Most recent data, analyses and feed-back from the 2016 DRID national updates
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1 Most recent data, analyses and feed-back from the 216 DRID national updates Eleni Kalamara, Dagmar Hedrich, Linda Montanari, Isabelle Giraudon June 217, Lisbon DRID/TDI annual expert meeting DRID among PWID in Europe FONTE, WBs, EDR,SB National abstracts Latest DRID situation ECDC Experts network, literature Structure of the presentation Latest HIV situation Hepatitis C and B DRID in prisons DRID prevention 2 1
2 Newly diagnosed HIV cases related to injecting drug use EU average: 2.4 cases/million population Cases in EU HIV Risk Assessment (RA) indicators HIV-related indicators Indicators of transmission risk among PWID OST and NS coverage indicators 3 DRID situation, Baltic countries (EE) EE. SP study in Kohtla-Jarve, Prevalence Behavioural data HIV HCV HbsAg Ever HIV tested Aware of HIV status 1 Sharing NS last 4 weeks 243 No of syringes (thousands) No of new HIV cases per IDU/year
3 DRID situation, Baltic countries (LV) LV. SP study in multiple cities, Prevalence Behavioural data HIV HCV HbsAg HIV tested last 18 months Ever in prison Sharing NS last 4 weeks per IDU/year No of syringes No of new HIV cases (thousands) DRID situation, Baltic countries (LT) LT. SP study in 3 cities, 214 Prevalence HIV HCV HbsAg Injecting daily or more than daily, last 4 weeks Behavioural data Ever in prison Sharing NS last 4 weeks 7.5 OST last 4 wks No of new HIV cases % in prisons High notification rates (15 per million in 215) Low OST coverage No sufficient syringes distributed Prevention measures in prisons include only leaflets and HIV testing 6 3
4 On-going HIV epidemics/alerts (LU) LU Enhance HR (i.e NS exchange) Targeted outreach programs Epidemiological studies 361 No of syringes 287 (thousands) Cocaine High frequency New HIV cases per million pop Highly marginalised Increased proportion of drug use related prostitution 7 Other on-going HIV epidemics/ issues identified HIV outbreak in IE Number of new HIV cases among PWID, by year of diagnosis, reported in Ireland, Injecting a PVP by homeless DUs Reusing needles/syringes Having sex with PWID Source: IE WB 216, Unpublished data reported to Department of Health by National Disease Surveillance Centre and HPSC, HIV outbreak in Glasgow (47 cases in 215, evidence of recent infection in 217) Homeless. Injecting psychoactive drugs, mainly heroin. Injecting in public places, in and around Glasgow city centre. Increase in HIV new cases among PWID in Bavaria, Munich Injecting NPS, particularly synthetic cathinones/ legal highs 8 4
5 HIV situation among PWIDs in GR and RO New HIV cases per million pop, GR and RO GR: HIV incidence dropped from 7.8 to 1.7 cases per 1pyrs between 212 and 213 (1) Romania Greece EU RO: 15% of new HIV cases attributed to IDUs in 216 Late diagnosis (CD4<1 cells/mm3 in half of the HIV cases among IDUs) No of syringes distributed, GR and RO 25 Greece 2 Romania Sypsa V, Psichogiou M, Paraskevis D, Nikolopoulos G, Tsiara C, et al. (217) Rapid decline in HIV incidence among persons who inject drugs during a fast-track combination prevention program after an HIV outbreak in Athens. The Journal of Infectious Diseases doi: 1.193/infdis/jix1. 9 HCV antibody/ HBsAg among injecting drug users HCV: 24 countries with data in (13 national) Range from 16%-84% among national samples Prevalence >5% in 5 out of 13 countries with national data 3 countries with s.s increase (GR, HU, SI) between HBsAg: 16 countries with data in (7 national) Range from ~3%-11% among national samples Source: EDR
6 HCV antibody/ HBsAg among injecting drug users: Where do we get the data from? Study design: Mainly DT 13 countries with sero- prevalent studies (3 national ) Specimen: Mainly serum 18/ 24 countries serum and 5 DBS Settings: Mainly DTC (16/24) & NSP (12/24) Trends (17/24) and 7/13 SP studies Sample sizes National: (3/13 <1) Subnational: HCV RNA data: Sparse data ( 5 countries since 21) Source: EDR & SB HCV antibody/ HBsAg among injecting drug users by age group Prevalence of hepatitis C infection among injecting drug users (%) <25yrs >35yrs Sample sizes <1 are excluded 12 6
7 OR, 95% CIs 27/6/217 HCV antibody/ HBsAg among injecting drug users by years of injection Prevalence of hepatitis C infection among injecting drug users (%) <2yrs >1yrs 13 DRID in prisons DRID epidemiology in prisons Association between prior prison history and HCV infection among PWID in Europe, Not many studies (6 countries in 26/15, 3 in 216/17) HIV : % - 18% HCV: 12% - 97% Odds of infection higher in people ever in prison Interventions for infectious diseases/ other harm reduction interventions (source: Prisons WB 216, L. Montanary, Joint EMCDDA-ECDC meeting Diverse responses in place, although availability is still scarce Particularly limited availability for some harm reduction interventions 14 7
8 Harm reduction coverage Density of NS services (% of NUTS II/III with NS services) 15 Percentage of high-risk opioid users receiving opioid substitution treatment, 215 Source: EDR
9 Again, a big thanks to all of you for your input and collaboration 17 9
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