World AIDS Day takes place on December 1st every year and is an opportunity to draw attention to the HIV epidemic around the world. Many people choose to organise an event on or around December 1st, to raise awareness of HIV, to remember loved ones who have died and to show solidarity with people living with HIV. For many people the day is associated with the red ribbon, an instantly recognisable symbol. For further information on World AIDS Day 2015, see the UNAIDS website.

In 2015, organisations from all over Ireland worked together to roll out a national co-ordinated campaign for five days from Friday 27th of November until World AIDS Day on the 1st of December. The focus of the Irish campaign is solidarity with all people living with HIV. The key messages of HIV Visibility, HIV Stigma, HIV Support and HIV Knowledge are being promoted through a social media campaign on Facebook and Twitter asking people to show their solidarity with people who are living with HIV. The Lord Mayors in Dublin, Cork, Limerick and Galway are supporting the campaign, and city councils and local authorities are showing their solidarity by lighting up prominent buildings in red in cities across the country. HIV organisations and sexual health services are supporting the campaign in many ways including organised events and activities that will run throughout the campaign and into December.

Latest Irish Data

To date this year, 427 new HIV diagnoses have been notified in Ireland, a significant increase on the 377 cases notified for all of 2014.¹Detailed information on all these cases is not yet available, as it takes approximately six months to have representative data on mode of transmission, CD4 count, and other epidemiological data. A final report for 2015 will be published in mid-2016. Some of this increase is due to an outbreak of HIV in people who inject drugs (PWID) in Dublin, and also a lowering of the threshold for notification of cases for surveillance.

The latest report from the Health Protection Surveillance Centre (HPSC) describing provisional data on new HIV diagnoses in Ireland in Quarter 1&2 2015² shows:

• 203 HIV diagnoses notified to HPSC in Quarter 1&2 2015, same as the number notified in Quarter 1&2 2014, but higher than in Quarter 3&4 2014.
• The majority of cases were sexually acquired; 47% among men who have sex with men (MSM), and 19% acquired heterosexually.
• Twelve percent were among PWID, the highest proportion reported since 2007. An outbreak of recently acquired HIV infection among PWID living in Dublin (18 confirmed recently acquired infections in PWID between in 2015) is contributing to the higher number of cases seen in this group.^3,4
• The probable route of transmission for 22% of cases is not yet known.
• Forty five percent were migrants (including 10% from countries with a generalised HIV epidemic), 33% were born in Ireland and 22% did not have information reported on country of birth.
• Of cases where CD4 count was known (67%), over half (53%) were diagnosed at a late stage of infection including just over a quarter (26%) who were diagnosed with advanced HIV infection. Fifteen percent of the new diagnoses had previously tested HIV positive in another country.

The full version of the Quarter 1&2 2015 report can be accessed on the HPSC website.  

A list of clinics that offer free and confidential HIV testing in Ireland is available at hivireland.ie.

Latest European Data

The latest report for 2014 from the European Centre for Disease Prevention and Control (ECDC)⁵ shows

• 29,992 persons were newly diagnosed with HIV in 2014 in the EU/EEA, a rate of 5.9 diagnoses per 100 000 population.
• Sex between men accounted (MSM) for 42% of all HIV diagnoses, 33% were attributed to heterosexual contact and 4% to injecting drug use. For 20% of new diagnoses, the transmission mode was not reported or was unknown.
• Among cases with information available on region of origin (88%), 35% were among migrants including 15% from countries with generalised HIV epidemics.
• Among those with data available on CD4 count at diagnosis, 47% had a CD4 cell count at diagnosis of less than 350 cells/µl including 27% with advanced HIV disease.

The authors conclude that HIV infection and AIDS can be eliminated in Europe, with more resolute prevention measures, early HIV diagnosis and access to effective treatment. In addition, greater investment in evidence-based HIV prevention measures is required along with greater attention to HIV testing using approaches that can reach those most at risk effectively.

More information on World AIDS Day in Europe can be found on the ECDC website.

Kate O’Donnell and Derval Igoe, HPSC

 References

1. Health Protection Surveillance Centre. Weekly HIV and STI report. Dublin: HPSC; 2015. Available here.
2. Health Protection Surveillance Centre. HIV in Ireland, Quarter 1&2 2015. Dublin: HPSC; 2015. Available here.
3. Ronan Glynn, Coralie Giese, Orla Ennis, Zorina Gibbons, Kate O’Donnell, Caroline Hurley, Mary Ward, Derval Igoe, Margaret Fitzgerald on behalf of the PWID HIV Control Group. Increases in diagnoses of recently acquired HIV in people who inject drugs. Epi-Insight. 2015; 16 (7)
4. Giese C, Igoe D, Gibbons Z, Hurley C, Stokes S, McNamara S, Ennis O, O'Donnell K, Keenan E, De Gascun C, Lyons F, Ward M, Danis K, Glynn R, Waters A, Fitzgerald M. Injection of new psychoactive substance snow blow associated with recently acquired HIV infections among homeless people who inject drugs in Dublin, Ireland. 2015. Euro Surveill. 2015; 20 (40)
5. European Centre for Disease Prevention and Control. WHO Regional Office for Europe. HIV/AIDS Surveillance in Europe 2014. Stockholm: ECDC; 2015. Available at