции увеличилась на
59% - с 10,3 на 100 000 населения (80 652 случая) до
16,4 на 100 000 населения (142 197 случаев). Такой
прирост обусловлен главным образом тенденцией к
росту в восточной части Региона, где частота случаев
продолжает увеличиваться, а прирост составляет
115% - с 20,1 на 100 000 населения в 2005 г. (51 058
случаев) до 43,2 на 100 000 населения в 2014 г. (109
921 случай). В 49 странах ii, предоставивших данные
в ЕЦКЗ и ВОЗ, частота случаев для Региона увеличилась на 11% - с 7,1 в 2005 г. (45 251 случай) до 7,9
в 2014 г. (56 945 случаев); в восточной части региона частота увеличилась на 59% - с 14,1 в 2005 г. (15
657 случаев) до 22,3 в 2014 году (24 669 случаев). В
центральной части частота увеличилась на 117% это самый большой относительный прирост из всех
трех географических зон - с 1,2 (2 165 случаев) до 2,6
(4 950 случаев), тогда как в западной части Региона
произошло снижение частоты на 20% - с 8,0 (27 429
случаев) в 2005 г. до 6,4 (27 325 случаев) в 2014 году.
i Этот подход к анализу отличается от остальных подходов,
используемых в докладе, где случаи с неизвестным путем
передачи ВИЧ показаны отдельно и включены в знаменатель для
вычисления процентов. По этой причине проценты по России не
полностью сопоставимы с процентами по другим странам или
группам стран в этом докладе.
ii Нет данных от Боснии и Герцеговины, России, Туркменистана и
Узбекистана.
xviii
SURVEILLANCE REPORT
Тенденции, наблюдаемые в путях передачи вируса
в 44 странах, которые располагают последовательными даннымиiii, указывают на рост числа людей,
инфицирование которых произошло в результате
гетеросексуальных контактов (увеличение на 28%)
и сексуальных контактов между мужчинами (увеличение на 28%), в то время как число случаев
инфицирования вследствие потребления инъекционных наркотиков снизилось на 22%. На востоке
Региона число случаев инфицирования в результате
гетеросексуальных контактов увеличилось на 171% и
в 10 раз – при передаче вируса во время сексуальных
контактов между мужчинами, в то время как число
случаев ВИЧ-инфицирования вследствие потребления инъекционных наркотиков сократилось на 17%
по сравнению с 2005 годом. Вместе с тем, число
новых случаев ВИЧ-инфекции у женщин увеличилось
на 74%, а у мужчин - на 49%. В центральной части
Региона число людей, инфицированных в результате
сексуальных контактов между мужчинами, увеличилось более чем в три раза, на 26% увеличилось
распространение вируса гетеросексуальным путем, и
в шесть раз - в связи с употреблением инъекционных
наркотиков, вследствие вспышки в Румынии, которая началась в 2011 году, достигла своего пика в 2012
году, после чего пошла на спад. На западе Региона
распространение вируса в результате сексуальных
контактов между мужчинами увеличилось на 15%,
тогда как число случаев передачи ВИЧ-инфекции
гетеросексуальным путем сократилось на 44% (при
этом более резкий спад наблюдался среди выходцев
из стран с генерализованной эпидемией) и на 60 % при потреблении инъекционных наркотиков.
Почти половина (48%) людей (>14 лет) с впервые
установленным диагнозом, по которым на момент
постановки диагноза ВИЧ имелась информация об
уровне клеток CD4, были случаями позднего обращения, когда количество клеток CD4 составляло
менее 350 на мм3, из них 28% новых случаев было
диагностировано на продвинутой стадии ВИЧинфекции (CD4<200/мм3). У 20% случаев уровень
CD4 был в диапазоне от 350 до 500 клеток на мм3, а
у 32% - число клеток CD4 было на уровне 500 и более
на мм3. Процент поздних обращений варьировался
по категориям распространения ВИЧ-инфекции и
был наивысшим среди людей, инфицированных в
результате потребления инъекционных наркотиков
(64%), далее следуют случаи передачи вируса через
гетеросексуальные контакты (56%), и самый низкий
процент – у мужчин, инфицированных в результате
сексуальных контактов между мужчинами (37%).
Процент людей, диагноз которым был поставлен
при количестве клеток CD4 на уровне или ниже 350/
мм3, с возрастом увеличивался, и у 61% людей в возрасте 50 лет и старше диагноз ВИЧ-инфекции был
iii Исключены данные из Эстонии, Польши и Турции, т.к. у них
отсутствует более 50% данных о путях распространения вируса;
данные из Испании и Италии были исключены, поскольку за
этот период времени увеличился охват их систем эпиднадзора;
данные из Боснии и Герцеговины, России, Туркменистана и
Узбекистана не были сообщены.
SURVEILLANCE REPORT
поставлен, когда число клеток CD4 было на уровне
или ниже 350 клеток на мм3.
В 2014 году в 47 странах Европейского региона
ВОЗi было диагностировано 16 037 случаев СПИДа;
частота случаев составила 2,3 на 100 000 населения.
В Восточной части Региона было диагностировано
74% случаев (11 890), на западе Региона - 20% (3 214),
и 6% (932) в его центральной части. Частота случаев была самой высокой также на востоке Региона
(10,7 на 100 000 населения), что в 13 раз выше, чем в
западной части (0,8 на 100 000) и в 21 раз выше, чем в
центральной части (0,5 на 100 000 населения).
В период между 2005 и 2014 годами частота новых
случаев СПИДа в Регионе сократилась на 4% - с 2,3 (14
294 случая) до 2,2 (16 037 случаев). При этом большие
колебания наблюдаются по трем географическим
зонам: увеличение на 143% - на востоке Региона - с
4,4 (4 926 случаев) до 10,7 (11 890 случаев) на 100
000 населения, увеличение на 25% в центральной
части Региона- с 0,4 (751 случай) до 0,5 (932 случая)
на 100 000 населения, и стабильное снижение на 69%
в западной части Региона - с 2,6 (8 617 случаев) до
0,8 (3 214 случаев) на 100 000 населения.
Выводы
Распространение
ВИЧ-инфекции
продолжает
вызывать серьезную обеспокоенность в Европе, в
особенности в восточной части Европейского региона ВОЗ. В 2014 г. диагноз ВИЧ был установлен у
более 142 000 человек - это самое большое число
новых случаев ВИЧ-инфекции, когда-либо зарегистрированных за один год. Из них 77% случаев было
диагностировано в восточной части Региона, и 21%
- в ЕС/ЕЭЗ. Последние данные эпиднадзора указывают на то, что, несмотря на значительные усилия по
профилактике и контролю ВИЧ, большого снижения
числа новых случаев ВИЧ-инфекции в западной части
Региона и в ЕС/ЕЭЗ не произошло, а в восточной части
Региона за последнее десятилетие это число увеличилось более чем в два раза. В центральной части
Региона число новых случаев остается на более низком уровне, чем на востоке и на западе, однако за
последнее десятилетие оно также увеличилось более
чем вдвое.
Несмотря на то, что модели и тенденции эпидемии в странах Европы значительно различаются, в
западной и центральной части Региона наблюдался
значительный рост числа случаев инфицирования
среди мужчин, имеющих сексуальные контакты
с мужчинами, в восточной части региона – среди
людей, инфицированных вследствие гетеросексуальных контактов, в особенности среди женщин. Число
случаев передачи вируса в результате потребления
инъекционных наркотиков продолжает сокращаться,
однако именно этот путь стал причиной возникновения более четверти новых случаев ВИЧ-инфекции
i Нет данных от Боснии и Герцеговины, России, Сан-Марино,
Туркменистана, Узбекистана и Швеции.
HIV/AIDS surveillance in Europe 2014
в восточной части Региона. В то же время, сокращается число новых случаев ВИЧ-инфекции среди
людей, рожденных за пределами страны, предоставившей отчетные данные, и особенно - среди
рожденных за пределами Европейского региона.
В 2015 г. были выпущены руководящие принципы
по лечению ВИЧ-инфекции, в которых рекомендуется начинать антиретровирусную терапию (АРТ)
всем людям, живущим с ВИЧ, вне зависимости от
числа клеток CD4 [3]. В настоящее время существуют доказательства того, что раннее начало
лечения благотворно влияет на здоровье людей,
получающих терапию, и предотвращает дальнейшее
распространение ВИЧ-инфекции [4, 5]. Однако слишком большому числу людей (48%) в Европейском
регионе ВОЗ диагноз устанавливают на поздней
стадии, что ведет к риску ухудшения состояния здоровья, смерти и дальнейшему распространению
ВИЧ-инфекции. Высокий и тревожный рост числа
случаев СПИДа в восточной части Региона также указывает на то, что поздняя постановка диагноза ВИЧ,
запоздалое начало АРТ и низкий охват лечением
остаются главными проблемами.
Для сокращения числа случаев поздней диагностики
нужны новые стратегии для оказания расширенных,
целенаправленных услуг тестирования на ВИЧ. Новые
сводные руководства ВОЗ для служб тестирования
на ВИЧ [6] дают новые рекомендации в поддержку
проведения тестирования на ВИЧ обученными
волонтерами (тестирование на ВИЧ на базе местных
сообществ) в дополнение к тестированию, проводимому по инициативе медицинских работников. В
них рассматриваются потенциальные возможности
проведения самостоятельного тестирования на ВИЧ
для повышения охвата тестированием и его доступности, а также целенаправленные стратегические
подходы к оказанию услуг по тестированию на ВИЧ,
которые необходимы для поддержки первого из трех
целевых ориентиров ООН «90-90-90» (90% людей,
живущих с ВИЧ, знают свой статус) [7]. Эти услуги
должны быть сосредоточены на группах населения, особенно подверженных ВИЧ-инфицированию
в местном эпидемическом контексте. Они должны
удовлетворять конкретные потребности этих групп и
способствовать установлению своевременной связи
с профилактикой, лечением ВИЧ и оказанием ухода.
Такой подход обеспечит раннюю диагностику и своевременное начало лечения, что в конечном итоге
приведет к улучшению результатов лечения, сокращению болезненности, смертности, заболеваемости
ВИЧ и будет способствовать достижению второго и
третьего целевого ориентира «90-90-90» (90% диагностированных ЛЖВ получают АРТ, и 90% людей,
получающих АРТ, достигают вирусной супрессии).
Меры по противодействию эпидемии должны быть
основаны на научных данных и адаптированы к национальным и местным эпидемиологическим условиям.
На основании данных эпиднадзора, представленных
в этом докладе, можно сделать следующие выводы:
xix
HIV/AIDS surveillance in Europe 2014
• Принимая во внимание устойчивый рост числа
случаев ВИЧ-инфекции среди МСМ, наблюдаемый
за последнее десятилетие, странам ЕС/ЕЭЗ и
западной части Региона необходимо укреплять
и расширять существующие мероприятия по
профилактике и борьбе с ВИЧ-инфекцией, которые
должны оставаться основой мер реагирования
на ситуацию с ВИЧ.
Многокомпонентные меры
вмешательства, в том числе новые стратегии, такие
как включение предэкспозиционной профилактики
ВИЧ (ПрЭП) в общий набор мероприятий по
профилактике, могут помочь в сдерживании этой
растущей тенденции [8, 9, 10]. Рост числа случаев
ВИЧ-инфекции среди людей, потребляющих
инъекционные наркотики, который наблюдается
в последнее время в ряде стран [2,3], указывает
на необходимость поддерживать проведение или
расширение масштабов программ по снижению
вреда.
• В странах центральной части Региона эпидемия
сохраняется на низком уровне, но имеет более
высокий относительный прирост, чем в других
частях Европы.
Он обусловлен ростом числа
случаев инфицирования в результате сексуальных
контактов, главным образом среди МСМ, но также
и вследствие гетеросексуальных контактов; 4 из
5 новых случаев ВИЧ-инфекции регистрируют у
мужчин, и приоритетом здесь является укрепление
и целенаправленное проведение целого ряда
мер по профилактике, тестированию и лечению
ВИЧ-инфекции в этой относительно широкой
группе населения. Ключевую роль в достижении
поставленной цели будут играть усилия по
сокращению стигмы и дискриминации.
• Для стран восточной части Региона существует
срочная необходимость расширять масштабы
действий, основанных на фактических данных, и
оказывать эффективные и всеобъемлющие услуги
через системы здравоохранения, которые успешно
воздействуют на социальные детерминанты
здоровья.
• Людям, подверженным риску гетеросексуальной
передачи ВИЧ-инфекции, а также людям,
употребляющим
инъекционные
наркотики,
необходимо
обеспечить
полный
охват
эффективными услугами по профилактике,
а всем нуждающимся следует предоставлять
услуги целевого тестирования на ВИЧ, доступ к
консультированию и комплексному уходу. В парах,
где у одного из партнеров отмечают поведение
повышенного риска (потребление инъекционных
наркотиков, использование коммерческих сексуслуг, бисексуальные отношения или длительная
работа за границей), более активные меры должны
помочь направить усилия на сокращение риска
распространения вируса гетеросексуальным путем.
К числу таких мер относят предэкспозиционную
профилактику ВИЧ-инфекции там, где это уместно
и согласуется с рекомендациями ВОЗ [3,11].
Доказательные практики, нацеленные на ключевые
xx
SURVEILLANCE REPORT
группы населения и, в частности, на потребителей
инъекционных наркотиков, включают программы
по снижению вреда. Их следует поддерживать как
основополагающие элементы ответных действий,
направленных на ВИЧ-инфекцию. Доступность
антиретровирусной терапии следует расширять
для лечения и профилактики распространения
ВИЧ-инфекции, а также для сокращения растущего
числа случаев СПИДа.
• Несмотря на то, что с 2005 года число случаев ВИЧ
среди мигрантов значительно сократилось, 31%
диагнозов регистрируют среди людей, рожденных
за границей, из них 22% являются выходцами из
стран, расположенных за пределами Европейского
региона ВОЗ. С 2005 года число новых случаев
ВИЧ-инфекции среди всех мигрантов в целом
сократилось на 28% и на 41% - среди людей, которые
являются выходцами из стран, расположенных за
пределами Европы. Существуют доказательства
того,
что
значительная
доля
мигрантов
инфицируется ВИЧ после миграции в Европейский
регион [12, 13, 14]. Поэтому странам по-прежнему
важно обеспечивать мигрантам доступность мер
по профилактике, лечению и уходу.
И наконец, для проведения точного и своевременного мониторинга и обоснованного выбора мер
общественного здравоохранения в ответ на эпидемию ВИЧ в Европе необходимы надежные данные
эпиднадзора. Со временем происходит постепенное
увеличение числа стран, осуществляющих усиленный эпиднадзор за ВИЧ и отчитывающихся по данным
эпиднадзора на уровне Европы. Впервые в 2014 году
33 страны предоставили объединенные данные по
ВИЧ и СПИДу, позволяющие лучше понять клинический статус людей с установленным диагнозом ВИЧ.
Этот подход расширяет возможности для проведения
долгосрочного мониторинга результатов континуума
медицинской помощи, таких как связь с помощью,
лечением и вирусной супрессией после установления
диагноза; он также способен поддержать национальные и глобальные усилия, направленные на
проведение мониторинга успехов на пути достижения целевых ориентиров ОНН: 90-90-90.
Ссылки
1 Российский федеральный научно-методический цент
по
профилактике и борьбе со СПИДом. Информационная записка
«Справка. ВИЧ-инфекция в Российской Федерации», 2014.
Москва: Российский федеральный научно-методический центр
по профилактике и борьбе со СПИДом; 2015. Смотрите на сайте:
http://hivrussia.org/files/spravkaHIV2014.pdf.
2
Hedrich D, Kalamara E, Sfetcu O, Pharris A, Noor A, Wiessing L, et
al. Human immunodeficiency virus among people who inject drugs:
Is risk increasing in Europe? Euro Surveill. 2013;18(48):pii=20648.
Смотрите на сайте: http://www.eurosurveillance.org/ViewArticle.
aspx?ArticleId=20648
3 World Health Organization. Guidelines on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva:
World Health Organization; 2015. http://apps.who.int/iris/bitstr
eam/10665/186275/1/9789241509565_eng.pdf
4 INSIGHT START Study Group. Initiation of antiretrovial therapy
in early asymptomatic HIV infection. N Engl J Med. 2015;373 (9)
:795-807.
5 Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC,
Kumarasamy N, et al. Prevention of HIV-1 infection with early
antiretroviral therapy. N Engl J Med. 2011;365(6):493-505.
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6
HIV/AIDS surveillance in Europe 2014
World Health Organization. Consolidated guidelines on HIV testing
services. Geneva: World Health Organization; 2015.
7 UNAIDS. Ambitious treatment targets: Writing the final chapter of the AIDS epidemic. Geneva; 2014. Смотрите на сайте:
h t t p://w w w. u n a i d s .o r g /s i t e s/d e f a u l t /f i l e s/m e d i a _ a s s e t /
JC2670_UNAIDS_Treatment_Targets_en.pdf
8
European Centre for Disease Prevention and Control. HIV and STI
prevention among men who have sex with men. ECDC Guidance.
Stockholm: ECDC; 2014. Смотрите на сайте: http://ecdc.europa.
eu/en/publications/Publications/hiv-sti-prevention-among-menwho-have-sex-with-men-guidance.pdf
9
Всемирная
организация
здравоохранения.
Сводное
руководство по использованию антиретровирусных препаратов
для лечения и профилактики ВИЧ-инфекции. Краткий обзор
основных особенностей и рекомендаций. Женева: Всемирная
организация здравоохранения; 2013.
10 McCormack S, Dunn DT, Desai M, Dolling DI, Gafos M, Gilson R, et
al. Pre-exposure prophylaxis to prevent the acquisition of HIV-1
infection (PROUD): effectiveness results from the pilot phase of
a pragmatic open-label randomised trial. Lancet. 2015 Sep 9. pii:
S0140-6736(15)00056-2[Epub ahead of print].
11 World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Geneva:
World Health Organization; 2014.
12. Rice BD, Elford J, Yin Z, Delpech VC. A new method to assign country
of HIV infection among heterosexuals born abroad and diagnosed
with HIV. AIDS 2012; 26(15):1961-1966.
13. Fakoya I, Alvarez-del Arco D, Woode-Owusu M, Monge S, RiveroMontesdeoca Y, Delpech V, et al. A systematic review of postmigration acquisition of HIV among migrants from countries with
generalised HIV epidemics living in Europe: implications for effectively managing HIV prevention programmes and policy. BMC Public
Health, 2015; 15: 561.
14. Alvarez-del Arco D; Fakoya I; Monge S; Gennotte AF; Touloumi G;
Zuure F; Barros H, et al. HIV Acquisition among migrants living in
Europe: Results from aMASE (Advancing Migrant Access to Health
Services in Europe). Устная презентация на 15-й Европейской
конференции по СПИДу; 21-24октября 2015; Барселона,
Испания.
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HIV/AIDS surveillance in Europe 2014
1 HIV and AIDS in the European Union and
European Economic Area
1.1 HIV diagnoses
In 2014, 29 992 new HIV diagnoses were reported by all
the 31 EU/EEA countries, with a rate of 5.9 per 100 000
population (6.4 per 100 000 when adjusted for reporting delay) (Table 1). The highest rates were reported by
Estonia (22.1; 291 cases), Latvia (17.3; 347 cases), and
Luxembourg (12.6; 69 cases). The lowest rates were
reported by Slovakia (1.6; 86 cases), Croatia (2.2; 92
cases), and the Czech Republic (2.2; 232 cases).
The overall rate for men in the EU/EEA was 9.2 per
100 000 population (Table 2) and for women, 2.6 per
100 000 population (Table 3). The overall male-to-female
ratio was 3.3. The ratio was highest in Slovenia (15.0),
Hungary (10.6), Croatia (9.2), the Czech Republic (9.1),
and Malta (9.0) (Figure 1.1). The predominant mode of
transmission in these countries was sex between men.
Men had higher age-specific rates than women in all age
groups, except among persons under 15 years, where
age-specific rates were similar (Figure 1.2). The highest
overall rate of new HIV diagnoses per 100 000 population was in the age group 25–29 years (14.6) with the
rate in men and women peaking in this age group at 22.7
and 6.2, respectively.
The 30–39-year-olds accounted for most HIV diagnoses
overall (32%) and in all transmission groups: 42% of
these cases were attributed to injecting drug use, 32%
to sex between men and 32% to heterosexual transmission (Figure 1.3). Cases attributed to sex between men
predominated in all age groups under 50 years while
cases attributed to sex between men and women were
predominant among those 50 years of age and over.
Young people 15 to 24 years of age comprised 12% of the
EU/EEA population and 11% of HIV diagnoses in 2014.
Romania, Slovakia Cyprus, and Luxembourg reported
more than 15% of their HIV diagnoses in this age group
(Figure 1.4). In ten countries, this proportion was lower
than 10%, and in two countries (Liechtenstein and
Iceland), no cases were reported among 15–24-year-olds.
Data on transmission mode provide information on the
groups that are most affected by HIV in the EU/EEA
(Table 12a, Tables 4–7):
• Sex between men remains the predominant mode of
HIV transmission reported in the EU/EEA, accounting
for 42% (12 677) of all HIV diagnoses in 2014, and 53%
of those where the route of transmission was known
(Table 4, Figure 1.5). Among those with known route
of HIV transmission, sex between men accounted for
more than half of new diagnoses in 16 countries reporting more than one case (Austria, Croatia, Cyprus, the
Czech Republic, Denmark, Germany, Greece, Hungary,
Ireland, Malta, the Netherlands, Poland, Slovakia,
Slovenia, Spain and the United Kingdom) (Figure 1.5).
• Sex between men and women is the second most commonly reported mode of transmission in the EU/EEA,
accounting for 41% (9 833) of HIV diagnoses where
the route of transmission was known (Table 6, Figure
1.5). Heterosexual transmission is the most commonly
reported known mode of transmission in 12 EU/EEA
countries (Belgium, Estonia, Finland, France, Italy,
Latvia, Lithuania, Luxembourg, Norway, Portugal,
Romania and Sweden). More than one quarter (28%;
2 771) of newly diagnosed cases among heterosexuals
originate from countries with generalised HIV epidemics. The highest proportions of these were observed
in Germany (63%), Ireland (57%), the United Kingdom
(48%) and France (46%) (Table 10).
• Five per cent (1 244 cases) of HIV diagnoses with
known route of HIV transmission were attributed to
injecting drug use (Table 5, Figure 1.5). Injecting drug
use was the probable route of transmission for one
quarter or more of cases reported in Lithuania (33%),
Latvia (31%), Estonia (28%) and Romania (25%) (Figure
1.5).
• Of the remainder, 236 diagnoses (1%) were reported
as mother-to-child transmission (Table 7); 41% (97)
of those cases originated from countries with generalised HIV epidemics. Seventy-one diagnoses were
reported to be due to transfusion of blood and its
products, and 22 cases were hospital-acquired infections (Table 12a). The majority of these cases were
born or thought to be acquired outside of the country
in which the case was reported.
• Transmission mode was reported as ‘unknown’ for
5 908 diagnoses (19.7%) with a wide variation between
countries: less than 5% of diagnoses reported as
‘unknown’ in Bulgaria, the Czech Republic, Denmark,
Luxembourg, Norway and Portugal and more than
60% reported as unknown in Iceland and Poland.
In 2014, 29 EU/EEA countries provided information on
the country of birth, country of nationality, or region of
origin for 25 445 (85%) HIV diagnoses. In the EU/EEA,
9 579 diagnoses (37% of those with known information
on region of origin) were made among people originating from outside of the reporting country. Of these,
4 139 diagnoses (16% of those with known information on region of origin), irrespective of transmission
mode, were among people originating from countries
with generalised HIV epidemics (Figure 1.6, Table 11). An
additional 21% of new diagnoses with known region of
origin (5 440 cases) were among people originating outside of the reporting country, but not from a generalised
epidemic country. Countries with at least half of new
HIV diagnoses among people originating from outside
1
HIV/AIDS surveillance in Europe 2014
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Figure 1.1: Male-to-female ratio in new HIV diagnoses, by country, EU/EEA, 2014 (n=29 912)
Slovenia
Hungary
Croatia
Czech Republic
Malta
Cyprus
Slovakia
Greece
Netherlands
Spain
Poland
Iceland
Bulgaria
Germany
Italy
Austria
EU/EEA average
Denmark
Finland
United Kingdom
Norway
Ireland
Portugal
Belgium
Romania
Latvia
France
Lithuania
Estonia
Luxembourg
Sweden
0
4
8
12
16
Male-to-female ratio
of the reporting country were Iceland (82%), Sweden
(78%), Luxembourg (65%), Norway (60%), Ireland (60%),
Belgium (53%), the United Kingdom (53%) and France
(51%) (Figure 1.6).
Information on CD4 cell count at the time of HIV diagnosis was provided by 23 countries (Table 14) for 18
411 HIV diagnoses (61%) in adults and adolescents. All
countries providing these data were able to provide CD4
cell counts for more than 50% of their reported cases.
Nearly half (47%) of all cases with a CD4 cell count
available were diagnosed with a count of less than 350
cells per mm3, including 27% of cases with advanced
HIV infection (CD4 <200 cells/mm3). The proportion
of those diagnosed with a CD4 count lower than 350
cells per mm3 was higher than 50% in eight countries:
Estonia (63%), Greece (51%), Italy (53%), Latvia (53%),
Luxembourg (52%), Portugal (51%), Romania (58%) and
Slovenia (62%). Among all cases diagnosed for whom a
CD4 cell count was available, 20% (3 749) had a CD4 cell
count of between 350 and 500 cells per mm3 and 33% (6
050) had a CD4 cell count of 500 cells or more per mm3.
When analysing CD4 cell count by transmission mode,
the highest proportion of people presenting at a later
stage of HIV infection (CD4 <350 cells/mm3) was observed
among people who acquired HIV through injecting drug
use (61%) (Figure 1.7; Table 14). The lowest proportion with CD4 counts lower than 350 cells per mm3 was
observed among men who acquired HIV through sex
2
with another man (37%). Twelve countries reported that
half or more of the cases acquired through injecting drug
use had a CD4 cell count lower than 350 cells per mm3
at diagnosis; four countries reported that more than half
of new diagnoses among MSM had a CD4 cell count of
less than 350 cells per mm3 at diagnosis (Table 14). The
proportion of cases diagnosed at or below 350 CD4 cells
per mm3 increased with age, and 61% of people aged
50 or older were diagnosed with HIV at or below 350
cells per mm3 (data not shown). Higher proportions of
migrants from sub-Saharan Africa (57%) and South and
Southeast Asia (57%) had CD4 counts of less than 350
cells per mm3 at diagnosis than non-migrants (46%) and
other migrant groups (Figure 1.8).
1.2 Trends in HIV diagnoses
The trend of reported HIV diagnoses for the period 2005–
2014 remains relatively stable, although the overall rate
of HIV diagnoses per 100 000 population fluctuated
between 6.6 and 6.9 until 2012 and has slightly declined
thereafter to 6.4 per 100 000 population (32 605 cases
when adjusted for reporting delay; see Annex 1 for methods; Annex 6 for results). Moreover, in the previous HIV/
AIDS surveillance report [1], 29 157 HIV diagnoses were
reported for 2013, but after additional data collections
included some historical data updates, this number
has increased by more than 3 000 cases and may still
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
missing. Data from Spain and Italy were also excluded
because coverage by the surveillance system was not
constant and increased over this time period. Data on
transmission mode from the countries consistently
reporting indicate the following (Table 8a, Figures 1.9
and 1.10):
increase further in similar updates over the coming one
to two years.
Over the past decade, trends at national level have varied widely. Since 2005, rates of HIV diagnoses have more
than doubled in Bulgaria, the Czech Republic, Hungary,
Malta and Slovakia and have increased by more than
50% in Poland. Rates of new HIV diagnoses decreased in
11 countries between 2005 and 2014, with decreases of
more than 25% observed in Austria, Estonia, France, the
Netherlands, Portugal and the United Kingdom (Table
1). Reporting delay affects some countries more than
others and, thus, decreases in the rates of new HIV diagnoses may be overestimated.
• The number of HIV diagnoses reported among MSM
increased from 7 451 cases in 2005 to 9 110 cases in
2014, with a peak of 9 726 cases in 2013. The proportion of all HIV diagnoses attributed to sex between
men increased over the period from 30% of cases
in 2005 to 42% of cases in 2014. Between 2005 and
2014, increases were observed in all but six EU/
EEA countries (Table 4). Cases attributed to MSM
increased over the period both among men born outside of the country of report and among native cases
(Figure 1.10).
Since 2005, 29 EU/EEA countries have consistently
reported data on transmission mode. Data from Estonia
and Poland were not included in this analysis because
more than 50% of their data on transmission mode was
Figure 1.2: Age- and gender-specific rates of new HIV diagnoses per 100 000 population, EU/EEA, 2014 (n=29 923)
25
Women
Cases per 100 000 population
Men
20
15
10
5
0
< 15
15-19
20-24
25-29
30-39
40-49
50+
Age category (years)
Figure 1.3: Number of new HIV diagnoses by age group and transmission mode, EU/EEA, 2014 (n=23 747)
5000
Sex between men
4000
Injecting drug use
Number of cases
Heterosexual contact
3000
2000
1000
0
15-19
20-24
25-29
30-39
40-49
50+
Age category (years)
Data for people <15 years old, other/unknown transmission, mother-to-child transmission, transfusion-related transmission, and nosocomial transmission not shown.
3
HIV/AIDS surveillance in Europe 2014
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Figure 1.4: Percentage of new HIV diagnoses in people between 15 and 24 years old, by country, EU/EEA, 2014
(n=29 992)
Romania
Slovakia
Cyprus
Luxembourg
Hungary
Bulgaria
Czech Republic
Croatia
Poland
Spain
Portugal
Ireland
United Kingdom
Germany
EU/EEA
Norway
Greece
Austria
Denmark
Malta
Latvia
Netherlands
France
Belgium
Italy
Sweden
Estonia
Lithuania
Finland
Slovenia
Liechtenstein
Iceland
0
5
10
15
20
25
Percentage
Figure 1.5: Percentage of new HIV diagnoses with known mode of transmission, by transmission route and country,
EU/EEA, 2014 (n=24 083)
Sex between men
Hungary
Croatia
Slovenia
Czech Republic
Cyprus
Slovakia
Malta
Netherlands
Germany
Poland
Spain
Greece
United Kingdom
Ireland
Denmark
EU/EEA
Austria
Italy
Belgium
Norway
France
Bulgaria
Finland
Sweden
Portugal
Luxembourg
Romania
Latvia
Lithuania
Estonia
Heterosexual contact
Injecting drug use
Other
0
20
40
60
80
100
Percentage
Unknown route of transmission is excluded from proportions presented here. One HIV case reported in Liechtenstein in 2014 was attributed to sex between men and
one case reported in Iceland in 2014 was attributed to injecting drug use.
4
HIV/AIDS surveillance in Europe 2014
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Figure 1.6: Percentage of new HIV diagnoses among migrants out of all reported cases with known information on
region of origin, by country of report, EU/EEA, 2014 (n=25 525)
New diagnoses among people
originating from countries with
generalised HIV epidemics
Iceland
Sweden
Luxembourg
Norway
Ireland
Belgium
United kingdom
France
Malta
Denmark
Austria
Finlad
EU/EEA
Cyprus
Germany
Netherlands
Spain
Portugal
Italy
Czech Republic
Greece
Slovenia
Bulgaria
Lithuania
Slovakia
Croatia
Estonia
Latvia
New diagnoses among people
originating from other countries
0
20
40
60
80
100
Percentage
One or no cases were reported in 2014 among people born abroad by Hungary, Liechtenstein, Poland and Romania.
Figure 1.7: New HIV diagnoses, by CD4 cell count per mm3 at diagnosis and transmission mode, EU/EEA, 2014
<200 cells/mm3
n = 8857
Transmission mode
Sex between men
200 to <350 cells/mm3
350 to <500 cells/mm3
≥500 cells/mm3
Heterosexual
n = 7122
Injecting drug use
n = 827
0
20
40
60
80
100
Percentage
5
HIV/AIDS surveillance in Europe 2014
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Region of origin
Figure 1.8: New HIV diagnoses, by CD4 cell count per mm3 at diagnosis and region of origin of the case diagnosed,
EU/EEA, 2014
Western Europe
n =819
Central and Eastern Europe
n =992
<200 cells/mm3
200 to <350 cells/mm3
350 to <500 cells/mm3
≥500 cells/mm3
n =1182
Latin America and Caribbean
n =11268
Non-migrants (native)
n =430
South and Southeast Asia
n =2698
Sub-Saharan Africa
0
20
40
60
80
100
Percentage
People diagnosed with other or unknown region of origin are not presented here
• The number of heterosexually acquired cases
decreased from 11 912 in 2005 to 7 110 in 2014, with
a steadily decreasing trend. The proportion of all HIV
diagnoses attributed to sex between men and women
decreased from 48% of cases in 2005 to 33% in 2014.
The number of cases among women and among foreign-born heterosexuals decreased between 2005
and 2014 more than cases among men and nonforeign-born people (Figures 1.9 and 1.10). This was
mainly due to a 52% decrease among cases originating from countries with generalised HIV epidemics (7
380 in 2005, 3 567 in 2014).
• The number of HIV diagnoses reported among people
who inject drugs has declined since 2005 (from 1 589
cases to 884 cases) in both foreign-born and non-foreign-born groups (Figure 1.10). A temporary increase
in overall numbers for the EU/EEA was observed in
2011 and 2012 due to localised outbreaks in Greece
and Romania, but reported cases in 2014 show a continued downward trend (Table 5).
• The number of diagnoses reported to be due to HIV
transmitted from mother to child decreased from 288
in 2005 to 215 in 2014.
• The number of HIV diagnoses reported to be due to
nosocomial infection has remained stable over this
period, with 24 cases in 2005 and 21 in 2014. The
number of cases reported to be due to transfusion
of blood and its products has decreased from 122 in
2005 to 61 cases in 2014. The majority of these cases
originate from outside of the reporting countries.
• The number of cases reported to have an unknown
mode of transmission has increased from 3 207 in
2005 to 4 177 cases in 2014. This increase is an underestimate as some countries reporting higher rates of
incomplete data on transmission mode were excluded
from the analysis.
• Reporting delays differ significantly between transmission categories for some countries. When
standardised adjustments for reporting delay are
made, these increase the number of reported HIV
cases in all transmission categories by between 8%
and 19%, depending on the category. Figure 1.9 shows
the adjusted trends.
The median CD4 count at diagnosis improved over time
among people with sex between men as the reported
route of HIV acquisition as well as among those with heterosexual contact as the route of transmission (Figure
1.11). The median CD4 cell count at diagnosis among
people that acquired HIV through injecting drug use
fluctuated during the period and did not improve substantially over time.
1.3 AIDS cases, morbidity and
mortality
For 2014, 4 020 diagnoses of AIDS were reported by 30
EU/EEA countriesi, resulting in a rate of 0.8 cases per
100 000 population (Table 15). The highest rates were
reported by Latvia (8.5, 171 cases) and Portugal (2.4,
249 cases). In the EU/EEA during the last decade, the
rate of reported AIDS cases has halved from the 2.0 per
100 000 (9 203 cases) reported in 2005. This decline
is noted in all transmission groups but appears greatest among cases attributed to heterosexual contact and
injecting drug use (Figure 1.12). Despite the general EU/
EEA-wide decline, since 2005 an increase in the rate
of AIDS diagnoses has been reported in Bulgaria, the
Czech Republic, Greece, Hungary, Latvia, Lithuania,
Malta, Norway and Slovenia.
In the 20 EU/EEA countries where it was possible to fully
link HIV and AIDS cases in 2014, 69% of AIDS diagnoses
i All EU/EEA countries except Sweden.
6
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
occurred at the same time as, or within 90 days of, the
HIV diagnosis. This ranged from 100% of AIDS cases
reported (Cyprus, Denmark, Norway and Slovakia) to
around 26% of new AIDS diagnoses in Latvia (Figure
1.13).
diagnosed with AIDS. Overall, 1 131 individuals with
AIDS were reported to have died during 2014 (Table 25).
This figure has been consistently decreasing since 2004
when 3 094 deaths were reported among the same 28
countries reporting deaths in 2014, although delays in
reporting affect the latest figures. From the beginning of
the HIV epidemic to the end of 2014, a cumulative total
of 344 265 individuals have been diagnosed with AIDS
in the EU/EEA (Table 15). The cumulative total of cases
reported as known to have died by the end of 2014 was
185 572 (Table 25).
In the EU/EEA, the most common AIDS-indicative diseases diagnosed in 2014 were Pneumocystis pneumonia
(22%), pulmonary and/or extra-pulmonary tuberculosis
(14%), oesophageal candidiasis (10%), and wasting syndrome due to HIV (9%) (Table 24).
Twenty-eight EU/EEA countries (all but Finland, Italy
and Sweden) reported data on deaths of individuals
Figure 1.9: New HIV diagnoses, by transmission mode and year of diagnosis, adjusted for reporting delay, EU/EEA,
2005-2014
12000
Sex between men
Heterosexual contact (women)
Number of cases
10000
Heterosexual contact (men)
Injecting drug use
8000
Mother-to-child transmission
Other/undetermined
6000
4000
2000
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
HIV diagnoses reported by Estonia and Poland excluded due to incomplete reporting on transmission mode during some years of the period; diagnoses reported by
Italy and Spain excluded due to increasing national coverage during the period
Figure 1.10: New HIV diagnoses, by transmission and migration status, EU/EEA, 2005-2014
9000
Heterosexual contact (native)
8000
Heterosexual contact (foreign-born)
Sex between men (native)
Number of cases
7000
Sex between men (foreign-born)
6000
Injecting drug use (native)
5000
Injecting drug use (foreign-born)
4000
3000
2000
1000
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
HIV diagnoses reported by Estonia and Poland excluded due to incomplete reporting on transmission mode during some years of the period; diagnoses reported by
Italy and Spain excluded due to increasing national coverage during the period
7
HIV/AIDS surveillance in Europe 2014
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CD4 cell count/mm3 at diagnosis
Figure 1.11: Median CD4 cell count per mm3 at HIV diagnosis, by transmission group, EU/EEA, 2005-2014
500
Sex between men
450
Injecting drug use
400
Heterosexual contact
350
300
250
200
150
100
50
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Excludes countries with >60% incomplete data on CD4 cell count during any year over the period (Belgium, Bulgaria, Croatia, Estonia, Finland, France, Germany,
Greece, Hungary, Ireland, Latvia, Lithuania, Malta, Norway, Poland, Portugal, Slovakia, Sweden)
Figure 1.12: AIDS diagnoses, by transmission mode, EU/EEA, 2005-2014 (logarithmic scale)
10000
Sex between men
Injecting drug use
Number of cases
Heterosexual contact
Other/undetermined
1000
100
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Data from Sweden excluded due to inconsistent reporting during the period
1.4 Conclusions
The 2014 HIV surveillance data suggest that the epidemic
in EU/EEA countries persists, with little fluctuation in
the rate of diagnoses per 100 000 population over the
last decade. While the 2014 rate of 5.9 per 100 000
population is lower than previous years, it is expected
to increase in future reporting cycles due to reporting
delay which is common for HIV generally, and in some
countries in the EU/EEA in particular.
Despite the stable trend of HIV in the region, these
data provide evidence of important changes in the
8
epidemiology of HIV during the past decade in EU/EEA
countries. There has been a sustained increase in HIV
diagnoses among both native and foreign-born MSM.
MSM account for the largest number of new HIV diagnoses and are the only population in the EU/EEA where
HIV cases continue to increase at an alarming rate.
During the past decade, HIV increases among MSM
were observed in all but six EU/EEA countries, and substantial increases were seen in countries with overall
low rates of HIV such as Bulgaria, Croatia, Cyprus, the
Czech Republic, Lithuania, Hungary, Malta, Romania
and Slovakia. While some of these increases could be
due to decreased stigmatisation resulting in reducing
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 1.13: Percentage of AIDS diagnoses made in 2014 which occurred within 90 days of HIV diagnosis, EU/EEA, 2014
(n= 2 381)
Slovenia
Norway
Denmark
Cyprus
Bulgaria
Ireland
Hungary
Czech Republic
Slovakia
United Kingdom
Poland
Netherlands
EU/EEA
Portugal
Romania
Greece
Luxembourg
France
Belgium
Austria
Latvia
0
20
40
60
80
100
Percentage
In countries not listed, it was not possible to fully link HIV and AIDS diagnoses
underreporting of sex between men as a transmission
mode over time, in many countries the data indicates a
pressing need to significantly scale up more effective
multi-component prevention programmes for this at-risk
population [2].
There has been a substantial decrease in the number
of HIV infections transmitted through sex between men
and women during the past decade. However, heterosexual transmission still remains the second most common
mode of HIV transmission in the EU/EEA and is the most
common transmission mode in some countries. Part of
the decline in heterosexual cases is the result of the
52% decline (since 2005) in the number of heterosexually acquired cases in persons originating from countries
with generalised HIV epidemics. However, cases among
non-migrant heterosexuals have also decreased. Further
investigation is required to understand whether the
trends in decreased HIV diagnoses are mainly driven
by decreasing incidence of HIV in these populations,
increased use of ART, decreased testing, migration
trends, or a combination of factors.
In 2014, migrants, (or persons originating from outside
of the reporting country), constituted a considerable
proportion (37%) of new HIV diagnoses in the EU/EEA.
There is evidence that a proportion of migrants, even
those originating from HIV-endemic areas, acquire HIV
after arrival in the EU/EEA [3-5] indicating the need
for targeted interventions directed at this vulnerable
population.
Transmission among people who inject drugs is declining and remains at a low level in most countries in the
EU/EEA. However, sudden increases were observed in
recent years in Romania and Greece, countries with previously very low levels of HIV among people who inject
drugs [6]. This illustrates the importance of maintaining
adequate coverage of harm reduction services and that
patterns can change quickly in this at-risk group, in the
absence of effective prevention delivered at scale [7].
Although small, the continued numbers of cases infected
through mother-to-child transmission indicate that
greater efforts are needed to address these entirely preventable cases still occurring in some EU/EEA countries.
Despite the clear evidence of the benefits of early introduction of antiretroviral treatment for the health of the
HIV-positive individual [8, 9], many persons continue to
be diagnosed with HIV at an advanced stage of illness.
In addition to the clinical and personal benefits to the
individual diagnosed, early diagnosis and treatment can
also benefit sexual and injecting partners by inhibiting
9
HIV/AIDS surveillance in Europe 2014
onward HIV transmission. Nearly half of people (47%)
diagnosed have a CD4 cell count of less than 350 cells per
mm3 at diagnosis, including 27% of cases with advanced
HIV infection (CD4 <200 cells/mm3). Furthermore, while
AIDS cases are declining in the EU/EEA, 69% of the AIDS
cases reported in 2014 were diagnosed at the same time
or shortly after being diagnosed with HIV. This suggests
problems with access to, and uptake of, HIV testing and
counselling by those most at risk in many countries.
The changes in the epidemiology of HIV infections
observed in the EU/EEA over the last decade indicate
that some progress has been achieved, particularly
with regard to reduced infections attributed to heterosexual transmission and injecting drug use. However,
these epidemiological trends also indicate that it is
crucial to sustain evidence-based HIV prevention interventions that are tailored to the local epidemiological
context and targeted at those most at risk. Programmes
on the prevention and control of HIV infection adapted
appropriately to key populations and maintained to
scale remain important in EU/EEA countries. For most
EU/EEA countries this means a strong focus on MSM,
including foreign-born men who have sex with men.
