1. HIV and AIDS Epidemic Among Adolescents and Youth in Poland Social AIDS Committee

2. General Context Poland

3. Some Basic Indicators in Poland Population of Poland – ca. 38 million people Percentage of the population under 15 – ca. 17% Percentage of the population under 24 – ca. 31%* Population between 15-24 – ca. 2,7 mln. * Concise Statistical Yearbook of Poland 2009

4. HIV/AIDS in Poland 1985-30.09.2013 17 219 HIV infections (accumulated number), incl. at least 5 997 infected due to drug use 1 197 due to heterosexual contacts 1 896 MSM – 2 975 AIDS cases – 1 225 AIDS-related deaths 7004 patients on ARV treatment, incl. 118 children (on Oct. 1, 2013) Estimated – about 35 000 HIV cases www.pzh.gov.pl

5. Newly Detected HIV Cases, AIDS Diagnoses, AIDS deaths in 1986-2012 AIDS CasesAIDS Deaths New HIV Cases Newly Detected HIV Cases AIDS Cases and Deaths www.pzh.gov.pl

6. Newly Detected HIV Cases in 2008-2012 per 100 000 Population www.pzh.gov.pl

7. AIDS cases in 2008-2012 per 100 000 population www.pzh.gov.pl

8. * Dane do października 2011 roku All newly identified HIV cases, including data reported by VCT centers in 2011 VCT NIH

9. HIV Cases by Route of Infection (1985-2012) MSM Risky Heterosexual Contacts No Information IDU Children Born by HIV+ Mothers IDU Iatrogenic infections www.pzh.gov.pl

10. Routes of Transmission in Case of VCT Center Clients in 2011 other no data

11. Na podstawie raportu z analizy ankiet przeprowadzonych w PKD w 2010 roku Sex of HIV-infected clients Sex of all VCT Center clients No data 0,7% Men Women Women Men Based on the analysis of data from questionnaires provided by VCT centers in 2010

12. Age of all VCT Center clients Age of HIV-infected clients

13. N=333 % of HIV+ cases among VCT Center clients (2006-2011) % of HIV+ among MSM population % of HIV+ among IDU population HIV test + result HIV test - result HIV test + result HIV test - result HIV test + result HIV test - result

14. HIV/AIDS Among Young People 48% of HIV-infected people are younger than 29 years, and out this group, 8% at the moment of infection were younger than 20 years of age More people infect themselves through risky sexual intercourse, often combined with the use of psychoactive substances 16,8% of girls and 27,3% of boys before turning 15 years old have already had their first sexual contact, what brings a risk of HIV transmission Another important risky behavior in this population is body piercing done with unsterile equipment

15. HCV Cases in Poland Estimated number of HCV infections - 730 000 In 2010 in Poland 2021 hepatitis C cases were registered (incidence 5.29 per 100,000) 15-34 age group make ca. 28% of newly detected cases Laskus I., Rosińska M. Wirusowe zapalenie wątroby typu C w Polsce w 2007 roku. Przegl Epidemiol 2009; 63: 251 – 254]

16. Hepatitis C in Poland 2010. Number of cases, incidence per 100 00 population and percentage by age, sex and location (urban vs. rural) Age group GenderAreaTOTAL malefemaleurbanrural IN.PR%IN.PR%IN.PR%IN.PR%IN.PR% 15- 19 493,884,4332,733,7483,533,1343,057,1823,324,1 20- 24 785,276,9513,585,7885,185,7413,48,51294,446,4 25- 29 1207,210,7603,716,71457,149,4352,797,31805,488,9 30- 34 1177,5610,4543,5861437,299,3282,555,81715,598,5 Total 11236,091008984,5510015396,611004823,2310020215,29100 http://www.pzh.gov.pl/przeglad_epimed/66-1/Przeg%20Epidem%202-2012.pdf

17. TB in Poland 7509 TB cases were reported in Poland in 2010 The incidence rate was 19,7 cases per 100000 The mean annual decrease of TB incidence in 2001 - 2010 was 2,9% The mean age of TB patients was 52,7 years. The incidence among men i.e. 28.0 was more than two times higher than among women i.e. 11.9 TB was initial AIDS indicative disease in 24 cases http://www.pzh.gov.pl/przeglad_epimed/66-1/Przeg%20Epidem%202-2012.pdf

18. TB Summary In Poland in the last decade the incidence of tuberculosis has decreased by nearly 30% but is higher than the average in EU countries. In 2010 the highest incidence occurred in older age groups and was higher in men. Positive characteristic also when compared with the situation in many EU countries is the low incidence of tuberculosis in children and the low percentage of patients with drug resistant tuberculosis. http://www.pzh.gov.pl/przeglad_epimed/66-1/Przeg%20Epidem%202-2012.pdf

19. Drug situation in Poland - THC 17,3 % people between 16 – 64 years old use marijuana at least one time in last 12 months 23% young people between 15-16 years old Social study - ESPAD 2012 shows that: – 24,3 % youth between 13 – 16 y.o. use marijuana and hashish – 37,3 % adolescents between 16 – 19 y.o. use marijuana and hashis – In last 12 months using in the group were at level 10,1% and 23,5 %.

20. Report made by govermental Supreme Audit Office shows that 31% of people between 13 – 19 y.o. witnessed how others used some psychoactive substance.

21. Drug situation in Poland EMCDDA 2012 EMCDDA study shows that: -3% people between 15-16 y.o. used cocaine in last 12 months at least one time -4% people between 15-16 y.o. used amphetamine in last 12 months at least one time -2% people between 15-16 y.o. used MDMA in last 12 months at least one time -23 % people between 15-16 y.o. used THC in last 12 months at least one time

22. Narcotic scene in Poland - last 2 years Many young people between 14-21 y.o. use in Poland: – Legal highs (alfa PVP, MDPV, 3MMC, 2CE2CX) – GHB/GBL – Non prescription drugs with DXM, codeine, benzydamine, – Synthetic cannabinoid – JWH 018,etc. – Mephedrone (4MMC) – other methcathinons (ephedrine, etc), beta ketones (penthedron, other euphorics). data from Drug Users Clinic MONAR