HIV Expert Group Work plan for 2009 Canada/Outi Karvonen and Pauli Leinikki, 2008 HIV Expert Group Work plan for 2009 Pauli Leinikki, Outi Karvonen Nov 19 2008

North-West Region of Russia Canada/Outi Karvonen and Pauli Leinikki, 2008 165,6 7,2 49,9 65,6 19,2 667,5 451,9 72,2 402,2 95,9 30,5 Prevalence per 100 thousands

Canada/Outi Karvonen and Pauli Leinikki, 2008 Reported cases of HIV infection Nordic countries 1990-2007- no of cases

HIV and AIDS in Poland 11 392 people living with HIV and AIDS* Canada/Outi Karvonen and Pauli Leinikki, 2008 HIV and AIDS in Poland *as from the beginning of the epidemic in 1985 till the end of February 2008* Epidemiological data: National Institute of Public Health - National Institute of Hygiene 11 392 people living with HIV and AIDS* Not less than 5 443 infected due to IDU (47,7%)* 2 050 AIDS cases * 912 cases of deaths due to HIV and AIDS* 25-35 000 estimated number of people living with HIV and AIDS (23% are women) 550 – 750 new HIV infections detected every year 716 HIV infections newly detected in 2007 3 382 patients receive ARV treatment

Main concerns: Incidence of HIV still very high in Estonia Canada/Outi Karvonen and Pauli Leinikki, 2008 Main concerns: Incidence of HIV still very high in Estonia HIV/TB coinfections increasing alarmingly in St Petersburg (10-fold increase in 7 years, drug resistance very common) Drug injection continues to be the most common risk factor in many of the countries Indirect indications exist that HIV among MSM may be a hidden time bomb

HIV/TB coinfections in St. Petersburg Canada/Outi Karvonen and Pauli Leinikki, 2008 HIV/TB coinfections in St. Petersburg (O. Panteleeva, St.P AIDS center, Nov 2008) HIV incidence ~70, stabile TB incidence ~22, stabile but: Coinfections are becoming common: Every 7th new TB case is HIV-infected TB is seen in more than 50% of AIDS deaths

TB/HIV coinfections: specific problems Canada/Outi Karvonen and Pauli Leinikki, 2008 TB/HIV coinfections: specific problems Individuals in risk hard to reach, cases hard to find Diagnosis is difficult (atypical presentations) Newly detected cases often very contagious These patients often loaded with other concomitant and opportunistic infections

TB/HIV coinfections: risks Canada/Outi Karvonen and Pauli Leinikki, 2008 TB/HIV coinfections: risks Spread of TB (to the general population also!) Spread of drug-resistant forms of TB Increase of fear and discrimination – new wave of HIV spread

NDPHS EG Activities/Fields Canada/Outi Karvonen and Pauli Leinikki, 2008 NDPHS EG Activities/Fields Estonia/Russia: promotion of a special project HIV/TB coinfection: New projects, thematic report Drug injection as a risk factor: Expansion and development of low-treshold and outreach services MSM: thematic report, common projects to map the risk factors Common standing in post-exposure prophylaxis – thematic report?

NDPHS EG Activities/Actions Canada/Outi Karvonen and Pauli Leinikki, 2008 NDPHS EG Activities/Actions Two EG meetings are scheduled: spring meeting in Canada, autumn meeting in Poland Involvement into international meetings (Vilnius, May, HIV Think-Tank x 2, etc)

NDPHS EG Activities/Actions Canada/Outi Karvonen and Pauli Leinikki, 2008 NDPHS EG Activities/Actions Barents project will continue and expand Several other projects are ongoing/will be launched Collaboration with other EG:s to develop projects (PH,PHC) Updating and new sections into the thematic report

Canada/Outi Karvonen and Pauli Leinikki, 2008