Other migrants, both those from high-endemic countries and other countries, are also a key population
that needs specific prevention and control efforts in
the majority of EU/EEA countries. Given the increasing
evidence of post-migration HIV acquisition, it is important that migrant-sensitive services for prevention and
HIV testing, combined with policies which promote and
ensure linkage to, and access to, care are delivered in
all countries across the EU/EEA. Finally, harm reduction
programmes among people who inject drugs and their
sexual partners are crucial and should be maintained
and scaled up where service coverage is low.
References
1
European Centre for Disease Prevention and Control/WHO Regional
Office for Europe. HIV/AIDS surveillance in Europe 2013. Stockholm:
ECDC; 2014. Available at: http://ecdc.europa.eu/en/publications/
Publications/hiv-aids-surveillance-report-Europe-2013.pdf
2
European Centre for Disease Prevention and Control. HIV and STI
prevention among men who have sex with men. ECDC Guidance.
Stockholm: ECDC: 2014. Available at: http://ecdc.europa.eu/en/
publications/Publications/hiv-sti-prevention-among-men-whohave-sex-with-men-guidance.pdf
3
Rice BD, Elford J, Yin Z, Delpech VC. A new method to assign country
of HIV infection among heterosexuals born abroad and diagnosed
with HIV. AIDS 2012; 26(15):1961-1966.
4
Fakoya I, Alvarez-del Arco D, Woode-Owusu M, Monge S, RiveroMontesdeoca Y, Delpech V, et al. A systematic review of postmigration acquisition of HIV among migrants from countries with
generalised HIV epidemics living in Europe: implications for effectively managing HIV prevention programmes and policy. BMC Public
Health. 2015; 15: 561. Available at: http://www.biomedcentral.com/
content/pdf/s12889-015-1852-9.pdf
5 Alvarez-del Arco D, Fakoya I, Monge S, Gennotte AF, Touloumi G,
Zuure F, et al; aMASE. HIV Acquisition among migrants living in
Europe: Results from aMASE (Advancing Migrant Access to Health
Services in Europe). Paper presented at: European AIDS Clinical
Society Conference. 15th European AIDS Conference; 2015 October
21-24; Barcelona, Spain.
6
Hedrich D, Kalamara E, Sfetcu O, Pharris A, Noor A, Wiessing L, et
al. Human immunodeficiency virus among people who inject drugs:
Is risk increasing in Europe?. Euro Surveill. 2013;18(48):pii=20648.
Available online: http://www.eurosurveillance.org/ViewArticle.
aspx?ArticleId=20648
7
European Centre for Disease Prevention and Control/European
Monitoring Centre for Drugs and Drug Addiction. Prevention of
infections among people who inject drugs. Stockholm: ECDC,
2011.
Available
at:
http://ecdc.europa.eu/en/publications/
Publications/111012_Guidance_Infectious_diseases_IDU_brief.pdf
10
SURVEILLANCE REPORT
8
INSIGHT START Study Group. Initiation of antiretrovial therapy in
early asymptomatic HIV infection. N Engl J Med. 2015:373(9):795-807.
9
World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV.
Geneva: WHO; 2015. Available at: http://apps.who.int/iris/bitstr
eam/10665/186275/1/9789241509565_eng.pdf
SURVEILLANCE REPORT
HIV/AIDS surveillance in Europe 2014
2 HIV and AIDS in the WHO European Region
2.1 HIV and AIDS diagnoses in
the WHO European Region
HIV diagnoses
With inclusion of 142 197 HIV infections newly diagnosed
in 50 of the 53 countries of the WHO European Region
in 2014i, the cumulative number of people diagnosed
with HIV in the Region since reporting began in the
1980s increased to 1 840 136, including 995 175 people
officially reported to the joint ECDC and WHO Regional
Office for Europe surveillance system (Figure B) and
907 607 diagnosed in Russiaii [1]. The 142 197 people
newly diagnosed in 2014 corresponded to a rate of
16.4 per 100 000 population (Table A). This number
includes 56 945 newly diagnosed infections officially
reported to ECDC/WHO Regional Office for Europe by 49
countriesiii and 85 252 new diagnoses from Russia [1].
The cited data for Russia were published by the Federal
Scientific and Methodological Centre for Prevention and
Control of AIDS and allowed inclusion of Russian data
into HIV annual and cumulative regional totals and rates,
quotation of country-specific annual and cumulative HIV
totals and rates and new HIV diagnoses by transmission mode, as well as cumulative total AIDS diagnoses.
All other regional HIV figures and all 2014 AIDS data
presented in this report are based on data from the 49
countries reporting to ECDC/WHO. Seventy-seven per
cent of people diagnosed with HIV in the 50 countries
in 2014 were diagnosed in the East (109 921), 19% in the
West (27 325) and 3% in the Centre of the Region (4 950)
(Table A) (see Annex 1, Figure A1 for grouping of countries). The rate was also highest in the East (43.2 per 100
000 population), almost seven times higher than in the
West (6.4 per 100 000) and sixteen times higher than in
the Centre (2.6 per 100 000) (Table A).
In the 49 countries reporting to ECDC/WHO, the 56 945
new diagnoses resulted in a rate of 7.9 per 100 000
population (not adjusted for reporting delayiv ). In the 49
countries, 43% of people newly diagnosed (24 669) were
reported in the East with a rate of 22.3 per 100 000, 48%
in the West and 9% in the Centre. For men, the rate for
the Region was 11.1 per 100 000 population (Table 2) and
for women, 4.7 per 100 000 population (Table 3).
i No data from Bosnia and Herzegovina, Turkmenistan or Uzbekistan.
One case from Liechtenstein is also included in the total number of
newly diagnosed HIV infections presented in this report but, since
Liechtenstein is not a Member State of the WHO European Region,
data for Liechtenstein are not included in the totals for the West,
Centre and East of the WHO European Region.
ii Minus the 62 581 cases officially reported to ECDC/WHO by Russia in
2010.
Rates of newly diagnosed HIV infections varied widely
across countries in the WHO European Region for 2014.
In Russia the rate was highest at 58.4 per 100 000 population [1]. Among reporting countries, the highest rates
were reported by Ukraine (36.9)v, Estonia (22.1), Moldova
(20.4), Belarus (19.1), Latvia (17.3), Kazakhstan (13.5),
Georgia (13.3), Luxembourg (12.6), Tajikistan (11.9) and
Kyrgyzstan (11.0) and the lowest were reported by the
former Yugoslav Republic of Macedonia (1.4), Serbia
(1.4), Slovakia (1.6), Croatia (2.2), the Czech Republic
(2.2), Turkey vi (2.3) and Slovenia (2.4) (Table 1). Monaco
reported zero cases.
Among reporting countries, the majority of people
newly diagnosed (36%) were in the age group 30–39
years, while 10% were young people aged 15–24 years.
The male-to-female ratio was 2.2, lowest in the East
(1.4), higher in the West (3.3) and highest in the Centre
(4.4) (Table A). At country level, the highest male-tofemale ratios were observed in Slovenia (15.0), Hungary
(10.6), Croatia (9.2), the Czech Republic (9.1) and Malta
(9.0) and the lowest in Moldova (1.2), Kazakhstan (1.3),
Kyrgyzstan (1.3), Tajikistan (1.3), Ukraine (1.3), Belarus
(1.4) and Sweden (1.4) (Figures 1.1, 2.5, 2.12).
Data on transmission mode provide information about
risk exposure among people newly diagnosed with HIV
in 2014 and indicate that (Table A, Tables 4–7):
• Forty-seven per cent of people newly diagnosed were
infected through heterosexual contact (26 664) (Table
6). Among people reported as infected through heterosexual contact, 13% originated from countries with
generalised epidemics (data not shown).
• Twenty-four per cent of people newly diagnosed were
infected through sex between men (13 926) (Table 4).
• Fourteen per cent were infected through injecting drug
use (7 998) (Table 5).
• One per cent (550) was infected through mother-tochild transmission (Table 7) and 0.2% (124) through
other transmission routes (nosocomial infection,
transfusion or use of other blood products). Eighteen
per cent of children infected through mother-to-child
transmission originated from countries with generalised epidemics (data not shown).
• Transmission mode was reported as unknown or missing for 13% (7 674 cases).
Information about country of birth, country of nationality or region of origin was provided by 43 countries
for 32 406 newly diagnosed infections (57% of all new
iii No data from Bosnia and Herzegovina, Russia, Turkmenistan or
Uzbekistan.
v Excluding data from Crimea and Sevastopol city
iv When adjusting the Regional rate for reporting delay it increases to
8.2 per 100 000 population (59 647 cases), see Annex 1 for methods
and Annex 6 for results.
vi HIV data for Turkey do not include persons diagnosed with AIDS at
the time of HIV diagnoses and are therefore not directly comparable
with data for other countries.
11
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.1: New HIV diagnoses, by CD4 cell count per mm3 at diagnosis and transmission mode, WHO European Region,
2014 (n=19 886)
<200 cells/mm3
n = 9343
Sex between men
200 to <350 cells/mm3
350 to <500 cells/mm3
Transmission mode
>500 cells/mm3
Heterosexual
n = 9215
Injecting drug use
n = 1328
0
20
40
60
80
100
Percentage
Figure 2.2a: Rates of new HIV diagnoses, by year of diagnosis, WHO European Region*, 2005-2014 (including Russia)
50
West
Cases per 100 000 population
Centre
East
40
WHO European Region
30
20
10
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
* In 50 countries (data from Bosnia and Herzegovina, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period).
Figure 2.2b: Rates of new HIV diagnoses, by year of diagnosis, WHO European Region*, 2005-2014 (excluding Russia)
25
West
Cases per 100 000 population
Centre
East
20
WHO European Region
15
10
5
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
* In 49 countries (data from Bosnia and Herzegovina, Russia, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period).
12
SURVEILLANCE REPORT
diagnoses) (Table 11). 31% of these people (10 157)
originated from outside of the reporting country, including 22% (7 174) who originated from outside the WHO
European Region and 9% (2 983) from a European country other than the country of report. 13% originated from
countries with generalised HIV epidemics.
Information about probable country of infection was
reported by 36 countries for 18 067 newly diagnosed
infections (covering 32% of all new diagnoses). Among
these people, 22% (3910 new diagnoses) were acquired
abroad, among whom 38% were reported as infected in
sub-Saharan Africa, 24% in central and eastern Europe,
15% in western Europe and 13% in south and south-east
Asia (Table 13).
In 2014, 34 countries provided information about CD4
cell count at the time of HIV diagnosis for 21 628 people over 14 years old (covering 38% of new diagnoses)
(Table 14). Close to half (48%) of these people were late
presenters with CD4 cell counts below 350 per mm3 at
the time of HIV diagnosis, including 28% with advanced
HIV infection (CD4 <200/mm3). 20% had a CD4 cell count
of between 350 and 500 cells per mm3 and 32% had a
CD4 cell count of 500 or more per mm3 (data not shown).
The percentage of people diagnosed with a CD4 count of
less than 350 per mm3 was higher than 50% in sixteen
countries (8 East, 4 Centre, 4 West). The percentage of
late presenters varied across transmission categories
and was highest for people infected through injecting
drug use (64%), lower for people infected through heterosexual contact (56%) and lowest for men infected
through sex with men (37%) (Figure 2.1). The percentage
of people diagnosed at or below 350 CD4 cells per mm3
increased with age, and 61% of people aged 50 or older
were diagnosed with HIV at or below 350 cells per mm3.
Trends in HIV diagnoses
The rate of newly diagnosed HIV infections increased
by 59% for the period 2005–2014, from 10.3 per 100
000 population in 2005 (80 652 cases) to 16.4 per 100
000 population in 2014 (142 197 cases) in 50 countries
with consistent datai. The increase is mainly driven by
an upward trend in the East where the rate increased by
115%, from 20.1 in 2005 (51 058 cases) to 43.2 in 2014
(109 921 cases) (Figure 2.2a).
In the 49 countries that reported to ECDC and WHO,
the regional rate increased by 11%, from 7.1 in 2005 (45
251 cases) to 7.9 in 2014 (56 945 cases) (not adjusted
for reporting delayii). In the East, the rate increased by
59%, from 14.1 in 2005 (15 657 cases) to 22.3 in 2014
(24 669 cases); in the Centre, by 117%, the largest relative increase across the three geographical areas from
1.2 (2 165 cases) to 2.6 (4 950 cases) whereas in
the West, the rate decreased by 20%, from 8.0
i Data from Bosnia and Herzegovina, San Marino, Turkmenistan and
Uzbekistan not included.
ii When adjusting the 2014 rate for the WHO European Region (49
countries) for reporting delay it increases to 8.2 per 100 000
population (59 630 cases) and the trend for the period 2005–2014
changes from an 11% increase to a 16% increase (see Annex 1 for
methods and Annex 6 for results).
HIV/AIDS surveillance in Europe 2014
(27 425 cases) to 6.4 (27 325 cases) (not adjusted for
reporting delay, see Chapter 2.4) (Figure 2.2b).
A total of 16 748 716 HIV tests performed for diagnostic purposes were reported by 26 countries for 2014.
Countries in the East and West tended to report higher
testing rates than countries in the Centre (Table 27). In
24 countries with data for both 2005 and 2014, the total
number of tests increased by 35%, from 12 263 189 to 16
558 233. The number of tests increased by 10% or more
in 18 countries and decreased by 10% or more in five
countries.
Some 44 countries have consistently reported data on
transmission mode for the period 2005–2014 (Table 8,
Figure 2.3). Data from Estonia, Poland and Turkey were
excluded because more than 50% of their data on transmission mode was missing; data from Spain and Italy
were excluded because coverage of the national surveillance system increased over this time period; and data
from Bosnia and Herzegovina, Russia, Turkmenistan and
Uzbekistan were not reported. Data on transmission
mode from the countries with consistent data indicate
the following:
• The number of new diagnoses of people infected
through heterosexual contact increased by 28% from
18 392 in 2005 to 23 456 in 2014 (Table 6, inconsistently reporting countries excluded).
• The number of new diagnoses of people infected
through sex between men increased by 28% from
7 859 in 2005 to 10 086 in 2014 (Table 4, inconsistently reporting countries excluded).
• The number of new diagnoses of people infected
through injecting drug use decreased by 22% from
9 738 in 2005 to 7 628 in 2014 with a peak of 11 427
in 2007 (Table 5, inconsistently reporting countries
excluded).
• The number of new diagnoses of children infected
through mother-to-child transmission decreased by
11% from 570 in 2005 to 507 in 2014 with a peak of
643 in 2007 (Table 7, inconsistently reporting countries excluded).
• Of the new diagnoses of people infected by other
means, nosocomial infections increased by 29% from
28 in 2005 to 36 in 2014 (with peaks of 117 in 2007
and 106 in 2012), and infections due to transfusion of
blood and its products decreased by 52% from 140 in
2005 to 67 in 2014.
• The number of new diagnoses reported with unknown
risk factors increased by 35% from 3 648 in 2005 to
4 934 in 2014.
Analysing trends by region of origin, there was a 27%
increase in new diagnoses among people originating
from within the reporting country, whereas new diagnoses among non-natives decreased by 28%. Examining
the trend among non-natives by region of origin revealed
a 41% decrease among non-European migrants (people
originating from a country outside the WHO European
13
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.3: New HIV diagnoses, by transmission mode and year of diagnosis, WHO European Region, 2005-2014
30000
Heterosexual
Sex between men
Number of cases
25000
Injecting drug use
Mother-to-child transmission
20000
Other/undetermined
15000
10000
5000
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Data from Bosnia and Herzegovina, Russia, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period; data from Estonia, Poland and
Turkey excluded due to incomplete reporting on transmission mode during the period; data from Italy and Spain excluded due to increasing coverage of national
surveillance during the period.
Cases per 100 000 population
Figure 2.4: Rates of new AIDS diagnoses, by geographical area and year of diagnosis, WHO European Region,
2005-2014
12
West
Centre
10
East
WHO European Region
8
6
4
2
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Data from Bosnia and Herzegovina, Russia, San Marino, Sweden, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period.
Region) and a 48% increase among European migrants
(i.e. people originating from a European country other
than the country of report) (Figure C). The decrease
among non-European migrants is mainly driven by a
decline in people with sub-Saharan African origin while
the increase in new diagnoses among European migrants
is mainly driven by an increase among people originating from central and eastern Europe (data not shown).
AIDS cases, morbidity and mortality
Since the beginning of the epidemic, at least 487 087
people have been diagnosed with AIDS in the WHO
European Region. This number includes 451 667 diagnoses officially reported to ECDC/WHO and 35 420 people
14
diagnosed with AIDS in Russia as of 31 December 2014
[1].
In 2014, 16 037 people were newly diagnosed with AIDS
in 47 countries of the WHO European Regioni, which is
a rate of 2.3 per 100 000 population (Table 15). 74% of
people (11 890) were diagnosed in the East, 20% (3 214)
in the West and 6% (932) in the Centre of the Region.
The rate was also highest in the East (10.7 per 100 000
population), 13 times higher than in the West (0.8 per
100 000) and 21 times higher than in the Centre (0.5 per
100 000).
i No data available from Bosnia and Herzegovina, Russia, San Marino,
Sweden, Turkmenistan or Uzbekistan.
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.5: Male-to-female ratio in all new HIV diagnoses and new diagnoses with heterosexual transmission, by
country, East, 2014
Georgia
Latvia
Armenia
1.8
0.9
1.6
0.7
1.4
0.8
Belarus
1.4
1.1
Ukraine
1.3
0.8
Tajikistan
1.1
Kazakhstan
1.3
0.6
1.0
0.5
1.3
1.3
0.7
Moldova
0.0
1.7
1.1
East average
Kyrgyzstan
1.8
1.4
Estonia
Azerbaijan
People infected through
heterosexual contact
2.1
1.2
Lithuania
All people newly diagnosed
2.6
1.1
1.0
1.2
1.5
2.0
2.5
3.0
Male-to-female ratio
At country level the rate of new AIDS diagnoses varied
widely, with the highest rates reported in Ukraine (23.0),
Latvia (8.5), Georgia (6.6), Armenia (5.7), Moldova (5.7)
and Belarus (5.0) and the lowest rates (0.3 or less)
in Slovakia (0.1), Czech Republic (0.2), Turkey (0.2) i,
Germany (0.3) and Poland (0.3). Andorra, Iceland and
Monaco reported zero cases.
Between 2005 and 2014, the rate of new AIDS diagnoses decreased by 4%, from 2.3 per 100 000 population
(14 294 cases) to 2.2 per 100 000 (16 037 cases) in the
47 countries with consistent AIDS dataii (Figure 2.4).
Because of reporting delays in some countries, this
decrease may even out over the coming years.
AIDS trends varied greatly across the three geographical areas. In the East, the rate increased by 143% from
4.4 in 2005 (4 926 cases) to 10.7 in 2014 (11 890 cases).
In the Centre, the rate increased by 25% from 0.4 in
2005 (751 cases) to 0.5 in 2014 (932 cases) while in the
West, the steady downward trend continued with a 69%
decrease in the rate from 2.6 in 2005 (8 617 cases) to 0.8
in 2014 (3 214 cases).
i AIDS data for Turkey only include people diagnosed with AIDS at the
time of HIV diagnosis and are therefore not comparable with AIDS
data from other countries.
ii Data from Bosnia and Herzegovina, Russia, San Marino, Sweden,
Turkmenistan and Uzbekistan excluded or not available.
Information about deaths of people who had previously been diagnosed with AIDS (irrespective of the
year of diagnosis) was provided by 45 countries in the
WHO European Regioniii for 2014. In these 45 countries,
5 052 people with AIDS were reported to have died
during 2014; a 12% decrease compared with the 5 725
deaths in 2005. Of the 5 052 deaths in 2014, 78% were
reported from the East of the Region, 15% from the West
and 7% from the Centre. These new figures bring the
total number of reported deaths of people with AIDS
from the beginning of reporting to 31 December 2014 to
263 727: 235 466 officially reported to ECDC/WHO and
28 261 in Russia as of December 2013iv [2].
2.2 HIV and AIDS diagnoses in
the East
HIV diagnoses in the East
In 2014, 109 921 people were newly diagnosed with HIV
in 13 countriesv in the East of the WHO European Region,
giving a rate of 43.2 per 100 000 population. This number includes 24 669 new diagnoses officially reported to
iii No data from Bosnia and Herzegovina, Finland, Italy, Russia, San
Marino, Sweden, Turkmenistan or Uzbekistan.
iv Latest publicly available data.
v No data from Turkmenistan and Uzbekistan.
15
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.6: New HIV diagnoses, by age group and transmission mode, East, 2014 (n= 23 828)
15-19
n = 6872
Transmission mode
Injecting drug use
20-24
25-29
30-39
Heterosexual contact
n = 16424
Sex between men
40-49
50+
n = 532
0
20
40
60
80
100
Percentage
No data from Russia, Turkmenistan or Uzbekistan.
WHO/ECDC and 85 252 from Russia [1] and it is the highest number of people and the highest rate ever observed
in the East.
• Twenty-eight per cent of people newly diagnosed
were infected through injecting drug use (6 872)
(Table 5).
For the 12 countries reporting to ECDC/WHO, the rate
was 22.3 per 100 000 population. At country level, the
highest rates for 2014 were observed in Russia (58.4 per
100 000 population) [1], Ukraine (36.9), Estonia (22.1),
Moldova (20.4), Belarus (19.1) and Latvia (17.3); while
the lowest rates were reported by Lithuania (4.8) and
Azerbaijan (6.3). In 11 of 13 countries the rate for 2014
was higher than 10 per 100 000 population.
• Two per cent were infected through sex between men
(532) (Table 4).
The majority of people newly diagnosed in the 12 reporting countries were in the age group 30–39 years (41%),
while 9% were young people aged 15–24 years (Table A).
The male-to-female ratio was 1.4, the lowest of the three
geographical areas, translating into 42% of new diagnoses being in women in the East. The male-to-female
ratio was highest in Georgia (2.6), Latvia (2.1) and
Armenia (1.8) and lowest in Moldova (1.2), Kazakhstan
(1.3), Kyrgyzstan (1.3), Tajikistan (1.3) and Ukraine (1.3)
(Figure 2.5). Among people infected through heterosexual contact, the male-to-female ratio was higher
than 1 (i.e. more men than women) in seven countries
(Armenia, Belarus, Estonia, Georgia, Latvia, Moldova
and Tajikistan) suggesting more men than women being
newly infected through heterosexual contact.
In the East of the Region, heterosexual contact and
injecting drug use are the main modes of HIV transmission while few people are reported as infected through
sex between men. For 2014, information about transmission mode was provided by 12 countries and indicates
the following (Table A, Tables 4–7):
• Sixty-six per cent of people newly diagnosed were
infected through heterosexual contact (16 247)
(Table 6).
16
• 1.2% (289) were infected through mother-to-child
transmission (Table 7) and 0.1% (17) through other
transmission routes (nosocomial infection, transfusion or use of other blood products).
• Transmission mode was reported as unknown or missing for 3% of people newly diagnosed (712).
In Russia, among people newly diagnosed with known
mode of HIV transmissioni (about half of cases [2]), 57%
were infected through injecting drug use, 40% through
heterosexual transmission, 1% through sex between
men and 0.1% through mother-to-child transmission [1]).
The 30–39-year-olds accounted for most HIV diagnoses in all transmission groups, including 51% of
people infected through injecting drug use, 38% of people infected through heterosexual contact and 34% of
people infected through sex between men. People in the
younger age groups tended to be infected through sex
between men while people in the older age groups were
more frequently infected through injecting drug use or
heterosexual contact, with people aged 50 and older
being twice as likely to be infected through heterosexual
contact as through drug injecting or sex between men
(Figure 2.6).
In 2014, heterosexual contact remained the main
reported transmission mode in all 12 countries in the East
while transmission through injecting drug use accounted
i This analysis approach differs from the rest of the report where
cases with unknown transmission mode are shown separately
and included in the denominator for percentage calculations. The
percentages for Russia are therefore not directly comparable with
those presented of other countries or groups of countries.
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.7: New HIV diagnoses by country and transmission mode, East, 2014 (n= 24 338)
Heterosexual contact
Armenia
Injecting drug use
Azerbaijan
Sex between men
Mother-to-child transmission
Belarus
Other
Estonia
Unkown
Georgia
Kazakhstan
Kyrgyzstan
Latvia
Lithuania
Moldova
Tajikistan
Ukraine
0
20
40
60
80
100
Percentage
for 30% or more of new diagnoses in four countries
(Azerbaijan, Georgia, Kazakhstan and Ukraine) and less
than 15% of new diagnoses in two countries (Armenia
and Moldova) (Figure 2.12). Information on transmission
mode was lacking for more than 10% of people newly
diagnosed in five of the 12 countries (Estonia, Latvia,
Lithuania, Moldova and Tajikistan).
Eight countries provided information about CD4 cell
count at the time of HIV diagnosis for 2 753 people over 14
years old (covering 11% of new diagnoses in the East and
60% of new diagnoses in the eight reporting countries)
(Table 14). 58% of these people were late presenters
with CD4 cell counts below 350 per mm3, including 33%
with advanced HIV infection (CD4 <200/mm3). 20% had
a CD4 cell count of between 350 and 500 cells per mm3
and 22% had a CD4 cell count of 500 or more per mm3.
The percentage of people diagnosed with a CD4 count
of less than 350/mm3 was higher than 50% in all countries: Kyrgyzstan (71%), Tajikistan (64%), Estonia (63%),
Georgia (58%), Armenia (55%), Latvia (53%), Azerbaijan
(52%) and Moldova (52%). The percentage of late presenters varied across transmission categories and was
highest for people infected through injecting drug use
(68%), lower for people infected through heterosexual
contact (56%) and lowest for men infected through sex
with men (44%) (Figure 2.8).
In 2014, seven countries in the East provided information on the probable source of infection for the 2 653
people infected through heterosexual contact (Armenia,
Azerbaijan, Estonia, Georgia, Kyrgyzstan, Moldova and
Tajikistan) (Table 10). Among those people, the probable
source of infection for 46% of cases (data not shown) was
a heterosexual partner from a country without a generalised epidemic , sexual contact with a person who injects
drugs was the source of infection for 5% of cases, and
‘other or unknown’ partner risk factors for 47% of cases.
These data suggest that the increasing numbers of people reported as infected through heterosexual contact
might be linked with periodical migration to neighbouring countries without a generalised epidemic.
Nine countries provided information about the probable
country of infection for 4 866 people newly diagnosed
in 2014 (covering 20% of new diagnoses in the East)
(Table 13). From that sample, 12% (578 new diagnoses)
were acquired abroad; among whom 92% were infected
in neighbouring countries of central and eastern Europe.
This variable, if better reported, could provide key information about the extent to which people are becoming
infected in their home country or during periods of being
abroad.
17
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.8: New HIV diagnoses, by CD4 cell count per mm3 at diagnosis and transmission mode, East, 2014 (n=2 609)
<200 cells/mm3
n = 117
Transmission mode
Sex between men
200 to <350 cells/mm3
350 to <500 cells/mm3
≥500 cells/mm3
Heterosexual
n = 1938
Injecting drug use
n = 554
0
20
40
60
80
100
Percentage
Trends in HIV diagnoses in the East
The trend of newly diagnosed HIV infections continued
to increase during the decade with a 115% increase in
the rate of diagnoses per 100 000 population between
2005 and 2014, from 20.1 in 2005 (51 058 cases) to
43.2 in 2014 (109 921 cases) (Russia included) (Figure
2.1a). In the 12 officially reporting countries, the rate
increased by 58% from 14.1 in 2005 (15 657 cases) to
22.3 in 2014 (24 669 cases) (Figure 2.1b). The number
of women newly diagnosed increased by 74% between
2005 and 2014 in the 12 countries, from 5 903 to 10 298
and the number of men newly diagnosed increased by
49%, from 9 562 to 14 251 (Tables 2 and 3).
Of the 12 countries with consistent data, 11 have
reported increasing numbers and rates of new HIV diagnoses during the period 2005–2014. The rate of new
diagnoses increased more than threefold in Armenia,
Kyrgyzstan and Tajikistan and more than doubled in
Azerbaijan, Belarus, Georgia and Kazakhstan. In Russia
the number of people newly diagnosed more than doubled with a 141% increase from 35 401 in 2005 to 85 252
in 2014. In Ukraine, the rate of new diagnoses seems to
have stabilised over the past four years with the rate in
2014 (36.9) remaining at a similar level as that for 2010
(36.4). In Estonia, the only country in the East where a
decrease was observed over the decade, the rate of new
diagnoses halved from 45.7 to 22.1 per 100 000 (Table 1).
During the same period, the number of HIV tests doubled in the 12 countries with consistent data, from
3 545 291 in 2005 to 7 424 986 in 2014 (Table 27).
Information about mode of transmission for the period
2005–2014 from the 11 countries with consistent datai
indicates the following (Table 8b, Figure 2.9):
in Azerbaijan, Kazakhstan and Kyrgyzstan it increased
more than fivefold.
• The number of new diagnoses of people infected
through injecting drug use decreased by 17% from
8 203 in 2005 to 6 805 in 2014 following a peak in
2007–2010 (Table 5, inconsistently reporting countries excluded). In six countries, however, the number
of new diagnoses has increased in comparison with
2005 (Azerbaijan, Belarus, Georgia, Kazakhstan,
Kyrgyzstan and Tajikistan) although the numbers
have decreased in comparison with more recent years
(2008–2011) in all countries.
• The number of new diagnoses of people infected
through sex between men increased almost ten times
from 57 in 2005 to 529 in 2014. (Table 4, inconsistently
reporting countries excluded).
• The number of children infected through mother-tochild transmission increased by 9% from 260 in 2005
to 284 in 2014. (Table 7, inconsistent reporting countries excluded).
• The number of new diagnoses for which the mode of
transmission was unknown increased by 16% from
568 in 2005 to 658 in 2014.
On a logarithmic scale, allowing comparison of rates
of change regardless of starting point, the very large
relative increase in the rate of new diagnoses acquired
through sex between men as compared with other transmission modes is clearly visible (Figure 2.9).
AIDS cases, morbidity and mortality in the East
• The number of new diagnoses of people infected
through heterosexual contact increased by 171% from
5 935 in 2005 to 16 085 in 2014 (Table 6, inconsistently reporting countries excluded). In Armenia and
Tajikistan the number increased tenfold or more and
In 2014, 11 890 people were diagnosed with AIDS in
the 12 countries in the Eastii that provided AIDS data,
giving a rate of 10.7 per 100 000 population. The highest rates were reported in Ukraine (23.0), Latvia (8.5),
Georgia (6.6), Armenia (5.7), Moldova (5.7) and Belarus
(5.0) and the lowest rates in Lithuania (1.3), Estonia (1.4),
Kazakhstan (1.4) and Kyrgyzstan (1.4) (Table 15). Since
the beginning of reporting and up to 31 December 2014,
i Data from Estonia, Russia and Uzbekistan not included.
ii No data from Russia, Turkmenistan or Uzbekistan.
18
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.9: New HIV diagnoses, by transmission mode and year of diagnosis, East, 2005-2014
Arithmetic scale
20000
Heterosexual contact
Sex between men
Injecting drug use
Number of cases
15000
Mother-to-child transmission
Other/undetermined
10000
5000
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Logarithmic scale
100000
Heterosexual contact
Sex between men
Number of cases
10000
Injecting drug use
Mother-to-child transmission
Other/undetermined
1000
100
10
1
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Data from Russia, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period; data from Estonia excluded due to incomplete reporting on
transmission mode during the period.
130 096 people in the East have been diagnosed with
AIDS: 94 676 diagnoses officially reported to ECDC/WHO
and 35 420 people diagnosed in Russia [1].
Between 2005 and 2014 the AIDS rate increased by
143%, from 4.4 cases per 100 000 population (4 926
cases) to 10.7 (11 890 cases) in the 12 countries (Figure
2.4). The number of new AIDS diagnoses increased in
all countries in the East except Estonia, most noticeably in Tajikistan (a 40-fold increase), Azerbaijan (a
10-fold increase) and in Armenia, Kyrgyzstan, Lithuania
and Moldova (3–4-fold increases). By mode of transmission, new AIDS diagnoses among people infected
through heterosexual transmission increased sixfold
while new diagnoses in men infected through sex with
men, although much lower in absolute terms, increased
almost as much (fivefold) in 2014 compared with 2005
(Figure 2.10).
The most common AIDS-indicative diseases diagnosed
in 2014 were pulmonary tuberculosis (24% of all disease events reported), wasting syndrome due to HIV
(14%) and oesophageal candidiasis (13%) (Table 24).
By transmission mode, pulmonary tuberculosis was the
most common disease in all three groups, while wasting
syndrome due to HIV, extrapulmonary tuberculosis and
oesophageal candidiasis were distributed across categories as the second and third most common diseases
(Figure 2.11).
Mortality among people who ever had an AIDS diagnosis remains high in the East. Some 3 941 deaths were
reported by the 12 countries for 2014, a 55% increase
19
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.10: New AIDS diagnoses, by transmission mode and year of diagnosis, East, 2005-2014
Arithmetic scale
8000
Heterosexual contact
7000
Sex between men
Injecting drug use
Number of cases
6000
Mother-to-child transmission
5000
Other/undetermined
4000
3000
2000
1000
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Logarithmic scale
100000
Heterosexual contact
Sex between men
Number of cases
10000
Injecting drug use
Mother-to-child transmission
Other/undetermined
1000
100
10
1
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Data from Russia, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period.
IDU
Hetero
Figure 2.11: Distribution of the three most common AIDS-defining illnesses per transmission mode, East, 2014
240
Mycobacterium tuberculosis, pulmonary
92
Wasting syndrome due to HIV
58
Candidiasis, oesophageal
240
Mycobacterium tuberculosis, pulmonary
127
Mycobacterium tuberculosis, extrapulmonary
64
MSM
Wasting syndrome due to HIV
6
Mycobacterium tuberculosis, pulmonary
5
Candidiasis, oesophageal
3
Mycobacterium tuberculosis, extrapulmonary
0
5
10
15
Percentage
No data from Russia, Turkmenistan or Uzbekistan.
Hetero: heterosexual transmission; IDU: injecting drug use; MSM: men having sex with men.
20
20
25
30
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.12: Male-to-female ratio in new HIV diagnoses, by country, Centre, 2014
Slovenia
Hungary
Croatia
Czech Republic
Cyprus
Slovakia
Serbia
Montenegro
Poland
Bulgaria
Centre average
Turkey
Albania
Romania
0
4
8
12
16
Male-to-female ratio
The former Yugoslav Republic of Macedonia did not report any female cases in 2014.
in comparison with the 2 544 deaths in 2005, although
the number of deaths has begun to decline since 2012
(Table 25). The 2014 data bring the cumulative number
of deaths in the East since the beginning of reporting to
70 846; 42 585 officially reported to WHO/ECDC and 28
261 in Russia [1].
2.3 HIV and AIDS diagnoses in
the Centre
HIV diagnoses in the Centre
The HIV epidemic in the Centre remains at a relatively low
level although the number of new diagnoses is increasing in many countries, especially in people infected
through sex between men. A total of 4 950 people were
newly diagnosed with HIV in 2014 in 14 of the 15 countries in the Centre of the WHO European Region, igiving
a rate of 2.6 per 100 000 population (Table 1). The highest rates were observed in Cyprus (6.5), Romania (4.0),
Bulgaria (3.4) and Montenegro (3.2); and the lowest in
the former Yugoslav Republic of Macedonia (1.4), Serbia
(1.4) and Slovakia (1.6).
The most affected age group in 2014 was the 30–39-yearolds with 34% of cases, whereas 15% were diagnosed
in young people aged 15–24 years (Table A). The maleto-female ratio was 4.4, higher than in both the West
and the East. The highest male-to-female ratios were
observed in Slovenia (15.0), Hungary (10.6), Croatia (9.2)
and the Czech Republic (9.1) (Figure 2.12).
In the Centre, sex between men and heterosexual contact were the predominant transmission modes. For
2014, information on transmission mode was provided
by 14 countries and indicates the following (Table A,
Tables 4–7):
• Twenty-eight per cent of people newly diagnosed
were infected through sex between men (1 386)
(Table 4).
• Twenty-four per cent of people newly diagnosed
were infected through heterosexual contact (1 205)
(Table 6).
i No data from Bosnia and Herzegovina for 2014
21
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
• Five per cent of people newly diagnosed were infected
through injecting drug use (270).
in 2005 to 878 in 2014 (Table 4, inconsistently reporting countries excluded).
• One per cent was infected through mother-to-child
transmission (50).
• The number of new diagnoses in people infected
through heterosexual transmission increased by 26%
from 501 cases in 2005 to 632 cases in 2014 (Table 6,
inconsistently reporting countries excluded).
• Transmission mode was unknown for 41% of people
newly diagnosed (2 026).
In 2014, sex between men remained the predominant
reported mode of transmission in ten countries: Bulgaria,
Croatia, Cyprus, the Czech Republic, the former Yugoslav
Republic of Macedonia, Hungary, Montenegro, Serbia,
Slovakia and Slovenia; whereas heterosexual transmission was the main mode of transmission in Albania and
Romania. In Poland and Turkey, transmission mode was
unknown for more than 50% of new diagnoses making
the assessment of main transmission mode uncertain.
Transmission mode information was lacking for more
than 10% of people newly diagnosed in nine of 14 countries (Figure 2.13).
Nine countries provided information about CD4 cell
count at HIV diagnosis for 1 596 people over 14 years
old (covering 33% of new diagnoses in the Centre) (Table
14). 51% of these people were late presenters with CD4
cell counts below 350 per mm3 at HIV diagnosis, including 32% with advanced HIV infection (CD4 <200/mm3).
19% had a CD4 cell count of between 350 and 500 cells
per mm3and 30% had a CD4 cell count of 500 or more
per mm3. The percentage of people diagnosed with CD4
counts of less than 350/mm3 was higher than 50% in two
countries: Albania (77%) and Serbia (67%). The percentage that were late presenters varied across transmission
categories and was highest for people infected through
injecting drug use (58%), lower for people infected
through heterosexual contact (54%) and lowest for men
infected through sex with men (39%) (Figure 2.14).
Trends in HIV diagnoses in the Centre
In the 14 countries in the Centre, the rate of new HIV
diagnoses increased by 117% between 2005 and 2014,
from 1.2 per 100 000 population in 2005 (2 165 cases) to
2.6 in 2014 (4 950 cases) (Figure 2.2). Rates increased in
all countries and more than doubled in seven: Albania,
Bulgaria, the Czech Republic, Hungary, Montenegro,
Slovakia and Turkey.
Reported data from six countries suggest a small
increase in HIV testing, with a reported 18% increase in
the number of tests performed in 2014 (3 163 703) compared with 2005 (2 677 179) in the eight countries with
data for both years (Table 27).
Information about mode of transmission for the period
2005–2014 in the 12 countries with consistent datai indicates the following (Table 8b, Figure 2.14):
• The number of new diagnoses in people infected
through sex between men more than tripled from 276
i Data from Bosnia and Herzegovina not reported, and data from
Poland and Turkey not included because information on transmission
mode was lacking for more than 50% of cases.
22
• The number of new diagnoses in people infected
through injecting drug use increased sixfold from 35
in 2005 to 223 in 2014, mainly due to an outbreak in
Romania that started in 2011 and decreased in 2014
(Table 5, inconsistently reporting countries excluded).
• The number of new diagnoses in people infected
through mother-to-child transmission decreased by
13%, from 30 children in 2005 to 26 in 2014 (Table 7,
inconsistently reporting countries excluded).
• The number of new diagnoses reported with unknown
transmission mode increased by 3% from 308 in 2005
to 316 in 2014.
AIDS cases, morbidity and mortality in the
Centre
A total of 932 people were diagnosed with AIDS in the 14
reporting countries in the Centre in 2014, corresponding
to a rate of 0.5 per 100 000 population (Table 15). The
highest rates were reported by Romania (1.9), Albania
(1.7) and Montenegro (1.1). In the other countries, AIDS
rates remained below 1.0 per 100 000 population.
Between 2005 and 2014 the rate of new AIDS diagnoses
increased by 25%, from 0.4 per 100 000 in 2005 (750
cases) to 0.5 per 100 000 in 2014 (932 cases) (Figure
2.4). At country level trends were heterogeneous. Of
the nine countries reporting more than 20 AIDS cases
in 2014, the rate increased in six (Albania, Bulgaria,
the Czech Republic, Hungary, Romania and Turkey),
decreased in two (Poland and Serbia) and remained
stable in one (Croatia) (Table 15). By mode of transmission, new AIDS diagnoses increased most among men
infected through sex between men (by 105%), second
most in people infected through injecting drug use (by
72%) and third most in people infected through heterosexual contact (by 32%) in 2014 compared with 2005.
Contrary to the distribution of transmission modes for
new HIV diagnoses in the Centre (where sex between
men predominates), the majority of new AIDS diagnoses
were in people infected through heterosexual contact
(Figure 2.16).
The most common AIDS-indicative diseases diagnosed
in 2014 were wasting syndrome due to HIV (18%), pulmonary tuberculosis (11%) and Pneumocystis pneumonia
(10%) (Table 24). By transmission mode, the most common diseases for people infected through sex between
men are Pneumocystis pneumonia, wasting syndrome
due to HIV and oesophageal candidiasis; for people
infected through injecting drug use, pulmonary tuberculosis, wasting syndrome due to HIV and extrapulmonary
tuberculosis; and for heterosexuals, wasting syndrome
due to HIV, pulmonary tuberculosis and oesophageal
candidiasis (Figure 2.17).
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.13: New HIV diagnoses by country and transmission mode, Centre, 2014 (n= 9 790)
Sex between men
Albania
Heterosexual contact
Turkey
Injecting drug use
Romania
Other
Poland
Unkown
Bulgaria
Serbia
Slovakia
Hungary
Montenegro
Slovenia
Cyprus
Czech Republic
Croatia
Former Yugoslav Republic
of Macedonia
0
20
40
60
80
100
Percentage
Mortality among people diagnosed with AIDS remains
low and stable in the Centre. Some 365 deaths were
reported by the 14 countries for 2014, no change compared with the 366 people who died in 2005 (Table 25).
2.4 HIV and AIDS diagnoses in
the West
HIV diagnoses in the West
The epidemiological pattern of HIV infection in the
West largely mirrors that of the EU/EEA as described in
Chapter 1. In 2014, 27 325 people were newly diagnosed
with HIV in the West of the WHO European Region in the
23 countries giving a rate of 6.4 per 100 000 population
(not adjusted for reporting delayi) (Table 1, Table A). Of
newly diagnosed HIV infections in 2014, the majority
(32%) were 30–39-year-olds, 11% were aged 15–24 years
old and the male-to-female ratio was 3.3 (Table A).
Sexual transmission between men remained the main
transmission mode in 2014, followed by heterosexual
transmission, together accounting for 78% of new diagnoses. Information about transmission mode indicates
the following (Table A, Tables 4–7):
i When adjusting the rate for the West for reporting delay it increases
to 7.0 per 100 000 population (29 728 cases), see Annex 1 for
methods and Annex 6 for results.
