Health Protection Surveillance Centre HIV in Ireland: Latest Trends November 2018 Health Protection Surveillance Centre

Summary Diagnoses and Rates (slides 4-10) The HIV diagnosis rate in Ireland between 2015 and 2017 has remained relatively stable. Between 2014 and 2015, there was a large increase (30%) followed by a small increase (5%) between 2015 and 2016 and a slight decrease (2%) between 2016 and 2017. The rate among males decreased slightly in 2017 while the rate among females remained stable In males, the rate among those aged 25-29 years increased in 2017 while in females the rate increased among those aged 40-44 years. The highest rate between 2015 and 2017 was in HSE East. Diagnoses among those previously positive remained stable in 2017, accounting for 39% of diagnoses Excluding those with a previous positive HIV diagnosis, there was a 4% decrease in the number of diagnoses in 2017

Summary Probable route of transmission (slides 11-16) Diagnoses among men who have sex with men (MSM) decreased slightly in 2017. Diagnoses among heterosexuals increased between 2015 and 2017 having remained stable between 2010 and 2015. The increase is higher among those with a history of being previously HIV positive abroad. Since 2009, there have been less than 30 diagnoses per year among people who inject drugs (PWID), apart from in 2015 (n=49) when there was an outbreak of HIV among homeless PWID living in Dublin. Region of Birth (slides 17-18) Since 2003, the number of HIV diagnoses among those who were born in Ireland has been less than among those born abroad. The rate of HIV diagnosis among those born in Ireland has remained stable since 2003 while the rate among those born abroad has increased from 18 per 100,000 in 2011 to 38 per 100,000 in 2016 and 2017.

HIV diagnoses and rates

HIV diagnoses by history of previous diagnosis abroad

Rates of HIV diagnosis by sex

Rates of HIV diagnosis by age group

Rates of HIV diagnosis by age group in males

Rates of HIV diagnosis by age group in females

HIV notification rates by HSE Area

HIV diagnoses by route of transmission

HIV diagnoses by history of previous diagnosis abroad and route of transmission

HIV diagnoses among MSM by geographic origin

HIV diagnoses among heterosexuals by sex

HIV diagnoses among heterosexuals by geographic origin

HIV diagnoses among people who inject drugs by sex

HIV diagnoses by region of birth

Rates of HIV diagnosis by region of birth

Explanatory Notes Data for this report were extracted from CIDR on 9th October 2018 and were correct at the time of publication. It is important to note that - the HIV surveillance system captures new diagnoses of HIV infection and therefore does not measure incidence. - persons newly diagnosed in Ireland may have been previously diagnosed with HIV in another country and are included in surveillance figures at first confirmatory test in Ireland. - data are presented by date of notification on CIDR (Computerised Infectious Disease Reporting) system 18

Further Information A detailed annual report on HIV in 2017 is available at http://www.hpsc.ie/a-z/hivstis/hivandaids/hivdataandreports/ Trend slides on HIV among MSM are available at http://www.hpsc.ie/a-z/hivstis/sexuallytransmittedinfections/dataonhivandstisamongmenwhohavesexwithmenmsm/ Weekly HIV and STI reports are available at http://www.hpsc.ie/notifiablediseases/weeklyidreports/ 19

Acknowledgements In order to accurately track the HIV epidemic in Ireland and to assess the impact of HIV prevention programmes, it is essential to have good quality surveillance data. The production of this annual report is the result of a huge amount of work carried out by many people in collecting and collating the data. We would like to sincerely thank all of the data providers and all who have contributed to this report including: National Virus Reference Laboratory (NVRL) Microbiology laboratories Departments of Public Health Consultants in Infectious Disease/Genitourinary Medicine Infectious Disease Unit, Our Lady’s Hospital for Children (OLHC), Crumlin for paediatric data GPs HIV clinical nurse specialists Health Advisors All other clinical staff involved.