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La situation épidémiologique du VIH/sida en
Europe mise à jour au 31 décembre 2002
Françoise Hamers EuroHIV Institut de Veille
Sanitaire, France
XVèmes Assises 1er Congrès de AIDES Parlement
Européen Strasbourg, 20-22 juin 2003
Centre Collaborateur de lOMS
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Adults and children estimated to be living with
HIV/AIDS at end 2002
Eastern Europe Central Asia 1.2 million
Western Europe 570 000
North America 980 000
East Asia Pacific 1.2 million
North Africa Middle East 550 000
South South-East Asia 6 million
Caribbean 440 000
Sub-Saharan Africa 29.4 million
Latin America 1.5 million
Australia New Zealand 15 000
Total 42 million
World Health Organization
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Definition of geographic areas West, Centre,
East used in this presentation (population in
million)
East (289)
West (398)
Centre (189)
EuroHIV
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HIV infections
newly diagnosed per million
population, by year of report (1994-2002) and
geographic area, WHO European Region
Cases
per million
350
300
250
200
150
100
50
0
Update at 31 December 2002
1994
1995
1996
1997
1998
1999
2000
2001
2002
Year of report
EuroHIV
Austria, Belgium, France, Italy, Netherlands,
Portugal, Spain excluded national data not
available for the whole period
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AIDS
incidence per million population, by
geographic area, 1986-2002, WHO European Region
Cases per
million
60
40
20
0
Update at 31 December 2002
1986
1988
1990
1992
1994
1996
1998
2000
2002
Year of diagnosis
EuroHIV
Data adjusted for reporting delays
Excluding Netherlands (West), Kazakhstan,
Kyrgyzstan, Russian Federation (East) data not
available for the whole period
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HIV infections
newly diagnosed in
adults/adolescents by transmission group
1997-2002, western Europe
Cases
5000
4500
4000
3500
3000
2500
2000
1500
1000
500
Update at 31 December 2002
0
1997
1998
1999
2000
2001
2002
Year of report
EuroHIV

Denmark, Finland, Germany, Greece, Iceland,
Luxembourg, Norway, Sweden, Switzerland, United
Kingdom
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HIV infections
newly diagnosed
per million population, 1994-2002
selected countries, western Europe
Cases
per million
250
200
150
100
50
Update at 31 December 2002
0
1994
1995
1996
1997
1998
1999
2000
2001
2002
Year of report
EuroHIV
Data not available for some of the most
severely affected countries France, Italy, Spain

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Percentage of cases originating from a country
with a generalised epidemic among new HIV
diagnoses reported in 2002 in heterosexually
infected persons, western Europe
Update at 31 December 2002
EuroHIV
HIV prevalence consistently gt1 in pregnant
women mostly sub-Saharan Africa
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AIDS cases and deaths, 1986-2002
western Europe
Number
25 000
20 000
15 000

10 000
5 000
0
Update at 31 December 2002
1986
1988
1990
1992
1994
1996
1998
2000
2002
Year
EuroHIV
AIDS cases by year of diagnosis, AIDS deaths by
year of death
Data adjusted for reporting delays
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Heroin Trafficking and Changes in Heroin Abuse
1996-2000
Source United Nations Office for Drug Control
and Crime Prevention, Global Illicit Drug Trends
2002
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Incidence of SyphilisWHO EURO Region
2000/2001Rate per 100,000 population
Source WHO Office for Europe
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HIV infections
newly diagnosed in
adults/adolescents by transmission group,
1994-2002, eastern Europe
Cases
50000
40000
30000
20000
10000
Update at 31 December 2002
0
1994
1995
1996
1997
1998
1999
2000
2001
2002
Year of report
EuroHIV

78 and 20 of cases reported by Russian
Federation and Ukraine respectively
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HIV infections
newly diagnosed
per million population, 1994-2002,
selected countries, eastern Europe
Cases
per million
1000
800
Estonia
600
400
Russian Federation
Latvia
200
Lithuania
Belarus
Update at 31 December 2002
0
1994
1995
1996
1997
1998
1999
2000
2001
2002
Year of report
EuroHIV
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AIDS
cases per million population
in selected countries, 1988-2002, eastern Europe
Cases per
Ukraine
million
25
Latvia
20
15
Georgia
10
5
Lithuania
Belarus
Update at 31 December 2002
0
1988
1990
1992
1994
1996
1998
2000
2002
Year of diagnosis
EuroHIV
Data adjusted for reporting delays
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Percentage of AIDS cases reported with
Tuberculosis (TB) as initial Opportunistic
Illness by Transmission Group, Western, Central
and Eastern Europe, and Central Asia
Eastern Europe Central Asia
Initial opportunistic illness
Western Europe
Central Europe
Pulmonary TB
Extra-pulmonary TB
IDU injecting drug user HC heterosexual
contact MSM men having sex with men
Update at 31 December 2001
EuroHIV
Cases diagnosed in 1994-2001
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Access to Combination Antiretroviral Treatment,
Europe, March 2003
good access (over 70)
partial access (10-70)
individuals on HAART
poor access ( lt10)
no access to HAART
Source WHO Office for Europe
24
HIV Infection among Street Drug Users,
Saint-Petersburg, 1999-2001
Source T. Smolskaya, North-West District AIDS
Centre of the Russian Federation Ministry of
Public Health
25
HIV Infection among Sex Workers, Eastern
European Cities
Source Momot, Ostrovski, Salamov, Selakova,
Grigorian, European HIV Prevalence Database
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HIV Infection among Prisoners Number and
HIV-Infected Prisoners, Russia, 1998-2001
10000
2.5
2
7500
1.5
Number HIV
HIV
5000
1
2500
0.5
0
0
1998
1999
2000
2001
Number HIV
HIV
Source Russian Federal AIDS Centre, Moscow
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Have heard of HIV/AIDS of adolescent girls (age
15-19) that ever heard of HIV/AIDS, various
countries in CEE/CIS
Moldova
Ukraine
Bosnia Herzegovina
Moldova
Kazakhstan
Albania
Yugoslavia (FR)
Georgia
Turkey
Uzbekistan
Azerbaijan
Tajikistan
0
20
40
60
80
100

World Health Organization
Source MICS, DHS, RHS
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Ouest épidémie mature et concentrée
Les migrants originaires de pays où lépidémie
est généralisée influence de plus en plus la
situation du VIH en Europe de lOuest Lincidence
du a cessé de diminuer, la mortalité continue à
baisser, la prévalence du VIH augmente
Recrudescence des comportements à risque chez
les homo/bisexuels masculins
EuroHIV
Prévalence du VIH gt 5 dans au moins une
sous-population et lt1 chez les femmes enceintes
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Centre épidémie peu active

• Globalement, épidémie peu active mais...
• Roumanie nombre important de jeunes adolescents
  contaminés vers 1990 et potentiellement à risque
  de transmettre linfection
• Facteurs de risque pour une diffusion du VIH
  présents

EuroHIV
HIV prevalence non gt5 dans aucune
sous-population
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Est épidémie récente et concentrée

• Epidémie sévère chez les UDI
• Émergence dune épidémie à transmission sexuelle
• Incertitude sur létendue de lépidémie chez les
  homo/bisexuels masculins (HBM)
• Dans un future proche sévère épidémie de sida
  et influence négative sur lépidémie de
  tuberculose

EuroHIV
Prévalence du VIH gt 5 dans au moins une
sous-population et lt1 chez les femmes enceintes