• Forty-four per cent of people newly diagnosed were
infected through sex between men (12 007) (Table 4).
• Thirty-four per cent of people newly diagnosed were
infected through heterosexual contact (9 212 cases)
(Table 6).
• Three per cent of people newly diagnosed were
infected through injecting drug use (856) (Table 5).
• Mother-to-child transmission accounted for 0.8% of
new diagnoses (211 cases) (Table 7).
• Transmission mode was unknown for 18% of new diagnoses (4 941).
Trends in HIV diagnoses in the West
Between 2005 and 2014 in the 23 countries, the rate of
new diagnoses declined by 20%, from 8.0 per 100 000
population (27 429) in 2005 to 6.4 (27 325) in 2014 (not
adjusted for reporting delayii). Rates increased by 10% or
more in six countries and decreased by 10% or more in 11
countries (not taking into account the impact of reporting delays in several countries).
ii When adjusting the 2014 rate for the West for reporting delay it
increases to 7.0 per 100 000 population (29 728 cases) and the
decreasing trend for the period 2005–2014 changes from a 20%
decline to a 12% decline (see Annex 1 for methods and Annex 6 for
results).
23
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.14: New HIV diagnoses, by CD4 cell count per mm3 category at diagnosis and transmission mode, Centre, 2014
(n=1 376)
<200 cells/mm3
n = 603
Transmission mode
Sex between men
200 to <350 cells/mm3
350 to <500 cells/mm3
≥500 cells/mm3
Heterosexual
n = 566
Injecting drug use
n = 207
0
20
40
60
80
100
Percentage
Information about trend by transmission mode during
the period 2005–2014 suggests the following (Table 8b,
Figure 2.18):
• New diagnoses of people infected through sex
between men increased by 15% from 7 526 to 8 679
(Table 4).
• New diagnoses of people infected through heterosexual contact decreased by 44% (from 11 956 to 6 739)
(Table 6), with the steepest decline among cases originating from countries with generalised epidemics (see
Chapter 1.2 and Figure 2.18).
• New diagnoses of people infected through injecting drug use decreased by 60%, from 1 500 to 600
(Table 5).
• New diagnoses of children infected through motherto-child transmission decreased by 30% from 280 to
197 (Table 7).
• New diagnoses with unknown transmission mode
increased by 43% from 2 772 to 3 960.
AIDS cases, morbidity and mortality in the
West
In 2014, 3 214 people were diagnosed with AIDS as
reported by 19 of the 23 countries in the Westi, giving a
rate of 0.8 per 100 000 population (Table 15). Between
2005 and 2014, the rate of new AIDS cases decreased
by 69%, from 2.6 (8 617 cases) to 0.8 (3 214 cases)
(Figure 2.4). By mode of transmission, new AIDS diagnoses decreased in all transmission groups, most notably
among people who inject drugs (a 83% decline) and
people infected through heterosexual contact (a 60%
decline) (Figure 2.19).
The most common AIDS-indicative diseases diagnosed
in the West in 2014 were Pneumocystis pneumonia
(23%) and oesophageal candidiasis (11%) (Table 24). By
transmission mode, the most common AIDS-indicative
diseases for men infected through sex with men were
i No data from Finland, Italy, San Marino and Sweden.
24
Pneumocystis pneumonia, Kaposi’s sarcoma and
oesophageal candidiasis; for people who inject drugs
and heterosexually infected cases it was Pneumocystis
pneumonia, oesophageal candidiasis and pulmonary
tuberculosis (Figure 2.20).
In the West, 736 people diagnosed with AIDS were
reported to have died in during 2014 in the 19 countries
(Table 25), continuing the decreasing trend from 2 815
deaths in 2005 (a 74% decrease).
2.5 Number of HIV tests
performed
The numbers of HIV tests performed annually for diagnostic purposes (i.e. excluding unlinked anonymous
tests and screening of blood donations) are presented
by country in Table 27. In 2014, 26 countries (12 East,
8 Centre and 4 West) reported a total of 16 748 716
HIV tests performed. Higher testing rates tended to be
reported by countries in the East and West, and lower
rates by countries in the Centre.
The number of tests increased by 35%, from 12 263 189
in 2005 to 16 558 233 in 2014 in 24 countries with consistent data. The number of tests increased by 10% or
more in 18 countries and decreased by 10% or more in
five countries.
Data on the number of HIV tests can support the interpretation of trends in newly diagnosed HIV infections. In the
East where the rate of newly diagnosed infections and
the number of HIV tests performed both doubled during
the decade in the same 12 countries, increased testing
activity may have contributed to the observed increase
in new diagnoses. In the Centre, however, the rate of
new diagnoses also doubled while the number of HIV
tests only increased by 18% (by 26% if all 14 countries
are included using the most recent data point available)
and it appears less likely that increased testing should
have contributed to the increase in new diagnoses. HIV
test data for the West are too sparse to provide the basis
for a similar assessment.
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.15: New HIV diagnoses, by transmission mode and year of diagnosis, Centre, 2005-2014
1000
Heterosexual
Sex between men
Injecting drug use
Number of cases
800
Mother-to-child transmission
Other/undetermined
600
400
200
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Data from Bosnia and Herzegovina excluded due to inconsistent reporting during the period; data from Poland and Turkey excluded due to incomplete reporting on
transmission mode during the period.
Figure 2.16: New AIDS diagnoses, by transmission mode and year of diagnosis, Centre, 2005-2014
400
Heterosexual contact
Sex between men
Injecting drug use
Number of cases
300
Mother-to-child transmission
Other/undetermined
200
100
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Year of diagnosis
Data from Bosnia and Herzegovina excluded due to inconsistent reporting during the period.
It should be noted, however, that the presented data
are derived from different sources, ranging from annual
reports from national HIV testing sites, to extrapolations
from information systematically gathered in laboratory networks performing HIV tests and to estimates
based on national surveys. Contrary to countries in the
East and the Centre, many countries in the West do not
systematically collect data on the number of HIV tests
and in some cases only estimates are available. Also,
increasing numbers of HIV tests overall do not necessarily generate a higher HIV testing yield (case detection
rate) if the HIV tests are performed among people at low
risk of HIV infection.
2.6 Conclusions
Three decades after the beginning of HIV surveillance
in Europe, HIV infection continues to be of major public
health importance in the Region and of particular concern in the eastern part of the Region. In 2014, more than
142 000 people were diagnosed with HIV infection in the
WHO European Regioni with a rate of 16.3 per 100 000
population – the highest number and rate ever reported
for the Region. 77% of these people were diagnosed in
the East of the Region with a rate of 42.4 per 100 000
population, while 19% were diagnosed in the West with
i No data from Bosnia and Herzegovina, San Marino, Turkmenistan and
Uzbekistan.
25
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Figure 2.17: Distribution of the three most common AIDS-defining illnesses per transmission mode, Centre, 2014
MSM
IDU
32
Candidiasis, oesophageal
36
Wasting syndrome due to HIV
51
Pneumocystis pneumonia
20
Mycobacterium tuberculosis, extrapulmonary
37
Wasting syndrome due to HIV
69
Mycobacterium tuberculosis, pulmonary
52
Hetero
Candidiasis, oesophageal
66
Mycobacterium tuberculosis, pulmonary
104
Wasting syndrome due to HIV
0
5
10
15
20
25
30
35
Percentage
No data from Bosnia and Herzegovina.
Hetero: heterosexual transmission; IDU: injecting drug use; MSM: men having sex with men.
Figure 2.18: New HIV diagnoses, by transmission mode and year of diagnosis, West, 2005-2014
12000
Heterosexual
Sex between men
Number of cases
10000
Injecting drug use
Mother-to-child
8000
Other/undetermined
6000
4000
2000
0
2007
2008coverage
2009
2010surveillance
2011 during
2012
2013
Data from Italy 2005
and Spain 2006
excluded due
to increasing
of national
the period.
2014
Year of diagnosis
Figure 2.19: New AIDS diagnoses, by transmission mode and year of diagnosis, West, 2005-2014
4000
Heterosexual contact
Sex between men
Injecting drug use
Number of cases
3000
Mother-to-child transmission
Other/undetermined
2000
1000
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
Year of diagnosis
Data from San Marino and Sweden excluded due to inconsistent reporting during the period.
26
2014
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
a rate of 6.4, and 3% were diagnosed in the Centre with
a rate of 2.6 per 100 000.
The 2014 surveillance data suggest that epidemic patterns and trends vary widely across European countries
but that HIV transmission is continuing in the majority of countries, mainly among men who have sex with
men in the western and central parts of the Region and
among people infected heterosexually, notably women,
and people who inject drugs and their sexual partners
in the eastern part of the Region. A third of new HIV
diagnoses were among persons originating from outside of the reporting country, including 22% originating
from outside the WHO European Region. New diagnoses decreased among non-European migrants (people
originating from a country outside the WHO European
Region) and increased among European migrants (people originating from a European country other than the
country of report), particularly in people from central
and eastern Europe. Overall, the predominant transmission modes, characteristics of population groups
most affected, and trends over time vary by country and
geographical/epidemiological area, demonstrating the
diversity in the epidemiology of HIV in Europe and corresponding responses needed.
In the eastern part of the Region, HIV transmission continues with increasing intensity in most countries. The
number of people newly diagnosed more than doubled
in 2014 compared with ten years ago and the trend for
the 13 countries with data available (Turkmenistan and
Uzbekistan lacking) continues its steady increase. Of the
two reporting countries that were most heavily affected
at the beginning of the reporting period, Estonia and
Ukraine, Estonia has truly reversed its epidemic and
halved the rate of new diagnoses over the decade.
Ukraine also appears to have started to halt and reverse
the epidemic in the last few years due to its expansion of
HIV prevention programmes for people who inject drugs
that began with the influx of external support in 2006
and expanded in the years following with considerable
increases in the provision of opioid substitution therapy and antiretroviral therapy for people who inject
drugs [3].
While HIV transmission through injecting drug use has
decreased during the decade overall and in recent years
in particular, injecting drug use still accounted for 28%
of new diagnoses in the East (in the countries reporting to ECDC/WHO) and for 57% of people with known
transmission mode in Russia in 2014 [1]. Heterosexual
transmission is the main reported mode of transmission in the East and there have been large and sustained
increases in people newly infected through heterosexual
contact in all countries over the past decade. At the same
time, although 58% of new diagnoses were in men, new
diagnoses among women increased by 74% compared
with a 49% increase among men.
For a considerable number of people infected through
heterosexual contact, the probable source of infection
was reported to be a heterosexual partner from a country without a generalised epidemic, suggesting that the
increases in heterosexual transmission might be linked
with periodical migration to neighbouring countries
without generalised epidemics. Further, there is also
evidence to suggest that a substantial proportion of men
reported as heterosexually infected may in fact be men
who have sex with men or injecting drug users and misclassified as heterosexually infected [4].
To halt and reverse the HIV epidemic in the East, there
is an urgent need to implement and scale up bold evidence-based actions: more comprehensive prevention
strategies for people at risk of heterosexual transmission and people who inject drugs, including harm
reduction interventions; HIV testing services that are in
line with new consolidated WHO recommendations(HIV
testing by trained lay providers (community-based
HIV testing) and consideration of HIV self-testing in
addition to provider initiated testing); and early ART
initiation in all population groups [5]. In couples where
IDU
MSM
Figure 2.20: Distribution of the three most common AIDS-defining illnesses per transmission mode, West, 2014
354
Pneumocystis pneumonia
188
Kaposi’s sarcoma
106
Candidiasis, oesophageal
57
Pneumocystis pneumonia
56
Candidiasis, oesophageal
43
Hetero
Mycobacterium tuberculosis, pulmonary
439
Pneumocystis pneumonia
181
Candidiasis, oesophageal
171
Mycobacterium tuberculosis, pulmonary
0
5
10
15
20
25
30
Percentage
No data from San Marino or Sweden.
Hetero: heterosexual transmission; IDU: injecting drug use; MSM: men having sex with men.
27
HIV/AIDS surveillance in Europe 2014
one of the partners engages in high-risk behaviour,
such as injecting drug use, purchased sex, bisexual
relations or is working abroad for longer periods of
time, prevention interventions should address the risk
of heterosexual transmission, including the use of preexposure prophylaxis where relevant and according to
WHO recommendations [6, 7]. The removal of laws and
policies that hamper access to, and uptake of, key HIV
prevention and treatment services for key populations
could facilitate further progress in the reduction of HIV
transmission among people who inject drugs and their
partners.
In the central part of the Region, the HIV epidemic
remains at a low level although the rate of new diagnoses increased more in the Centre than in any other part of
the WHO European Region and the number of new diagnoses is increasing in almost all countries. The epidemic
in this part of Europe is diverse but sexual transmission prevails (with sex between men dominating over
heterosexual transmission in the majority of countries)
and men are far more affected than women in comparison with other parts of Europe. Recent increasing
trends in new diagnoses are mostly driven by sustained
increases among people infected through sex between
men although new diagnoses in people infected through
heterosexual contact also increased. Increases of HIV
among people who inject drugs in the EU/EEA in recent
years indicate that even low numbers can rapidly evolve
into an outbreak when public health interventions are
insufficient [8].
In the western part of the Region, the HIV epidemic
remains constant overall but with continuing and
increasing transmission among men who have sex with
men. This population group accounts for the highest
number of new diagnoses in the West in 2014 and is
the only group where the trend continues to increase.
Despite considerable efforts to prevent and control HIV
among MSM in the West, further strengthening of combination HIV prevention strategies appears to be needed
[7, 9, 10]. Recent guidance by WHO now recommends
that countries consider offering pre-exposure prophylaxis as an additional prevention choice for people at
substantial risk of HIV infection as part of combination
prevention approaches [6]. Heterosexual transmission
is decreasing, both among people originating from
countries with a generalised epidemic and among nonmigrant heterosexuals. There is also evidence that a
certain proportion of migrants, even those originating from HIV-endemic areas, acquire HIV after arrival
in the EU/EEA [3, 4]. The extent to which the observed
decreases can be explained by decreased incidence of
HIV in migrant populations, decreased testing, changed
migration patterns, or a combination of factors, is
unclear. Despite these decreasing trends, the public
health challenge of ensuring access to health services
for migrant populations in general, and to HIV prevention, testing, treatment and care services specifically,
remains as relevant as ever in Europe in 2015.
28
SURVEILLANCE REPORT
It is of major concern that 48% of people newly diagnosed are detected late with CD4 cell counts below
350 per mm3 at diagnosis, and that, further, 28% of the
newly diagnosed have CD4 cell counts below 200 per
mm3. Among people infected through injecting drug
use in the East, fully 68% had CD4 cell counts below
350 per mm3 at the time of their HIV diagnosis. These
so-called late presenters reflect the low access to, and
uptake of, HIV testing and counselling by those most
at risk. Delayed initiation of antiretroviral treatment
decreases the clinical benefits as well as the impact of
treatment on preventing further HIV transmission. HIV
testing strategies need to be reconsidered, including
innovative approaches that consider the new consolidated WHO guidance on HIV testing service and focus on
the most affected population groups and with services
tailored to the specific needs of these groups. Support
for timely linkage to HIV prevention, treatment and
care is also essential. Appropriate HIV testing services
delivered at sufficient scale are key to support progress
towards the three UN 90:90:90 targets (90% of people
living with HIV know their HIV status, 90% of diagnosed
people living with HIV receive treatment, and 90% of
people on treatment achieve viral suppression) [11], with
improved treatment outcomes and reductions in further
HIV transmission.
AIDS trends varied greatly across the three geographical areas. While the rate continued its steady decline
in the West, it increased slightly in the Centre and dramatically in the East of the Region. The high number of
AIDS cases in the East is indicative of late HIV diagnosis, low treatment coverage and delayed initiation of
life-saving HIV treatment. New WHO treatment guidance
now recommends that antiretroviral therapy should be
initiated for all persons living with HIV, irrespective of
CD4 cell count [6, 12]. Improved access to, and earlier
initiation of, treatment, particularly for key populations
and discordant couples, is needed throughout Europe
but particularly in the eastern part of the WHO European
Region.
The number of countries conducting enhanced surveillance for HIV in Europe has increased over the years.
Enhanced HIV surveillance in Europe is essential to
provide the strategic information for monitoring the epidemic and guiding the public health response to HIV.
Interventions to control the epidemic need to be based
on evidence and adapted to national and local epidemiology. In order to achieve this aim, surveillance data
should be of high quality and provide complete case
reports linked with clinical markers and with information
about key variables such as transmission mode, probable country and source of infection and origin.
SURVEILLANCE REPORT
HIV/AIDS surveillance in Europe 2014
References
1
Russian Federal Scientific and Methodological Center for Prevention
and Control of AIDS. Information note ‘Spravka’ on HIV infection in
the Russian Federation as of 31 December 2014. Moscow: Russian
Federal Scientific and Methodological Center for Prevention and
Control of AIDS; 2015. Available at: http://hivrussia.org/files/
spravkaHIV2014.pdf.
2
Russian Federal Scientific and Methodological Center for Prevention
and Control of AIDS. HIV-infection Bulletin number 39. Moscow: The
Federal Service for Surveillance of Consumer Rights Protection and
human well-being; 2014.
3
Vitek CR, Čakalo JI, Kruglov YV, Dumchev KV, Salyuk TO, Božičević
I, et al. Slowing of the HIV epidemic in Ukraine: evidence from
case reporting and key population surveys, 2005-2012. PLoS One.
2014;9(9):e103657.
4
Čakalo JI, Božičević I, Vitek CR, Mandel JS, Salyuk TO, Rutherford
GW. Misclassification of Men with Reported HIV Infection in Ukraine.
AIDS Behav. 2015;19:1938-1940.
5
World Health Organization. Consolidated guidelines on HIV testing
services. Geneva: World Health Organization; 2015.
6
World Health Organization. Guidelines on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Geneva: World
Health Organization; 2015.
7
World Health Organization. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Geneva:
World Health Organization; 2014.
8 Hedrich D, Kalamara E, Sfetcu O, Pharris A, Noor A, Wiessing L, et
al. Human immunodeficiency virus among people who inject drugs:
Is risk increasing in Europe? Euro Surveill. 2013;18(48):pii=20648.
Available online: http://www.eurosurveillance.org/ViewArticle.
aspx?ArticleId=20648
9
European Centre for Disease Prevention and Control. HIV and STI
prevention among men who have sex with men. ECDC Guidance.
Stockholm: ECDC; 2014. Available at: http://ecdc.europa.eu/en/
publications/Publications/hiv-sti-prevention-among-men-whohave-sex-with-men-guidance.pdf
10 United Nations Population Fund, Global Forum on MSM and
HIV, United Nations Development Programme, World Health
Organization, United States Agency for International Development,
the US President’s Emergency Plan for AIDS Relief, and the Bill &
Melinda Gates Foundation. Implementing comprehensive HIV and
STI programmes with men who have sex with men. New York (NY):
United Nations Population Fund; 2015.
11UNAIDS. Ambitious treatment targets: Writing the final
chapter of the AIDS epidemic. Geneva; 2014. Available at:
h t t p://w w w. u n a i d s .o r g /s i t e s/d e f a u l t /f i l e s/m e d i a _ a s s e t /
JC2670_UNAIDS_Treatment_Targets_en.pdf
12 INSIGHT START Study Group. Initiation of antiretrovial therapy in
early asymptomatic HIV infection. N Engl J Med. 2015;373(9):795-807.
29
HIV/AIDS surveillance in Europe 2014
30
SURVEILLANCE REPORT
SURVEILLANCE REPORT
HIV/AIDS surveillance in Europe 2014
Tables
31
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 1: New HIV diagnoses and rates per 100 000 population, by country and year of diagnosis (2005-2014) and
cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
Country*
EU/EEA
West Austria
West Belgium
Centre Bulgaria
Centre Croatia
Centre Cyprus
Centre Czech Republic
West Denmark
East
Estonia
West Finland
West France
West Germany
West Greece
Centre Hungary
West Iceland
West Ireland
West Italy
East
Latvia
Liechtenstein
East
Lithuania
West Luxembourg
West Malta
West Netherlands
West Norway
Centre Poland
West Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West Spain
West Sweden
West United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West Monaco
Centre Montenegro
East
Russia***
West San Marino
Centre Serbia****
West Switzerland
East
Tajikistan
Centre Turkey*****
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of
start of
reporting
2005
2006
2007
2008
2009
N
Rate
N
Rate
N
Rate
N
Rate
N
Rate
1980
1985
1986
1985
1986
1985
1990
1988
1980
2003
1993
1984
1985
1983
1981
2004
1987
1985
1988
1983
2001
1980
1984
1985
1985
1987
1985
1985
2003
1983
1981
339
1070
83
68
41
90
264
621
134
5995
2492
539
106
8
325
1490
299
0
120
55
15
1231
219
705
2225
597
21
38
1654
396
7889
29129
4.1
10.2
1.1
1.6
5.6
0.9
4.9
45.7
2.6
9.6
3.0
4.9
1.0
2.7
7.9
7.6
13.3
0.0
3.6
11.9
3.7
7.5
4.8
1.8
21.2
2.8
0.4
1.9
9.4
4.4
13.1
6.7
341
1018
91
57
34
91
245
668
191
5698
2643
506
81
11
353
2018
299
2
100
54
24
1144
276
811
2270
494
27
33
1784
397
7447
29208
4.1
9.7
1.2
1.3
4.6
0.9
4.5
49.5
3.6
9
3.2
4.6
0.8
3.7
8.4
8.4
13.4
5.7
3
11.5
5.9
7
5.9
2.1
21.6
2.3
0.5
1.6
10
4.4
12.3
6.6
356
1072
126
49
45
121
306
633
187
5679
2772
557
119
13
391
2221
350
0
106
45
14
1238
248
807
2173
480
39
37
2805
488
7354
30831
4.3
10.1
1.7
1.1
5.9
1.2
5.6
47.1
3.5
8.9
3.4
5
1.2
4.2
9
7.2
15.8
0
3.3
9.5
3.5
7.6
5.3
2.1
20.6
2.3
0.7
1.8
11.5
5.4
12
6.8
373
1092
123
71
37
148
285
545
147
5766
2830
612
145
10
404
2482
358
0
95
59
28
1321
299
839
2242
563
53
48
3471
426
7220
32092
4.5
10.2
1.6
1.6
4.8
1.4
5.2
40.7
2.8
9
3.4
5.5
1.4
3.2
9.1
6.7
16.3
0
3
12.2
6.9
8.1
6.3
2.2
21.2
2.7
1
2.4
12.4
4.6
11.7
6.9
311
1132
171
55
38
156
236
411
172
5458
2868
607
140
15
395
3825
275
1
180
60
19
1207
282
961
2041
550
53
48
3628
431
6659
32385
3.7
10.5
2.3
1.3
4.8
1.5
4.3
30.8
3.2
8.5
3.5
5.4
1.4
4.7
8.7
6.6
12.7
2.8
5.7
12.2
4.6
7.3
5.9
2.5
19.3
2.7
1
2.4
11.1
4.7
10.7
6.6
1993
2004
1988
1987
1981
1986
1993
1989
1981
1987
1987
1987
1985
1989
2010
1985
1984
1985
1991
1985
1990
1987
1981
31
6
75
206
751
13
1
239
355
958
171
533
0
10
4
103
724
220
271
0
11464
2159
18294
1
7.8
2.5
2.4
7.8
0.3
0
5.3
5.4
6.2
3.3
12.8
0
1.6
13.5
1.1
9.8
3.2
0.4
0
24.5
8.3
7.9
33
1
68
239
733
11
8
278
337
1729
244
621
1
8
2
88
760
201
276
0
13456
2205
21299
1.1
1.3
2.3
2.8
7.6
0.3
0.4
6.3
5
11.1
4.7
15
3
1.3
6.7
1
10.2
2.9
0.4
0
28.9
8.4
9.2
43
5
107
437
990
4
5
341
365
1973
409
731
1
9
0
91
757
350
349
0
13469
3169
23605
1.4
6.2
3.6
5
10.4
0.1
0.2
7.8
5.3
12.5
7.8
17.7
3
1.5
0
1
10
4.9
0.5
0
29.1
11.9
10.1
52
3
136
433
881
9
4
355
394
2321
553
793
0
11
4
118
763
362
396
0
15444
3061
26093
1.8
3.6
4.6
4.9
9.2
0.2
0.2
8.2
5.6
14.6
10.4
19.3
0
1.8
12.5
1.3
10
5
0.6
0
33.6
11.4
11.1
64
2
149
455
1072
6
6
387
387
2078
696
704
0
14
1
131
654
444
471
0
16268
4055
28044
2.2
2.4
5
5.1
11.3
0.2
0.3
9
5.3
12.9
12.9
17.2
0
2.3
3.2
1.4
8.5
6
0.7
0
35.5
14.8
11.8
27429
2178
17816
47423
8
1.2
13
7.1
27521
2143
20841
50507
7.9
1.1
15.2
7.5
29047
2324
23065
54436
8
1.2
16.8
7.9
30231
2617
25337
58185
8.1
1.4
18.4
8.3
30390
2864
27174
60429
7.6
1.5
19.6
8.3
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** No official data were reported by Russia, except for 2010. Information about new and cumulative HIV diagnoses was obtained from the Federal Scientific and
Methodological Center for Prevention and Control of AIDS: 2005 (35 401), 2006 (39 312), 2007 (45 099), 2008 (54 799), 2009 (58 142), 2010 (58 305), 2011 (62
385), 2012 (70 744), 2013 (79 728), 2014 (85 252), cumulative as of 31 December 2014 (907 607). Reference: HIV-infection bulletin number 39, available from
http://hivrussia.org/files/bul_39.pdf and Spravka HIV 2014, available from http://hivrussia.org/files/spravkaHIV2014.pdf.
32
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
2010
2011
2012
2013
2014
Cumulative Country*
total**
N
Rate
N
Rate
N
Rate
N
Rate
N
Rate
332
1198
163
70
41
180
275
376
184
5539
2714
639
182
24
330
4027
274
4
153
53
18
1206
258
957
1937
553
28
35
3748
457
6348
32303
4
11.1
2.2
1.6
5
1.7
5
28.2
3.4
8.6
3.3
5.7
1.8
7.6
7.3
6.8
12.9
11.1
4.9
10.6
4.3
7.3
5.3
2.5
18.3
2.7
0.5
1.7
11.4
4.9
10.2
6.5
328
1183
201
77
54
153
266
366
172
5416
2699
953
162
23
328
3889
299
1
166
56
21
1151
269
1120
1685
784
49
55
3493
391
6181
31991
3.9
10.8
2.7
1.8
6.4
1.5
4.8
27.5
3.2
8.3
3.3
8.6
1.6
7.2
7.2
6.6
14.4
2.8
5.4
10.9
5.1
6.9
5.5
2.9
15.9
3.9
0.9
2.7
10.6
4.2
9.8
6.5
326
1229
157
74
58
212
201
315
156
5668
2978
1142
219
19
349
4144
339
0
160
58
30
1062
242
1098
1607
870
50
45
3732
381
6247
33168
3.9
11.1
2.1
1.7
6.7
2
3.6
23.8
2.9
8.7
3.6
10.3
2.2
5.9
7.6
7
16.6
0
5.3
11.1
7.2
6.3
4.9
2.9
15.2
4.3
0.9
2.2
9.9
4
9.8
6.6
266
1125
200
85
54
235
233
325
157
5525
3288
864
240
11
343
3811
340
0
177
61
36
1014
233
1103
1464
898
83
44
3866
354
6024
32459
3.1
10.1
2.7
2
6.2
2.2
4.2
24.6
2.9
8.4
4
7.9
2.4
3.4
7.5
6.4
16.8
0
6
11.4
8.5
6
4.6
2.9
14
4.5
1.5
2.1
8.3
3.7
9.4
6.3
235
1039
247
92
56
232
256
291
181
4327
3525
714
271
11
359
3695
347
1
141
69
40
831
268
1061
920
791
86
49
3366
350
6141
29992
2.8
9.3
3.4
2.2
6.5
2.2
4.5
22.1
3.3
6.6
4.4
6.5
2.7
3.4
7.8
6.1
17.3
2.7
4.8
12.6
9.4
4.9
5.2
2.8
8.8
4
1.6
2.4
7.2
3.6
9.5
5.9
8420
27896
2077
1206
903
2354
6828
8993
3399
65929
53760
14440
2845
321
7345
33268
6214
65
2378
1348
263
23076
5638
18757
52694
20536
625
683
34690
11137
139778
557866
43
5
149
459
1069
7
5
457
424
1987
567
703
0
15
62581
6
148
605
995
524
0
16617
3795
91161
1.5
5.9
5
5
11.3
0.2
0.2
10.8
5.7
12.2
10.4
17.2
0
2.4
43.7
19.2
1.6
7.7
13.1
0.7
0
36.4
13.7
23.9
78
2
182
548
1196
27
1
429
450
1999
614
721
0
9
8
127
559
978
654
0
17305
25887
2.7
2.6
6.1
5.9
12.6
0.7
0
10.2
5.9
12.1
11.1
17.7
0
1.4
25.1
1.4
7.1
12.6
0.9
0
38.1
12.2
81
2
228
517
1223
25
15
534
487
2011
701
757
0
14
5
130
621
849
1069
0
16850
26119
2.8
2.6
7.7
5.5
12.9
0.7
0.7
12.9
6.3
12
12.4
18.6
0
2.2
15
1.4
7.7
10.7
1.4
0
37.2
12.2
119
5
238
514
1533
27
15
480
473
2140
503
706
0
10
1
148
576
893
1319
17860
27560
4.1
6.6
8
5.4
16.1
0.7
0.7
11.8
6.1
12.5
8.8
17.3
0
1.6
3
1.7
7.1
11
1.7
39.5
12.7
77
3
332
604
1811
30
536
477
2350
645
831
0
20
3
126
515
985
1812
15796
26953
2.7
3.9
11
6.3
19.1
1.4
13.3
6
13.5
11
20.4
0
3.2
8.9
1.4
6.3
11.9
2.3
36.9
12.7
780
71
1953
4902
17522
250
101
4695
8465
24220
5758
9371
34
175
62581
85
3175
34461
6558
8589
2
219543
24018
437409
30327
2951
90182
123464
7.5
1.6
31.9
14.1
29523
3551
24803
57878
7.3
1.9
22.2
8.2
30686
4117
24484
59287
7.4
2.1
21.8
8.3
29730
4580
25709
60019
7
2.4
22.8
8.2
27325
4950
24669
56945
6.4
2.6
22.3
7.9
533346
63056
398708
995175
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia***
San Marino
Serbia****
Switzerland
Tajikistan
Turkey*****
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
**** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (0, 0.0), 2006 (2, 0.1), 2007 (1, 0.0), 2008 (3, 0.1), 2009 (6, 0.3), 2010 (0, 0.0), 2011 (3, 0.2), 2012 (3, 0.2), 2013 (2, 0.1), 2014 (6, 0.3),
cumulative 2000-2014 (46).
***** The 1812 new HIV diagnoses for Turkey in 2014 differ from national statistics for 2014 due to 6 cases diagnosed in 2013 and 8 cases diagnosed in the period
2001-2012.
33
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 1a: New HIV diagnoses and rates per 100 000 population, by country and year of statistics (2005-2014) and
cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
Country*
EU/EEA
West Austria
West Belgium
Centre Bulgaria
Centre Croatia
Centre Cyprus
Centre Czech Republic
West Denmark
East
Estonia
West Finland
West France
West Germany
West Greece
Centre Hungary
West Iceland
West Ireland
West Italy
East
Latvia
Liechtenstein
East
Lithuania
West Luxembourg
West Malta
West Netherlands
West Norway
Centre Poland
West Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West Spain
West Sweden
West United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West Monaco
Centre Montenegro
East
Russia***
West San Marino
Centre Serbia****
West Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
2005
N
Rate
2006
N
Rate
2007
N
Rate
2008
N
Rate
2009
N
Rate
339
1070
83
68
41
90
264
621
134
5995
2492
566
106
8
325
1490
299
120
62
15
1231
219
705
2225
597
21
38
1654
388
7889
29155
4.1
10.2
1.1
1.6
5.6
0.9
4.9
45.7
2.6
9.6
3
5.1
1
2.7
7.9
7.6
13.3
0
3.6
13.4
3.7
7.5
4.8
1.8
21.2
2.8
0.4
1.9
9.4
4.3
13.1
6.7
341
1018
91
57
34
91
245
668
191
5698
2643
572
81
11
353
2018
299
2
100
57
22
1144
276
811
2270
494
27
33
1784
385
7447
29263
4.1
9.7
1.2
1.3
4.6
0.9
4.5
49.5
3.6
9
3.2
5.1
0.8
3.7
8.4
8.4
13.4
5.7
3
12.2
5.4
7
5.9
2.1
21.6
2.3
0.5
1.6
10
4.3
12.3
6.6
356
1072
126
49
45
121
306
633
187
5679
2772
521
119
13
391
2221
350
106
48
16
1238
248
807
2173
480
39
37
2805
528
7354
30840
4.3
10.1
1.7
1.1
5.9
1.2
5.6
47.1
3.5
8.9
3.4
4.7
1.2
4.2
9
7.2
15.8
0
3.3
10.1
3.9
7.6
5.3
2.1
20.6
2.3
0.7
1.8
11.5
5.8
12
6.8
373
1092
123
71
37
148
285
545
147
5766
2830
659
145
10
404
2482
358
95
68
28
1321
299
839
2242
563
53
48
3471
441
7220
32163
4.5
10.2
1.6
1.6
4.8
1.4
5.2
40.7
2.8
9
3.4
5.9
1.4
3.2
9.1
6.7
16.3
0
3
14.1
6.9
8.1
6.3
2.2
21.2
2.7
1
2.4
12.4
4.8
11.7
6.9
311
1132
171
55
38
156
236
411
172
5458
2868
611
141
15
395
3825
275
1
180
64
18
1207
282
961
2041
550
53
48
3628
485
6659
32447
3.7
10.5
2.3
1.3
4.8
1.5
4.3
30.8
3.2
8.5
3.5
5.5
1.4
4.7
8.7
6.6
12.7
2.8
5.7
13
4.4
7.3
5.9
2.5
19.3
2.7
1
2.4
11.1
5.2
10.7
6.6
30
10
75
206
751
13
1
242
355
958
171
533
0
10
4
103
724
220
298
0
11464
2159
18327
1
13
2.5
2.4
7.8
0.3
0
5.4
5.4
6.2
3.3
12.8
0
1.6
13.5
1.1
9.8
3.2
0.4
0
24.5
8.3
7.9
32
1
66
239
733
17
8
276
337
1729
244
621
1
8
2
88
760
201
260
0
13456
2205
21284
1
1.3
2.2
2.8
7.6
0.4
0.4
6.2
5
11.1
4.7
15
3
1.3
6.7
1
10.2
2.9
0.4
0
28.9
8.4
9.2
43
3
109
437
990
4
5
344
365
1973
409
731
1
9
0
91
757
350
399
0
13469
3169
23658
1.4
3.7
3.6
5
10.4
0.1
0.2
7.8
5.3
12.5
7.8
17.7
3
1.5
0
1
10
4.9
0.6
0
29.1
11.9
10.1
48
4
136
433
881
9
4
351
394
2321
551
793
0
11
4
118
763
362
393
0
15444
3061
26081
1.6
4.8
4.6
4.9
9.2
0.2
0.2
8.1
5.6
14.6
10.4
19.3
0
1.8
12.5
1.3
10
5
0.6
0
33.6
11.4
11.1
61
2
149
455
1072
7
6
385
387
2078
687
704
0
14
1
131
654
444
470
0
16268
4041
28016
2.1
2.4
5
5.1
11.3
0.2
0.3
9
5.3
12.9
12.8
17.2
0
2.3
3.2
1.4
8.5
6
0.7
0
35.5
14.8
11.8
27459
2204
17819
47482
8
1.2
13
7.1
27576
2132
20837
50547
7.9
1.1
15.2
7.5
29054
2374
23070
54498
8
1.3
16.8
7.9
30303
2610
25331
58244
8.1
1.4
18.4
8.3
30451
2862
27149
60463
7.6
1.5
19.6
8.3
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** No official data were reported by Russia, except for 2010. Information about new and cumulative HIV diagnoses was obtained from the Federal Scientific and
Methodological Center for Prevention and Control of AIDS: 2005 (35 401), 2006 (39 312), 2007 (45 099), 2008 (54 799), 2009 (58 142), 2010 (58 305), 2011 (62
385), 2012 (70 744), 2013 (79 728), 2014 (85 252), cumulative as of 31 December 2014 (907 607). Reference: HIV-infection bulletin number 39, available from
http://hivrussia.org/files/bul_39.pdf and Spravka HIV 2014, available from http://hivrussia.org/files/spravkaHIV2014.pdf.
**** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (0), 2006 (2), 2007 (1), 2008 (3), 2009 (6), 2010 (0), 2011 (3), 2012 (3), 2013 (2), 2014 (6), cumulative 2000-2014 (46).
34
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
2010
N
Rate
2011
N
Rate
2012
N
Rate
2013
N
Rate
2014
N
Rate
Cumulative Country*
total**
332
1198
163
70
41
180
275
372
184
5539
2714
613
182
24
330
4027
274
4
153
63
19
1206
258
957
1937
553
28
35
3748
493
6348
32320
4
11.1
2.2
1.6
5
1.7
5
27.9
3.4
8.6
3.3
5.5
1.8
7.6
7.3
6.8
12.9
11.1
4.9
12.5
4.6
7.3
5.3
2.5
18.3
2.7
0.5
1.7
11.4
5.3
10.2
6.5
328
1183
201
77
54
153
266
370
172
5416
2699
969
162
23
326
3889
299
1
166
73
21
1151
269
1120
1685
784
49
55
3493
461
6181
32096
3.9
10.8
2.7
1.8
6.4
1.5
4.8
27.8
3.2
8.3
3.3
8.7
1.6
7.2
7.1
6.6
14.4
2.8
5.4
14.3
5.1
6.9
5.5
2.9
15.9
3.9
0.9
2.7
10.6
4.9
9.8
6.5
326
1229
157
74
58
212
201
315
156
5668
2978
1188
219
19
340
4144
339
160
83
30
1062
242
1098
1607
870
50
45
3732
441
6247
33290
3.9
11.1
2.1
1.7
6.7
2
3.6
23.8
2.9
8.7
3.6
10.7
2.2
5.9
7.4
7
16.6
0
5.3
15.8
7.2
6.3
4.9
2.9
15.2
4.3
0.9
2.2
9.9
4.7
9.8
6.6
266
1125
200
85
54
235
233
325
157
5525
3288
921
240
11
343
3811
340
177
82
36
1014
233
1103
1464
898
83
44
3866
458
6024
32641
3.1
10.1
2.7
2
6.2
2.2
4.2
24.6
2.9
8.4
4
8.4
2.4
3.4
7.5
6.4
16.8
0
6
15.3
8.5
6
4.6
2.9
14
4.5
1.5
2.1
8.3
4.8
9.4
6.4
235
1039
247
92
56
232
256
291
181
4327
3525
806
271
11
370
3695
347
1
141
96
40
831
268
1061
920
791
86
49
3366
350
6141
30122
2.8
9.3
3.4
2.2
6.5
2.2
4.5
22.1
3.3
6.6
4.4
7.4
2.7
3.4
8
6.1
17.3
2.7
4.8
17.5
9.4
4.9
5.2
2.8
8.8
4
1.6
2.4
7.2
3.6
9.5
5.9
8420
27896
2077
1206
903
2354
6828
8993
3399
65929
53760
14440
2845
321
7345
33268
6214
65
2378
1348
263
23076
5638
18757
52694
20536
625
683
34690
11137
139778
557866
48
6
148
459
1069
7
5
455
424
1987
570
703
0
15
62581
6
148
605
995
489
0
16617
3809
91146
1.7
7.1
5
5
11.3
0.2
0.2
10.7
5.7
12.2
10.4
17.2
0
2.4
43.7
19.2
1.6
7.7
13.1
0.7
0
36.4
13.7
23.9
72
2
182
548
1196
28
1
424
450
1999
598
721
0
9
8
127
559
978
699
0
17305
25906
2.5
2.6
6.1
5.9
12.6
0.7
0
10.1
5.9
12.1
10.8
17.7
0
1.4
25.1
1.4
7.1
12.6
1
0
38.1
12.2
90
2
228
517
1223
25
14
526
487
2011
724
757
0
14
5
130
621
849
1068
0
16850
26141
3.1
2.6
7.7
5.5
12.9
0.7
0.7
12.7
6.3
12
12.8
18.6
0
2.2
15
1.4
7.7
10.7
1.4
0
37.2
12.2
124
7
238
514
1533
27
17
490
473
2140
504
706
0
10
1
148
576
893
1313
17860
27574
4.3
9.2
8
5.4
16.1
0.7
0.8
12
6.1
12.5
8.8
17.3
0
1.6
3
1.7
7.1
11
1.7
39.5
12.7
84
3
334
604
1811
29
564
477
2350
645
831
0
20
3
126
515
985
1826
15796
27015
2.9
3.9
11.1
6.3
19.1
1.4
14
6
13.5
11
20.4
0
3.2
8.9
1.4
6.3
11.9
2.4
36.9
12.7
780
71
1953
4902
17522
250
101
4695
8465
24220
5758
9371
34
175
62581
85
3175
34461
6558
8601
2
219543
24018
437409
30349
2921
90192
123466
7.5
1.5
31.9
14.1
29624
3591
24786
58002
7.3
1.9
22.2
8.2
30808
4124
24499
59431
7.5
2.2
21.8
8.3
29914
4581
25720
60215
7.1
2.4
22.8
8.3
27455
4982
24699
57137
6.5
2.6
22.3
7.9
533346
63056
398708
995175
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia***
San Marino
Serbia****
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
35
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 2: New HIV diagnoses in males and rates per 100 000 population, by country and year of diagnosis (2005-2014)
and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
Country*
EU/EEA
West Austria
West Belgium
Centre Bulgaria
Centre Croatia
Centre Cyprus
Centre Czech Republic
West Denmark
East
Estonia
West Finland
West France
West Germany
West Greece
Centre Hungary
West Iceland
West Ireland
West Italy
East
Latvia
Liechtenstein
East
Lithuania
West Luxembourg
West Malta
West Netherlands
West Norway
Centre Poland
West Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West Spain
West Sweden
West United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West Monaco
Centre Montenegro
East
Russia
West San Marino
Centre Serbia***
West Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
2005
N
Rate
2006
N
Rate
2007
N
Rate
2008
N
Rate
2009
N
246
622
56
58
26
70
193
391
95
3697
1975
409
80
5
188
1067
193
0
90
31
9
937
122
512
1535
323
15
35
1262
229
4660
19131
6.2
12.2
1.5
2.8
7.2
1.4
7.2
61.9
3.7
12.2
4.9
7.5
1.7
3.4
9.2
11.3
18.7
0
5.8
13.6
4.5
11.6
5.3
2.8
30.4
3.1
0.6
3.6
14.5
5.1
15.8
9
256
674
71
48
20
71
174
429
134
3572
2121
402
49
8
221
1480
185
1
78
38
16
917
179
607
1525
269
20
30
1389
243
4500
19727
6.4
13.1
1.9
2.3
5.5
1.4
6.5
68.3
5.2
11.7
5.3
7.3
1
5.3
10.5
12.6
18.1
5.8
5.1
16.4
8
11.4
7.8
3.3
30.1
2.6
0.8
3.1
15.8
5.4
15.2
9.2
277
661
105
44
30
97
224
374
136
3664
2299
467
88
6
242
1604
224
0
74
33
8
998
166
575
1442
268
32
35
2216
304
4710
21403
6.9
12.8
2.8
2.1
8.1
1.9
8.3
59.9
5.3
11.9
5.7
8.5
1.8
3.8
11.1
10.7
22.1
0
4.9
14
4
12.3
7.1
3.1
28.5
2.6
1.2
3.5
18.6
6.7
15.8
9.6
281
745
102
68
24
121
204
315
105
3747
2340
508
110
7
258
1814
231
0
65
48
17
1116
182
615
1533
318
48
45
2761
267
4597
22592
7
14.3
2.8
3.3
6.3
2.4
7.5
50.6
4
12.1
5.8
9.2
2.3
4.4
11.6
10
22.9
0
4.4
20
8.4
13.8
7.7
3.3
30.2
3.2
1.8
4.6
20
5.9
15.2
9.9
246
748
133
49
26
130
179
243
106
3595
2394
511
109
6
258
2881
170
1
131
43
10
1000
183
733
1382
331
48
40
2915
281
4469
23351
6.1
14.2
3.7
2.4
6.7
2.5
6.6
39.1
4.1
11.5
6
9.3
2.3
3.7
11.5
10.3
17.1
5.7
8.9
17.6
4.9
12.3
7.6
4
27.3
3.3
1.8
4
18.1
6.1
14.7
9.7
23
5
60
172
399
8
0
173
226
692
122
316
0
10
2
87
478
198
179
0
6756
1715
11621
1.5
12.5
4.1
4.1
8.9
0.4
0
8.2
6.9
9.3
4.8
15.9
0
3.3
13.7
1.9
13.2
5.8
0.5
0
31.1
13.4
10.5
23
0
43
213
391
9
2
201
219
1278
181
369
1
6
2
73
498
152
193
0
7890
1683
13427
1.5
0
2.9
5
8.7
0.5
0.2
9.6
6.6
17
7.1
18.6
6.2
2
13.6
1.6
13.6
4.4
0.6
0
36.6
13
11.9
29
5
75
380
540
4
2
243
247
1391
287
422
1
8
0
75
524
268
248
0
8198
2087
15034
1.9
11.8
5
8.8
12.1
0.2
0.2
11.7
7.2
18.4
11.1
21.3
6.2
2.6
0
1.7
14.1
7.5
0.7
0
38.3
15.9
13.3
35
3
104
350
454
7
3
253
251
1642
309
438
0
8
2
98
550
285
273
0
8641
1830
15536
2.3
6.9
6.8
8
10.2
0.4
0.3
12.3
7.2
21.4
11.8
22.2
0
2.6
12.2
2.2
14.6
7.8
0.8
0
40.6
13.8
13.6
45
2
96
377
562
6
6
278
267
1393
514
400
0
12
1
122
468
337
345
0
9089
2248
16568
3
4.5
6.3
8.5
12.7
0.3
0.6
13.6
7.4
18
19.4
20.3
0
3.9
6.5
2.7
12.3
9
1
0
42.9
16.7
14.4
17993
1482
11277
30752
10.7
1.6
17.2
9.5
18569
1491
13093
33154
10.9
1.6
20
10.1
20234
1640
14563
36437
11.4
1.8
22.2
10.9
21336
1875
14917
38128
11.6
2
22.6
11.2
21945
2135
15838
39919
11.2
2.3
23.9
11.2
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (0), 2006 (2), 2007 (1), 2008 (3), 2009 (5), 2010 (0), 2011 (3), 2012 (2), 2013 (2), 2014 (5), cumulative 2000-2014 (34).
