1. Rights of PLWHA in Hungary Application of Patients’ Rights in Cross-Border Health Care Regional meeting and workshop by Ferenc Bagyinszky Hungarian Civil Liberties Union Application of Patients’ Rights in Cross-Border Health Care Regional meeting and workshop

2. HIV-prevalence in Hungary:  number of registered PLWH: 1,583 (184 unknown)  number of PLWA: 567  number of AIDS-deaths: 293  HIV-prevalence: < 0,1%

3. MSM-driven epidemic  PLWH: 805  PLWA: 380  AIDS-deaths: 214  MSM-population: 500,000  HIV-prevalence in MSM-population: 0,16%  share of MSM among PLWH: 68%

4. MSM-targeted prevention  2 organizations in this field  targeted VCT  information booklet  HIV telephone helpline

5. Estimated figures  Total number of PLWH: 8,000-10,000  Hungarian HIV-prevalence: 0,1%  Total number of PLWH in MSM- population: 7,000  Hungarian HIV-prevalence in MSM- population: 1,4%

6. IDU-targeted prevention  22 HIV-cases (19 foreign citizens)  Hepatitis C prevalence: 25%(!)  targeted VCTs  27 needle exchange programs by 15 NGOs over 2,000 IDUs reached over 2,000 IDUs reached over 213,000 needles handed out over 213,000 needles handed out

7. Anonymous VCT services  Act CLIV/1997 on Health Care (Health Care Act) Paragraph 59, section (5) ensures anonymity at any stage of testing asked by the patient  7 testing facilities in Budapest  15 testing facilities in the country  STI centres  problems in practice

8. Care of PLWHA  1 care centre in Budapest: Szent László Hospital Immunology Department  3 HIV-specialists  880 patients on outpatient care  503 on ART

9. Outpatient care  every 3 months visit to the hospital  blood test: cd4 cells, viral load (only every 6 months), general laboratory tests (blood- sugar, enzymes, cholesterol etc)  Visit to the doctor  Prescription of medication for 3 months

10. Guidelines for ART  AIDS is defined by the appearance of the first opportunistic infection and/or tumour  ART is usually started when cd4 count drops under 250 and/or first opportunistic infections and/or tumours appear

11. National Health Insurance  All examinations and hospital stay are covered  ART is covered by the NHI  HUF300 (cca.1euro) charged for each container prescribed

12. Medical data  Act CLIV/1997 on the Handling and Protecting Medical and Personal Data and Ministry of Health Decree 18/2002 Paragraph 6, section (1) regulate the registry and report of new HIV/AIDS cases in Hungary

13. Anonymous HIV register and reporting  New HIV/AIDS-cases are reported without personal identifiers for the National Centre of Epidemiology  Blood samples for cd4/viral load are sent to the laboratory without personal identifiers

14. Problems of PLWHA  Discrimination: Health care Health care When to disclose your statusWhen to disclose your status Refusal of treatment by doctors (esp. dental care, and other invasive care)Refusal of treatment by doctors (esp. dental care, and other invasive care) Work, education and other fields of social life Work, education and other fields of social life