36
Rate
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
2010
N
Rate
2011
N
Rate
2012
N
Rate
2013
N
Rate
2014
N
Rate
Cumulative Country*
total**
265
794
132
67
34
159
201
230
130
3651
2301
561
142
17
241
3038
170
2
125
37
16
1014
173
715
1301
336
25
31
3073
277
4312
23570
6.5
14.9
3.7
3.2
8.5
3.1
7.3
37
5
11.7
5.7
10.2
3
10.6
10.7
10.6
17.5
11.3
8.6
14.8
7.8
12.4
7.1
3.9
25.7
3.4
1
3.1
19
6
14.1
9.8
259
784
163
66
39
140
192
226
112
3590
2268
810
122
12
239
2930
196
1
134
42
17
984
190
918
1169
542
46
48
2881
245
4396
23761
6.3
14.5
4.5
3.2
9.5
2.7
7
36.5
4.2
11.4
5.7
14.9
2.6
7.5
10.5
10.2
20.7
5.6
9.5
16.5
8.2
11.9
7.7
5
23.1
5.5
1.8
4.7
17.9
5.2
14.2
9.8
263
836
123
71
49
185
146
209
111
3819
2522
968
186
13
252
3262
218
0
114
40
23
891
166
918
1129
632
44
42
3156
231
4510
25129
6.4
15.3
3.4
3.4
11.7
3.6
5.3
33.8
4.2
12.1
6.3
17.9
3.9
8.1
11.1
11.4
23.3
0
8.2
15.3
11.1
10.8
6.6
5
22.4
6.5
1.7
4.1
17
4.9
14.5
10.3
222
786
161
77
46
211
178
200
102
3701
2694
780
191
8
257
2972
203
0
125
50
30
886
158
944
1032
635
71
39
3288
223
4523
24793
5.4
14.3
4.5
3.7
10.9
4.1
6.4
32.5
3.8
11.7
6.7
14.6
4.1
5
11.3
10.3
21.9
0
9.1
18.6
14.3
10.7
6.2
5.1
20.7
6.5
2.7
3.8
14.3
4.7
14.4
9.9
184
725
202
83
49
209
196
182
138
2923
2864
615
212
9
261
2943
236
1
90
43
36
712
200
876
665
549
75
45
2851
203
4603
22980
4.4
13.2
5.7
4
11.7
4
7
29.6
5.1
9.2
7.2
11.6
4.5
5.5
11.5
10
25.7
5.4
6.6
15.6
16.9
8.5
7.8
4.8
13.4
5.6
2.8
4.4
12.5
4.2
14.5
9.2
6329
17560
1530
1040
645
1973
4972
6043
2474
42298
42654
11900
2198
228
3815
25152
4250
39
1902
996
196
18469
3818
14400
38110
11929
536
597
28161
7549
97479
399432
28
5
98
365
563
7
5
324
290
1254
399
341
0
15
36172
6
132
444
770
385
0
9521
2062
53186
1.9
11.4
6.4
8.1
12.8
0.4
0.5
16.1
7.9
16
14.8
17.4
0
4.9
54.5
39.1
3
11.5
20.2
1.1
0
45.1
15.1
29.2
55
2
115
410
621
23
0
305
297
1208
422
377
0
8
6
110
421
685
485
0
9472
15022
3.8
5
7.6
9
14.1
1.2
0
15.3
7.9
15.1
15.4
19.2
0
2.6
38.4
2.5
10.8
17.5
1.3
0
45.1
14.7
58
2
158
356
659
23
10
387
355
1169
406
375
0
13
2
119
462
517
819
0
9400
15290
4
5
10.7
7.7
14.9
1.2
1
19.6
9.3
14.4
14.6
19.1
0
4.2
12.3
2.7
11.7
12.9
2.2
0
44.9
14.7
82
4
161
329
802
21
15
362
353
1204
292
381
0
10
0
135
421
519
1077
10011
16179
5.7
10.3
11.1
7
18.2
1.1
1.5
18.6
9.1
14.6
10.3
19.4
0
3.2
0
3.1
10.5
12.7
2.9
47.9
15.4
59
3
215
375
1052
29
389
343
1337
366
451
0
17
3
109
384
565
1478
8993
16168
4.1
7.7
15.1
7.8
23.8
2.8
20.2
8.7
15.9
12.7
23
0
5.5
18.4
2.5
9.5
13.5
3.9
45.4
15.7
555
58
1349
3728
10393
201
79
3455
5558
16071
3866
5431
21
147
36172
66
2493
21765
4527
6399
1
130557
16234
269126
22147
2213
52394
76756
11.2
2.4
39.4
18.1
21846
2765
14171
38783
11
3
26.7
11.3
23159
3292
13968
40419
11.5
3.5
26.2
11.6
22668
3715
14589
40972
10.9
3.9
27.3
11.5
20904
3992
14251
39148
10.1
4.3
27.1
11.1
379749
44788
243982
668558
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia***
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
37
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 3: New HIV diagnoses in females and rates per 100 000 population, by country and year of diagnosis (2005-2014)
and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
Country*
EU/EEA
West Austria
West Belgium
Centre Bulgaria
Centre Croatia
Centre Cyprus
Centre Czech Republic
West Denmark
East
Estonia
West Finland
West France
West Germany
West Greece
Centre Hungary
West Iceland
West Ireland
West Italy
East
Latvia
Liechtenstein
East
Lithuania
West Luxembourg
West Malta
West Netherlands
West Norway
Centre Poland
West Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West Spain
West Sweden
West United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West Monaco
Centre Montenegro
East
Russia
West San Marino
Centre Serbia***
West Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
2005
N
Rate
2006
N
Rate
2007
N
Rate
2008
N
Rate
2009
N
92
440
27
10
15
20
71
230
39
2297
481
130
14
3
137
423
106
0
30
24
6
294
97
174
690
274
6
3
392
167
3229
9921
2.2
8.2
0.7
0.4
4
0.4
2.6
31.6
1.5
7.1
1.1
2.3
0.3
2
6.6
4.2
8.7
0
1.7
10.3
3
3.6
4.2
0.9
12.7
2.5
0.2
0.3
4.4
3.7
10.5
4.4
84
338
20
9
14
20
71
239
57
2117
499
104
13
3
132
538
114
1
22
16
8
227
97
175
745
225
7
3
397
152
2947
9392
2
6.3
0.5
0.4
3.7
0.4
2.6
33.1
2.1
6.5
1.2
1.8
0.2
2
6.3
4.3
9.5
5.6
1.2
6.8
3.9
2.7
4.1
0.9
13.7
2.1
0.3
0.3
4.4
3.3
9.5
4.1
78
404
21
5
15
24
82
259
51
1995
449
89
10
7
149
617
126
0
32
12
6
240
82
155
731
212
7
2
589
184
2644
9277
1.8
7.5
0.5
0.2
3.9
0.5
3
36
1.9
6.1
1.1
1.6
0.2
4.6
6.9
3.9
10.5
0
1.8
5
2.9
2.9
3.5
0.8
13.4
2
0.3
0.2
4.8
4
8.5
4
90
343
21
3
13
27
81
230
42
1998
465
104
9
3
146
668
127
0
30
11
11
205
117
152
709
245
5
3
710
158
2623
9349
2.1
6.3
0.5
0.1
3.3
0.5
2.9
32.1
1.6
6
1.1
1.8
0.2
1.9
6.5
3.5
10.7
0
1.7
4.5
5.4
2.5
4.9
0.8
12.9
2.3
0.2
0.3
5
3.4
8.4
3.9
65
381
38
6
12
26
57
168
66
1843
458
96
15
9
137
944
105
0
49
17
9
207
99
160
659
219
5
8
713
149
2190
8910
1.5
6.9
1
0.3
2.9
0.5
2.1
23.5
2.4
5.6
1.1
1.7
0.3
5.7
6
3.2
9
0
2.9
6.8
4.4
2.5
4.1
0.8
12
2.1
0.2
0.8
4.3
3.2
6.9
3.5
8
1
15
34
352
5
1
66
128
266
49
217
0
0
2
16
242
22
92
0
4516
444
6476
0.5
2.7
1
0.8
6.8
0.3
0.1
2.8
3.8
3.3
1.9
10
0
0
13.2
0.3
6.4
0.6
0.3
0
18
3.4
5.5
10
1
25
26
342
2
5
77
118
451
63
249
0
2
0
15
254
49
83
0
5366
522
7660
0.7
2.7
1.7
0.6
6.7
0.1
0.5
3.3
3.4
5.6
2.4
11.5
0
0.6
0
0.3
6.7
1.4
0.2
0
21.5
3.9
6.4
14
0
32
57
450
0
1
98
116
582
115
309
0
1
0
16
222
82
101
0
5038
1082
8316
0.9
0
2.2
1.3
8.8
0
0.1
4.2
3.3
7.1
4.3
14.4
0
0.3
0
0.3
5.8
2.3
0.3
0
20.3
8
7
17
0
32
83
427
2
1
102
143
679
182
355
0
3
2
20
203
77
123
0
6582
1231
10264
1.2
0
2.2
1.9
8.4
0.1
0.1
4.5
4
8.2
6.8
16.6
0
1
12.8
0.4
5.2
2.1
0.3
0
26.6
9
8.5
19
0
53
78
510
0
0
109
120
685
182
304
0
2
0
9
180
107
126
0
7002
1807
11293
1.3
0
3.7
1.7
10
0
0
4.8
3.3
8.2
6.7
14.3
0
0.6
0
0.2
4.6
2.9
0.3
0
28.4
13
9.5
9385
665
6347
16397
5.4
0.7
8.9
4.8
8903
603
7545
17052
5
0.6
10.5
4.9
8747
584
8262
17593
4.7
0.6
11.5
5
8832
644
10137
19613
4.6
0.7
14.1
5.4
8399
645
11159
20203
4.1
0.7
15.4
5.4
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (0), 2006 (0), 2007 (0), 2008 (0), 2009 (1), 2010 (0), 2011 (0), 2012 (1), 2013 (0), 2014 (1), cumulative 2000-2014 (12).
38
Rate
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
2010
N
Rate
2011
N
Rate
2012
N
Rate
2013
N
Rate
2014
N
Rate
Cumulative Country*
total**
67
402
31
3
7
21
74
146
54
1877
402
78
9
7
89
985
104
2
28
16
2
192
85
154
636
217
3
4
675
179
2036
8585
1.6
7.3
0.8
0.1
1.7
0.4
2.7
20.5
2
5.6
1
1.4
0.2
4.4
3.9
3.2
9
11
1.7
6.3
1
2.3
3.5
0.8
11.5
2.1
0.1
0.4
4
3.8
6.4
3.4
69
399
38
11
15
13
74
140
60
1824
424
143
12
11
89
959
103
0
32
14
4
167
79
160
516
242
3
7
612
146
1782
8148
1.6
7.1
1
0.5
3.5
0.2
2.6
19.7
2.2
5.4
1
2.5
0.2
6.9
3.9
3.1
9.1
0
1.9
5.4
1.9
2
3.2
0.8
9.3
2.3
0.1
0.7
3.7
3.1
5.6
3.2
63
392
34
3
9
27
54
106
45
1827
454
174
14
6
97
882
121
0
46
16
7
171
76
159
478
238
6
3
576
149
1736
7969
1.5
6.9
0.9
0.1
2
0.5
1.9
15
1.6
5.4
1.1
3.1
0.3
3.8
4.2
2.9
10.9
0
2.8
6.1
3.3
2
3.1
0.8
8.7
2.3
0.2
0.3
3
3.1
5.4
3.1
43
339
39
8
8
24
55
125
55
1802
592
84
17
3
86
839
137
0
52
11
6
128
75
146
432
263
12
5
577
130
1500
7593
1
6
1
0.4
1.8
0.4
1.9
17.8
2
5.3
1.4
1.5
0.3
1.9
3.7
2.7
12.5
0
3.2
4.1
2.8
1.5
3
0.7
7.9
2.6
0.4
0.5
2.4
2.7
4.6
2.9
51
314
45
9
7
23
60
109
43
1386
659
98
20
2
98
752
111
0
51
26
4
119
68
171
255
242
11
3
513
146
1536
6932
1.2
5.5
1.2
0.4
1.6
0.4
2.1
15.6
1.6
4.1
1.6
1.7
0.4
1.2
4.2
2.4
10.2
0
3.2
9.5
1.9
1.4
2.7
0.9
4.7
2.4
0.4
0.3
2.2
3
4.7
2.6
2082
10053
460
166
258
381
1855
2934
925
23484
10300
2495
296
93
2206
8112
1964
23
476
349
67
4607
1820
3781
14574
8607
89
85
6526
3580
42256
154926
15
0
51
94
506
0
0
133
134
733
168
362
0
0
26409
0
16
160
225
139
0
6915
1733
37793
1
0
3.5
2
10
0
0
6
3.6
8.7
6.1
17.1
0
0
34.4
0
0.3
4
6
0.4
0
28.2
12.3
19.2
23
0
67
138
575
4
0
124
152
791
192
344
0
1
2
17
132
293
167
0
7697
10719
1.6
0
4.6
3
11.3
0.2
0
5.6
4
9.2
6.8
16.3
0
0.3
12.3
0.4
3.3
7.6
0.4
0
31.5
9.9
23
0
70
161
564
2
4
147
132
842
295
382
0
1
3
11
150
332
250
0
7301
10670
1.6
0
4.7
3.4
11.1
0.1
0.4
6.8
3.4
9.7
10.3
18.1
0
0.3
17.5
0.2
3.7
8.4
0.7
0
30
9.6
37
1
77
185
731
6
0
118
120
936
211
325
0
0
1
13
151
374
242
7722
11250
2.6
2.7
5
3.9
14.4
0.3
0
5.5
3
10.6
7.3
15.4
0
0
5.8
0.3
3.7
9.3
0.6
31.8
10.2
18
0
117
229
759
0
147
133
1013
279
380
0
3
0
17
123
420
334
6683
10655
1.2
0
7.4
4.7
14.9
0
7
3.3
11.3
9.4
18
0
0.9
0
0.4
3
10.3
0.8
29.1
9.8
225
13
604
1174
7129
46
16
1240
2799
8061
1823
3922
13
28
26409
19
682
9984
2031
2188
1
87064
7783
163254
8150
619
37607
46378
3.9
0.7
25.2
10.3
7658
713
10496
18867
3.7
0.7
17.9
5.2
7488
784
10367
18639
3.6
0.8
17.6
5.1
7030
820
10993
18843
3.3
0.8
18.6
5.1
6386
903
10298
17587
3
0.9
17.7
4.7
148212
17329
152616
318180
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia***
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
39
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 4: New HIV diagnoses in men infected through sex with men, by country and year of diagnosis (2005-2014) and
cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West Luxembourg
West Malta
West Netherlands
West Norway
Centre Poland
West Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West Spain
West Sweden
West United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West Monaco
Centre Montenegro
East
Russia***
West San Marino
Centre Serbia****
West Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of diagnosis
2009
2010
2011
2012
2013
2014
Cumulative
total**
161
402
32
60
22
129
112
0
48
1505
1595
373
126
5
134
1267
18
0
7
23
6
771
85
162
454
65
21
28
1838
115
2728
12292
165
407
47
49
27
113
113
0
36
1423
1480
337
106
0
145
1279
20
0
9
29
4
753
97
314
465
103
32
35
1803
94
2844
12329
158
398
59
65
31
152
82
1
47
1612
1709
328
149
1
173
1578
18
0
11
27
8
694
76
346
486
90
28
33
1935
116
3057
13468
137
425
72
70
35
179
116
6
43
1584
1752
335
163
0
155
1507
27
0
30
29
16
709
98
272
433
94
58
27
2003
111
3028
13514
111
335
97
68
39
169
132
3
55
1136
1904
332
171
0
174
1513
28
1
11
21
25
555
115
236
283
125
53
33
1815
89
3048
12677
3074
6766
421
714
360
1526
2793
103
1074
16618
25215
6726
1656
105
2092
10910
313
3
169
523
78
13275
1836
2265
8264
764
397
431
16058
3675
62807
191011
6
1
5
2
9
3
3
7
142
20
0
12
0
6
0
84
250
0
3
0
94
1
648
5
3
0
7
14
4
5
26
147
22
0
6
0
11
0
0
81
245
0
32
0
90
0
698
15
1
4
5
29
12
1
25
151
27
0
5
0
5
4
66
210
0
0
0
143
703
9
1
4
12
31
21
7
43
155
24
3
4
0
8
0
84
227
0
0
0
152
785
11
3
13
11
41
13
13
67
163
40
14
4
0
6
0
94
195
0
189
262
1139
8
3
10
11
53
26
63
146
44
17
9
0
13
0
76
215
6
272
277
1249
90
27
47
63
215
79
62
281
2018
231
36
58
14
82
0
21
972
5516
6
681
0
1241
29
11769
11719
581
173
12473
12017
783
190
12990
11840
925
267
13032
12868
1082
303
14253
12842
1296
515
14653
12007
1386
532
13926
189485
10500
2792
202780
2005
2006
2007
2008
101
256
4
34
14
53
120
0
32
1375
1251
248
56
3
60
363
14
0
3
9
4
639
56
46
305
25
9
31
548
107
2642
8408
135
299
10
37
7
56
100
0
62
1360
1388
251
40
2
89
536
15
0
9
17
7
670
90
51
355
20
14
25
623
102
2600
8970
133
299
24
30
19
77
142
0
72
1455
1559
299
63
0
91
595
15
0
4
19
0
770
77
38
338
15
25
30
1257
124
2819
10389
164
368
17
52
9
93
133
0
49
1495
1578
324
93
2
105
716
21
0
9
29
0
855
92
62
437
49
33
34
1639
119
2655
11232
144
378
28
42
9
107
108
0
43
1432
1652
335
87
2
138
1183
14
0
9
26
4
772
87
80
416
59
35
29
1724
122
2760
11825
3
3
2
0
2
3
0
8
92
3
0
5
0
4
0
43
223
0
25
0
20
10
446
0
0
2
3
1
5
2
4
78
10
1
2
0
4
0
45
263
0
29
0
35
0
484
1
3
2
3
4
0
3
11
123
10
1
0
1
5
0
40
270
0
25
0
48
0
550
7
3
3
2
5
1
0
6
125
13
0
2
0
8
0
66
264
0
0
0
65
0
570
8437
350
67
8854
9027
345
82
9454
10446
395
98
10939
11152
524
126
11802
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** No official data were reported by Russia. Information about new and cumulative HIV diagnoses by mode of transmission were obtained from the Federal
Scientific and Methodological Center for Prevention and Control of AIDS: 2005 (178), 2006 (137), 2007 (203), 2008 (278), 2009 (364), 2010 (357), 2011 (380),
2012 (296), 2013 (371), cumulative as of 31 December 2013 (3647). Reference: HIV-infection bulletin number 39, available from http://hivrussia.org/files/bul_39.
pdf.
**** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (0), 2006 (0), 2007 (1), 2008 (3), 2009 (0), 2010 (0), 2011 (0), 2012 (1), 2013 (1), 2014 (4), cumulative 2000-2014 (10).
40
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 5: New HIV diagnoses in people infected through injecting drug use, by country and year of diagnosis
(2005-2014) and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West Luxembourg
West Malta
West Netherlands
West Norway
Centre Poland
West Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West Spain
West Sweden
West United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West Monaco
Centre Montenegro
East
Russia***
West San Marino
Centre Serbia****
West Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of diagnosis
2009
2010
2011
2012
2013
2014
Cumulative
total**
35
15
56
2
0
5
8
62
8
126
81
25
0
9
23
265
86
0
107
1
0
7
11
44
228
22
2
0
243
24
154
1649
37
17
63
4
0
9
10
69
8
119
77
311
0
12
18
186
90
1
87
1
0
6
10
66
138
171
1
0
225
13
130
1879
39
14
40
1
0
6
11
72
7
127
82
518
0
3
16
212
94
0
64
4
0
7
11
43
128
282
1
1
193
17
118
2111
23
17
33
0
0
6
13
72
3
103
101
260
1
1
22
178
77
0
64
5
3
6
8
39
94
275
0
2
159
8
127
1700
21
11
46
0
3
10
11
67
7
64
111
102
1
1
25
141
74
0
38
16
0
0
7
37
40
154
1
2
115
8
131
1244
1729
864
474
65
12
104
530
3950
381
1728
3438
1567
24
53
1563
2183
3117
5
1510
157
9
761
611
6079
18539
976
13
18
3028
1200
5947
60635
1
0
46
292
212
0
0
225
42
1230
466
62
0
0
0
9
26
263
1
0
7105
612
10592
0
0
49
273
223
0
0
216
41
1081
347
59
0
0
0
0
6
20
672
0
0
6934
1850
11771
0
0
41
319
254
0
0
190
42
903
355
61
0
0
0
9
21
455
5
0
6588
9243
1
0
44
217
247
0
0
230
71
774
255
40
0
1
0
5
24
299
6
0
5933
8147
0
0
32
204
201
1
0
168
71
719
188
20
0
0
0
11
13
243
4
5847
7722
1
0
42
183
376
0
171
38
772
181
62
0
0
0
5
7
236
10
4670
6754
5
13
546
2635
6937
22
2
2315
1151
13866
3147
2763
8
5
0
11
971
3767
3120
109
0
109885
11390
162668
1466
169
10794
12429
1324
137
11959
13420
1381
328
9412
11122
1602
387
8269
10258
1215
372
7835
9422
856
270
6872
7998
49238
8879
165181
223303
2005
2006
2007
2008
62
14
12
3
1
4
17
192
16
186
134
20
2
0
67
149
115
0
85
7
0
17
20
160
599
2
0
0
309
20
186
2399
41
19
34
3
0
5
10
191
10
173
150
14
0
1
59
187
108
0
62
3
3
15
7
126
522
10
1
0
278
34
196
2262
56
21
43
2
2
12
21
115
12
154
143
13
3
1
55
184
141
0
59
6
0
13
13
99
410
12
1
0
261
62
174
2088
40
18
54
1
1
8
13
36
7
142
115
9
2
0
40
212
100
0
44
5
2
8
12
55
396
6
3
0
279
23
175
1806
29
14
74
0
0
4
14
85
13
129
92
15
0
5
30
277
78
0
118
0
0
7
11
62
282
17
1
0
299
25
156
1837
0
0
46
108
276
2
0
129
61
664
103
228
0
0
0
11
74
179
6
0
6270
1120
9277
0
0
24
172
242
1
1
155
49
1208
168
236
1
1
0
8
56
125
5
0
7127
1454
11033
1
0
32
318
298
0
0
184
40
1292
254
224
0
0
0
12
50
209
5
0
7084
1816
11819
0
0
36
286
195
0
0
200
41
1475
294
136
0
0
0
10
30
206
0
0
7009
1561
11479
1958
203
9515
11676
1828
195
11272
13295
1689
192
12026
13907
1567
140
11578
13285
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** No official data were reported by Russia. Information about new and cumulative HIV diagnoses by mode of transmission were obtained from the Federal
Scientific and Methodological Center for Prevention and Control of AIDS: 2005 (10 988), 2006 (11 893), 2007 (12 429), 2008 (16 689), 2009 (16 009), 2010 (16
308), 2011 (16 937), 2012 (18 029), 2013 (19 875), cumulative as of 31 December 2013 (299 923). Reference: HIV-infection bulletin number 39, available from
http://hivrussia.org/files/bul_39.pdf.
**** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (0), 2006 (0), 2007 (0), 2008 (0), 2009 (1), 2010 (0), 2011 (0), 2012 (0), 2013 (0), 2014 (0), cumulative 2000-2014 (2).
41
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 6: New HIV diagnoses in people infected through heterosexual contact, by country and year of diagnosis
(2005-2014) and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West Luxembourg
West Malta
West Netherlands
West Norway
Centre Poland
West Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West Spain
West Sweden
West United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West Monaco
Centre Montenegro
East
Russia***
West San Marino
Centre Serbia****
West Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of diagnosis
2009
2010
2011
2012
2013
2014
Cumulative
total**
110
438
71
7
15
38
141
71
94
2198
450
118
18
10
127
1880
131
3
29
28
10
345
157
101
1190
279
4
7
1232
238
2995
12535
107
439
89
22
23
25
132
56
88
2039
517
147
19
6
126
1811
144
0
34
26
13
298
155
91
1046
313
12
8
1071
222
2830
11909
112
460
58
7
23
41
96
127
71
2160
485
149
24
0
134
1764
112
0
50
25
15
291
142
98
963
323
14
4
1096
198
2606
11648
86
385
70
13
16
44
90
169
67
2084
598
114
24
0
134
1690
125
0
51
23
10
232
123
82
898
336
21
7
1075
167
2223
10957
82
360
96
11
10
45
102
162
70
1443
780
127
28
0
119
1598
132
0
66
27
9
209
141
88
560
320
18
4
875
166
2185
9833
2874
10891
1108
348
481
603
3024
964
1360
27718
11905
3084
416
100
2849
15161
1619
12
456
546
129
7075
2948
1353
23923
4974
151
108
11732
4969
61713
204595
52
1
83
116
823
3
2
147
177
750
173
574
0
6
0
23
253
165
218
0
8541
955
13062
34
2
86
130
789
3
0
201
209
819
186
606
0
3
0
35
222
296
203
0
9122
852
13798
60
1
127
190
881
14
0
203
208
1010
181
613
0
4
4
37
211
437
251
0
10248
14680
66
1
161
243
919
4
7
244
203
1138
307
664
0
5
3
27
219
392
377
0
10440
15420
100
1
176
270
1265
12
2
237
185
1273
276
325
0
1
0
20
221
518
431
11472
16785
61
0
262
359
1349
4
292
192
1399
389
620
0
4
0
31
167
569
485
10648
16831
628
21
1224
1736
9954
126
31
1952
4296
8850
2020
5702
11
67
0
23
736
7306
2792
3612
0
101160
4711
156958
12624
852
12514
25991
12194
818
13318
26333
11497
968
14124
26589
11193
1078
14797
27068
10406
1179
16157
27742
9212
1205
16247
26664
203658
14742
143141
361553
2005
2006
2007
2008
159
467
65
26
25
29
110
0
67
2812
559
175
20
5
172
665
96
0
21
38
9
467
134
90
1263
268
12
2
696
208
4768
13428
140
420
46
15
27
25
127
0
93
2420
533
152
15
7
182
910
87
1
16
32
10
374
164
74
1335
220
8
3
748
201
4313
12698
139
441
58
15
21
28
130
0
74
2322
481
131
15
0
167
1059
127
0
28
20
12
372
141
72
1369
238
12
2
1063
228
3993
12758
148
402
52
15
22
44
122
3
59
2484
515
160
17
6
190
1153
164
0
28
25
24
360
185
62
1349
267
8
4
1251
207
3880
13206
122
425
68
12
27
43
105
17
91
2259
509
121
23
8
166
1852
133
1
37
28
9
343
170
76
1281
284
9
6
1228
209
3267
12929
24
2
25
63
428
8
0
81
177
247
58
291
0
5
0
25
364
39
158
0
4586
364
6945
30
1
38
41
464
4
5
112
187
334
71
366
0
2
1
24
340
70
153
0
5646
495
8384
36
1
70
77
657
4
2
125
176
504
107
500
0
4
0
23
295
123
295
0
5736
701
9436
43
0
86
100
656
8
3
132
201
682
162
588
0
2
0
28
279
142
275
0
7780
716
11883
13317
757
6299
20373
12690
651
7740
21082
12614
825
8755
22194
13000
850
11239
25089
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** No official data were reported by Russia. Information about new and cumulative HIV diagnoses by mode of transmission were obtained from the Federal
Scientific and Methodological Center for Prevention and Control of AIDS: 2005 (5653), 2006 (6329), 2007 (7255), 2008 (9910), 2009 (10 526), 2010 (12 230), 2011
(12 785), 2012 (14 038), 2013 (15 604), cumulative as of 31 December 2013 (117 389). Reference: HIV-infection bulletin number 39, available from http://hivrussia.
org/files/bul_39.pdf.
**** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (0), 2006 (2), 2007 (0), 2008 (0), 2009 (3), 2010 (0), 2011 (3), 2012 (1), 2013 (1), 2014 (2), cumulative 2000-2014 (31).
42
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 7: New HIV diagnoses in people infected through mother-to-child transmission, by country and year of diagnosis
(2005-2014) and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West Luxembourg
West Malta
West Netherlands
West Norway
Centre Poland
West Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West Spain
West Sweden
West United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West Monaco
Centre Montenegro
East
Russia***
West San Marino
Centre Serbia****
West Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of diagnosis
2009
2010
2011
2012
2013
2014
Cumulative
total**
1
7
4
0
0
0
3
2
1
41
20
3
0
0
9
12
4
0
0
0
0
23
1
11
17
27
0
0
15
16
105
322
2
10
2
1
0
0
3
2
1
35
15
4
0
0
3
24
2
0
1
0
0
9
4
7
9
22
0
1
11
13
107
288
0
8
0
0
1
2
4
4
2
50
20
0
1
0
5
13
7
0
0
1
0
12
7
4
5
19
0
0
7
8
78
258
1
5
5
0
0
0
5
2
2
31
21
0
1
0
3
9
10
0
1
0
0
4
1
4
10
23
0
0
12
3
90
243
1
7
1
1
0
1
5
5
2
29
25
1
1
0
2
12
4
0
2
2
0
4
3
2
6
18
0
0
2
3
97
236
56
437
20
14
3
7
101
51
26
425
361
65
12
1
77
131
63
1
5
10
0
297
79
195
426
701
0
7
97
206
2504
6378
2
0
3
5
15
0
0
4
10
22
16
8
0
0
0
2
4
11
7
0
169
96
374
0
0
3
11
22
0
0
13
7
21
19
10
0
0
0
0
0
7
14
0
0
177
73
377
3
0
2
9
23
0
0
7
8
18
20
16
0
0
0
1
4
26
4
0
136
277
3
0
3
14
16
0
0
9
7
30
33
9
0
0
0
0
2
39
12
0
149
326
6
0
5
10
16
0
0
3
9
36
10
13
0
0
0
4
3
46
11
127
299
3
0
7
18
15
0
5
9
22
15
19
0
0
0
1
1
55
22
122
314
30
1
35
83
245
1
2
86
240
265
150
141
1
4
0
1
46
191
203
104
0
1905
363
4097
261
49
354
664
288
42
369
699
262
41
262
565
229
42
313
584
209
54
279
542
211
50
289
550
5733
1146
3595
10475
2005
2006
2007
2008
1
8
1
0
1
0
3
4
1
39
24
2
2
0
3
9
2
0
0
1
0
15
5
7
9
24
0
0
4
12
136
313
2
6
0
1
0
0
2
4
1
28
19
3
0
0
2
5
5
0
0
0
0
9
6
25
12
20
0
0
4
9
137
300
4
19
1
1
0
0
7
2
0
38
27
3
2
0
6
5
8
0
1
0
0
13
9
16
18
8
0
0
11
8
118
325
1
8
0
1
0
0
4
8
1
29
16
1
0
0
7
5
8
0
0
0
0
23
4
13
16
14
0
0
10
17
102
288
2
4
1
0
0
0
0
3
2
34
11
0
2
0
5
7
2
0
0
1
0
18
4
12
15
23
0
0
13
11
120
290
0
0
2
3
34
0
1
7
16
9
2
9
0
0
0
1
5
0
5
0
192
11
297
3
0
4
1
19
1
0
6
13
20
2
14
0
1
0
0
1
1
3
0
200
31
320
4
0
3
3
25
0
0
15
11
30
8
7
0
0
0
1
7
8
3
0
230
84
439
1
0
0
5
17
0
0
12
16
44
25
17
0
1
0
1
2
3
8
0
217
57
426
293
42
275
610
259
54
307
620
304
36
424
764
262
39
413
714
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** No official data were reported by Russia. Information about new and cumulative HIV diagnoses by mode of transmission were obtained from the Federal
Scientific and Methodological Center for Prevention and Control of AIDS: 2005 (549), 2006 (581), 2007 (523), 2008 (621), 2009 (557), 2010 (494), 2011 (487), 2012
(446), 2013 (366), cumulative as of 31 December 2013 (5964). Reference: HIV-infection bulletin number 39, available from http://hivrussia.org/files/bul_39.pdf.
**** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (0), 2006 (0), 2007 (0), 2008 (0), 2009 (2), 2010 (0), 2011 (0), 2012 (0), 2013 (0), 2014 (0), cumulative 2000-2014 (2).
43
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 8: New HIV diagnoses*, by sex, transmission mode and year of diagnosis (2005–2014) and cumulative totals
Table 8a: EU/EEA and non-EU/EEA countries
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
*
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
312
7008
148
72
15
1147
8702
7449
1272
4952
140
50
9
2027
15899
7451
1589
11977
289
122
24
3207
24659
324
6372
137
49
11
1152
8045
7750
1152
4583
125
49
7
2156
15822
7760
1480
10966
262
98
18
3343
23927
324
5972
168
38
14
1141
7657
8479
1101
4577
122
35
14
2306
16634
8499
1429
10564
291
73
28
3481
24365
248
6003
126
33
12
1167
7589
8793
974
4720
126
27
9
2438
17087
8815
1224
10737
252
61
21
3645
24755
1621
4039
39
13
1
220
5933
14635
408
6528
2376
50
5
3
347
9717
25616
408
8149
6415
281
18
4
572
15847
40506
1834
4868
41
9
24
277
7053
15097
449
7739
2863
44
8
51
386
11540
27361
450
9573
7731
285
17
75
674
18805
42730
1899
4878
57
6
33
260
7133
14790
523
8093
3556
65
6
56
396
12695
29329
525
9998
8436
352
12
89
671
20083
44448
1764
6742
67
1
38
294
8906
16495
569
8109
4138
75
8
36
489
13424
30511
569
9918
10884
361
9
86
796
22623
47378
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unkown
Total
229
4283
110
30
6
1248
5906
9704
1023
3657
105
31
10
2859
17389
9726
1252
7941
216
61
16
4142
23354
197
3767
101
28
7
1287
5387
9095
687
3342
113
32
14
2844
16128
9110
884
7110
215
61
21
4177
21579
0
9890
96627
3002
2237
3068
18748
133572
161525
34689
78232
2880
4402
3977
39967
325673
150
816
524
22
108
0
1293
2913
161675
45395
175383
5904
6747
7045
60008
462158
1311
9244
71
6
4
365
11001
16907
937
6406
7098
90
5
11
534
15081
32470
937
7717
16342
288
11
15
903
26213
49567
1119
8826
80
4
7
285
10321
15708
975
5625
7519
92
2
8
466
14687
30813
977
6744
16346
292
6
15
758
25138
46715
0
30765
86392
771
180
200
8091
126399
259948
10762
119537
61690
923
270
292
15491
208965
534598
204
929
407
1934
105
13
2952
6544
9454
10966
151231
148489
3628
555
505
26534
341908
804000
Data from Bosnia and Herzegovina, Russia, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period; data from Estonia, Poland
and Turkey excluded due to incomplete reporting on transmission mode during the period; data from Italy and Spain excluded due to increasing national
coverage over the period. Therefore, totals by transmission mode, gender and overall may data from totals presented in Tables 1-7.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
44
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
241
5393
146
27
8
1110
6925
8819
870
4357
109
29
12
2383
16579
8838
1114
9756
255
56
20
3521
23560
212
5089
160
44
10
1110
6625
9014
823
4157
122
27
12
2359
16514
9025
1035
9251
282
71
22
3509
23195
263
4722
129
33
8
1122
6277
8931
1070
4155
112
22
6
2510
16806
8933
1333
8880
244
55
14
3664
23123
320
4618
115
35
6
1152
6246
9584
1271
3945
115
32
4
2633
17584
9608
1591
8563
230
67
10
3810
23879
1759
7277
32
7
16
269
9360
16285
641
8220
4609
70
5
25
398
13968
30546
641
9979
11886
271
12
41
681
23511
47070
1713
7525
49
4
7
214
9512
16135
662
8208
5215
78
1
9
381
14554
31066
662
9921
12740
304
5
16
600
24248
47439
1791
8463
65
2
23
202
10546
16823
686
7447
5948
71
6
32
318
14508
31313
687
9238
14411
273
8
55
526
25198
48320
1427
8643
79
6
39
221
10415
16661
763
6714
6392
86
3
57
431
14446
32030
764
8141
15036
314
9
96
660
25020
48899
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
45
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 8: New HIV diagnoses*, by sex, transmission group and year of diagnosis (2005–2014) and cumulative totals
Table 8b: West, Centre and East of the WHO European Region
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
310
7035
138
63
10
1012
8568
7524
1185
4904
141
41
2
1865
15662
7526
1500
11956
280
104
12
2903
24281
311
6440
134
44
10
1031
7970
7858
1048
4580
116
45
6
2045
15698
7868
1363
11031
250
89
16
3100
23717
292
5976
166
41
12
1054
7541
8574
948
4500
121
35
12
2224
16414
8594
1244
10492
288
76
24
3303
24021
227
5979
127
34
11
1074
7452
8775
847
4602
120
29
8
2378
16759
8797
1076
10596
247
64
19
3475
24274
5
215
19
15
5
135
394
276
30
286
11
12
7
161
783
276
35
501
30
27
12
308
1189
8
193
9
10
1
122
343
259
55
227
16
7
1
117
682
260
63
420
25
17
2
258
1045
16
188
11
1
2
110
328
330
72
266
6
3
2
134
813
332
88
454
17
4
4
265
1164
7
220
9
0
1
130
367
461
78
285
9
2
1
144
980
461
85
505
18
2
2
300
1373
-
57
57
-
82
82
-
98
98
-
126
126
Injecting drug use
1618
6585
8203
1839
7788
9627
1915
8174
10095
1778
8158
9981
Heterosexual contact
3797
2138
5935
4606
2639
7245
4686
3367
8054
6546
3971
10520
30
38
260
35
37
272
48
60
338
57
72
348
Haemophiliac/transfusion recipient
7
2
9
4
5
9
2
3
5
0
4
4
Nosocomial infection
1
3
4
24
51
75
33
56
89
38
36
86
Mother-to-child
Other/undetermined
Total East
Total WHO European Region
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
220
348
568
276
379
658
237
344
584
257
405
666
5673
9171
15036
6784
10981
17968
6921
12102
19263
8676
12772
21731
14635
25616
40506
15097
27361
42730
14790
29329
44448
16495
30511
47378
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unkown
Total
160
4167
93
33
6
1154
5613
9310
718
3473
94
34
9
2770
16408
9332
878
7641
188
67
15
3931
22052
147
3641
95
31
6
1201
5121
8663
453
3096
101
33
13
2747
15107
8679
600
6739
197
65
19
3961
20261
0
10126
98139
2851
1410
137
20892
133555
162345
33065
78050
2630
3270
142
46867
326370
151
825
553
23
108
0
3718
5378
162496
44016
176742
5504
4788
279
71477
465303
60
257
18
0
0
91
426
822
268
397
21
0
1
164
1673
822
328
654
39
0
1
287
2131
35
244
13
0
1
105
398
877
188
388
13
0
1
171
1638
878
223
632
26
0
2
316
2077
0
369
3971
363
970
2931
2301
10905
7279
1563
5343
456
1361
3835
2863
22700
203
832
340
27
103
0
474
1979
7482
2764
9654
846
2434
6766
5638
35584
-
509
509
-
529
529
0
2660
0
2660
Injecting drug use
1320
6443
7763
1134
5671
6805
30157
119596
88
149841
Heterosexual contact
9103
6885
15988
8708
7377
16085
80906
56520
38
137464
70
80
277
73
91
284
559
716
1906
3181
Haemophiliac/transfusion recipient
3
2
5
1
1
2
37
41
2
80
Nosocomial infection
4
11
15
7
8
15
200
292
13
505
Mother-to-child
Other/undetermined
368
459
827
266
392
658
3629
5704
50
9383
Total East
10868
14389
25384
10189
14069
24378
115488
185529
2097
303114
Total WHO European Region
16907
32470
49567
15708
30813
46715
259948
534598
9454
804000
*
Data from Bosnia and Herzegovina, Russia, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period; data from Estonia, Poland
and Turkey excluded due to incomplete reporting on transmission mode during the period; data from Italy and Spain excluded due to increasing national
coverage over the period. Therefore, totals by transmission mode, gender and overall may differ from totals presented in Tables 1-7.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
46
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
206
5303
136
32
8
1057
6742
8793
681
4235
105
32
12
2290
16148
8812
890
9544
241
64
20
3365
22936
192
5048
147
48
9
1046
6490
8901
624
4029
114
27
12
2323
16030
8912
816
9082
261
75
21
3379
22546
202
4666
123
32
8
1054
6085
8752
768
3942
100
25
5
2437
16029
8754
970
8611
227
57
13
3501
22133
221
4561
104
35
5
1101
6027
9331
976
3768
105
33
4
2522
16739
9355
1197
8330
209
68
9
3637
22805
17
240
18
0
0
84
359
495
89
315
12
1
0
139
1051
495
106
555
30
1
0
239
1426
10
204
18
0
1
93
326
585
83
307
13
1
0
117
1106
585
93
511
31
1
1
241
1463
49
226
13
2
0
92
382
598
208
386
17
1
1
128
1339
599
257
612
30
3
1
248
1750
75
215
14
1
1
67
373
714
263
384
12
0
0
159
1532
715
338
599
26
1
1
245
1925
-
172
172
-
190
190
-
267
267
-
302
1777
8320
10097
1723
8324
10047
1803
7540
9343
1451
6746
7127
4415
11542
7361
5034
12395
8293
5775
14068
8485
6185
24
62
255
44
73
294
58
66
260
76
84
2
1
3
0
0
0
1
2
3
5
2
16
25
41
7
9
16
23
32
55
39
57
302
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
8197 Injecting drug use
14670 Heterosexual contact
309 Mother-to-child
7 Haemophiliac/transfusion recipient
96 Nosocomial infection
238
352
598
184
300
488
178
263
441
205
383
9184
13347
22708
9319
13930
23430
10356
13945
24437
10261
13759
24169 Total East
588 Other/undetermined
16285
30546
47070
16135
31066
47439
16823
31313
48320
16661
32030
48899 Total WHO European Region
47
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 9: New HIV diagnoses*, by sex, age and year of diagnosis (2005–2014) and cumulative totals
Table 9a: EU/EEA and non-EU/EEA countries
Age category
EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total EU/EEA
Non-EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total non-EU/EEA
Total WHO European Region
Age category
EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total EU/EEA
Non-EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
173
432
1131
1941
3146
1359
770
154
9106
171
351
1226
2395
6124
3989
2223
323
16802
346
784
2360
4353
9285
5357
3000
500
25985
174
366
935
1718
3017
1313
774
162
8459
159
288
1204
2383
6094
4193
2194
343
16858
333
654
2144
4115
9140
5516
2969
535
25406
182
341
939
1617
2851
1384
741
16
8071
137
285
1428
2662
6133
4377
2476
85
17583
321
628
2376
4308
9023
5785
3225
139
25805
145
306
856
1498
2803
1451
890
22
7971
150
313
1452
2654
6040
4728
2601
79
18017
295
622
2323
4169
8892
6193
3492
153
26139
60
401
278
293
1704
560
147
2582
68
159
317
609
3876
1597
378
2892
320
560
595
902
5580
2158
526
5477
73
395
327
379
2136
747
198
2881
109
167
370
719
4822
1964
481
3101
382
563
697
1099
6958
2713
679
5990
109
445
444
534
2532
866
267
2037
141
125
512
955
5483
2319
610
2798
480
570
958
1490
8021
3187
877
4849
123
400
1813
2334
2932
1064
349
14
133
98
1098
2992
6018
2617
719
22
487
500
2914
5335
8974
3689
1071
49
6025
9896
16118
7136
11733
19081
7234
12943
20432
9029
13697
23019
16397
30752
47423
17051
33153
50505
17593
36437
54436
19613
38128
58185
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unkown
Total
97
197
556
945
2106
1293
974
9
6177
95
295
1820
2948
5910
4347
3084
34
18533
193
493
2380
3898
8027
5651
4061
79
24782
87
171
498
813
1976
1157
961
4
5667
82
317
1604
2856
5308
4012
2979
28
17186
171
489
2104
3676
7300
5178
3944
69
22931
7541
6409
17635
28137
46126
19909
12549
2080
140386
9231
7585
32001
56881
119894
72564
43048
5516
346720
80
37
153
304
523
235
97
2072
3501
16847
14020
49722
85189
166345
92547
55570
9668
489908
119
250
1337
2219
4055
2174
1083
6
174
92
938
2559
7002
3749
1630
14
420
342
2275
4779
11058
5923
2713
22
143
234
1145
2056
3875
2044
1154
4
167
115
960
2460
6984
3713
1752
14
430
349
2107
4517
10860
5760
2906
21
1527
6310
15167
20611
41242
15913
6665
21445
1931
4386
13109
27853
86109
36556
12623
33119
1773
17
142
224
302
100
38
3950
5227
10712
28403
48647
127558
52501
19284
58505
Total non-EU/EEA
11243
16158
27532
10655
16165
26950
128880
215686
6546
350837
Total WHO European Region
18843
40972
60019
17587
39147
56944
318377
669397
10055
996855
*
Data from Bosnia and Herzegovina, Russia, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period; data from Italy and Spain
excluded due to increasing national coverage over the period. Therefore, totals by gender and overall may differ from totals presented in Tables 1-3.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
48
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
145
272
770
1325
2485
1324
915
17
7253
118
282
1497
2538
5763
4591
2698
68
17555
263
554
2273
3885
8283
5930
3617
127
24932
158
224
708
1175
2300
1417
932
11
6925
118
289
1648
2499
5644
4416
2793
52
17459
276
513
2361
3689
7976
5851
3732
130
24528
125
206
689
1112
2300
1275
864
6
6577
110
279
1640
2793
5733
4469
2881
45
17950
238
485
2331
3906
8036
5750
3747
116
24609
116
197
591
1039
2268
1310
976
14
6511
100
327
1844
2902
5880
4574
3027
57
18711
218
524
2440
3951
8167
5891
4003
98
25292
73
388
1824
2307
3171
1264
452
7
114
90
1072
2870
6488
2827
833
19
356
478
2896
5179
9659
4092
1285
37
71
321
1561
2367
3368
1407
549
7
95
99
1112
2760
6715
3138
1007
13
343
420
2673
5127
10084
4545
1556
24
120
295
1586
2343
3802
1791
769
7
147
81
943
2537
6850
3262
1163
10
404
376
2530
4880
10653
5055
1933
21
169
284
1444
2250
3782
1869
858
9
241
76
798
2413
6788
3487
1449
13
559
360
2242
4663
10572
5356
2308
29
Age category
EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total EU/EEA
Non-EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
9486
14313
23982
9651
14939
24772
10713
14993
25852
10665
15265
26089 Total non-EU/EEA
20203
39918
60428
46376
76754
123460
18867
38782
57877
18639
40419
59287 Total WHO European Region
49
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 9: New HIV diagnoses*, by sex, age and year of diagnosis (2005–2014) and cumulative totals
Table 9b: West, Centre and East of the WHO European Region
Age category
West
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total West
Centre
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total Centre
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
160
301
1124
2036
3398
1504
836
26
9385
161
225
1212
2500
6827
4484
2522
62
17993
323
527
2338
4549
10237
5995
3365
95
27429
160
243
923
1726
3340
1475
858
178
8903
143
202
1144
2393
6843
4896
2640
308
18569
303
446
2070
4126
10204
6378
3499
495
27521
176
260
851
1602
3210
1592
853
203
8747
135
234
1344
2686
7310
5179
2965
381
20234
311
495
2199
4299
10538
6788
3821
596
29047
145
261
767
1537
3205
1698
989
230
8832
143
285
1497
2791
7298
5745
3172
405
21336
288
548
2271
4334
10532
7452
4162
644
30231
35
98
109
136
156
69
45
17
29
99
160
293
453
250
161
37
64
197
270
433
612
322
207
73
28
94
88
136
145
68
38
6
36
80
185
290
506
231
125
38
64
174
275
434
659
304
163
70
25
76
93
120
157
51
57
5
18
86
204
348
511
252
183
38
45
163
304
486
690
311
245
80
21
64
117
128
182
65
64
3
21
74
221
369
636
340
187
27
42
139
346
508
838
411
251
82
665
1482
2178
603
1491
2143
584
1640
2324
644
1875
2617
1168
East
<15
63
92
347
137
193
530
232
226
688
359
578
15–19
472
235
707
471
209
680
515
156
671
434
122
558
20–24
351
458
809
409
460
869
722
687
1409
2060
1211
3274
25–29
324
958
1282
427
994
1421
823
1371
2195
2649
3213
5871
30–39
1734
4398
6132
2170
5382
7552
2752
6196
8953
3137
6404
9565
40–49
573
1717
2290
749
2066
2815
919
2575
3495
1136
2722
3865
50+
136
302
438
176
443
619
266
569
835
348
658
1009
Unknown
2694
3117
5811
3006
3346
6355
2033
2783
4819
14
9
27
Total East
6347
11277
17816
7545
13093
20841
8262
14563
23065
10137
14917
25337
16397
30752
47423
17051
33153
50505
17593
36437
54436
19613
38128
58185
Total WHO European Region
Age category
West
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total West
Centre
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total Centre
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unkown
86
182
574
1036
2449
1528
1166
9
7030
99
313
2037
3356
7212
5648
3973
30
22668
186
496
2613
4395
9671
7186
5142
41
29730
84
169
536
874
2213
1379
1124
7
6386
75
343
1852
3191
6418
5165
3835
25
20904
161
513
2391
4067
8642
6553
4963
35
27325
3451
4946
18074
30594
51617
22788
14315
2596
148381
3709
5735
32569
61084
135454
85195
51165
5494
380405
120
48
240
424
674
267
116
3496
5385
7271
10718
50820
91961
187508
108050
65441
11577
533346
26
28
124
153
259
132
94
4
31
67
453
755
1395
655
344
15
57
95
579
911
1657
788
438
55
29
38
99
170
309
133
125
-
31
90
512
868
1387
671
416
17
60
128
612
1044
1703
808
541
54
4704
1283
2573
2588
3490
1448
1003
291
6192
1472
5628
8017
13164
6198
3552
787
2
4
52
94
123
62
15
2208
10898
2758
8234
10666
16721
7679
4559
3286
903
3992
4950
17380
45010
2560
64801
Total
820
3715
4580
East
<15
113
160
400
127
153
400
2259
3254
1731
7244
15–19
255
72
327
227
76
303
6958
5504
2
12464
20–24
1316
776
2092
1135
704
1839
14541
11419
3
25963
25–29
2191
2319
4510
2007
2133
4140
19456
24788
10
44254
30–39
3951
6498
10449
3719
6386
10105
39677
83410
30
123117
40–49
2123
3382
5505
2000
3371
5371
15440
34074
8
49522
50+
1042
1379
2421
1082
1428
2510
5968
9641
4
15613
2
3
5
1
0
1
48317
71892
322
120531
Unknown
Total East
10993
14589
25709
10298
14251
24669
152616
243982
2110
398708
Total WHO European Region
18843
40972
60019
17587
39147
56944
318377
669397
10055
996855
*
Data from Bosnia and Herzegovina, Russia, Turkmenistan and Uzbekistan excluded due to inconsistent reporting during the period; data from Italy and Spain
excluded due to increasing national coverage over the period. Therefore, totals by gender and overall may differ from totals presented in Tables 1-3.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
50
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
146
234
686
1331
2979
1642
1071
310
8399
125
296
1545
2684
7316
5937
3475
567
21945
271
530
2234
4029
10312
7586
4547
881
30390
154
214
720
1383
2797
1771
1096
15
8150
117
313
1877
3006
7300
5857
3638
39
22147
271
527
2598
4395
10107
7637
4735
57
30327
129
207
700
1275
2719
1550
1071
7
7658
112
294
1849
3203
6998
5716
3644
30
21846
245
501
2550
4478
9721
7271
4718
39
29523
116
182
590
1180
2643
1608
1155
14
7488
95
328
2057
3408
7376
5922
3928
45
23159
213
510
2649
4595
10035
7534
5084
66
30686
29
47
131
125
184
61
66
2
23
57
256
400
765
366
238
30
52
104
390
535
967
436
307
73
24
26
130
112
181
79
63
4
21
41
321
444
754
359
250
23
45
67
455
565
958
448
319
94
22
28
145
128
207
115
65
3
25
59
357
560
985
472
287
20
47
87
504
689
1192
590
352
90
26
33
129
138
245
131
80
2
28
67
433
674
1169
593
308
20
54
100
565
815
1419
727
388
49
645
2135
2864
619
2213
2951
713
2765
3551
784
3292
4117 Total Centre
366
679
1214
482
663
1322
112
140
388
161
227
Age category
West
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total West
Centre
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
East
537 <15
427
102
529
347
114
461
299
70
369
284
61
345 15–19
2142
1131
3273
1821
1181
3002
1606
867
2473
1454
675
2129 20–24
2843
3087
5930
2750
2933
5683
2333
2465
4798
2204
2209
4413 25–29
3546
7028
10574
3708
7152
10860
3709
6614
10323
3665
6404
10069 30–39
1373
3014
4387
1525
3249
4774
1720
3027
4747
1785
3188
4973 40–49
459
780
1239
564
922
1486
713
980
1693
806
1198
2004 50+
3
17
28
26410
36180
62594
4
8
12
8
6
11159
15838
27174
37607
52394
90182
10496
14171
24803
10367
13968
24484 Total East
14 Unknown
20203
39918
60428
46376
76754
123460
18867
38782
57877
18639
40419
59287 Total WHO European Region
51
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 10: HIV diagnoses in people infected through heterosexual contact, by country and transmission subcategory,
cases diagnosed in 2014, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Case from country
with generalised HIV
epidemic
Partner from a
country with a
generalised HIV
epidemic
N
%
Partner IDU
N
%
14
157
4
0
1
2
43
0
19
664
494
0
0
0
68
0
0
0
0
11
2
48
0
0
122
0
0
0
0
73
1048
2771
17.1
43.6
4.2
0.0
10.0
4.4
42.2
0.0
27.1
46.0
63.3
0.0
0.0
0.0
57.1
0.0
0.0
0.0
0.0
40.7
22.2
23.0
0.0
0.0
21.8
0.0
0.0
0.0
0.0
44.0
48.0
28.2
1
0
0
0
0
1
33
0
27
226
50
0
0
0
8
0
0
0
0
0
0
0
60
0
17
0
0
1
0
0
0
423
0
0
0
0
0
-
0.0
0.0
0.0
0.0
0.0
-
0
0
0
0
0
-
0
0.0
0
0.0
0
50
0
0
0
0
0
0
0
37
0
0
0
87
0.0
26.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
22.2
0.0
0.0
0.0
0.5
45
2
0
0
0
0
0
0
1
25
0
0
0
73
15.4
1.0
0.0
0.0
0.0
0.0
0.0
0.0
3.2
15.0
0.0
0.0
0.0
0.4
2850
8
0
2858
30.9
0.7
0.0
10.7
449
2
45
496
4.9
0.2
0.3
1.9
34
3
128
165
Other/
undetermined**
Bisexual partner
Total
N
%
N
%
N
%
N
1.2
0.0
0.0
0.0
0.0
2.2
32.4
0.0
38.6
15.7
6.4
0.0
0.0
0.0
6.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
42.6
0.0
3.0
0.0
0.0
25.0
0.0
0.0
0.0
4.3
2
0
0
0
0
3
0
7
1
11
6
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
4
36
2.4
0.0
0.0
0.0
0.0
6.7
0.0
4.3
1.4
0.8
0.8
0.0
0.0
0.0
0.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.2
0.0
0.0
0.0
0.0
0.0
0.2
0.4
1
0
0
0
0
0
1
0
0
0
8
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
3
15
1.2
0.0
0.0
0.0
0.0
0.0
1.0
0.0
0.0
0.0
1.0
0.0
0.0
0.0
0.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
25.0
0.0
0.0
0.1
0.2
64
203
92
11
9
39
25
155
23
542
222
127
28
0
41
1598
132
0
66
16
7
161
81
88
420
320
18
2
875
93
1130
6588
78.0
56.4
95.8
100.0
90.0
86.7
24.5
95.7
32.9
37.6
28.5
100.0
100.0
0.0
34.5
100.0
100.0
0.0
100.0
59.3
77.8
77.0
57.4
100.0
75.0
100.0
100.0
50.0
100.0
56.0
51.7
67.0
82
360
96
11
10
45
102
162
70
1443
780
127
28
0
119
1598
132
0
66
27
9
209
141
88
560
320
18
4
875
166
2185
9833
0.0
0.0
0.0
0.0
0.0
-
0
0
19
43
0
-
0.0
0.0
7.3
12.0
0.0
-
0
0
0
0
0
-
0.0
0.0
0.0
0.0
0.0
-
61
0
243
316
1349
-
100.0
0.0
92.7
88.0
100.0
-
61
0
262
359
1349
-
0
0.0
0
0.0
4
100.0
4
45
7
0
14
0
0
0
0
0
1
0
0
0
129
15.4
3.6
0.0
3.7
0.0
0.0
0.0
0.0
0.0
0.6
0.0
0.0
0.0
0.8
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
3.2
0.0
0.0
0.0
0.0
0.0
202
133
1399
375
620
0
4
0
29
104
569
485
10648
16541
69.2
69.3
100.0
96.4
100.0
0.0
100.0
0.0
93.5
62.3
100.0
100.0
100.0
98.3
292
192
1399
389
620
0
4
0
31
167
569
485
10648
16831
0.4
0.2
0.8
0.6
14
2
0
16
0.2
0.2
0.0
0.1
5865
1190
16074
23129
63.7
98.8
98.9
86.7
9212
1205
16247
26664
* Country-specific comments are in Annex 5
** The category ‘other/undetermined’ includes a substantial proportion of cases with partners reported as heterosexual from a non-generalised epidemic country
in the following countries: Albania (18%), Armenia (93%), Azerbaijan (23%), Czech Republic (18%), Denmark (22%), Georgia (27%), Kyrgyzstan (48%), Moldova
(99.7%), Norway (32%), Portugal (23%). Countries reporting aggregate data (Ukraine and Kazakhstan for 2014) are classified as unknown because information
on region of origin and partner risk factors are not included in the aggregate reporting metadataset.
53
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 11: HIV diagnoses, by country of report and region of origin, cases diagnosed in 2014, in EU/EEA and other
countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Country of report
N
%
Western Europe
N
%
Central & Eastern Europe
N
%
Sub-Saharan Africa
N
%
124
353
231
89
36
173
129
285
81
1366
2111
506
0
2
130
2680
342
0
136
24
20
545
103
0
581
787
83
44
2287
69
2629
15946
52.8
34.0
93.5
96.7
64.3
74.6
50.4
97.9
44.8
31.6
59.9
70.9
0.0
18.2
36.2
72.5
98.6
0.0
96.5
34.8
50.0
65.6
38.4
0.0
63.2
99.5
96.5
89.8
67.9
19.7
42.8
53.2
11
93
1
0
11
7
23
0
8
66
108
5
0
3
22
40
1
1
1
18
8
28
23
0
8
0
0
0
106
12
514
1118
4.7
9.0
0.4
0.0
19.6
3.0
9.0
0.0
4.4
1.5
3.1
0.7
0.0
27.3
6.1
1.1
0.3
100.0
0.7
26.1
20.0
3.4
8.6
0.0
0.9
0.0
0.0
0.0
3.1
3.4
8.4
3.7
63
28
5
1
7
44
21
6
30
74
344
80
0
1
36
223
3
0
4
4
1
36
15
0
9
1
0
4
102
24
412
1578
26.8
2.7
2.0
1.1
12.5
19.0
8.2
2.1
16.6
1.7
9.8
11.2
0.0
9.1
10.0
6.0
0.9
0.0
2.8
5.8
2.5
4.3
5.6
0.0
1.0
0.1
0.0
8.2
3.0
6.9
6.7
5.3
20
214
7
0
1
3
51
0
15
940
487
24
0
3
78
387
0
0
0
19
5
81
64
0
169
0
3
0
185
143
1240
4139
8.5
20.6
2.8
0.0
1.8
1.3
19.9
0.0
8.3
21.7
13.8
3.4
0.0
27.3
21.7
10.5
0.0
0.0
0.0
27.5
12.5
9.7
23.9
0.0
18.4
0.0
3.5
0.0
5.5
40.9
20.2
13.8
76
0
332
586
1809
30
534
160
0
616
831
0
20
126
198
985
0
0
6303
98.7
0.0
100.0
97.0
99.9
100.0
99.6
33.5
0.0
95.5
100.0
0.0
100.0
100.0
38.4
100.0
0.0
0.0
23.4
0
3
0
0
0
0
0
8
0
0
0
0
0
0
77
0
0
0
88
0.0
100.0
0.0
0.0
0.0
0.0
0.0
1.7
0.0
0.0
0.0
0.0
0.0
0.0
15.0
0.0
0.0
0.0
0.3
0
0
0
18
2
0
2
131
0
25
0
0
0
0
21
0
0
0
199
0.0
0.0
0.0
3.0
0.1
0.0
0.4
27.5
0.0
3.9
0.0
0.0
0.0
0.0
4.1
0.0
0.0
0.0
0.7
0
0
0
0
0
0
0
67
0
0
0
0
0
0
64
0
0
0
131
0.0
0.0
0.0
0.0
0.0
0.0
0.0
14.0
0.0
0.0
0.0
0.0
0.0
0.0
12.4
0.0
0.0
0.0
0.5
14098
1695
6456
22249
51.6
34.2
26.2
39.1
1184
19
2
1206
4.3
0.4
0.0
2.1
1655
62
60
1777
6.1
1.3
0.2
3.1
4256
14
0
4270
15.6
0.3
0.0
7.5
* Country-specific comments are in Annex 5
** Countries reporting aggregate data (Ukraine and Kazakhstan for 2014) are classified as unknown because information on region of origin is not included in the
aggregate reporting metadataset.
54
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Latin America & Caribbean
N
Rate
South & South-east Asia
N
%
Other
N
%
Unknown**
N
%
Total Country
3
34
0
1
0
0
6
0
3
179
69
1
0
1
42
204
0
0
0
3
1
60
16
0
51
0
0
1
508
8
299
1490
1.3
3.3
0.0
1.1
0.0
0.0
2.3
0.0
1.7
4.1
2.0
0.1
0.0
9.1
11.7
5.5
0.0
0.0
0.0
4.3
2.5
7.2
6.0
0.0
5.5
0.0
0.0
2.0
15.1
2.3
4.9
5.0
7
14
0
0
1
5
16
0
12
52
96
17
0
0
13
51
0
0
0
0
1
31
31
0
1
0
0
0
0
39
276
663
3.0
1.3
0.0
0.0
1.8
2.2
6.3
0.0
6.6
1.2
2.7
2.4
0.0
0.0
3.6
1.4
0.0
0.0
0.0
0.0
2.5
3.7
11.6
0.0
0.1
0.0
0.0
0.0
0.0
11.1
4.5
2.2
1
21
3
0
0
0
9
0
0
103
50
13
0
1
3
97
1
0
0
0
4
25
5
0
0
0
0
0
68
20
167
591
0.4
2.0
1.2
0.0
0.0
0.0
3.5
0.0
0.0
2.4
1.4
1.8
0.0
9.1
0.8
2.6
0.3
0.0
0.0
0.0
10.0
3.0
1.9
0.0
0.0
0.0
0.0
0.0
2.0
5.7
2.7
2.0
6
282
0
1
0
0
1
0
32
1547
260
68
271
0
35
13
0
0
0
1
0
25
11
1061
101
3
0
0
110
35
604
4467
2.6
27.1
0.0
1.1
0.0
0.0
0.4
0.0
17.7
35.8
7.4
9.5
100.0
0.0
9.7
0.4
0.0
0.0
0.0
1.4
0.0
3.0
4.1
100.0
11.0
0.4
0.0
0.0
3.3
10.0
9.8
14.9
235
1039
247
92
56
232
256
291
181
4327
3525
714
271
11
359
3695
347
1
141
69
40
831
268
1061
920
791
86
49
3366
350
6141
29992
0
0
0
0
0
0
0
9
0
0
0
0
0
0
27
0
0
0
36
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.9
0.0
0.0
0.0
0.0
0.0
0.0
5.2
0.0
0.0
0.0
0.1
0
0
0
0
0
0
0
20
0
3
0
0
0
0
10
0
0
0
33
0.0
0.0
0.0
0.0
0.0
0.0
0.0
4.2
0.0
0.5
0.0
0.0
0.0
0.0
1.9
0.0
0.0
0.0
0.1
1
0
0
0
0
0
0
82
0
1
0
0
0
0
7
0
0
0
91
1.3
0.0
0.0
0.0
0.0
0.0
0.0
17.2
0.0
0.2
0.0
0.0
0.0
0.0
1.4
0.0
0.0
0.0
0.3
0
0
0
0
0
0
0
0
2350
0
0
0
0
0
111
0
1812
15796
20070
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
100.0
0.0
0.0
0.0
0.0
0.0
21.6
0.0
100.0
100.0
74.5
77
3
332
604
1811
30
536
477
2350
645
831
0
20
126
515
985
1812
15796
26953
1524
2
0
1526
5.6
0.0
0.0
2.7
687
6
3
696
2.5
0.1
0.0
1.2
676
4
2
682
2.5
0.1
0.0
1.2
3245
3148
18144
24537
11.9
63.6
73.6
43.1
27325
4950
24669
56945
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
55
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 12: HIV diagnoses, by geographical area, transmission mode and country or subcontinent of origin, cases
reported in 2014
Table 12a: EU/EEA and non-EU/EEA countries
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
Country of report
N
%
Western Europe
N
%
Central & Eastern Europe
N
%
Sub-Saharan Africa
N
%
8921
888
4202
88
14
10
1823
15946
70.4
71.4
42.7
37.3
19.7
45.5
30.9
53.2
753
49
221
5
4
2
84
1118
5.9
3.9
2.2
2.1
5.6
9.1
1.4
3.7
578
170
562
13
7
1
246
1578
4.6
13.7
5.7
5.5
9.9
4.5
4.2
5.3
212
13
3426
97
36
3
352
4139
1.7
1.0
34.8
41.1
50.7
13.6
6.0
13.8
522
1258
3996
140
2
14
371
6303
22249
41.8
18.6
23.7
44.6
28.6
58.3
20.9
23.4
39.1
54
2
24
0
0
0
8
88
1206
4.3
0.0
0.1
0.0
0.0
0.0
0.5
0.3
2.1
23
39
108
1
1
1
26
199
1776
1.8
0.6
0.6
0.3
14.3
4.2
1.5
0.7
3.1
3
0
119
1
2
0
6
131
4270
0.2
0.0
0.7
0.3
28.6
0.0
0.3
0.5
7.5
Table 12b: West, Centre, East of the WHO European Region
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total East
Total WHO European Region
56
Country of report
N
%
Western Europe
N
%
Central & Eastern Europe
N
%
Sub-Saharan Africa
N
%
8583
518
3469
59
14
8
1447
14098
71.5
60.5
37.7
28.0
18.7
42.1
29.3
51.6
794
50
240
5
4
2
89
1184
6.6
5.8
2.6
2.4
5.3
10.5
1.8
4.3
565
187
618
13
8
1
262
1655
4.7
21.8
6.7
6.2
10.7
5.3
5.3
6.1
215
13
3537
98
38
3
352
4256
1.8
1.5
38.4
46.4
50.7
15.8
7.1
15.6
652
214
570
24
0
2
233
1695
47.0
79.3
47.3
48.0
0.0
16.7
11.5
34.2
12
1
5
0
0
0
1
19
0.9
0.4
0.4
0.0
0.0
0.0
0.0
0.4
35
6
14
1
0
0
6
62
2.5
2.2
1.2
2.0
0.0
0.0
0.3
1.3
0
0
8
0
0
0
6
14
0.0
0.0
0.7
0.0
0.0
0.0
0.3
0.3
208
1414
4159
145
2
14
514
6456
22249
39.1
20.6
25.6
50.2
100.0
93.3
72.2
26.2
39.1
0
0
0
0
0
0
2
2
1206
0.0
0.0
0.0
0.0
0.0
0.0
0.3
0.0
2.1
1
16
38
0
0
1
4
60
1776
0.2
0.2
0.2
0.0
0.0
6.7
0.6
0.2
3.1
0
0
0
0
0
0
0
0
4270
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
7.5
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Latin America & Caribbean
N
%
South & South-east Asia
N
%
Other
N
%
Unknown
N
%
Total Transmission mode
903
10
455
5
2
0
115
1490
7.1
0.8
4.6
2.1
2.8
0.0
1.9
5.0
303
17
280
6
5
3
49
663
2.4
1.4
2.8
2.5
7.0
13.6
0.8
2.2
271
12
197
8
1
1
101
591
2.1
1.0
2.0
3.4
1.4
4.5
1.7
2.0
736
85
490
14
2
2
3138
4467
5.8
6.8
5.0
5.9
2.8
9.1
53.1
14.9
12677
1244
9833
236
71
22
5908
29992
24
2
9
0
0
0
1
36
1526
1.9
0.0
0.1
0.0
0.0
0.0
0.1
0.1
2.7
7
0
19
5
1
0
1
33
696
0.6
0.0
0.1
1.6
14.3
0.0
0.1
0.1
1.2
15
1
13
0
0
0
62
91
682
1.2
0.0
0.1
0.0
0.0
0.0
3.5
0.3
1.2
601
5452
12543
167
1
9
1299
20072
24539
48.1
80.7
74.5
53.2
14.3
37.5
73.2
74.5
43.1
1249
6754
16831
314
7
24
1774
26953
56944
Latin America & Caribbean
N
%
South & South-east Asia
N
%
Other
N
%
Unknown
N
%
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
Total Transmission mode
925
12
464
5
2
0
116
1524
7.7
1.4
5.0
2.4
2.7
0.0
2.3
5.6
308
17
292
11
6
3
50
687
2.6
2.0
3.2
5.2
8.0
15.8
1.0
2.5
283
13
207
8
1
1
163
676
2.4
1.5
2.2
3.8
1.3
5.3
3.3
2.5
334
46
385
12
2
1
2465
3245
2.8
5.4
4.2
5.7
2.7
5.3
49.9
11.9
12007
856
9212
211
75
19
4944
27325
2
0
0
0
0
0
0
2
0.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1
0
5
0
0
0
0
6
0.1
0.0
0.4
0.0
0.0
0.0
0.0
0.1
2
0
2
0
0
0
0
4
0.1
0.0
0.2
0.0
0.0
0.0
0.0
0.1
682
49
601
25
1
10
1780
3148
49.2
18.1
49.9
50.0
100.0
83.3
87.9
63.6
1386
270
1205
50
1
12
2026
4950
0
0
0
0
0
0
0
0
1526
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.7
1
0
2
0
0
0
0
3
696
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.2
1
0
1
0
0
0
0
2
682
0.2
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.2
321
5442
12047
144
0
0
192
18146
24539
60.3
79.2
74.1
49.8
0.0
0.0
27.0
73.6
43.1
532
6872
16247
289
2
15
712
24669
56944
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total East
Total WHO European Region
57
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 13: New HIV diagnoses, by country of report and probable region of infection, in 2014, in EU/EEA and other
countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Centre former Yugoslav Republic of Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Country of report
N
%
Western Europe
N
%
Central & Eastern Europe
N
%
Sub-Saharan Africa
N
%
35
268
0
92
36
0
123
208
84
1252
0
714
271
1
143
0
213
0
97
21
33
516
75
958
587
787
76
0
0
67
3181
9838
14.9
25.8
0.0
100.0
64.3
0.0
48.0
71.5
46.4
28.9
0.0
100.0
100.0
9.1
39.8
0.0
61.4
0.0
68.8
30.4
82.5
62.1
28.0
90.3
63.8
99.5
88.4
0.0
0.0
19.1
51.8
32.8
2
40
0
0
6
2
23
5
13
0
0
0
0
0
19
0
4
0
5
0
4
20
36
0
5
0
3
0
0
26
300
513
0.9
3.8
0.0
0.0
0.0
0.9
9.0
1.7
7.2
0.0
0.0
0.0
0.0
0.0
5.3
0.0
1.2
0.0
3.5
0.0
10.0
2.4
13.4
0.0
0.5
0.0
3.5
0.0
0.0
7.4
4.9
1.7
2
14
0
0
5
1
15
1
36
0
0
0
0
0
11
0
3
0
4
0
0
7
16
0
2
1
4
0
0
22
201
345
0.9
1.3
0.0
0.0
8.9
0.4
5.9
0.3
19.9
0.0
0.0
0.0
0.0
0.0
3.1
0.0
0.9
0.0
2.8
0.0
0.0
0.8
6.0
0.0
0.2
0.1
4.7
0.0
0.0
6.3
3.3
1.2
5
115
0
0
1
0
48
0
15
0
0
0
0
1
57
0
0
0
0
0
0
29
66
0
93
0
3
0
0
132
836
1401
2.1
11.1
0.0
0.0
1.8
0.0
18.8
0.0
8.3
0.0
0.0
0.0
0.0
9.1
15.9
0.0
0.0
0.0
0.0
0.0
0.0
3.5
24.6
0.0
10.1
0.0
3.5
0.0
0.0
37.7
13.6
4.7
50
3
135
296
1809
30
230
268
0
613
678
0
0
0
0
198
0
0
0
4319
64.9
100.0
40.7
49.0
99.9
100.0
42.9
56.2
0.0
96.4
81.6
0.0
0.0
0.0
0.0
38.4
0.0
0.0
0.0
16.0
5
0
0
1
0
0
19
4
0
0
0
0
0
0
0
32
0
0
0
61
6.5
0.0
0.0
0.2
0.0
0.0
3.5
0.8
0.0
0.0
0.0
0.0
0.0
0.0
0.0
6.2
0.0
0.0
0.0
0.2
0
0
187
155
0
0
131
56
0
19
33
0
0
0
0
7
0
0
0
588
0.0
0.0
56.3
25.7
0.0
0.0
24.4
11.7
0.0
3.0
4.0
0.0
0.0
0.0
0.0
1.4
0.0
0.0
0.0
2.2
0
0
0
0
0
0
0
48
0
0
0
0
0
0
0
40
0
0
0
88
0.0
0.0
0.0
0.0
0.0
0.0
0.0
10.1
0.0
0.0
0.0
0.0
0.0
0.0
0.0
7.8
0.0
0.0
0.0
0.3
7569
2300
4288
14157
27.7
46.5
17.4
24.9
524
16
34
574
1.9
0.3
0.1
1.0
389
11
533
933
1.4
0.2
2.2
1.6
1485
4
0
1489
5.4
0.1
0.0
2.6
* Country-specific comments are in Annex 5
** Countries reporting aggregate data (Ukraine and Kazakhstan for 2014) are classified as unknown because information on probable country of infection is not
included in the aggregate reporting metadataset.
58
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Latin America & Caribbean
N
Rate
South & South-east Asia
N
%
Other
N
%
Unknown**
N
%
Total Country
1
15
0
0
1
1
4
0
1
0
0
0
0
0
25
0
0
0
0
0
1
12
10
0
13
0
0
0
0
7
95
186
0.4
1.4
0.0
0.0
1.8
0.4
1.6
0.0
0.6
0.0
0.0
0.0
0.0
0.0
7.0
0.0
0.0
0.0
0.0
0.0
2.5
1.4
3.7
0.0
1.4
0.0
0.0
0.0
0.0
2.0
1.5
0.6
2
26
0
0
0
2
28
2
29
0
0
0
0
0
4
0
0
0
0
1
0
19
48
0
0
0
0
0
0
53
264
478
0.9
2.5
0.0
0.0
0.0
0.9
10.9
0.7
16.0
0.0
0.0
0.0
0.0
0.0
1.1
0.0
0.0
0.0
0.0
1.4
0.0
2.3
17.9
0.0
0.0
0.0
0.0
0.0
0.0
15.1
4.3
1.6
0
8
0
0
2
0
8
0
3
0
0
0
0
1
9
0
0
0
0
0
2
4
7
0
0
0
0
0
0
30
99
173
0.0
0.8
0.0
0.0
3.6
0.0
3.1
0.0
1.7
0.0
0.0
0.0
0.0
9.1
2.5
0.0
0.0
0.0
0.0
0.0
5.0
0.5
2.6
0.0
0.0
0.0
0.0
0.0
0.0
8.6
1.6
0.6
188
553
247
0
5
226
7
75
0
3075
3525
0
0
8
91
3695
127
1
35
47
0
224
10
103
220
3
0
49
3366
13
1165
17058
80.0
53.2
100.0
0.0
8.9
97.4
2.7
25.8
0.0
71.1
100.0
0.0
0.0
72.7
25.3
100.0
36.6
100.0
24.8
68.1
0.0
27.0
3.7
9.7
23.9
0.4
0.0
100.0
100.0
3.7
19.0
56.9
235
1039
247
92
56
232
256
291
181
4327
3525
714
271
11
359
3695
347
1
141
69
40
831
268
1061
920
791
86
49
3366
350
6141
29992
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
14
0
0
0
19
0.0
0.0
0.0
0.0
0.0
0.0
0.0
1.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
2.7
0.0
0.0
0.0
0.1
0
0
0
0
0
0
1
14
0
3
0
0
0
0
0
16
0
0
0
34
0.0
0.0
0.0
0.0
0.0
0.0
0.2
2.9
0.0
0.5
0.0
0.0
0.0
0.0
0.0
3.1
0.0
0.0
0.0
0.1
0
0
3
0
0
0
1
13
0
1
0
0
0
0
0
6
0
0
0
24
0.0
0.0
0.9
0.0
0.0
0.0
0.2
2.7
0.0
0.2
0.0
0.0
0.0
0.0
0.0
1.2
0.0
0.0
0.0
0.1
22
0
7
152
2
0
154
69
2350
0
120
0
20
3
126
202
985
1812
15796
21820
28.6
0.0
2.1
25.2
0.1
0.0
28.7
14.5
100.0
0.0
14.4
0.0
100.0
100.0
100.0
39.2
100.0
100.0
100.0
81.0
77
3
332
604
1811
30
536
477
2350
636
831
0
20
3
126
515
985
1812
15796
26953
203
2
0
205
0.7
0.0
0.0
0.4
504
2
6
512
1.8
0.0
0.0
0.9
190
2
5
197
0.7
0.0
0.0
0.3
16461
2613
19803
38878
60.2
52.8
80.3
68.3
27325
4950
24669
56945
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
59
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 14: Percentage of new HIV diagnoses (2014) among persons >14 years reported with information about CD4 cell
count, by CD4 cell count level (<200 and <350 cells per mm3 blood) and by transmission mode in cases with CD4 <350,
in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre
Poland
West
Portugal
Centre
Romania
Centre
Slovakia
Centre
Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre
Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre
Bosnia and Herzegovina
Former Yugoslav Republic of
Centre
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre
Montenegro
East
Russia
West
San Marino
Centre
Serbia
West
Switzerland
East
Tajikistan
Centre
Turkey***
East
Turkmenistan
East
Ukraine
East
Uzbekistan
total Non EU-EEA
WHO European Region
West
Centre
East
Total WHO European Region
Number of cases
with CD4**
Completeness
(%) CD4
CD4 <200 (%)
CD4 <350 (%)
CD4 < 350 per mm3 blood (%)
N
%
N
%
Hetero
IDU
MSM
222
605
220
48
203
174
162
140
2308
516
306
2862
247
1
56
760
686
731
62
45
2888
5169
18411
94.9
59.0
89.8
85.7
87.9
69.0
56.8
79.1
53.7
72.3
86.0
77.8
72.0
100.0
83.6
92.3
75.1
94.8
72.1
91.8
85.9
84.6
61.4
61
137
60
7
30
42
62
36
620
159
81
998
82
1
12
193
227
280
12
22
801
1131
5069
27.5
22.6
27.3
14.6
14.8
24.1
38.3
25.7
26.9
30.8
26.5
34.9
33.2
100.0
21.4
25.4
33.1
38.3
19.4
48.9
27.7
21.9
27.4
109
261
95
13
64
79
102
58
1080
264
145
1529
130
1
29
337
351
426
23
28
1334
2080
8608
49.1
43.1
43.2
27.1
31.5
45.4
63.0
41.4
46.8
51.2
47.4
53.4
52.6
100.0
51.8
44.3
51.2
58.3
37.1
62.2
46.2
40.2
46.6
59.5
52.9
53.8
50.0
38.5
57.1
60.4
49.2
55.6
66.1
60.9
49.7
53.9
56.5
58.8
54.8
53.2
68.8
57.0
54.9
55.4
30.0
25.0
44.7
100.0
37.5
50.0
69.6
20.0
59.5
77.3
42.9
46.1
52.3
41.7
63.0
61.6
50.0
75.0
64.2
60.9
45.8
31.4
35.4
16.2
28.6
37.9
66.7
30.0
32.7
37.0
37.0
35.6
45.8
100.0
57.9
36.6
42.5
48.3
24.4
63.3
39.5
28.9
36.9
52
295
347
-
74.3
90.8
59.2
-
32
108
108
-
61.5
36.6
31.1
-
40
162
179
-
76.9
54.9
51.6
-
74.4
51.9
47.7
-
100.0
77.1
62.5
-
87.5
50.0
42.9
-
24
80.0
1
4.2
9
37.5
33.3
-
38.1
468
248
149
463
16
107
338
622
88
3217
88.3
54.6
24.9
57.0
80.0
85.6
66.1
71.7
4.9
12.3
162
74
45
121
5
45
96
227
11
1035
34.6
29.8
30.2
26.1
31.3
42.1
28.4
36.5
12.5
32.2
273
121
106
243
7
72
162
399
35
1808
58.3
48.8
71.1
52.5
43.8
67.3
47.9
64.1
39.8
56.2
56.9
58.9
67.5
52.4
66.7
77.8
56.7
62.4
40.5
56.5
69.4
48.1
84.6
51.7
100.0
80.0
71.2
68.3
37.9
40.2
75.0
66.7
41.7
56.9
38.8
40.0
42.1
43.3
17278
1596
2753
21627
63.0
33.0
11.5
37.9
4668
505
915
6088
27.0
31.6
33.2
28.1
7939
812
1594
10345
46.2
50.9
57.9
48.0
55.7
54.1
56.1
55.7
61.7
58.5
67.7
63.7
37.0
39.1
44.4
37.2
* Country-specific comments are in Annex 5
** Completeness is for all cases; there is some variation by country for CD4 cell count completeness by transmission group
*** Data for Turkey exclude people diagnosed with AIDS at the time of HIV diagnosis.
61
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 15: AIDS diagnoses and rates per 100 000 population, by country and year of diagnosis (2005-2014) and
cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia***
West
San Marino
Centre Serbia****
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of
start of
reporting
2005
2006
2007
2008
2009
N
Rate
N
Rate
N
Rate
N
Rate
N
Rate
1982
1983
1987
1986
1986
1986
1980
1992
1983
1980
1981
1981
1986
1985
1983
1982
1990
1989
1988
1983
1986
1999
1983
1986
1985
1985
1985
1986
1981
1982
1981
96
156
19
21
11
13
44
29
26
1371
736
104
33
1
42
1531
119
0
10
11
3
357
32
151
995
379
3
10
1874
46
980
9203
1.2
1.5
0.2
0.5
1.5
0.1
0.8
2.1
0.5
2.2
0.9
0.9
0.3
0.3
1
7.9
5.3
0
0.3
2.4
0.7
2.2
0.7
0.4
9.5
1.8
0.1
0.5
4.3
0.5
1.6
2
98
106
16
20
8
18
51
32
26
1184
720
90
22
3
42
1454
90
0
27
9
7
285
32
167
920
324
4
5
1752
55
891
8458
1.2
1
0.2
0.5
1.1
0.2
0.9
2.4
0.5
1.9
0.9
0.8
0.2
1
1
6
4
0
0.8
1.9
1.7
1.7
0.7
0.4
8.8
1.5
0.1
0.2
4
0.6
1.5
1.8
110
105
21
11
12
23
32
57
33
1019
664
93
23
0
35
1405
81
0
28
11
2
298
9
141
813
311
6
9
1639
62
844
7897
1.3
1
0.3
0.3
1.6
0.2
0.6
4.2
0.6
1.6
0.8
0.8
0.2
0
0.8
4.5
3.7
0
0.9
2.3
0.5
1.8
0.2
0.4
7.7
1.5
0.1
0.4
3.7
0.7
1.4
1.7
97
119
29
25
12
29
40
61
27
1063
587
109
23
2
36
1341
103
0
54
8
9
278
18
180
847
336
1
11
1544
829
7818
1.2
1.1
0.4
0.6
1.5
0.3
0.7
4.6
0.5
1.7
0.7
1
0.2
0.6
0.8
3.6
4.7
0
1.7
1.7
2.2
1.7
0.4
0.5
8
1.6
0
0.5
3.4
1.3
1.6
90
121
30
22
8
23
36
38
23
954
624
103
23
0
35
1204
101
0
37
3
1
271
18
131
692
268
4
18
1418
655
6952
1.1
1.1
0.4
0.5
1
0.2
0.7
2.8
0.4
1.5
0.8
0.9
0.2
0
0.8
2.1
4.7
0
1.2
0.6
0.2
1.6
0.4
0.3
6.6
1.3
0.1
0.9
3.1
1.1
1.4
1993
2004
1988
1995
1991
1986
12
0
41
20
163
6
0.4
0
1.4
0.2
1.7
0.2
10
0
46
21
331
4
0.3
0
1.5
0.2
3.4
0.1
24
1
59
200
308
4
0.8
1.2
2
2.3
3.2
0.1
32
2
83
76
351
5
1.1
2.4
2.8
0.9
3.7
0.1
34
0
84
109
532
2
1.2
0
2.8
1.2
5.6
0.1
1989
10
0.5
10
0.5
10
0.5
9
0.4
2
0.1
1989
1981
1993
1999
1989
1985
1990
140
61
100
23
60
1
5
1
52
196
4
32
0
4217
11
5155
3.1
0.9
0.6
0.4
1.4
3
0.8
3.4
0.6
2.6
0.1
0
0
9
0
2.2
162
70
132
29
93
0
5
1
51
160
21
30
0
4723
13
5912
3.7
1
0.8
0.6
2.2
0
0.8
3.3
0.6
2.1
0.3
0
0
10.2
0
2.5
183
49
176
24
218
0
3
0
39
176
30
30
0
4573
35
6142
4.2
0.7
1.1
0.5
5.3
0
0.5
0
0.4
2.3
0.4
0
0
9.9
0.1
2.6
232
53
174
36
92
0
6
0
39
161
55
55
0
4380
184
6025
5.3
0.7
1.1
0.7
2.2
0
1
0
0.4
2.1
0.8
0.1
0
9.5
0.7
2.6
284
52
173
75
262
0
8
0
52
151
70
67
0
4437
129
6523
6.6
0.7
1.1
1.4
6.4
0
1.3
0
0.6
2
0.9
0.1
0
9.7
0.5
2.8
8664
757
4937
14358
2.4
0.4
3.6
2.1
7956
694
5720
14370
2.1
0.4
4.2
2.1
7400
667
5972
14039
1.9
0.4
4.3
2
7170
792
5881
13843
1.9
0.4
4.3
2
6452
692
6331
13475
1.6
0.4
4.6
1.8
1986
1985
1980
1998
1985
2002
1988
1992
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (4), 2006 (0, 0.0), 2007 (1, 0.0), 2008 (1, 0.0), 2009 (0, 0.0), 2010 (3, 0.1), 2011 (3, 0.2), 2012 (1, 0.1), 2013 (1, 0.1), 2014 (1, 0.1), cumulative
1986-2014 (50).
62
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
2010
2011
2012
2013
2014
Cumulative Country*
total**
N
Rate
N
Rate
N
Rate
N
Rate
N
Rate
81
104
32
21
10
26
44
26
32
978
508
103
28
1
38
1145
132
0
33
8
6
286
22
173
736
248
2
7
1206
667
6704
1
1
0.4
0.5
1.2
0.2
0.8
2
0.6
1.5
0.6
0.9
0.3
0.3
0.8
1.9
6.2
0
1.1
1.6
1.4
1.7
0.5
0.5
7
1.2
0
0.3
2.6
1.1
1.3
78
87
40
26
5
26
59
38
25
847
495
101
32
2
47
1052
112
1
21
11
5
229
19
184
632
323
4
15
1063
421
6000
0.9
0.8
0.5
0.6
0.6
0.2
1.1
2.9
0.5
1.3
0.6
0.9
0.3
0.6
1
1.8
5.4
2.8
0.7
2.1
1.2
1.4
0.4
0.5
6
1.6
0.1
0.7
2.3
0.7
1.2
91
92
65
28
7
30
41
36
19
817
488
122
48
1
36
1066
142
1
38
8
6
256
25
157
581
325
7
11
953
432
5929
1.1
0.8
0.9
0.7
0.8
0.3
0.7
2.7
0.4
1.3
0.6
1.1
0.5
0.3
0.8
1.8
6.9
2.7
1.3
1.5
1.4
1.5
0.5
0.4
5.5
1.6
0.1
0.5
2
0.7
1.2
68
80
71
17
3
27
38
26
20
659
412
137
42
1
27
1056
133
0
44
10
1
220
28
161
459
345
6
11
683
345
5132
0.8
0.7
1
0.4
0.3
0.3
0.7
2
0.4
1
0.5
1.2
0.4
0.3
0.6
1.8
6.6
0
1.5
1.9
0.2
1.3
0.6
0.4
4.4
1.7
0.1
0.5
1.8
0.5
1
76
84
64
22
6
24
29
18
20
405
235
115
51
0
29
858
171
1
37
9
4
157
45
125
249
378
4
16
444
344
4020
0.9
0.7
0.9
0.5
0.7
0.2
0.5
1.4
0.4
0.6
0.3
1.1
0.5
0
0.6
1.4
8.5
2.7
1.3
1.6
0.9
0.9
0.9
0.3
2.4
1.9
0.1
0.8
1.3
0.5
0.8
2949
4469
529
440
254
428
2956
434
636
69786
30474
3678
796
67
1220
67248
1524
12
415
289
107
5964
1114
3172
20857
8774
78
228
84538
2172
28657
344265
26
0
94
210
475
6
0.9
0
3.2
2.3
5
0.2
46
1
87
195
590
7
1.6
1.3
2.9
2.1
6.2
0.2
49
0
133
235
598
4
1.7
0
4.5
2.5
6.3
0.1
65
2
144
189
547
7
2.3
2.6
4.8
2
5.8
0.2
50
0
171
200
474
-
1.7
0
5.7
2.1
5
-
406
8
1006
1519
4544
127
6
0.3
8
0.4
10
0.5
10
0.5
16
0.8
149
339
38
264
130
306
0
7
0
0
49
163
101
60
0
5861
220
8355
8
0.5
1.6
2.4
7.5
0
1.1
0
0
0.5
2.1
1.3
0.1
0
12.8
0.8
3.5
395
55
226
90
439
0
2
1
53
127
136
80
0
9189
11727
9.4
0.7
1.4
1.6
10.8
0
0.3
3.1
0.6
1.6
1.8
0.1
0
20.2
5.5
359
46
234
88
183
0
7
2
54
94
150
95
0
10073
12414
8.7
0.6
1.4
1.6
4.5
0
1.1
6
0.6
1.2
1.9
0.1
0
22.2
5.8
303
43
261
67
234
0
7
0
45
95
170
95
9362
11646
7.4
0.6
1.5
1.2
5.7
0
1.1
0
0.5
1.2
2.1
0.1
20.7
5.4
268
63
236
81
234
1
7
44
47
156
125
9844
12017
6.6
0.8
1.4
1.4
5.7
3
1.1
0.5
0.6
1.9
0.2
23
5.6
2932
1534
2209
678
2285
50
95
0
23
1784
9686
899
1237
1
75579
651
107402
6167
701
8191
15059
1.5
0.4
5.9
2
5357
851
11518
17727
1.3
0.4
10.3
2.5
5176
897
12269
18343
1.3
0.5
10.9
2.6
4386
912
11480
16778
1.1
0.5
10.2
2.3
3214
932
11890
16037
0.8
0.5
10.7
2.3
338482
18497
94676
451667
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of
Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia***
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
63
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 16: AIDS diagnoses in males and rates per 100 000 population, by country and year of diagnosis (2005-2014) and
cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia***
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
2005
N
Rate
2006
N
Rate
2007
N
Rate
2008
N
Rate
2009
N
Rate
Rate
67
83
16
19
6
8
30
15
25
924
600
80
29
1
28
1145
74
0
7
6
1
272
18
117
790
208
2
8
1448
35
622
6684
1.7
1.6
0.4
0.9
1.7
0.2
1.1
2.4
1
3
1.5
1.5
0.6
0.7
1.4
12.1
7.2
0
0.4
2.6
0.5
3.4
0.8
0.6
15.6
2
0.1
0.8
6.8
0.8
2.1
3
75
66
12
14
7
13
31
22
20
817
595
65
15
2
34
1080
63
0
22
6
5
224
24
130
677
187
4
5
1355
33
532
6135
1.9
1.3
0.3
0.7
1.9
0.3
1.2
3.5
0.8
2.7
1.5
1.2
0.3
1.3
1.6
9.2
6.2
0
1.4
2.6
2.5
2.8
1
0.7
13.4
1.8
0.2
0.5
6.2
0.7
1.8
2.7
86
65
18
10
8
18
22
46
22
697
528
71
17
0
18
1077
59
0
26
8
2
228
6
109
615
180
4
7
1280
40
558
5825
2.1
1.3
0.5
0.5
2.2
0.4
0.8
7.4
0.9
2.3
1.3
1.3
0.4
0
0.8
7.2
5.8
0
1.7
3.4
1
2.8
0.3
0.6
12.1
1.7
0.2
0.7
5.8
0.9
1.9
2.5
78
76
20
24
10
22
33
44
24
720
488
96
21
2
27
991
77
0
45
5
9
225
11
139
627
181
0
9
1173
517
5694
1.9
1.5
0.5
1.2
2.6
0.4
1.2
7.1
0.9
2.3
1.2
1.7
0.4
1.2
1.2
5.5
7.6
0
3
2.1
4.4
2.8
0.5
0.8
12.4
1.8
0
0.9
5.2
1.7
2.5
63
76
22
20
8
17
25
26
15
677
506
81
17
0
27
908
67
0
28
2
1
228
13
99
503
158
3
16
1086
447
5139
1.6
1.4
0.6
1
2.1
0.3
0.9
4.2
0.6
2.2
1.3
1.5
0.4
0
1.2
3.2
6.7
0
1.9
0.8
0.5
2.8
0.5
0.5
9.9
1.6
0.1
1.6
4.7
1.5
2.1
62
59
21
20
7
20
34
21
23
671
420
84
26
1
27
845
86
0
27
4
4
225
20
132
518
141
2
7
933
437
4878
1.5
1.1
0.6
1
1.8
0.4
1.2
3.4
0.9
2.1
1
1.5
0.5
0.6
1.2
3
8.9
0
1.9
1.6
1.9
2.7
0.8
0.7
10.2
1.4
0.1
0.7
4.1
1.4
2
11
0
32
16
114
4
0.7
0
2.2
0.4
2.5
0.2
6
0
37
19
220
3
0.4
0
2.5
0.4
4.9
0.2
20
1
46
169
208
4
1.3
2.4
3
3.9
4.7
0.2
23
2
62
68
231
4
1.5
4.6
4.1
1.6
5.2
0.2
32
0
57
90
326
2
2.2
0
3.7
2
7.4
0.1
18
0
73
195
291
6
1.2
0
4.8
4.3
6.6
0.3
8
0.8
9
0.9
9
0.9
5
0.5
2
0.2
6
0.6
105
44
78
20
49
1
5
1
44
142
4
27
0
2986
10
3701
5
1.4
1.1
0.8
2.5
6.2
1.7
6.9
1
3.9
0.1
0.1
0
13.8
0.1
3.3
129
52
88
23
53
0
4
1
39
113
16
26
0
3407
9
4254
6.2
1.6
1.2
0.9
2.7
0
1.3
6.8
0.9
3.1
0.5
0.1
0
15.8
0.1
3.8
138
38
111
24
137
0
3
0
25
126
21
25
0
3208
27
4340
6.7
1.1
1.5
0.9
6.9
0
1
0
0.6
3.4
0.6
0.1
0
15
0.2
3.8
179
34
124
24
59
0
4
0
29
113
43
48
0
3060
141
4253
8.7
1
1.6
0.9
3
0
1.3
0
0.7
3
1.2
0.1
0
14.4
1.1
3.7
209
34
111
61
166
0
6
0
45
108
55
60
0
3019
92
4475
10.3
0.9
1.4
2.3
8.4
0
2
0
1
2.8
1.5
0.2
0
14.3
0.7
3.9
245
22
194
111
179
0
7
0
0
42
121
79
46
0
3988
163
5786
12.1
0.6
2.5
4.1
9.1
0
2.3
0
0
0.9
3.1
2.1
0.1
0
18.9
1.2
5
6363
512
3510
10385
3.5
0.6
5.4
3.1
5807
474
4108
10389
3.2
0.5
6.3
3.1
5488
457
4220
10165
2.9
0.5
6.4
2.9
5251
539
4157
9947
2.8
0.6
6.3
2.9
4800
507
4307
9614
2.4
0.6
6.5
2.7
4511
501
5652
10664
2.2
0.5
8.5
2.9
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (3), 2006 (0), 2007 (1), 2008 (1), 2009 (0), 2010 (2), 2011 (2), 2012 (1), 2013 (0), 2014 (1), cumulative 1986-2014 (33).
64
2010
N
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
2011
N
Rate
2012
N
Rate
2013
N
Rate
2014
N
Rate
Cumulative Country*
total**
60
55
38
25
2
18
40
31
18
620
416
85
27
1
34
800
80
1
15
7
3
181
17
142
461
199
4
12
828
288
4508
1.5
1
1.1
1.2
0.5
0.3
1.5
5
0.7
2
1
1.6
0.6
0.6
1.5
2.8
8.4
5.6
1.1
2.7
1.5
2.2
0.7
0.8
9.1
2
0.2
1.2
3.6
0.9
1.8
72
56
47
26
6
24
35
25
16
562
384
101
45
1
28
778
102
1
28
5
5
201
23
120
414
204
7
10
731
298
4355
1.8
1
1.3
1.3
1.4
0.5
1.3
4
0.6
1.8
1
1.9
1
0.6
1.2
2.7
10.9
5.5
2
1.9
2.4
2.4
0.9
0.7
8.2
2.1
0.3
1
3.2
1
1.8
50
57
53
14
2
22
29
19
17
473
329
118
38
1
20
796
90
0
31
9
1
179
19
130
323
235
6
10
532
250
3854
1.2
1
1.5
0.7
0.5
0.4
1
3.1
0.6
1.5
0.8
2.2
0.8
0.6
0.9
2.8
9.7
0
2.3
3.4
0.5
2.2
0.7
0.7
6.5
2.4
0.2
1
2.8
0.8
1.6
54
53
52
20
5
18
23
13
14
274
200
93
41
0
20
651
110
1
29
6
4
131
36
100
198
271
3
15
352
235
3022
1.3
1
1.5
1
1.2
0.3
0.8
2.1
0.5
0.9
0.5
1.8
0.9
0
0.9
2.2
12
5.4
2.1
2.2
1.9
1.6
1.4
0.5
4
2.8
0.1
1.5
2.2
0.7
1.3
2245
3038
400
387
198
348
2511
320
518
54951
26078
3096
696
58
937
51847
1060
11
335
225
93
4801
871
2498
16559
5098
66
200
67362
1775
22444
271026
35
1
65
171
365
4
2.4
2.5
4.3
3.7
8.3
0.2
34
0
95
209
375
4
2.4
0
6.4
4.5
8.5
0.2
50
1
100
162
369
6
3.5
2.6
6.9
3.4
8.4
0.3
36
0
124
162
310
-
2.5
0
8.7
3.4
7
-
312
6
746
1320
2932
102
5
0.5
8
0.8
9
0.9
13
1.3
110
277
37
150
69
269
0
2
1
45
89
84
65
0
6141
7875
13.9
1
1.9
2.5
13.7
0
0.7
6.4
1
2.3
2.2
0.2
0
29.2
7.6
248
34
180
65
93
0
7
2
50
66
106
83
0
6498
8157
12.6
0.9
2.2
2.3
4.7
0
2.3
12.3
1.1
1.7
2.6
0.2
0
31
7.8
219
32
192
49
128
0
7
0
39
67
95
76
6013
7614
11.3
0.8
2.3
1.7
6.5
0
2.3
0
0.9
1.7
2.3
0.2
28.8
7.3
201
44
176
56
141
1
4
38
36
104
99
6119
7664
10.5
1.1
2.1
1.9
7.2
6.2
1.3
0.9
0.9
2.5
0.3
30.9
7.4
2179
1113
1585
533
1393
39
77
0
21
1348
7210
612
1028
0
50886
494
74046
4042
623
7717
12383
2
0.7
14.5
3.6
3812
675
8024
12512
1.9
0.7
15.1
3.6
3304
697
7467
11468
1.6
0.7
14
3.3
2425
715
7545
10686
1.2
0.8
14.3
3.1
267798
12868
64395
345072
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of
Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia***
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
65
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 17: AIDS diagnoses in females and rates per 100 000 population, by country and year of diagnosis (2005-2014)
and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia***
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
2005
N
Rate
2006
N
Rate
2007
N
Rate
2008
N
Rate
2009
N
Rate
Rate
29
73
3
2
5
5
14
14
1
446
136
24
4
0
14
386
45
0
3
5
2
85
14
34
205
171
1
2
426
11
358
2518
0.7
1.4
0.1
0.1
1.3
0.1
0.5
1.9
0
1.4
0.3
0.4
0.1
0
0.7
3.8
3.7
0
0.2
2.1
1
1
0.6
0.2
3.8
1.6
0
0.2
1.9
0.2
1.2
1.1
22
40
4
6
1
5
20
10
6
365
125
25
7
1
8
374
27
0
5
3
2
61
8
37
243
137
0
0
397
22
359
2320
0.5
0.7
0.1
0.3
0.3
0.1
0.7
1.4
0.2
1.1
0.3
0.4
0.1
0.7
0.4
3
2.2
0
0.3
1.3
1
0.7
0.3
0.2
4.5
1.3
0
0
1.8
0.5
1.2
1
24
40
3
1
4
5
10
11
11
317
136
22
6
0
15
328
22
0
2
3
0
70
3
32
198
131
2
2
359
22
286
2065
0.6
0.7
0.1
0
1
0.1
0.4
1.5
0.4
1
0.3
0.4
0.1
0
0.7
2.1
1.8
0
0.1
1.2
0
0.8
0.1
0.2
3.6
1.2
0.1
0.2
1.6
0.5
0.9
0.8
19
43
9
1
2
7
7
17
3
340
99
13
2
0
9
350
26
0
9
3
0
53
7
41
220
155
1
2
371
312
2121
0.4
0.8
0.2
0
0.5
0.1
0.3
2.4
0.1
1
0.2
0.2
0
0
0.4
1.8
2.2
0
0.5
1.2
0
0.6
0.3
0.2
4
1.5
0
0.2
1.6
1
0.9
27
45
8
2
0
6
11
12
8
275
118
22
6
0
8
296
34
0
9
1
0
43
5
32
189
110
1
2
332
208
1811
0.6
0.8
0.2
0.1
0
0.1
0.4
1.7
0.3
0.8
0.3
0.4
0.1
0
0.4
1
2.9
0
0.5
0.4
0
0.5
0.2
0.2
3.4
1
0
0.2
1.4
0.7
0.7
19
45
11
1
3
6
10
5
9
305
88
19
2
0
11
300
46
0
6
4
2
61
2
41
218
107
0
0
273
230
1824
0.4
0.8
0.3
0
0.7
0.1
0.4
0.7
0.3
0.9
0.2
0.3
0
0
0.5
1
4
0
0.4
1.6
1
0.7
0.1
0.2
4
1
0
0
1.2
0.7
0.7
1
0
9
4
49
2
0.1
0
0.6
0.1
1
0.1
4
0
9
2
111
1
0.3
0
0.6
0
2.2
0.1
4
0
13
31
100
0
0.3
0
0.9
0.7
2
0
9
0
21
8
120
1
0.6
0
1.4
0.2
2.4
0.1
2
0
27
19
206
0
0.1
0
1.9
0.4
4.1
0
8
0
21
15
184
0
0.6
0
1.5
0.3
3.6
0
2
0.2
1
0.1
1
0.1
4
0.4
0
0
0
0
35
17
21
3
11
0
0
0
8
54
0
5
0
1231
1
1453
1.5
0.5
0.3
0.1
0.5
0
0
0
0.2
1.4
0
0
0
4.9
0
1.3
33
18
44
6
40
0
1
0
12
47
5
4
0
1316
4
1658
1.4
0.5
0.5
0.2
1.9
0
0.3
0
0.3
1.2
0.1
0
0
5.3
0
1.4
45
11
65
0
81
0
0
0
14
50
9
5
0
1365
8
1802
1.9
0.3
0.8
0
3.8
0
0
0
0.3
1.3
0.3
0
0
5.5
0.1
1.6
53
19
50
9
33
0
2
0
10
48
12
7
0
1320
43
1769
2.3
0.5
0.6
0.3
1.5
0
0.6
0
0.2
1.2
0.3
0
0
5.3
0.3
1.5
75
18
62
14
96
0
2
0
7
42
15
7
0
1418
37
2047
3.3
0.5
0.7
0.5
4.5
0
0.6
0
0.2
1.1
0.4
0
0
5.8
0.3
1.7
94
16
70
19
127
0
0
0
0
7
42
22
14
0
1873
57
2569
4.2
0.4
0.8
0.7
6
0
0
0
0
0.2
1.1
0.6
0
0
7.6
0.4
2.1
2300
245
1426
3971
1.2
0.3
2.1
1.1
2146
220
1612
3978
1.1
0.2
2.3
1.1
1905
210
1752
3867
1
0.2
2.5
1.1
1916
253
1721
3890
1
0.3
2.4
1.1
1649
185
2024
3858
0.8
0.2
2.8
1
1654
200
2539
4393
0.8
0.2
3.5
1.2
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (1), 2006 (0), 2007 (0), 2008 (0), 2009 (0), 2010 (1), 2011 (1), 2012 (0), 2013 (1), 2014 (0), cumulative 1986-2014 (17).
66
2010
N
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
2011
N
Rate
2012
N
Rate
2013
N
Rate
2014
N
Rate
Cumulative Country*
total**
18
32
2
1
3
8
19
7
7
226
79
16
5
1
13
252
32
0
6
4
2
48
2
42
171
124
0
3
235
133
1491
0.4
0.6
0.1
0
0.7
0.1
0.7
1
0.3
0.7
0.2
0.3
0.1
0.6
0.6
0.8
2.8
0
0.4
1.6
1
0.6
0.1
0.2
3.1
1.2
0
0.3
1
0.4
0.6
19
36
18
2
1
6
6
11
3
252
104
21
3
0
8
288
40
0
10
3
1
55
2
37
167
121
0
1
222
134
1571
0.4
0.6
0.5
0.1
0.2
0.1
0.2
1.6
0.1
0.7
0.2
0.4
0.1
0
0.3
0.9
3.6
0
0.6
1.1
0.5
0.7
0.1
0.2
3
1.2
0
0.1
0.9
0.4
0.6
18
23
18
3
1
5
9
7
3
181
83
19
4
0
7
260
43
0
13
1
0
41
9
31
136
110
0
1
151
95
1273
0.4
0.4
0.5
0.1
0.2
0.1
0.3
1
0.1
0.5
0.2
0.3
0.1
0
0.3
0.8
3.9
0
0.8
0.4
0
0.5
0.4
0.2
2.5
1.1
0
0.1
0.8
0.3
0.5
22
31
12
2
1
6
6
5
6
131
35
21
10
0
9
207
61
0
8
3
0
26
9
25
51
107
1
1
92
109
997
0.5
0.5
0.3
0.1
0.2
0.1
0.2
0.7
0.2
0.4
0.1
0.4
0.2
0
0.4
0.7
5.6
0
0.5
1.1
0
0.3
0.4
0.1
0.9
1
0
0.1
0.5
0.3
0.4
702
1429
129
53
56
80
445
114
118
14808
4396
581
100
9
281
15401
464
1
80
64
14
1163
243
674
4297
3676
12
28
17176
397
6213
73204
11
0
22
24
225
3
0.8
0
1.5
0.5
4.4
0.2
15
0
38
26
223
0
1
0
2.5
0.6
4.4
0
15
1
44
27
178
1
1
2.7
2.8
0.6
3.5
0.1
14
0
47
38
164
-
1
0
3
0.8
3.2
-
94
2
260
199
1612
23
0
0
2
0.2
1
0.1
3
0.3
33
118
18
76
21
170
0
0
0
8
38
52
15
0
3048
3849
5.4
0.5
0.9
0.7
8
0
0
0
0.2
0.9
1.4
0
0
12.5
3.6
111
12
54
23
90
0
0
0
4
28
44
12
0
3575
4257
5.1
0.3
0.6
0.8
4.3
0
0
0
0.1
0.7
1.1
0
0
14.7
3.9
84
11
69
18
106
0
0
0
6
28
75
19
3349
4032
3.9
0.3
0.8
0.6
5
0
0
0
0.1
0.7
1.9
0
13.8
3.6
67
19
60
25
93
0
3
6
11
52
26
3725
4353
3.2
0.5
0.7
0.8
4.4
0
0.9
0.1
0.3
1.3
0.1
16.2
4
753
421
620
142
892
11
18
0
2
436
2475
287
209
1
24693
157
33340
1314
225
3801
5340
0.6
0.2
6.5
1.5
1361
222
4245
5828
0.6
0.2
7.2
1.6
1077
215
4013
5305
0.5
0.2
6.8
1.4
788
217
4345
5350
0.4
0.2
7.5
1.5
70648
5621
30274
106544
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of
Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
67
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 18: AIDS diagnoses in men infected through sex with men, by country and year of diagnosis (2005-2014) and
cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia***
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of diagnosis
2009
2010
2011
2012
2013
2014
Cumulative
total**
31
31
5
19
4
10
15
0
7
249
252
63
23
0
13
252
10
0
0
2
0
127
9
29
83
14
1
7
338
201
1796
31
30
2
18
0
12
13
0
6
236
213
54
24
0
17
265
7
0
2
5
1
111
9
42
88
13
3
7
314
146
1669
25
23
8
22
1
11
13
1
2
189
211
50
37
0
14
261
4
0
2
3
0
123
10
25
81
7
3
8
308
156
1598
22
21
12
11
2
12
11
0
4
193
188
48
30
0
6
298
10
0
5
7
1
115
15
45
55
15
2
7
225
113
1473
24
26
9
15
4
8
10
1
6
100
112
37
37
0
10
237
7
1
3
3
1
76
18
32
42
23
2
10
155
121
1130
999
1418
76
235
107
202
1734
27
292
27943
17890
1994
551
43
378
11578
107
2
71
126
42
2933
504
607
2633
166
43
130
12804
1086
14921
101642
1
0
1
4
2
5
5
1
2
1
6
2
6
0
2
1
3
4
6
1
5
3
3
3
8
0
7
1
4
-
48
4
22
15
21
28
2005
2006
2007
2008
22
40
7
3
2
6
18
1
10
336
341
50
19
0
6
314
4
0
0
2
1
154
11
23
84
5
1
5
291
8
250
2014
34
25
4
11
2
3
17
1
8
292
340
38
10
2
8
309
3
0
1
2
3
124
11
14
79
10
3
4
302
9
245
1914
37
25
4
6
4
8
13
0
13
247
317
44
12
0
7
316
3
0
2
2
0
134
2
19
81
3
2
6
300
17
254
1878
27
22
4
12
4
7
16
1
10
257
274
57
16
1
8
300
3
0
7
0
1
132
6
27
108
9
0
7
322
229
1867
31
34
4
17
4
10
12
0
6
263
279
49
13
0
10
293
7
0
1
1
0
135
7
25
73
14
1
10
315
189
1803
0
0
1
0
0
1
0
0
0
0
0
0
2
1
1
2
0
0
6
1
3
1
0
0
6
0
0
1
0
0
3
2
2
2
1
1
4
3
3
5
37
5
12
0
0
0
1
1
1
15
49
0
4
0
8
0
101
3
9
0
0
0
0
3
0
18
43
0
4
0
8
0
90
3
5
0
1
2
0
2
0
12
63
0
5
0
9
0
110
7
5
1
0
0
0
3
0
15
48
0
11
0
10
0
113
3
8
0
0
2
0
4
0
25
42
0
2
0
10
0
104
10
6
0
0
2
0
5
0
0
22
61
0
3
0
10
0
133
11
8
1
0
2
0
1
1
21
34
0
0
0
31
131
11
4
0
0
0
0
4
2
30
33
0
0
0
45
148
16
8
1
0
0
0
3
0
19
31
0
12
50
164
21
9
0
0
2
1
3
22
18
0
15
55
171
104
308
3
1
12
22
38
0
11
381
3269
0
108
0
239
1
4672
2001
95
19
2115
1900
88
16
2004
1878
87
23
1988
1824
123
33
1980
1747
136
24
1907
1741
149
39
1929
1583
154
63
1800
1508
169
69
1746
1362
182
93
1637
1006
193
101
1301
102932
2757
623
106314
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** Includes data from Kosovo (in accordance with the UN Security Council Resolution No. 1244 (1999)): 2005 (0), 2006 (0), 2007 (0), 2008 (1), 2009 (0), 2010 (0),
2011 (0), 2012 (0), 2013 (0), 2014 (1), cumulative 1986-2014 (3).
68
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 19: AIDS diagnoses in people infected through injecting drug use, by country and year of diagnosis (2005-2014)
and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia***
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of diagnosis
2009
2010
2005
2006
2007
2008
18
9
1
1
0
0
4
16
7
129
62
5
2
0
9
446
71
0
7
3
0
26
4
76
442
2
0
0
850
4
33
2227
19
7
0
1
0
4
3
23
1
106
82
5
0
0
9
398
51
0
17
0
2
10
4
89
356
3
0
0
750
3
25
1968
20
3
1
1
0
3
3
45
8
87
63
3
1
0
10
383
45
0
21
2
0
13
0
77
278
3
0
0
671
6
30
1777
24
8
4
0
0
5
6
41
1
85
52
3
0
0
11
318
60
0
35
0
0
7
2
74
263
2
0
0
537
27
1565
15
5
7
0
0
2
3
26
2
56
46
6
0
0
8
275
49
0
20
0
0
10
1
55
217
4
0
0
450
19
1276
0
0
27
12
97
1
0
0
28
13
216
1
1
0
25
131
198
1
0
1
30
50
191
0
0
0
33
69
265
0
2011
2012
2013
2014
Cumulative
total**
11
3
10
1
0
4
4
14
3
60
34
3
0
0
6
228
70
0
20
0
0
6
3
70
212
12
0
0
336
27
1137
12
4
17
1
0
1
4
20
0
58
40
8
0
0
10
194
57
0
9
1
0
8
0
61
159
27
0
0
290
14
996
18
1
39
1
0
2
4
15
4
43
40
22
0
0
3
180
70
0
21
0
0
4
1
55
145
57
0
0
226
11
962
12
2
29
0
0
2
5
9
2
33
30
41
0
0
1
179
62
0
19
0
0
4
1
43
96
77
0
0
156
10
813
14
1
26
0
0
2
1
6
0
18
9
42
0
0
0
105
73
0
16
1
1
1
0
25
42
101
0
1
91
12
588
771
274
135
25
3
33
254
241
55
13797
4302
240
6
5
374
34755
835
7
195
40
4
335
155
1469
9126
294
1
7
49776
242
1504
119260
0
0
41
160
208
0
1
0
33
148
266
0
0
0
42
159
242
0
0
0
24
123
193
0
1
0
34
109
155
-
3
2
360
1019
2128
18
1
2
1
0
0
0
0
0
0
0
9
79
4
0
17
42
0
0
0
11
41
2
1
0
3041
3
3379
105
14
102
19
45
0
0
0
7
29
12
1
0
3360
9
3963
103
9
96
20
101
0
0
0
12
21
14
2
0
3086
20
3841
134
12
118
27
55
0
0
0
6
19
35
1
0
2868
116
3663
170
7
104
53
103
0
0
0
11
14
50
4
0
2732
70
3685
186
3
185
102
95
0
0
0
0
6
11
59
2
0
3458
131
4647
191
7
132
58
101
0
0
0
12
17
71
2
0
4979
6018
160
9
151
55
17
0
1
0
5
6
74
1
0
4933
5855
141
15
157
38
22
0
0
0
8
7
51
1
4273
5053
117
11
144
38
28
0
0
5
2
60
2
3856
4562
1574
236
1190
455
723
19
4
0
6
655
3299
433
61
0
38604
380
51178
2096
96
3414
5606
1823
108
4000
5931
1610
103
3905
5618
1376
92
3760
5228
1134
83
3744
4961
950
105
4729
5784
826
122
6065
7014
717
161
5939
6817
594
160
5112
5866
351
163
4636
5150
119571
2723
48137
170438
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** No AIDS diagnoses in people infected through injecting drug use reported from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244
and the ICJ Opinion on the Kosovo Declaration of Independence).
69
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 20: AIDS diagnoses in people infected through heterosexual contact, by country and year of diagnosis
(2005-2014) and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia***
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of diagnosis
2009
2010
2005
2006
2007
2008
48
95
11
14
7
7
22
10
8
724
199
45
8
1
25
660
31
0
3
5
2
140
16
36
447
127
2
2
579
23
642
3939
39
64
12
8
6
9
29
8
15
610
193
41
11
1
22
626
21
0
3
7
2
108
16
35
470
106
1
0
535
36
562
3596
45
66
16
4
6
11
16
10
11
546
180
36
5
0
14
614
22
0
4
7
2
111
7
27
441
112
3
2
490
30
505
3343
39
75
15
10
7
14
16
17
11
592
146
45
5
0
13
604
25
0
6
8
5
102
10
34
455
116
1
1
535
512
3419
38
73
19
4
4
11
18
10
12
508
154
36
8
0
15
525
32
0
15
1
1
104
10
24
385
108
1
0
491
386
2994
12
0
9
8
51
4
10
0
17
6
103
3
20
0
32
55
99
3
26
0
46
14
145
5
28
0
45
34
254
2
2011
2012
2013
2014
Cumulative
total**
31
66
14
1
5
12
23
7
12
528
118
31
4
1
12
558
36
0
11
6
6
121
10
51
423
106
1
0
394
376
2964
30
49
20
6
5
12
40
9
15
440
151
33
7
2
17
500
34
0
9
5
3
83
9
43
379
158
1
3
344
244
2651
37
65
15
4
4
13
22
16
10
487
132
38
6
1
19
507
55
1
13
4
5
98
12
34
341
138
3
1
316
248
2645
27
44
20
6
1
10
21
10
12
351
116
28
10
0
17
491
37
0
15
2
0
72
11
34
294
139
4
3
223
203
2202
35
49
25
4
1
12
17
8
9
231
72
27
12
0
15
423
59
17
5
2
56
27
28
158
143
2
0
148
186
1771
885
2336
282
150
124
158
782
125
222
19780
3988
952
152
15
342
16513
405
3
118
105
37
1995
397
611
8352
2070
29
41
15279
667
10038
86953
24
0
42
38
246
1
39
0
50
44
305
4
40
0
83
68
348
0
55
1
102
57
344
3
40
0
120
83
301
-
342
2
565
424
2246
68
6
6
4
4
1
3
3
6
6
10
84
41
41
0
5
15
0
3
0
13
97
2
16
0
941
0
1264
53
41
19
8
43
0
2
0
17
85
9
15
0
1089
2
1528
61
33
33
0
108
0
1
0
8
84
14
20
0
1265
6
1846
76
34
38
6
31
0
3
0
12
73
17
32
0
1342
51
1955
102
34
55
17
101
0
4
0
9
75
18
28
0
1509
40
2356
132
26
70
24
146
0
2
0
0
11
83
39
26
0
2264
68
3245
181
38
81
26
321
0
1
0
11
68
53
36
0
3944
5205
184
30
76
27
118
0
2
0
9
49
57
35
0
4873
6005
139
19
87
24
139
0
1
0
7
50
81
41
4875
6031
126
42
87
37
173
0
3
10
19
75
58
5806
6990
1150
841
546
180
1233
6
43
0
5
400
2624
366
592
0
28536
183
40436
3819
268
1116
5203
3502
241
1381
5124
3238
242
1709
5189
3275
285
1814
5374
2867
251
2232
5350
2825
261
3123
6209
2450
349
5057
7856
2421
310
5918
8650
1983
340
5910
8233
1521
348
6892
8761
86163
5146
36077
127389
*
Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by the country since the start of reporting
*** Includes data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of
Independence): 2005 (4), 2006 (0), 2007 (1), 2008 (0), 2009 (0), 2010 (3), 2011 (3), 2012 (1), 2013 (1), 2014 (0), cumulative 1986-2014 (46).
70
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 21: AIDS diagnoses in people infected through mother-to-child transmission, by country and year of diagnosis
(2005–2014) and cumulative totals, in EU/EEA and other countries of the WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia***
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
Year of diagnosis
2009
2010
2011
2012
2013
2014
Cumulative
total**
0
0
2
0
0
0
1
0
0
5
1
1
0
0
1
3
0
0
0
0
0
5
0
1
1
8
0
0
3
11
43
1
0
1
1
0
0
0
0
0
8
2
0
0
0
0
3
2
0
0
0
0
2
0
3
1
11
0
0
3
7
45
0
0
0
0
0
0
0
0
0
11
2
0
1
0
0
4
1
0
0
1
0
1
0
1
1
11
0
0
3
1
38
0
0
3
0
0
0
1
0
0
9
1
0
0
0
1
7
2
0
1
0
0
2
1
0
3
16
0
0
3
4
54
0
2
0
0
0
0
0
0
1
1
0
0
0
0
0
2
0
0
0
0
0
2
0
0
1
8
0
0
0
2
19
13
123
7
4
2
0
25
2
7
777
115
24
4
0
36
738
18
0
1
4
1
64
7
58
119
297
0
2
974
22
705
4149
0
0
1
1
13
0
1
0
1
1
12
0
2
0
0
3
4
0
4
0
4
3
3
0
0
0
7
2
8
-
9
0
20
14
105
0
1
0
1
1
0
6
11
1
2
0
3
0
0
0
0
1
2
1
0
0
129
8
174
8
1
5
3
3
0
0
0
0
0
5
0
0
118
158
1
1
2
4
1
0
0
0
0
1
6
1
0
88
115
3
1
6
1
9
0
0
0
1
1
14
0
59
110
2
0
1
0
3
0
0
0
0
2
1
60
86
63
39
31
11
44
0
1
0
0
26
109
29
13
0
1078
22
1620
28
17
158
203
26
17
110
153
34
25
105
164
11
9
85
105
3902
429
1438
5769
2005
2006
2007
2008
1
0
0
0
1
0
0
0
0
10
3
0
1
0
0
4
1
0
0
0
0
1
0
3
5
8
0
0
9
1
32
80
0
1
0
0
0
0
2
0
0
6
1
1
0
0
0
9
2
0
0
0
0
3
0
4
3
7
0
0
7
1
27
74
1
4
0
0
0
0
0
0
1
8
2
0
0
0
1
2
0
0
0
0
0
4
0
1
3
6
0
0
10
2
27
72
1
4
0
0
0
0
0
0
0
9
0
0
0
0
3
2
5
0
0
0
0
2
0
5
4
7
0
0
8
22
72
2
1
0
0
0
0
0
0
0
10
0
0
1
0
1
5
1
0
0
0
0
3
0
7
3
13
0
0
8
20
75
0
0
2
0
13
0
0
0
1
0
10
0
1
0
1
2
7
0
0
0
0
0
12
0
0
0
2
2
10
0
0
0
1
0
0
6
2
0
0
1
0
0
0
1
0
0
1
0
139
0
165
1
2
1
1
4
0
0
0
1
0
0
0
0
122
2
145
13
1
5
0
7
0
0
0
1
1
1
0
0
110
3
154
10
1
4
2
6
0
0
0
2
0
0
0
0
73
6
116
4
1
5
0
1
0
0
0
1
1
0
2
0
86
3
118
68
15
162
245
63
12
144
219
67
10
149
226
56
14
118
188
55
24
114
193
35
13
169
217
* Country-specific comments are in Annex 5
** Cumulative total is the total number of cases reported by country since the start of reporting
*** No AIDS diagnoses in people infected through mother-to-child transmission reported from Kosovo (without prejudice to positions on status, and in line with
UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of Independence)
71
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 22: AIDS diagnoses*, by sex, transmission mode and year of diagnosis (2005–2014) and cumulative totals
Table22a: EU/EEA and non-EU/EEA countries
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
*
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
428
1756
41
32
27
223
2507
2005
1795
2160
38
48
25
578
6649
2006
2223
3916
79
80
52
801
9157
391
1607
35
28
23
214
2298
1902
1574
1953
38
35
19
581
6102
1905
1965
3560
73
63
42
795
8403
360
1412
30
14
24
203
2043
1855
1411
1900
40
23
16
540
5785
1861
1771
3313
70
37
40
743
7835
336
1484
32
25
26
218
2121
1864
1229
1935
40
27
29
570
5694
1867
1565
3419
72
52
55
788
7818
43
130
12
2
1
31
219
2726
91
291
189
14
6
0
109
700
7349
91
334
319
26
8
1
141
920
10077
107
211
7
1
1
10
337
2635
82
486
223
14
2
0
27
834
6936
82
593
434
21
3
1
37
1171
9574
120
263
19
1
12
14
429
2472
101
614
309
22
2
14
39
1101
6886
101
734
572
41
3
26
53
1530
9365
94
263
17
0
2
29
405
2526
103
582
294
20
1
1
47
1048
6742
103
679
557
37
1
3
76
1456
9274
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unkown
Total
175
919
27
5
7
139
1272
1468
638
1282
27
8
7
423
3853
1473
813
2201
54
13
14
562
5130
98
732
12
6
6
143
997
1130
490
1038
7
5
10
342
3022
1130
588
1771
19
11
16
485
4020
0
24549
37509
2057
2371
1354
5028
72868
100571
94511
48877
2072
5936
1705
15740
269412
28
2
4
0
0
0
1
35
100556
119018
86286
4127
8307
3058
20741
342093
91
506
21
1
3
60
682
1954
111
689
647
30
2
1
115
1595
5448
111
780
1153
51
3
4
175
2277
7407
95
482
9
2
2
38
628
1625
116
611
702
17
1
2
96
1545
4566
116
706
1184
26
3
4
134
2173
6192
0
2316
5305
239
107
26
469
8462
81329
4392
9843
6333
280
288
31
1369
22536
291937
2
4
2
1
0
0
5
14
49
4393
12163
11631
520
395
57
1841
31000
373081
Data from Bosnia and Herzegovina, Russia, San Marino, Sweden, Turkmenistan, Ukraine and Uzbekistan excluded due to inconsistent reporting during the
period. Therefore, totals by gender and overall may differ from totals presented in Tables 15-21.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
72
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
255
1278
39
16
13
209
1810
1802
1021
1715
36
21
15
529
5139
1803
1276
2993
75
37
28
739
6951
241
1347
30
6
13
187
1824
1793
896
1617
13
17
13
528
4877
1795
1137
2964
43
23
26
715
6703
179
1114
23
7
11
157
1491
1668
817
1537
22
3
10
451
4508
1669
996
2651
45
10
21
608
6000
195
1170
21
10
16
159
1571
1595
767
1475
17
15
4
482
4355
1598
962
2645
38
25
20
641
5929
125
411
15
6
2
33
592
2402
94
757
394
14
3
3
97
1362
6501
94
883
805
29
9
5
130
1955
8906
130
440
17
3
1
48
639
2463
118
928
472
20
1
4
86
1629
6506
118
1058
912
37
4
5
134
2268
8971
142
618
14
0
1
23
798
2289
95
897
638
26
9
2
62
1729
6236
97
1039
1257
40
9
3
85
2530
8529
94
535
13
1
1
38
682
2253
97
828
597
14
9
1
107
1653
6007
97
922
1132
27
10
2
145
2335
8263
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
73
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 22: AIDS diagnoses*, by sex, transmission mode and year of diagnosis (2005–2014) and cumulative totals
Table 22b: West, Centre, East of the WHO European Region
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
389
1700
36
17
2
145
2289
1991
1703
2096
31
33
1
472
6327
1992
2092
3796
67
50
3
617
8617
366
1573
28
13
3
141
2124
1888
1454
1893
34
21
4
479
5773
1891
1820
3466
62
34
7
620
7900
329
1385
29
10
2
128
1883
1855
1275
1822
36
14
3
443
5448
1861
1604
3208
65
24
5
571
7338
299
1434
25
15
3
140
1916
1821
1077
1841
31
20
4
457
5251
1824
1376
3275
56
35
7
597
7170
18
95
7
15
25
83
243
94
77
169
8
18
24
118
508
94
95
264
15
33
49
201
751
16
90
6
15
20
72
219
88
91
148
6
16
15
107
471
88
107
238
12
31
35
179
690
27
81
4
4
23
71
210
87
75
158
6
10
13
104
453
87
102
239
10
14
36
175
663
23
103
6
10
23
87
252
123
69
177
8
8
25
125
535
123
92
280
14
18
48
212
787
-
11
11
-
8
8
-
14
14
-
23
23
64
306
370
116
515
631
124
675
799
108
665
776
Heterosexual contact
91
84
175
155
135
290
209
229
438
210
211
421
Mother-to-child
10
13
23
8
12
20
16
20
36
18
21
39
Haemophiliac/transfusion recipient
2
3
5
1
0
1
1
1
2
0
0
0
Nosocomial infection
1
0
1
1
0
1
11
14
25
2
1
3
Other/undetermined
26
97
124
11
22
33
18
32
50
20
35
55
Injecting drug use
Total East
Total WHO European Region
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
194
514
709
292
692
984
379
985
1364
358
956
1317
2726
7349
10077
2635
6936
9574
2472
6886
9365
2526
6742
9274
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unknown
Total
130
841
16
4
2
83
1076
1357
464
1141
18
7
1
315
3303
1362
594
1982
34
11
3
398
4384
63
634
8
4
0
79
788
1006
288
886
3
3
1
238
2425
1006
351
1521
11
7
1
317
3214
0
24997
37381
1951
2007
47
3900
70283
101843
94344
48181
1930
5465
54
14299
266116
28
3
4
0
0
0
1
36
101835
119323
85491
3880
7472
101
18185
336287
34
106
13
1
5
55
214
179
126
231
12
2
6
135
691
179
160
337
25
3
11
190
905
19
121
4
4
6
63
217
193
144
227
5
2
9
135
715
193
163
348
9
6
15
198
932
0
579
1843
198
463
1308
1232
5623
2735
2141
3258
231
745
1653
2041
12804
2
0
2
1
0
0
1
6
2729
2698
5065
429
1208
2960
3260
18349
-
43
43
-
46
46
0
383
0
383
Injecting drug use
102
737
839
111
669
780
1288
7863
3
9153
Heterosexual contact
478
557
1035
459
627
1086
3590
3768
0
7358
19
27
46
9
16
25
147
191
0
338
Haemophiliac/transfusion recipient
1
1
2
0
1
1
8
14
0
22
Nosocomial infection
3
1
4
2
2
4
25
29
0
54
Other/undetermined
61
88
149
39
65
104
365
769
4
1137
Mother-to-child
Total East
664
1454
2118
620
1426
2046
5423
13017
7
18445
Total WHO European Region
1954
5448
7407
1625
4566
6192
81329
291937
49
373081
*
Data from Bosnia and Herzegovina, Russia, San Marino, Sweden, Turkmenistan, Ukraine and Uzbekistan excluded due to inconsistent reporting during the
period. Therefore, totals by gender and overall may differ from totals presented in Tables 15-21.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
74
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
231
1223
26
17
2
149
1648
1746
902
1643
29
18
3
459
4800
1747
1134
2866
55
35
5
609
6451
202
1291
22
7
5
127
1654
1738
748
1534
13
13
3
461
4510
1740
950
2825
35
20
8
588
6166
149
1042
16
5
1
101
1314
1581
677
1408
12
3
0
360
4041
1582
826
2450
28
8
1
461
5356
148
1077
15
8
1
112
1361
1503
569
1344
11
12
0
371
3810
1506
717
2421
26
20
1
483
5174
15
85
15
3
11
56
185
136
68
164
9
5
12
111
505
136
83
249
24
8
23
167
690
23
95
9
2
8
63
200
144
82
165
4
4
10
86
495
144
105
260
13
6
18
149
695
23
119
7
2
10
61
222
150
99
225
10
8
10
117
619
152
122
345
17
10
20
178
844
35
107
10
2
15
53
222
165
126
203
7
12
4
154
671
165
161
310
17
14
19
207
893
24
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
-
14
14
-
29
29
-
32
32
-
24
134
808
942
146
994
1140
149
937
1086
106
900
1006 Injecting drug use
381
302
683
401
390
791
571
542
1113
521
524
1045 Heterosexual contact
13
12
25
16
16
32
14
26
40
9
13
2
1
3
0
1
1
0
1
1
1
0
1 Haemophiliac/transfusion recipient
2
3
5
1
4
5
1
2
3
1
1
2 Nosocomial infection
22 Mother-to-child
37
56
93
45
67
112
18
36
54
32
64
569
1196
1765
609
1501
2110
753
1576
2329
670
1526
2196 Total East
96 Other/undetermined
2402
6501
8906
2463
6506
8971
2289
6236
8529
2253
6007
8263 Total WHO European Region
75
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 23: AIDS diagnoses*, by sex, age and year of diagnosis (2005–2014) and cumulative totals
Table 23a: EU/EEA and non-EU/EEA countries
Age category
EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total EU/EEA
Non-EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total non-EU/EEA
Total WHO European Region
Age category
EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total EU/EEA
Non-EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
77
78
154
363
924
617
293
1
2507
79
86
226
533
2350
2171
1199
5
6649
156
164
380
896
3275
2788
1492
6
9157
64
84
136
314
825
586
285
4
2298
67
86
192
525
2042
2051
1133
6
6102
131
170
328
840
2868
2638
1418
10
8403
56
75
115
275
703
546
272
1
2043
59
80
229
499
1827
1937
1151
3
5785
115
155
344
776
2533
2485
1423
4
7835
60
62
137
270
674
622
296
0
2121
74
69
213
479
1771
1910
1176
2
5694
134
131
350
749
2447
2533
1472
2
7818
13
5
18
46
84
39
14
0
19
2
22
98
278
185
95
1
32
7
41
144
362
224
109
1
9
2
24
72
144
61
23
2
14
3
24
125
401
184
80
3
23
5
48
197
545
245
103
5
38
11
36
82
150
84
28
0
43
11
41
160
499
248
99
0
81
22
77
242
649
332
127
0
19
6
34
78
179
66
22
1
25
11
51
132
467
261
101
0
44
17
85
211
648
327
123
1
219
700
920
337
834
1171
429
1101
1530
405
1048
1456
2726
7349
10077
2635
6936
9574
2472
6886
9365
2526
6742
9274
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unkown
Total
28
29
81
130
366
343
295
0
1272
33
32
158
298
1058
1213
1060
1
3853
61
61
239
429
1425
1558
1356
1
5130
18
29
82
102
291
258
217
0
997
19
35
129
286
849
883
820
1
3022
37
64
211
388
1140
1141
1038
1
4020
4032
1216
5752
14914
28549
11436
6919
50
72868
4996
1914
12301
41617
112352
59921
36079
232
269412
0
1
0
9
16
6
2
1
35
9023
3121
18035
56498
140858
71314
42961
283
342093
36
9
32
92
266
155
91
1
45
8
41
153
657
471
216
4
81
17
73
245
923
626
307
5
19
6
26
76
191
169
141
0
30
20
75
167
498
453
300
2
49
26
101
243
689
622
441
2
310
93
628
1590
3532
1516
781
12
401
151
812
2985
9666
5617
2840
64
1
0
2
2
3
2
1
3
712
244
1441
4577
13197
7129
3621
79
Total non-EU/EEA
682
1595
2277
628
1545
2173
8462
22536
14
31000
Total WHO European Region
1954
5448
7407
1625
4566
6192
81329
291937
49
373081
*
Data from Bosnia and Herzegovina, Russia, San Marino, Sweden, Turkmenistan, Ukraine and Uzbekistan excluded due to inconsistent reporting during the
period. Therefore, totals by gender and overall may differ from totals presented in Tables 15-17.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
76
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
52
49
105
222
600
517
265
0
1810
52
34
168
389
1571
1758
1167
0
5139
104
83
273
612
2172
2275
1432
0
6951
40
33
134
215
540
526
336
0
1824
30
18
198
389
1404
1637
1201
0
4877
70
51
332
604
1946
2163
1537
0
6703
31
29
123
169
450
430
258
1
1491
31
35
147
409
1307
1488
1088
3
4508
62
64
270
578
1758
1918
1346
4
6000
40
26
113
176
484
426
306
0
1571
27
40
192
375
1252
1398
1070
1
4355
67
66
305
553
1737
1824
1376
1
5929
18
13
58
112
238
111
41
1
20
13
47
186
617
343
131
5
38
26
105
298
855
455
172
6
20
9
42
113
279
118
57
1
24
17
73
222
730
395
166
2
44
26
115
335
1009
513
223
3
18
3
54
119
363
165
75
1
33
2
51
194
791
457
197
4
51
5
105
313
1154
623
272
7
19
2
35
108
282
172
64
0
33
3
36
156
691
522
211
1
52
5
71
264
973
694
275
1
592
1362
1955
639
1629
2268
798
1729
2530
682
1653
2335 Total non-EU/EEA
2402
6501
8906
2463
6506
8971
2289
6236
8529
2253
6007
8263 Total WHO European Region
Age category
EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total EU/EEA
Non-EU/EEA
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
77
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 23: AIDS diagnoses*, by sex, age and year of diagnosis (2004–2013) and cumulative totals
Table 23b: West, Centre, East of the WHO European Region
Age category
West
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total West
Centre
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total Centre
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
33
35
123
333
886
597
281
1
2289
33
37
190
465
2264
2135
1198
5
6327
66
72
313
798
3151
2732
1479
6
8617
27
31
120
287
804
581
270
4
2124
34
27
158
464
1943
2021
1121
5
5773
61
58
278
752
2748
2603
1391
9
7900
28
30
94
248
674
543
265
1
1883
29
34
180
423
1709
1912
1158
3
5448
57
64
274
673
2386
2457
1423
4
7338
20
27
102
241
641
603
281
1
1916
30
33
172
396
1632
1833
1154
1
5251
50
60
274
637
2275
2437
1435
2
7170
46
44
22
28
50
37
16
0
47
51
34
69
126
112
68
1
93
95
56
97
176
149
84
1
36
54
14
24
40
26
23
2
35
61
28
61
140
79
63
4
71
115
42
85
180
105
86
6
31
46
16
27
43
27
20
0
31
47
42
53
144
78
58
0
62
93
58
80
187
105
78
0
43
36
43
66
144
123
79
1
82
70
78
94
208
152
102
1
663
39
34
35
28
64
29
23
0
252
535
787
46
243
508
751
219
471
690
210
453
East
<15
11
18
29
10
12
22
35
42
77
20
26
15–19
4
4
1
1
2
10
10
20
7
11
18
20–24
27
0
24
52
26
30
56
41
48
89
34
49
83
25–29
48
97
145
75
125
200
82
183
265
79
149
229
30–39
72
238
310
125
360
485
136
473
609
148
462
612
40–49
22
109
131
40
135
175
60
195
255
56
215
271
50+
10
28
38
15
29
44
15
34
49
14
44
58
0
0
0
0
0
0
0
0
0
0
0
0
194
514
709
292
692
984
379
985
1364
358
956
1317
2726
7349
10077
2635
6936
9574
2472
6886
9365
2526
6742
9274
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unknown
Total
10
18
58
96
307
315
272
0
1076
15
16
107
217
842
1102
1002
2
3303
25
34
165
314
1150
1419
1275
2
4384
6
12
42
81
236
225
186
0
788
4
21
78
174
625
769
753
1
2425
10
33
120
255
861
994
940
1
3214
2061
823
5424
14936
28803
11334
6852
50
70283
2469
1516
11725
41185
112617
60034
36340
230
266116
0
1
0
9
16
7
2
1
36
4529
2337
17140
56101
141401
71334
43164
281
336287
21
11
23
28
59
31
40
1
20
18
67
99
238
142
105
2
41
29
90
127
297
173
145
3
14
9
27
30
60
40
37
0
16
13
57
111
259
155
103
1
30
22
84
141
319
195
140
1
2072
409
511
575
1102
556
389
9
2637
454
870
1552
3546
2216
1477
52
1
0
0
0
0
1
1
3
4706
856
1371
2114
4621
2760
1857
64
217
715
932
5623
12804
6
18349
500
Unknown
Total East
Total WHO European Region
Age category
West
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total West
Centre
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total Centre
214
691
905
East
<15
33
43
76
17
29
46
209
291
0
15–19
9
6
15
14
21
35
77
95
0
172
20–24
32
25
57
39
69
108
445
518
2
965
25–29
98
135
233
67
168
235
993
1862
2
2857
30–39
266
635
901
186
463
649
2175
5852
3
8029
40–49
152
440
592
162
412
574
1062
3286
0
4347
74
169
243
135
263
398
459
1099
0
1558
0
1
1
0
1
1
3
14
0
17
Total East
664
1454
2118
620
1426
2046
5423
13017
7
18445
Total WHO European Region
1954
5448
7407
1625
4566
6192
81329
291937
49
373081
50+
Unknown
*
78
Data from Bosnia and Herzegovina, Russia, San Marino, Sweden, Turkmenistan, Ukraine and Uzbekistan excluded due to inconsistent reporting during the
period. Therefore, totals by gender and overall may differ from totals presented in Tables 15-17.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
20
34
78
187
566
510
253
0
1648
26
18
131
335
1448
1696
1146
0
4800
46
52
209
523
2015
2207
1399
0
6451
21
23
97
190
501
493
329
0
1654
15
13
161
327
1258
1572
1164
0
4510
36
36
258
517
1761
2065
1493
0
6166
12
23
79
138
405
409
247
1
1314
10
26
110
313
1117
1420
1043
2
4041
22
49
189
451
1523
1829
1290
3
5356
14
16
76
144
427
399
285
0
1361
10
28
129
269
1046
1284
1043
1
3810
24
44
205
415
1474
1683
1328
1
5174
33
18
28
29
37
19
21
0
28
16
43
61
153
114
90
0
61
34
71
90
190
133
111
0
20
12
35
26
52
32
23
0
17
9
44
69
157
105
94
0
37
21
79
95
209
137
117
0
19
6
46
31
56
33
31
0
21
9
47
99
217
121
103
2
40
15
93
130
273
155
134
4
30
10
34
28
56
40
24
0
21
12
66
106
215
159
92
0
51
22
100
134
271
199
116
0
185
505
690
200
495
695
222
619
844
222
671
893 Total Centre
17
18
35
19
22
41
18
33
51
15
29
Age category
West
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
Total West
Centre
<15
15–19
20–24
25–29
30–39
40–49
50+
Unknown
East
44 <15
10
13
23
7
13
20
3
2
5
2
3
5 15–19
57
41
98
44
66
110
52
41
93
38
33
71 20–24
118
179
297
112
215
327
119
191
310
112
156
268 25–29
235
587
822
266
719
985
352
764
1116
283
682
965 30–39
99
291
390
119
355
474
153
404
557
159
476
635 40–49
32
62
94
41
109
150
55
138
193
61
146
207 50+
1
5
6
1
2
3
1
3
4
0
1
569
1196
1765
609
1501
2110
753
1576
2329
670
1526
2196 Total East
1 Unknown
2402
6501
8906
2463
6506
8971
2289
6236
8529
2253
6007
8263 Total WHO European Region
79
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 24: The most common AIDS-indicative diseases diagnosed in 2014, ordered by frequency
Table 24a: EU/EEA and non-EU/EEA countries
Men
N
Diseases
EU/EEA
Pneumocystis pneumonia
Candidiasis, oesophageal
Mycobacterium tuberculosis, pulmonary in an adult or an adolescent
(aged 13 years or over)
Wasting syndrome due to HIV
Kaposi’s sarcoma
Toxoplasmosis of brain in a patient over one month of age
Mycobacterium tuberculosis, extrapulmonary
Cytomegalovirus disease (other than liver, spleen or nodes) in a patient over
one month of age
Encephalopathy, HIV-related
Cryptococcosis, extrapulmonary
Non-EU/EEA
Mycobacterium tuberculosis, pulmonary in an adult or an adolescent
(aged 13 years or over)
Mycobacterium tuberculosis, extrapulmonary
Wasting syndrome due to HIV
Candidiasis, oesophageal
Pneumocystis pneumonia
Pneumonia, recurrent in an adult or an adolescent (aged 13 years or over)
Encephalopathy, HIV-related
Candidiasis of bronchi, trachea or lungs
Isosporiasis, intestinal with diarrhoea (>1 months duration)
Bacterial infections, multiple or recurrent in a child under 13 years of age
%
837
368
22.4
9.8
Women
N
227
139
%
18.6
11.4
Total
N
%
1064
507
21.5
10.2
Children
N
3
3
%
4.7
4.7
370
9.9
127
10.4
497
10.0
9
14.1
346
304
176
165
9.3
8.1
4.7
4.4
133
23
127
87
10.9
1.9
10.4
7.1
479
327
303
252
9.7
6.6
6.1
5.1
14
0
1
5
21.9
0.0
1.6
7.8
205
5.5
45
3.7
250
5.0
1
1.6
137
85
3.7
2.3
65
21
5.3
1.7
202
106
4.1
2.1
10
1
15.6
1.6
422
26.3
124
21.0
546
24.9
9
15.8
164
145
104
86
50
49
38
36
23
10.2
9.1
6.5
5.4
3.1
3.1
2.4
2.2
1.4
44
61
52
27
15
15
16
17
11
7.5
10.3
8.8
4.6
2.5
2.5
2.7
2.9
1.9
208
206
156
113
65
64
54
53
34
9.5
9.4
7.1
5.2
3.0
2.9
2.5
2.4
1.6
9
4
3
1
1
1
4
5
6
15.8
7.0
5.3
1.8
1.8
1.8
7.0
8.8
10.5
Table 24b: West, Centre, East of the WHO European Region
Diseases
West
Pneumocystis pneumonia
Candidiasis, oesophageal
Kaposi’s sarcoma
Wasting syndrome due to HIV
Mycobacterium tuberculosis, pulmonary in an adult or an adolescent
(aged 13 years or over)
Toxoplasmosis of brain in a patient over one month of age
Cytomegalovirus disease (other than liver, spleen or nodes) in a patient over
one month of age
Mycobacterium tuberculosis, extrapulmonary
Encephalopathy, HIV-related
Cryptococcosis, extrapulmonary
Centre
Wasting syndrome due to HIV
Mycobacterium tuberculosis, pulmonary in an adult or an adolescent (aged 13
years or over)
Candidiasis, oesophageal
Pneumocystis pneumonia
Encephalopathy, HIV-related
Pneumonia, recurrent in an adult or an adolescent (aged 13 years or over)
Toxoplasmosis of brain in a patient over one month of age
Mycobacterium tuberculosis, extrapulmonary
Kaposi’s sarcoma
Cytomegalovirus disease (other than liver, spleen or nodes) in a patient over
one month of age
East
Mycobacterium tuberculosis, pulmonary in an adult or an adolescent
(aged 13 years or over)
Mycobacterium tuberculosis, extrapulmonary
Wasting syndrome due to HIV
Candidiasis, oesophageal
Pneumocystis pneumonia
Candidiasis of bronchi, trachea or lungs
Encephalopathy, HIV-related
Isosporiasis, intestinal with diarrhoea (>1 months duration)
Pneumonia, recurrent in an adult or an adolescent (aged 13 years or over)
Cryptococcosis, extrapulmonary
80
Men
N
757
287
278
199
%
25.8
9.8
9.5
6.8
Women
N
201
103
21
75
%
21.5
11.0
2.2
8.0
Total
N
958
390
299
274
%
24.8
10.1
7.7
7.1
Children
N
2
1
0
1
%
15.4
7.7
0.0
7.7
189
6.5
81
8.6
270
7.0
1
7.7
139
4.7
110
11.7
249
6.4
0
0.0
188
6.4
43
4.6
231
6.0
1
7.7
130
88
69
4.4
3.0
2.4
73
37
14
7.8
3.9
1.5
203
125
83
5.3
3.2
2.1
2
1
1
15.4
7.7
7.7
178
18.8
65
21.7
243
19.5
13
24.1
159
16.8
33
11.0
192
15.4
8
14.8
105
110
49
44
34
34
36
11.1
11.6
5.2
4.7
3.6
3.6
3.8
32
25
29
11
17
12
2
10.7
8.4
9.7
3.7
5.7
4.0
0.7
137
135
78
55
51
46
38
11.0
10.9
6.3
4.4
4.1
3.7
3.1
3
1
9
7
1
4
0
5.6
1.9
16.7
13.0
1.9
7.4
0.0
27
2.9
3
1.0
30
2.4
0
0.0
444
30.3
137
23.8
581
28.5
9
16.7
165
113
80
55
50
49
34
38
27
11.3
7.7
5.5
3.8
3.4
3.3
2.3
2.6
1.8
46
54
56
28
24
14
16
9
13
8.0
9.4
9.7
4.9
4.2
2.4
2.8
1.6
2.3
211
167
136
83
74
63
50
47
40
10.3
8.2
6.7
4.1
3.6
3.1
2.5
2.3
2.0
8
4
2
1
4
1
5
1
0
14.8
7.4
3.7
1.9
7.4
1.9
9.3
1.9
0.0
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 25: Deaths among people diagnosed with HIV and/or AIDS, by country and year of death (2005–2014) and
cumulative totals in EU/EEA and other countries of the WHO European Region*
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country**
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Total EU/EEA
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic of
Centre former
Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
Total non-EU/EEA
WHO European Region
West
Centre
East
Total WHO European Region
2005
2006
2007
2008
51
46
12
3
7
10
27
12
400
156
49
6
0
8
862
35
0
5
3
1
94
15
65
300
223
0
2
1205
19
359
3975
36
34
8
6
4
6
19
18
332
164
38
7
1
8
812
40
0
9
6
7
64
6
43
240
186
4
0
1032
8
314
3452
51
32
6
2
3
11
20
11
243
172
42
12
0
6
819
47
0
15
3
1
101
1
61
225
156
3
3
1010
6
314
3376
29
26
9
7
5
0
8
20
78
3
9
0
15
21
138
5
7
0
20
43
141
1
Year of diagnosis
2009
2010
39
19
14
10
3
10
3
2
207
113
48
15
0
5
645
57
0
12
1
0
64
2011
2012
2013
2014
Cumulative
total***
25
28
16
8
5
14
2
5
152
84
50
11
1
1
636
88
0
10
7
2
84
1
57
174
186
3
1
307
156
2114
34
33
14
8
3
12
4
2
122
102
42
11
0
0
107
0
18
3
0
80
2
46
205
199
0
5
248
157
1457
29
33
13
4
2
14
0
2
70
60
44
19
0
0
106
0
16
1
1
65
3
35
126
237
0
3
143
131
1131
1428
2031
156
181
112
228
2028
108
0
36302
14553
1846
393
39
414
43029
748
6
172
132
61
1488
628
1272
8536
4010
39
97
48070
1323
16168
185572
13
0
38
47
188
0
10
0
40
30
126
2
13
0
46
36
18
0
136
1
326
416
1423
57
14
3
8
230
129
31
11
0
3
754
58
0
20
4
0
95
3
71
209
144
0
5
852
308
3023
32
27
2
7
3
11
9
0
179
126
30
11
0
5
715
69
0
17
3
0
96
3
46
210
120
2
1
534
280
2538
53
214
134
1
2
423
310
2404
34
31
17
6
4
13
6
7
169
121
53
17
1
4
644
80
0
9
3
1
82
1
68
200
215
1
1
370
158
2316
3
1
32
43
146
0
13
0
40
27
151
1
12
0
23
45
146
0
11
0
26
40
158
0
4
5
2
1
0
1
4
0
3
0
64
56
30
77
24
41
0
0
0
25
71
0
4
2188
9
2643
36
37
86
16
45
1
1
0
24
57
11
2
2420
9
2938
67
39
91
18
68
0
2
0
13
50
13
0
2507
19
3101
74
30
137
15
65
0
1
0
22
34
30
0
2710
124
3468
63
23
130
21
54
0
2
0
25
41
34
0
2591
40
3256
80
23
168
26
72
0
4
0
29
23
53
0
3096
66
3867
94
32
150
19
127
0
2
0
30
13
61
0
3744
4511
83
22
148
19
11
0
1
0
18
3
86
0
3870
4547
82
28
147
6
22
0
1
0
20
4
98
10
3514
4143
68
26
108
9
33
0
2
12
4
73
11
3436
3895
828
920
1439
198
697
18
41
0
8
1080
5891
463
95
1
35443
323
49868
3696
369
2553
6618
3216
310
2864
6390
3135
282
3060
6477
2741
288
3462
6491
2313
244
3237
5794
2137
288
3846
6271
1923
389
4515
6827
1735
333
4593
6661
1064
344
4192
5600
736
365
3951
5052
184914
7961
42585
235466
*
Comparisons between country data should be made with caution. Some country data include only AIDS-related deaths while other country data include data for
all deaths among people diagnosed with HIV and/or AIDS, irrespective of the cause of death.
** Country-specific comments are in Annex 5
*** Cumulative total is the total number of cases reported by country since the start of reporting
81
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 26: Deaths among AIDS cases*, by transmission mode and year of death (2005–2014) and cumulative totals
Table 26a: EU/EEA and non-EU/EEA countries
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
*
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
221
330
10
19
25
66
671
586
1011
543
17
31
35
199
2422
586
1232
873
27
50
60
265
3093
186
289
6
11
22
58
572
494
853
471
10
26
39
167
2060
494
1039
760
16
37
61
225
2632
194
286
3
10
25
61
579
489
834
445
12
14
26
152
1972
489
1028
731
15
24
51
213
2551
184
262
3
7
19
69
544
434
693
380
14
27
22
155
1725
434
877
642
17
34
41
224
2269
25
47
3
0
1
15
91
762
30
164
72
4
3
1
78
352
2774
30
189
119
7
3
2
93
443
3536
55
71
0
0
1
6
133
705
24
229
103
2
2
0
11
371
2431
24
284
174
2
2
1
17
504
3136
61
74
4
1
0
3
143
722
16
276
108
4
4
3
20
431
2403
16
337
182
8
5
3
23
574
3125
54
98
4
0
0
7
163
707
23
289
138
5
1
0
14
470
2195
23
344
236
9
1
0
21
634
2903
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unkown
Total
93
180
5
10
18
59
365
312
333
310
4
15
16
102
1092
312
426
490
9
25
34
161
1457
52
140
3
7
16
38
256
254
245
223
3
14
22
107
868
255
297
364
6
21
38
145
1126
0
9938
10110
683
1436
643
1709
24519
50045
40236
14537
776
4042
935
6336
116907
2
0
1
0
0
0
0
3
50022
50118
24568
1457
5474
1562
8013
141214
49
96
6
0
0
10
161
526
21
250
165
7
0
0
23
466
1558
21
299
261
13
0
0
33
627
2084
20
91
2
0
1
6
120
376
22
176
118
1
0
0
22
339
1207
22
196
209
3
0
1
28
459
1585
0
1415
1687
84
63
4
168
3421
27940
2514
5032
2199
93
203
5
575
10621
127522
0
1
0
1
0
0
4
6
9
2513
6447
3878
178
266
9
745
14036
155244
Data from Bosnia and Herzegovina, Finland, Italy, Russia, San Marino, Sweden, Turkmenistan, Ukraine and Uzbekistan excluded due to inconsistent reporting
during the period. Therefore, totals by gender and overall may differ from totals presented in Table 25.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
82
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
116
240
6
9
15
61
447
389
508
310
7
12
23
127
1376
389
624
550
13
21
38
188
1823
94
221
12
5
14
44
390
403
413
355
2
20
21
155
1369
403
507
576
14
25
35
199
1759
96
213
5
8
28
63
413
383
374
331
9
18
19
125
1259
383
470
544
14
26
47
188
1672
103
170
5
9
25
40
352
328
320
302
5
19
21
130
1125
329
423
472
10
28
46
170
1478
52
116
3
0
1
7
179
626
23
275
126
2
0
1
18
445
1821
23
327
242
5
0
2
25
624
2447
53
124
2
1
0
9
189
579
24
330
143
3
1
0
15
516
1885
24
383
267
5
2
0
24
705
2464
46
165
3
0
0
8
222
635
18
311
187
8
1
0
20
545
1804
18
357
352
11
1
0
28
767
2439
47
117
4
1
0
2
171
523
12
318
162
2
0
0
12
506
1631
12
365
279
6
1
0
14
677
2155
Transmission mode
EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total EU/EEA
Non-EU/EEA
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total non-EU/EEA
Total WHO European Region
83
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Table 26: Deaths among AIDS cases*, by transmission mode and year of death (2005–2014) and cumulative totals
Table 26b: West, Centre, East of the WHO European Region
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
Female
2005
Male
Total**
Female
2006
Male
Total**
Female
2007
Male
Total**
Female
2008
Male
Total**
215
303
11
8
1
31
569
582
974
507
11
16
1
155
2246
582
1189
810
22
24
2
186
2815
177
276
4
5
2
35
499
492
809
442
5
20
0
129
1897
492
986
718
9
25
2
164
2396
187
271
3
5
1
35
502
470
764
436
7
8
0
123
1808
470
951
707
10
13
1
158
2310
174
244
3
6
1
38
466
413
620
351
12
18
1
106
1521
413
794
595
15
24
2
144
1987
7
41
0
11
24
35
118
29
41
65
7
18
34
54
248
29
48
106
7
29
58
89
366
6
33
2
6
20
24
91
24
31
65
6
8
39
41
214
24
37
98
8
14
59
65
305
9
23
1
6
24
25
88
32
38
49
5
9
26
34
193
32
47
72
6
15
50
59
281
8
26
1
1
18
31
85
35
38
50
3
10
21
46
203
35
46
76
4
11
39
77
288
-
5
5
-
2
2
3
9
160
184
58
242
300
308
367
56
9
24
59
3
Injecting drug use
324
381
Heterosexual contact
207
33
43
76
51
67
118
66
68
134
90
117
Mother-to-child
2
3
5
0
1
1
3
4
7
3
4
7
Haemophiliac/transfusion recipient
0
0
0
0
0
0
0
1
1
0
0
0
Nosocomial infection
1
1
2
1
0
1
0
3
3
0
0
0
Other/undetermined
15
68
83
5
8
13
4
15
19
7
17
24
Total East
75
280
355
115
320
435
132
402
534
156
471
628
762
2774
3536
705
2431
3136
722
2403
3125
707
2195
2903
Female
2013
Male
Total**
Female
2014
Male
Total**
Female
Cumulative total***
Male Unkown
Total
69
134
0
6
0
17
226
280
250
237
1
7
0
63
838
280
319
371
1
13
0
80
1064
36
94
1
1
0
10
142
225
166
148
1
5
0
47
592
226
202
243
2
6
0
57
736
0
10516
10118
660
1261
20
1262
23837
51263
40960
14358
708
3783
18
5746
116836
2
0
1
0
0
0
0
3
51242
51442
24425
1368
5043
38
6996
140554
13
35
7
4
18
35
112
41
41
80
3
8
16
41
230
41
54
115
10
12
34
76
342
9
44
2
6
16
27
104
47
51
71
2
9
22
59
261
47
60
115
4
15
38
86
365
0
274
674
79
237
623
473
2360
1179
1059
1122
120
458
917
782
5637
0
0
0
1
0
0
1
2
1176
1314
1762
198
692
1524
1238
7904
60
12
12
4
0
116
0
116
292
352
27
4
Injecting drug use
204
231
563
3246
1
3806
Heterosexual contact
Total WHO European Region
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
107
158
265
93
122
215
1005
1254
0
2257
Mother-to-child
4
7
11
2
1
3
28
41
0
69
Haemophiliac/transfusion recipient
0
0
0
0
0
0
1
4
0
5
Nosocomial infection
0
0
0
1
0
1
4
5
0
9
Other/undetermined
17
21
38
7
23
30
142
383
3
524
Total East
188
490
678
130
354
484
1743
5049
4
6786
Total WHO European Region
526
1558
2084
376
1207
1585
27940
127522
9
155244
*
Data from Bosnia and Herzegovina, Finland, Italy, Russia, San Marino, Sweden, Turkmenistan, Ukraine and Uzbekistan excluded due to inconsistent reporting
during the period. Therefore, totals by gender and overall may differ from totals presented in Table 25.
** Annual totals include people diagnosed whose gender was unknown
*** Cumulative total is the total number of cases reported by country since the start of reporting
84
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Female
2009
Male
Total**
Female
2010
Male
Total**
Female
2011
Male
Total**
Female
2012
Male
Total**
108
227
5
6
2
34
382
371
452
284
4
8
2
95
1216
371
560
511
9
14
4
129
1598
81
202
7
3
0
24
317
369
371
309
2
9
0
115
1175
369
452
511
9
12
0
139
1492
75
167
3
4
0
23
272
345
309
253
4
13
0
83
1007
345
384
420
7
17
0
106
1279
77
138
4
1
1
12
233
299
239
254
2
7
0
64
865
300
316
392
6
8
1
76
1099
6
26
2
3
13
23
73
37
28
41
4
4
21
35
170
37
34
67
6
7
34
58
243
8
28
6
3
14
20
79
54
23
56
0
12
21
43
209
54
31
84
6
15
35
63
288
13
54
2
4
28
36
137
49
42
83
7
5
19
47
252
49
55
137
9
9
47
83
389
16
25
3
8
24
25
101
35
45
54
3
12
21
62
232
35
61
79
6
20
45
87
333
6
Transmission mode
West
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total West
Centre
Men who have sex with men
Injecting drug use
Heterosexual contact
Mother-to-child
Haemophiliac/transfusion recipient
Nosocomial infection
Other/undetermined
Total Centre
East
Men who have sex with men
-
4
4
-
4
4
-
7
7
-
6
54
303
357
58
349
407
54
334
388
57
354
411 Injecting drug use
103
111
214
115
133
248
157
182
339
124
156
280 Heterosexual contact
2
1
3
1
3
4
3
6
9
2
2
0
0
0
0
0
0
0
1
1
1
0
1 Haemophiliac/transfusion recipient
1
1
2
0
0
0
0
0
0
0
0
0 Nosocomial infection
4 Mother-to-child
11
15
26
9
12
21
12
15
27
5
16
171
435
606
183
501
684
226
545
771
189
534
723 Total East
21 Other/undetermined
626
1821
2447
579
1885
2464
635
1804
2439
523
1631
2155 Total WHO European Region
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HIV/AIDS surveillance in Europe 2014
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Table 27: Number of HIV tests performed, excluding unlinked anonymous testing and testing of blood donations, by
country and year (2005–2014) and number of tests per 1 000 population in 2014, in EU/EEA and other countries of the
WHO European Region
Area
EU/EEA
West
West
Centre
Centre
Centre
Centre
West
East
West
West
West
West
Centre
West
West
West
East
Country*
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece**
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
East
Lithuania
West
Luxembourg
West
Malta
West
Netherlands
West
Norway
Centre Poland
West
Portugal
Centre Romania
Centre Slovakia
Centre Slovenia
West
Spain
West
Sweden
West
United Kingdom
Non-EU/EEA
Centre Albania
West
Andorra
East
Armenia
East
Azerbaijan
East
Belarus
Centre Bosnia and Herzegovina
Yugoslav Republic
Centre former
of Macedonia, the
East
Georgia
West
Israel
East
Kazakhstan
East
Kyrgyzstan
East
Moldova
West
Monaco
Centre Montenegro
East
Russia
West
San Marino
Centre Serbia
West
Switzerland
East
Tajikistan
Centre Turkey
East
Turkmenistan
East
Ukraine
East
Uzbekistan
*
**
86
Number of HIV tests
2009
2010
2005
2006
2007
2008
667825
591193
110000
26085
38708
330233
143671
61249
142427
5442919
70512
9397
85538
58424
13975
6197
193075
136040
917117
188279
103718
24522
-
659693
578717
105000
26124
37763
317823
154332
65861
147601
5181244
80168
9106
85117
52988
14339
10309
188550
159180
191223
93426
25624
-
777935
595394
160000
32698
41913
344874
141880
68478
153478
5157143
33558
65980
9351
63000
79279
60333
13379
11957
176728
220226
88520
31120
-
751749
619418
110000
38996
42294
342223
124935
74357
186822
5055365
29908
83408
9522
72444
162381
13366
181118
282248
66926
31183
-
770901
635150
140000
40938
48158
347135
112533
78735
190380
5026694
35171
91181
7794
184980
59331
100799
13308
213138
284053
132990
37105
-
3700
1884
39469
237027
440675
10834
3098
3077
50221
237183
441299
20904
1686
3546
55342
293086
437983
16858
2458
2803
60701
322525
430175
-
2143
2810
60103
340048
459032
-
Tests/1000
2014 population
2011
2012
2013
831675
651095
160000
32848
48385
353507
168923
78054
185114
5011668
31070
89137
7318
180055
58826
178554
8533
229783
291915
109261
36977
-
826256
679655
180000
32928
49074
334569
137877
85025
5216466
31918
84464
184521
58799
102234
57685
317286
306679
110025
38110
-
703486
190000
40071
54120
349205
134709
73367
5247398
34622
93060
175488
60491
101042
64778
358953
293204
110506
33602
-
695433
210000
29998
50235
341583
137151
82279
5225638
32241
95861
150597
58302
102161
68020
14522
302898
114574
33457
-
697684
230000
349448
82266
5266055
22455
168028
60614
108781
332422
126187
35498
-
62.3
31.7
33.2
62.5
80
2.1
36.5
30.3
37
16.7
23.2
17.2
-
2168
2678
60731
353772
517625
20793
3260
2590
68449
365090
621780
-
3140
2062
71957
514434
683125
-
3063
2310
83431
482282
770136
-
2378
94122
612860
1157072
-
31.2
31.3
63.6
121.8
-
7526
11172
10574
10426
11842
18721
17811
18105
24562
-
-
26026
234835
621261
162075
185922
3594
17744347
4723
35083
72114
1881750
153090
1555511
515972
16989
242484
862058
179407
216566
3988
18535043
5061
37829
91310
1908257
136145
1661600
545240
16989
269071
1491190
227879
347709
3838
3976
42573
92474
1998163
211789
1937440
619130
18792
271641
1643938
268134
355711
4229
3825
44555
129330
5045319
2280442
796371
17562
278887
1758026
325855
342666
5812
4181
47734
214207
2347084
987464
25370
286995
1786289
297959
336871
6492
25209546
5090
51727
280281
2319946
1506724
21799
274294
1897476
381295
340397
6914
3961
56086
438532
2392970
-
15562
233516
2026174
470355
342418
6781
3845
64031
447636
2343099
-
18091
2127136
370160
146105
6970
4004
65829
514701
2155108
2941748
-
86290
2190757
410331
133476
6571
3427
56282
634791
2027295
1853626
-
21.4
126.1
70.2
32.8
10.5
102.1
7.9
76.5
28.1
43.3
-
Country-specific comments are in Annex 5
HIV tests reported for Greece refer to only to those performed in reference centres and do not include all tests carried out in public hospitals or private
laboratories.
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HIV/AIDS surveillance in Europe 2014
Maps
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HIV/AIDS surveillance in Europe 2014
Map 1: New HIV diagnoses per 100 000 population, 2014
<2
2 to < 10
10 to < 20
≥ 20
Missing or excluded data
Andorra
Liechtenstein
Luxembourg
Malta
Monaco
San Marino
Map 2: New HIV diagnoses in men per 100 000 male population, 2014
<2
2 to < 10
10 to < 20
≥ 20
Missing or excluded data
Andorra
Liechtenstein
Luxembourg
Malta
Monaco
San Marino
88
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HIV/AIDS surveillance in Europe 2014
Map 3: New HIV diagnoses in women per 100 000 female population, 2014
<2
2 to < 10
10 to < 20
≥ 20
Missing or excluded data
Andorra
Liechtenstein
Luxembourg
Malta
Monaco
San Marino
Map 4: New HIV diagnoses in men who have sex with men per 100 000 male population, 2014
<1
1 to < 3
3 to < 5
≥5
Missing or excluded data
Andorra
Liechtenstein
Luxembourg
Malta
Monaco
San Marino
89
HIV/AIDS surveillance in Europe 2014
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Map 5: New HIV diagnoses acquired through injecting drug use per 100 000 population, 2014
<1
1 to < 3
3 to < 5
≥5
Missing or excluded data
Andorra
Liechtenstein
Luxembourg
Malta
Monaco
San Marino
Map 6: New HIV diagnoses acquired through heterosexual transmission per 100 000 population, 2014
<1
1 to < 3
3 to < 5
≥5
Missing or excluded data
Andorra
Liechtenstein
Luxembourg
Malta
Monaco
San Marino
90
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HIV/AIDS surveillance in Europe 2014
Map 7: Percentage of adult (>14 years) HIV diagnoses with CD4 <350 cells/mm3 at diagnosis, 2014
< 30%
30% to < 40%
40% to < 50%
≥ 50%
Missing or excluded data
Andorra
Liechtenstein
Luxembourg
Malta
Monaco
San Marino
Map 8: AIDS diagnoses reported per 100 000 population, 2014
<1
1 to < 3
3 to < 5
≥5
Missing or excluded data
Andorra
Liechtenstein
Luxembourg
Malta
Monaco
San Marino
91
HIV/AIDS surveillance in Europe 2014
92
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HIV/AIDS surveillance in Europe 2014
Annexes
93
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HIV/AIDS surveillance in Europe 2014
Annex 1: Framework for data collection,
validation and presentation
Since 2008, the European Centre for Disease Prevention
and Control (ECDC) and the World Health Organization
Regional Office for Europe (WHO Regional Office) have
jointly carried out the enhanced surveillance of HIV/
AIDS in Europe. Both strive to ensure a high quality of
standardised HIV and AIDS surveillance data from the 53
countries of the WHO European Region, including the 28
countries of the European Union (EU) and the three countries of the European Economic Area (EEA) (in this report
referred to together as EU/EEA).
1 Reporting
In EU/EEA countries, the Member States’ Coordinating
Competent Bodies have nominated national operational contact points for HIV/AIDS surveillance to work
on reporting surveillance data to the joint ECDC/WHO
database for HIV/AIDS surveillance. For non-EU/EEA
countries, nominations for national HIV/AIDS surveillance focal points were received directly by the WHO
Regional Office via the respective ministries of health.
Data are submitted through a web-based platform
to a joint database of The European Surveillance
System (TESSy). Four types of data are collected: HIV
(case-based and aggregate), AIDS (case-based and
aggregate), HIVAIDS (case-based data which links HIV
and AIDS diagnoses) and number of HIV tests performed
(aggregate).
Data are uploaded directly by the reporting country into
the database. When uploading data, a built-in set of validation rules ensures the verification of the data within
the database. This verification of the data during the
uploading process improves the quality of the data and
allows each country to test their datasets prior to submission. Further validation checks are carried out before
the data is considered of sufficient quality to be used
for analysis.
Bosnia and Herzegovina, Russia, Turkmenistan and
Uzbekistan did not report any HIV data through this system for 2014. HIV data for Russia were therefore obtained
through publicly available national sources, with the
assumption that the data has been validated to the
same rigor as for the other countries, and then incorporated with the other countries’ reported data to enable a
more complete presentation of the epidemiology of HIV
and AIDS in Europe. Bosnia and Herzegovina, Russia,
San Marino, Sweden, Turkmenistan and Uzbekistan did
not report any AIDS data through this system for 2014.
Surveillance systems – data sources
To describe the national source of data and specify the
national surveillance system from which the reported
data originate, the variable ‘data source’ is included as a
compulsory part of reporting (Annexes 4 and 4a). Some
cross-country comparisons are hampered by differences
in surveillance systems as the quality and coverage of
national surveillance are not consistent. Particularly in
the early part of the period covered in this report (2005–
2014), some countries did not have national HIV/AIDS
data and others established or substantially modified
the national reporting systems over the course of the
reporting period. These issues are detailed in Annex 5.
2 Data collection and validation
Data collection 2015
The 2014 data submission for HIV and AIDS surveillance
took place between 15 March and 15 September 2015.
Data presented in this report were extracted from the
joint database on 5 November 2015, although minor corrections were made during subsequent country reviews
and verification of the data presented in the draft report.
Individual country datasets
Data were uploaded, validated and approved in the
joint database for HIV/AIDS surveillance by the reporting countries. Once the data were submitted, individual
datasets were validated. The HIVAIDS record type was
used for the first time in 2014 to collected case-based
joined HIV and AIDS data. Thirty-three countries used
the joined record type for 2014 reporting and, of these,
twenty-eight countries uploaded all historical data
in the new format, two countries uploaded several
years of data in the new format, and three countries
uploaded only 2014 data in the new format. Two countries (Kazakhstan and Ukraine) reported aggregated HIV
data. Ukraine reported aggregated AIDS data for the
years 2005 to 2014 and Belarus reported aggregate AIDS
data for 2014. All other countries reported case-based
AIDS data.
Reporting of aggregated HIV and AIDS data has an
impact on the data presentation and analysis and the
epidemiological overview of HIV/AIDS in Europe because
fewer variables are available from the aggregated datasets, hence reducing the amount of data that can be
presented in certain tables and figures.
3 Data re-coding and
adjustments
Dates used for data presentation
In this report the HIV and AIDS data are presented by
‘date of diagnosis’ with the exception of Table 1a. If
countries could not provide this date, the ‘date of notification’ or ‘date of statistics’ was used instead.
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HIV/AIDS surveillance in Europe 2014
Region of origin
When available, countries were encouraged to provide
data on the specific country of origin or nationality of
the case. This information was used first and, if absent,
the variable ‘region of origin’ was used to group cases
into region of origin presented in Table 11 (stratified by
reporting country) and Table 12 (all countries stratified
by mode of transmission).
Origin of reported cases
Cases originating from countries outside of the reporting country, including those from outside of Europe or
from countries with generalised HIV epidemics are, on
occasion, separated from other cases for the analyses
presented here. This approach has been taken so as to
inform epidemiological understanding and to guide public health resource allocation and prevention efforts.
In order to compare the impact of the epidemic on all
transmission modes, cases reported as originating
from regions or countries of sub-Saharan Africa were
used as a proxy for cases originating from countries
with a generalised epidemic (in Tables 11, 12 and in
selected Figures). As most of the cases originating from
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sub-Saharan Africa were reported from west European
countries within the EU/EEA, this information is presented in detail in Chapter 1.
Reporting delay
Reporting delays refer to the time delay between HIV/
AIDS diagnosis (or death) and the report of this event at
national level, identified by ‘date of notification’. Due to
delays in reporting, HIV trends analysed at a European
level are often biased downwards for the most recent
year (2014) and, to a lesser extent for the 2 to 3 years
prior to the reporting period. To provide a more accurate
picture of trends, surveillance data should be corrected
to more accurately describe the trends in HIV diagnoses.
In this report, we apply a statistical approach, as
described by Heisterkamp, et al [1] to adjust the surveillance data for reporting delays. Annual reporting delay
probabilities were estimated using historical data from
2005 to 2014. Countries were excluded from reporting
delay adjustment:
1 when they showed an inconsistent and non-stationary
pattern in their reporting delay distribution during the
period 2005–2014, or
Figure A1: Geographical/epidemiological division of the WHO European Region
West
Centre
East
Andorra
Luxembourg
Malta
Monaco
San Marino
The countries covered by the report are grouped as follows:
• West, 23 countries: Andorra, Austria*, Belgium*, Denmark*, Finland*, France*, Germany*, Greece*, Iceland, Ireland*, Israel, Italy*, Luxembourg*,
Malta*, Monaco, Netherlands*, Norway, Portugal*, San Marino, Spain*, Sweden*, Switzerland, United Kingdom*.
• Centre, 15 countries: Albania, Bosnia and Herzegovina, Bulgaria*, Croatia*, Cyprus*, Czech Republic*, Hungary*, the former Yugoslav Republic of
Macedonia, Montenegro, Poland*, Romania*, Serbia, Slovakia*, Slovenia*, Turkey.
• East, 15 countries: Armenia, Azerbaijan, Belarus, Estonia*, Georgia, Kazakhstan, Kyrgyzstan, Latvia*, Lithuania*, Moldova, Russia, Tajikistan,
Turkmenistan, Ukraine, Uzbekistan.
* Countries which constitute the European Union as of 1 July 2014.
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HIV/AIDS surveillance in Europe 2014
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2 when they reported aggregated data during the period
2005–2014.
maps presenting figures for MSM, rates are calculated
using the male population.
Adjusting for reporting delays is a valuable tool to indicate HIV trends more precisely, as well as in monitoring
the timeliness of data collection, an important aspect of
quality control.
Data are presented by year but also as cumulative totals
per country. The cumulative total includes all data
reported by that particular country since the beginning
of national reporting and is not limited to the selected
number of years presented.
Reporting delays were applied for the graphs showing
trends for the EU/EEA and by transmission mode. The
list of countries with the number of reported diagnoses
adjusted for reporting delay are presented in Annex 6.
4 Data presentation
Geographical presentation
Data are presented for the WHO European Region
and the EU/EEA. The EU comprises 28 Member States
and the EEA comprises an additional three countries
(Norway, Iceland and Liechtenstein) which are included
in the overview of the EU/EEA.
The tables are presented by EU/EEA countries, non-EU/
EEA countries, by individual countries and by totals.
The 53 countries of the WHO European Region are also
subdivided into three geographical areas based on epidemiological considerations and in accordance with the
division used in previous reports on HIV/AIDS surveillance in Europe: West (23 countries), Centre (15 countries)
and East (15 countries) (see Figure A1). The division
reflects similarities in epidemiological dynamics such
as epidemic levels, trends over time and transmission
patterns. Of the EU/EEA countries, 19 Member States
are classified as being in the West, nine in the Centre
and three in the East. Liechtenstein is not included in
the WHO European Region classification and, therefore,
totals for West, Centre and East may not always equal
the EU/EEA and non-EU/EEA totals. Data from Kosovoi
are included as footnotes to Tables 1–7 and 15–21.
Population data and rates
Data are presented in absolute numbers and rates as
cases per 100 000 population.
The population estimates up to 2014 were derived
from Eurostat for all EU/EEA countries and from United
Nations (UN) Population Division for non-EU/EEA countries [2]. The Eurostat data are from 31 March 2015
(http://ec.europa.eu/eurostat/data/database) and the
UN population data are from September 2015 (http://
esa.un.org/unpd/wpp/DVD).
The population data used for HIV and AIDS for Spain and
for HIV for Italy were adjusted according to the extent of
sub-national coverage for relevant years.
For data presented by gender and age, rates were calculated using relevant male and female population
denominators from the sources described above. For
i This designation is without prejudice to positions on status, and is in
line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration
of Independence.
Trend data
For presentation of the overall trends, only countries
reporting consistently were included and these are
noted in the footnotes to the trend graphs.
When presenting HIV trends for 2005–2014 by transmission mode, countries reporting transmission mode
inconsistently or incompletely were excluded (e.g.
Estonia, Poland and Turkey) from Table 8 and relevant figures reporting trends by transmission mode.
Countries with varying geographic coverage of the
national surveillance system over time (Spain and Italy)
were also excluded from Tables 8 and 9 and from graphs
showing HIV trends.
When presenting trends for AIDS deaths, only countries reporting consistently were included (i.e. Bosnia
and Herzegovina, Finland, Italy, Russia, Sweden,
Turkmenistan, Ukraine and Uzbekistan were not included
in the presentation of trends for AIDS deaths in Table 26
or the description in the text).
5 Data limitations
Surveillance systems are not identical across Europe,
and differences in data collection methods and testing
policies could impact the results and introduce bias in
comparisons between countries. Particularly, factors
such as underreporting and reporting delay may influence the country figures and rankings presented in the
report.
The data in the report are to be considered as provisional because they are subject to regular updates (e.g.
detection and deletion of duplicate cases, inclusion of
new information about cases already reported). The limitations described below and country comments in Annex
5 and the information on HIV and AIDS case reporting
systems available in Annexes 4 and 5 need to be taken
into account when interpreting the data presented here.
Official reports of newly diagnosed cases of HIV do not
represent true incidence. Newly reported HIV diagnoses
include recently infected individuals as well as those
who were infected several years ago but only recently
tested for HIV. These reports are also influenced by
several factors such as the uptake of HIV testing, patterns of reporting, the long incubation period and a slow
progression of the disease. In order to better interpret
trends in HIV case reporting data, the total numbers of
HIV tests performed annually for diagnostic purposes
(excluding unlinked anonymous tests and screening of
blood donations) are presented to help provide some
background on HIV testing patterns.
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HIV/AIDS surveillance in Europe 2014
Although the table in Annex 6 adjusts for reporting
delay for those countries where this is possible, no
adjustments are made for underreporting or underascertainment bias. Fewer than 40% of European
countries have evaluated their surveillance systems for
underreporting and only two have published the results
[4]. Previous estimates of underreporting range from
0% to 25% for AIDS cases [3], while national estimates
of underreporting for HIV can range from 10% (Iceland
and Italy) to around 40% (Germany and the UK) [4, 5].
Estimates with regard to the underreporting of AIDSrelated deaths are not available.
References
1
Heisterkmap SH, Jager JC, Ruitenberg EJ, van Druten JAM, Downs
AM. Correcting Reported Aids Incidence: A statistical approach.
Statistics in Medicine. Vol. 8, 963-976 (1989).
2 United Nations, Department of Economic and Social Affairs,
Population Division. World Population Prospects: The 2015 Revision,
DVD Edition. New York; 2015. Available at: http://esa.un.org/unpd/
wpp/DVD/ [accessed 14 September 2015].
3
EuroHIV. Completeness of AIDS case reporting in Europe. HIV/AIDS
Surveillance in Europe, Quarterly Report 1996. Paris: Institut de
médecine et d’épidémiologie africaines; 1996. No.49:30-33.
4
EuroHIV. EuroHIV 2006 survey on HIV and AIDS surveillance in the
WHO European Region. Saint-Maurice: Institut de veille sanitaire;
2007.
5
Personal communication to ECDC. F. Cazein, 08/11/12.
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Annex 2
List of variables* for 2014 HIV/AIDS data collection
HIVAIDS case-based
HIV case-based
AIDS case-based
HIV aggregated
AIDS aggregated
HIV tests aggregate
RecordID
RecordType
RecordTypeVersion
Subject
Status
DataSource
ReportingCountry
DateUsedForStatistics
Age
Gender
Outcome
DateOfOnset
DateOfDiagnosis
DateOfNotification
Classification
ClinicalCriteria
LaboratoryResult
EpiLinked
RecordID
RecordType
RecordTypeVersion
Subject
Status
DataSource
ReportingCountry
DateUsedForStatistics
Age
Gender
Outcome
DateOfOnset
DateOfDiagnosis
DateOfNotification
Classification
ClinicalCriteria
LaboratoryResult
EpiLinked
RecordType
RecordTypeVersion
Subject
DataSource
AgeClass
Gender
ReportingCountry
DateUsedForStatistics
Classification
Number of cases
-
RecordType
RecordTypeVersion
Subject
DataSource
AgeClass
Gender
ReportingCountry
DateUsedForStatistics
Classification
Number of cases
-
RecordType
RecordTypeVersion
Subject
DataSource
DateUsedForStatistics
ReportingCountry
NumberOfTests
-
HIVType
Stage
Transmission
TransmissionHetero
TransmissionMTCT
HIVStatus
DateOfAIDSDiagnosis
CountryOfBirth
CountryOfNationality
RegionOfOrigin
CD4Cells
ProbableCountryOfInfection
DateOfDeath
-
HIVType
ARTTreatment
Transmission
TransmissionHetero
TransmissionMTCT
DateOfHIVDiagnosis
CountryOfBirth
CountryOfNationality
RegionOfOrigin
AgeClass
AIDSIndicatorDisease
DateOfDeath
DateOfReportDeath
Transmission
-
Transmission
-
-
Common set of variables
RecordID
RecordType
RecordTypeVersion
Subject
Status
DataSource
ReportingCountry
DateUsedForStatistics
Age
Gender
DateOfDiagnosis
DateOfNotification
Disease-specific variables
HIVType
ART
Transmission
TransmissionPartner
HIVStatus
CountryOfBirth
RegionOfOrigin
First CD4Count
First CD4Date
ProbableCountryOfInfection
AcuteInfection
YearOfArrival
LastAttendanceDate
CD4Latest
CD4LatestDate
VLLatest
VLLatestDate
DateofAIDSDiagnosis
AIDSIndicatorDiseaases
DateofDeath
DeathCause
*
Additional optional variables ‘PlaceOfNotification’ and ‘PlaceOfResidence’ were added from TESSy metadataset 20 for all diseases and can be reported via HIV
case-based and HIV aggregate.
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HIV/AIDS surveillance in Europe 2014
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Annex 3
Completeness of variables for data reported in 2013 and 2014
EU/EEA Countries
Age
Gender
Date of diagnosis
Date of notification
Transmission
Date of AIDS diagnosis
Date of death
Country of birth
Region of origin
CD4 cell count
Probable country of infection
WHO European Region
Age
Gender
Date of diagnosis
Date of notification
Transmission
Date of AIDS diagnosis
Date of death
Country of birth
Region of origin
CD4 cell count
Probable country of infection
100
Number of
countries
2013
Completeness
%
Minimal
Maximal
Number of
countries
2014
Completeness
%
Minimal
Maximal
30
30
30
27
30
30
24
22
23
22
25
99.8
99.8
100
74.7
81.6
31.3
5.9
57.2
71.5
64.2
42.8
83.3
86.7
100
74.1
9.1
3.4
0.3
34.3
32.6
7.3
5.5
100
100
100
100
98.7
100
100
100
100
97.7
100
31
31
31
29
31
31
26
22
23
23
25
99.8
99.7
100
74.3
80.3
29.3
3.4
56.9
69.1
61.9
43.2
84.8
85.6
100
1.1
9.1
3.1
0.3
38.4
63.9
4.5
2.6
100
100
100
100
100
100
100
100
100
100
100
49
49
49
41
48
46
38
36
37
35
37
99.8
99.7
100
48.9
87.4
23.6
9.3
39.9
48.8
38.9
30.1
83.3
86.7
100
48.9
9.1
3.4
0.3
34.3
32.6
7.3
5.5
100
100
100
100
100
100
100
100
100
97.7
100
49
49
49
42
48
44
40
35
36
36
36
99.8
99.6
100
49.7
86.5
17.9
3.5
41.2
48.5
37.9
31.8
84.9
85.6
100
1.1
9.1
3.1
0.3
38.5
48.5
4.5
2.6
100
100
100
100
100
100
100
100
100
100
100
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Annex 4a
HIV surveillance system overview: data source information
Country
EU/EEA
Austria
Belgium
Bulgaria
Cyprus
Croatia
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
HIV Data source
Type HIV
Period
Legal
Coverage
AT-HIV
BE-HIV/AIDS
BG-HIV
CY-HIV/AIDS
HR-CNIPH
CZ-HIV/AIDS
DK-HIV
EE-NAKIS
FI-NIDR
FR-HIVAIDS
DE-SURVNET@RKI7.3-HIV
EL-NOTIFIABLE_DISEASES
HU-HIV/AIDS
IS-SUBJECT_TO_REGISTRATION
IE-CIDR
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIV
HIVAIDS
HIVAIDS
HIV
HIV
HIVAIDS
HIV
HIVAIDS
HIVAIDS
HIV
HIVAIDS
1980-2014
1978-2014
1986-2014
1986-2014
1985-2014
1985-2013
1990-2014
1988-2014
1980-2014
2003-2014
1993-2014
1981-2014
1985-2014
1983-2014
1981-2014
V
V
C
C
C
C
C
C
C
C
C
C
C
C
C
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Italy
Latvia
IT-COA-ISS
LV-HIV/AIDS
HIV
HIVAIDS
2004-2014
1987-2014
C
C
Co
Co
Liechtenstein
CH-SFOPH-LI
HIV
1985-2014
V
NS/unk
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic
of Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
LT-AIDS_CENTRE
LU-HIVAIDS
MT-DISEASE_SURVEILLANCE
NL-HIV/AIDS
NO-MSIS_B
PL-HIV
PT-HIVAIDS
RO-RSS
SK-EPIS
SI-HIVAIDS
ES-HIV
SE-SmiNet
UK-HIVAIDS
HIV
HIVAIDS
HIV
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIV
HIVAIDS
HIVAIDS
1988-2014
1983-2014
1986-2014
1980-2014
1980-2014
1984-2014
1983-2014
1985-2014
1985-2014
1985-2014
2003-2014
1983-2014
1981-2014
C
V
C
V
C
C
C
C
C
C
C
C
V
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
AL-NIoPH
AD-MoHWFH
AM-NAC
AZ-AIDS-CENTER-NEW
BY-NAC
BA-FMoH-MoHSWRS
MK-NHASS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIV
HIV
1993-2014
2004-2014
1988-2014
1987-2014
1981-2014
1986-2013
1987-2014
C
V
V
V
C
C
C
Co
Co
Co
Se
Co
Co
Co
GE-IDACIRC
IL-MOH
KZ-RCfAPC
KG-HIV KG 2008
HIVAIDS
HIVAIDS
HIV
HIVAIDS
1989-2014
1981-2014
1987-2014
1987-2014
C
C
NS/unk
V
Co
Co
NS/unk
Co
Moldova
MD-NAC
HIVAIDS
1987-2014
V
Other
Montenegro
Monaco
Russia
San Marino
Serbia*
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
ME-IOPH
MC-MoSH-GEN
RU-MOH
SM-AIDS/HIV
RS-NAC
CH-FOPH
TJ-RHAC
TR-MOH
TM-NAC
UA-NAC
UZ-RAC
HIVAIDS
HIV
HIVAGGR
HIV
HIVAIDS
HIV
HIVAIDS
HIV
HIV
HIVAGGR
HIV
1989-2014
1985-2014
2010
1985-2013
1984-2014
1985-2014
1991-2014
1984-2014
1981-2012
1987-2014
1981-2010
C
C
C
C
C
C
C
C
V
V
V
Co
Co
Co
Co
Co
Co
Co
Co
Co
Other
Co
Comments
HIV record type used 1986 through 2013
HIV record type used 1990-2013
Data source EE-HIV used 1988-2012
Data source DE-HIV-Pre-IfSG used 1993-2001
Data source IE-HIV/AIDS used for for years
1981-2011
See Annex 5 about historical coverage
Same data source in HIV record type used for
1987-2013; HIVAIDS record type in 2014 only
Cases reported through Switzerland's
surveillance system using another data source
HIV record type used in years 1980-2013
HIV record type used in years 1985-2013
See Annex 5 about historical coverage
Data source SE-SweHIVReg used 1983-2009
HIV record type used 1981-2013
Did not report 2014 cases
Data source KG-RCfAPC-GE8 used for 19872007; HIV record type used for 1987-2013
Data source MD-NAC-NCfPC-GEN used 20082013; HIV record type used 1987-2013
Did not report 2014 cases
HIV aggregate record type used 1984-2001
Did not report 2013 or 2014 cases
Did not report cases 2011-2014
*
Data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of Independence),
reported through data source XK-HIV AIDS for 2014 and through data source RS-Kosova NIPH for 2000-2013. HIV record type used for all reporting years
Type: HIVAIDS (HIV and AIDS joined case-based record type); HIV (HIV case-based record type); AIDS (AIDS case-based record type); HIVAGGR (HIV aggregate record
type); AIDSAGGR (AIDS aggregate record type)
Legal: voluntary reporting (V), compulsory reporting (C ), not specified/unknown (NS/unk)
Coverage: sentinel system (Se), comprehensive (Co), not specified/unknown (NS/unk)
101
HIV/AIDS surveillance in Europe 2014
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Annex 4b
AIDS surveillance system overview: data source information
Country
EU/EEA
Austria
Belgium
Bulgaria
Cyprus
Croatia
Czech Republic
Denmark
Type
Period
Legal
Coverage
AT-AIDS
BE-HIV/AIDS
BG-AIDS
CY-HIV/AIDS
HR-CNIPH
CZ-HIV/AIDS
DK-HIV
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
AIDS
HIVAIDS
HIVAIDS
1980-2014
1978-2014
1986-2014
1986-2014
1985-2014
1985-2013
1980-2014
V
V
C
C
C
C
C
Co
Co
Co
Co
Co
Co
Co
Estonia
EE-NAKIS
AIDS
1988-2014
C
Co
Finland
France
FI-NIDR
FR-HIVAIDS; FR-AIDS
AIDS
HIVAIDS
1980-2014
2003-2014
C
C
Co
Co
Germany
Greece
Hungary
Iceland
Ireland
DE-AIDS
EL-NOTIFIABLE_DISEASES
HU-HIV/AIDS
IS-SUBJECT_TO_REGISTRATION
IE-CIDR
AIDS
HIVAIDS
HIVAIDS
AIDS
HIVAIDS
1970-2014
1981-2014
1985-2014
1983-2014
1981-2014
V
C
C
C
V
Co
Co
Co
Co
Co
Italy
Latvia
IT-COA-ISS
LV-AIDS
AIDS
HIVAIDS
1982-2014
1990-2014
C
C
Co
Co
Liechtenstein
CH-SFOPH-LI
AIDS
1985-2014
V
NS/unk
Lithuania
Luxembourg
Malta
Netherlands
Norway
LT-AIDS_CENTRE
LU-HIVAIDS
MT-DISEASE_SURVEILLANCE
NL-HIV/AIDS
NO-MSIS_B
AIDS
HIVAIDS
AIDS
HIVAIDS
HIVAIDS
1988-2014
1983-2014
1986-2014
1980-2014
1980-2014
C
V
C
V
C
Co
Co
Co
Co
Co
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of Macedonia, the
Georgia
Israel
Kazakhstan
Kyrgyzstan
PL-HIV
PT-HIVAIDS
RO-RSS
SK-EPIS
SI-HIVAIDS
ES-AIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
AIDS
UK-HIVAIDS
HIVAIDS
1984-2014
1983-2014
1985-2014
1985-2014
1985-2014
1980-2014
1983-2009
1981-2014
C
C
C
C
C
C
V
V
Co
Co
Co
Co
Co
Co
Co
Co
AL-NIoPH
AD-MoHWFH
AM-NAC
AZ-AIDS-CENTER-NEW
BY-NAC
BA-FMoH-MoHSWRS
MK-NHASS
GE-IDACIRC
IL-MOH
KZ-RCfAPC
KG-HIV KG 2008
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
AIDS
AIDS
HIVAIDS
HIVAIDS
HIVAIDS
HIVAIDS
1993-2014
2004-2014
1988-2014
1987-2014
1991-2014
1986-2013
1987-2014
1989-2014
1981-2014
1987-2014
1987-2007
C
V
V
V
C
C
C
C
C
NS
V
Co
Co
Se
Co
Co
Co
Co
Co
Co
NS
Co
Moldova
MD-NAC
HIVAIDS
1989-2014
V
Co
Montenegro
Monaco
Russia
San Marino
Serbia*
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
ME-IOPH
MC-MoSH-GEN
SM-AIDS/HIV
RS-NAC
CH-FOPH
TJ-RHAC
TR-MOH
TM-NAC
UA-NAC
UZ-RAC
HIVAIDS
HIV
1989-2014
1985-2014
2010
AIDS
1985-2013
HIVAIDS 1985-2014
AIDS
1985-2014
HIVAIDS 1991-2014
AIDS
1984-2014
AIDS
1981-2012
AIDSAGGR 1987-2014
AIDS
1981-2010
C
C
C
C
C
C
C
V
V
V
Co
Co
Co
Co
Co
Co
Co
Co
Co
Co
*
AIDS Data source
Comments
AIDS record type used 1986 through 2013
HIVAIDS from data source DK-MIS used
1980-2013
AIDS record type from data source EE-AIDS used
1988-2012
Additional data from data source FR-AIDS used
for the years 1978-2014
Data source IE-HIV/AIDS used for years
1981-2011
Same data source in HIV record type used for
1990-2013; HIVAIDS record type in 2014 only
Cases reported through Switzerland's
surveillance system using another data source
Data source NO-MSIS-A and record type AIDS
used in years 1980-2013
AIDS record type used in years 1985-2013
See Annex 5 about coverage
AIDS surveillance discontinued in 2000
AIDS record type used 1991-2013
Did not report 2014 cases
HIVAIDS record type used for AIDS only
Data source KG-RCfAPC-GEN used for 19872007; AIDS record type used for 1987-2013
Data source MD-NAC-NCfPC-GEN used 20082013; AIDS record type used 1987-2013
Has not reported AIDS cases
Did not report 2014 cases
AIDS record type used 1985-2001
Did not report 2013 or 2014 cases
Did not report cases 2011-2014
Data from Kosovo (without prejudice to positions on status, and in line with UNSCR 1244 and the ICJ Opinion on the Kosovo Declaration of Independence),
reported through data source XK-HIV AIDS for 2013 and through data source RS-Kosova NIPH for 2000-2013. AIDS record type used for all reporting years
Type: HIVAIDS (HIV and AIDS joined case-based record type); HIV (HIV case-based record type); AIDS (AIDS case-based record type); HIVAGGR (HIV aggregate record type); AIDSAGGR (AIDS aggregate record type)
Legal: voluntary reporting (V), compulsory reporting (C ), not specified/unknown (NS/unk)
Coverage: sentinel system (Se), comprehensive (Co), not specified/unknown (NS/unk)
102
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Annex 5
Country-specific comments regarding national HIV and AIDS reporting
Country
Comments
EU/EEA
Bulgaria
Case-based reporting of HIV is available from 2007 onwards.
Croatia
The data presented in Table 4 for 2014 is 80 persons for the MSM transmission route (out of total 92 HIV diagnoses for Croatia for 2014). The
reason for the discrepancy between data submitted to TESSy and national data will be investigated and duly corrected in the next reporting
round.
Czech Republic
Foreigners with short-time stays in the Czech Republic are not included in reported data.
Estonia
Surveillance system was substantially modified in 2008. Previously, the probable mode of HIV transmission was not reported by Estonia (from
2003 to 2007 Estonia supplied partial information on PWID only).
France
Case-based data reported through TESSy are not exhaustive, because of reporting delays (cases reported several months or several
years after the diagnosis) but also because of underreporting (cases that are diagnosed but never reported). The most recent estimates of
underreporting are 41% in 2007-2009 for AIDS and 29% in 2013 for HIV in France. To assess the real the number of HIV and AIDS diagnoses
in France it is essential to use adjusted data, which take into account both reporting delays (for the last two years) and underreporting (for
the whole surveillance period). Adjusting for these factors, the estimated number of new HIV diagnoses in 2013 was 6220 95%CI [5759-6682]
and estimated number of new AIDS diagnoses was 1212 95% CI [1092-1333]. The 2014 adjusted numbers of HIV and AIDS diagnoses will be
available at the end of November 2015.
Ireland
HIV was made a notifiable disease in September 2011. HIV reporting system was modified substantially in 2012. AIDS cases and deaths among
AIDS cases are now only reported if at the time of HIV diagnosis.
Italy
New HIV diagnoses were reported by 10 of the 22 Italian regions between 2004 and 2006, 11 regions in 2007, 12 regions in 2008, 18 regions in
2009, and all of the 22 regions of Italy for 2012 and 2013. Between 2004 and 2011, population denominators are based on the annual resident
population in the regions reporting cases. From 2012 the coverage of the surveillance system is national and, thus, the total Italian population
is used as a denominator. AIDS deaths for years 2011, 2012, 2013 are not reported due to lack of updated data from the national mortality
register.
Liechtenstein
Liechtenstein with only 35 000 inhabitants has small numbers of communicable diseases. Therefore public health authorities refrain
from collecting data due to limited public health added value. In 1970 Liechtenstein adopted the Swiss Law of Epidemiology. Since then all
communicable disease data are reported to the officials in Switzerland as demanded by the Federal Office of Public Health. These data are
reported through Switzerland to TESSy but may not represent all cases diagnosed in Liechtenstein.
Luxembourg
HIV tests reported up to 2010 include only tests performed at two major public laboratories and, thus, underestimate the total number of HIV
tests performed during those years. From 2011, tests reported include all laboratories in the country.
Malta
New HIV reporting system started in 2004.
Portugal
PT-HIV database is now fully case-based containing details of cases diagnosed from 1983. In 2013 and 2014, the Portuguese HIV/AIDS
Programme implemented a strategy to address underreporting and reporting delay, resulting in significant increases of the number of reported
cases diagnosed between 1983 and 2012 which are reflected in the present report.
Romania
New HIV diagnoses who have AIDS are reported only in in the AIDS database and AIDS tables. The total number of new HIV diagnoses for
Romania is a sum of the HIV and AIDS case reports for any given year. Data on AIDS deaths for 2013 are not complete and will be updated in
future reporting years.
Spain
HIV reporting has existed since the 1980s in some of the 19 Autonomous Regions of Spain. For 2003-11 data are available only for 9 Regions:
Asturias, Balearic Islands, Basque Country, Canary Islands, Catalonia, Ceuta, Extremadura, La Rioja, and Navarre; since 2004, data are
available for 10 Regions (+ Galicia); since 2007, data are available for 11 Regions (+Madrid); since 2008, data are available for 14 Regions (+
Aragón, Castilla-La Mancha and Melilla); since 2009, data are available for 17 Regions (+ Cantabria, Castilla-León and Murcia); since 2012
data are available for 18 Regions (+Valencia). Since 2013 data are available for all the 19 Regions of Spain (+ Andalucía). Rates based on the
corresponding populations for each year. AIDS reporting, 2014: for technical reasons, it has not been possible to include data from one region
in 2013 and from two regions in 2014. Rates in 2013 and 2014 are based on the corresponding population.
Sweden
Due to changes in the HIV/AIDS surveillance system, AIDS reporting has not been mandatory since 2000. Since 2008, no AIDS data are
reported from Sweden because the national AIDS surveillance system has been discontinued.
Non-EU/EEA
Andorra
New HIV reporting system started in 2004.
Belarus
AIDS deaths for 2014 only include deaths among people diagnosed with AIDS in 2014 and are likely to be an under-estimate
former Yugoslavic Republic of
Macedonia
Reported HIV cases exclude persons diagnosed with AIDS at the time of HIV diagnosis.
Serbia
Updated information from national statistics for two AIDS diagnoses was reported as date of diagnoses in 2008 instead of 2009.
Data on HIV tests refer to the number of people tested and do not include people tested in reference laboratory or private laboratories.
Turkey
Reported HIV cases exclude persons diagnosed with AIDS at the time of HIV diagnosis.
Reported AIDS cases only include people diagnosed with AIDS at the time of HIV diagnosis.
Ukraine
Ukraine data reported exclude Crimea and Sevastopol City for 2014; corresponding population denominators were used to compute rates;
Table 7: MTCT cases for 2005-2007 are calculated from best available data, data for 2008-2012 data are validated and final, and data for 2013
and 2014 are provisional and may be adjusted in the coming few years.
103
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Annex 6
HIV diagnoses and rate per 100 000 population, adjusted for reporting delay and adjustment coefficients*, EU/EEA
countries, 2011–2014
Country**
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France***
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Total EU/EEA
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslav Republic of
Macedonia
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
Total Non-EU/EEA
WHO European Region
Total West
Total Centre
Total East
Total WHO Region
2011
N
Rate
2012
N
Rate
2013
N
Rate
2014
N
Rate
2011
Adjustment coefficients*
2012
2013
2014
328
1183
201
77
54
153
266
366
172
6085
2699
953
162
23
328
3928
299
1
166
59
21
1174
269
1131
1904
784
49
55
3493
399
6305
33087
3.9
10.8
2.7
1.8
6.4
1.5
4.8
27.5
3.2
9.4
3.3
8.6
1.6
7.2
7.2
6.6
14.4
2.8
5.4
11.6
5.1
7.0
5.5
3.0
18.0
3.9
0.9
2.7
10.6
4.2
10.0
6.7
326
1229
157
74
58
212
201
315
156
6217
2978
1142
219
19
349
4333
339
0
160
63
30
1104
242
1131
1880
870
50
45
3732
396
6497
34525
3.9
11.1
2.1
1.7
6.7
2.0
3.6
23.8
2.9
9.5
3.6
10.3
2.2
5.9
7.6
7.3
16.6
0.0
5.3
12.0
7.2
6.6
4.9
3.0
17.8
4.3
0.9
2.2
9.9
4.2
10.2
6.9
266
1125
200
85
54
235
233
325
159
6220
3288
890
240
12
343
3983
340
0
177
68
36
1085
233
1158
1801
898
83
44
3866
375
6385
34207
3.1
10.1
2.7
2.0
6.2
2.2
4.2
24.6
2.9
9.5
4.0
8.1
2.4
3.6
7.5
6.7
16.8
0.0
6.0
12.7
8.5
6.5
4.6
3.0
17.2
4.5
1.5
2.1
8.3
3.9
10.0
6.7
235
1039
247
92
62
232
282
291
190
3525
785
271
13
363
3861
347
1
141
81
40
1006
308
1273
1234
791
86
54
3366
385
6509
32605
2.8
9.3
3.4
2.2
7.2
2.2
5.0
22.1
3.5
4.4
7.2
2.7
3.9
7.9
6.4
17.3
2.7
4.8
14.8
9.4
6.0
6.0
3.3
11.8
4.0
1.6
2.6
7.2
4.0
10.1
6.4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.01
0
0
0
0.06
0
0.02
0
0.01
0.13
0
0
0
0
0.02
0.02
0.03
0
0
0
0
0
0
0
0
0
0.01
0
0
0
0
0
0.01
0
0
0
0.09
0
0.04
0
0.03
0.17
0
0
0
0
0.04
0.04
0.04
0
0
0
0
0
0
0
0
0.01
0.02
0
0.03
0
0.05
0
0.02
0
0
0
0.12
0
0.07
0
0.05
0.23
0
0
0
0
0.06
0.06
0.05
0
0
0
0
0.1
0
0.1
0
0.05
0.27
0
0.1
0
0.16
0.01
0.2
0
0
0
0.18
0
0.21
0.15
0.2
0.45
0
0
0.1
0
0.1
0.43
0.09
78
2
182
548
1196
27
1
2.7
2.6
6.1
5.9
12.6
0.7
0.0
81
2
228
517
1223
25
15
2.8
2.6
7.7
5.5
12.9
0.7
0.7
119
5
238
514
1533
27
15
4.1
6.6
8.0
5.4
16.1
0.7
0.7
77
3
332
604
1811
2.7
3.9
11.0
6.3
19.1
30
1.4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
429
450
1999
614
721
0
9
8
127
559
978
654
0
17305
25887
31046
3562
24805
59413
59413
10.2
5.9
12.1
11.1
17.7
0.0
1.4
25.1
1.4
7.1
12.6
0.9
38.1
12.2
7.6
1.9
22.2
8.4
8.4
534
487
2011
701
757
0
14
5
130
621
849
1069
0
16850
26119
32549
4150
24484
61183
61183
12.9
6.3
12.0
12.4
18.6
0.0
2.2
15.0
1.4
7.7
10.7
1.4
37.2
12.2
7.9
2.2
21.8
8.5
8.5
480
473
2140
503
706
0
10
1
149
576
893
1319
17860
27561
31991
4637
25709
62337
62337
11.8
6.1
12.5
8.8
17.3
0.0
1.6
3.0
1.7
7.1
11.0
1.7
39.5
12.7
7.6
2.4
22.8
8.6
8.6
541
477
2350
651
831
0
20
3
136
541
985
1848
15796
27037
29728
5219
24683
59630
59647
13.4
6.0
13.5
11.1
20.4
0.0
3.2
8.9
1.5
6.6
11.9
2.4
36.9
12.7
7.0
2.7
22.3
8.2
8.2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.00
0.05
0.00
0.00
0.03
0.03
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.00
0.06
0.01
0.00
0.03
0.03
0
0
0
0
0
0
0
0
0
0.01
0
0
0
0
0
0
0.00
0.08
0.01
0.00
0.04
0.04
0.01
0
0
0.01
0
0
0
0
0
0.08
0.05
0
0.02
0
0
0
0.00
0.09
0.05
0.00
0.05
0.05
* The coefficients present the adjustments for the current year of reporting.
** Country-specific comments are in Annex 5. For Italy and Portugal, specific additional adjustments were applied to align with national methods.
*** French data for 2011-2013 are adjusted for both reporting delay and underreporting. These adjustments for 2014 were not available in time for full inclusion in
this report, but it is estimated that 6584 people were diagnosed with HIV in France during 2014. EU/EEA, West and Regional totals’ adjustments are calculated
104 including only reporting delay adjustments for France and, thus, may sum to more than the country total for 2014.
HIV/AIDS surveillance in Europe 2014
SURVEILLANCE REPORT
Annex 7
HIV/AIDS surveillance in Europe: participating countries and national institutions
Country
EU/EEA
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
United Kingdom
Non-EU/EEA
Albania
Andorra
Armenia
Azerbaijan
Belarus
Bosnia and Herzegovina
former Yugoslavic Republic of
Macedonia
Georgia
Israel
Kazakhstan
Kyrgyzstan
Moldova
Monaco
Montenegro
Russia
San Marino
Serbia
Switzerland
Tajikistan
Turkey
Turkmenistan
Ukraine
Uzbekistan
National institutions
Federal Ministry of Health, Family and Youth
Scientific Institute of Public Health
Ministry of Health
Croatian National Institute of Public Health
Ministry of Health
National Institute of Public Health
Statens Serum Institut
Health Board
National Public Health Institute (KTL)
Institut de veille sanitaire
Robert Koch Institute
Hellenic Center for Disease Control and Prevention
National Center for Epidemiology (Országos Epidemiológiai Központ)
Health Protection Agency Centre for Infections
Health Protection Surveillance Centre (HPSC)
Ministry of Health DG Prevention - Unit V
Centre for Disease Prevention and Control of Latvia
Principality of Liechtenstein
Center for Communicable Diseases and AIDS
National Service of Infectious Diseases, Centre Hospitalier
Department of Health Promotion and Disease Prevention
National Institute for Public Health and the Environment (RIVM)
Norwegian Institute of Public Health – Department of Infectious Disease Epidemiology
National Institute of Public Health – National Institute of Hygiene (NIZP-PZH)
National Institute of Health Dr Ricardo Jorge (Instituto Nacional de Saúde Doutor Ricardo Jorge, I.P.)
Institute of Public Health and National Institute for Infectious Diseases "Prof. Dr. Matei Bals"
Regional Public Health Authority of capital Bratislava
National Institute of Public Health
Instituto de Salud Carlos III Centro Nacional de Epidemiologia
Swedish Institute for Infectious Disease Control
Public Health England
National Institute of Public Health
Ministry of Health, Social Welfare and Family
National Center for AIDS Prevention
Azerbaijan AIDS Center
National Centre for Hygiene, Epidemiology and Public Health
Federal Ministry of Health, Republika Srpska;Serbia Institute for Public Health of Serbia
Public Health Institute
Infectious Diseases, AIDS & Clinical Immunology Research Center
Ministry of Health
National Center for the Prevention and Control of AIDS
Republic Centre for AIDS Prevention and Control
National AIDS Center; National Center for Preventative Care
Ministry of Social Health
Institute of Public Health of Montenegro
Federal Scientific and Methodological Center for Prevention and Control of AIDS
Ospedale di Stato
Institute of Public Health of Serbia
Bundesamt für Gesundheit
Republican HIV/AIDS Center
Public Health Institute of Turkey, Ministry of Health
National AIDS Prevention Center
State Institution "Ukrainian Center for Socially Dangerous Disease Control of the MOH of Ukraine"
Republican AIDS Center
105
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