Week 48, 2018

World AIDS Day 2018

Saturday 1 December will see the 30th World AIDS Day. This year, the international theme is “Know your HIV status”. Statens Serum Institut believes that more people should get tested and diagnosed far earlier than now so that they can start timely treatment.

This Saturday will bring a worldwide focus on HIV and AIDS. This is so because 1 December will see the 30th World AIDS Day - this year with the theme “Know your HIV status”.

For a number of years, HIV medication has evolved rapidly. Therefore, people who have HIV can now live just as long as everyone else - if they get treatment, that is.

Thus, the problem in the Western world and in many other areas is no longer getting access to HIV treatment. Rather, the main problem is that too many people are unaware that they are HIV positive. They quite simply have not taken an HIV test.

Only people who are aware that they are HIV positive can receive a treatment offer and thereby be protected against the continued deterioration of the immune system that the HIV virus causes if it goes untreated.

In addition to preventing the HIV virus from damaging the HIV-positive person’s immune system, the medicine also reduces the amount of virus in the blood to a level so low that it is not possible to infect your sex partner with HIV.

If you know or believe that you are at risk of having become infected with HIV, you need to see your doctor, a clinic for sexually transmittable diseases or one of the free Check Points in Copenhagen, Odense and Aarhus. Here, you can be tested without having an appointment, and you can have your test result straight away.

Today, the infectious disease departments of most hospitals offer the same type of rapid testing as the Check Points. Furthermore, if you are HIV positive, you will be offered treatment immediately, regardless of whether you have a full-functioning or deteriorated immune system. Therefore, getting tested is the key to a healthier life and also provides certainty that you cannot pass on HIV to other people.

Even so, nearly half of those who are diagnosed with HIV in Denmark are not tested until they have had HIV for many years, at a point when their immune system has become damaged. Shame and stigma are important in this context, just as it is important that the message that well-treated HIV is not infectious has not gained a very strong foothold. Many people simply do not believe that this is true. Furthermore, the tenaciousness of the absolutely out-dated perception of HIV as a disease that causes weakened health and premature death also plays a part. Fortunately, these consequences are a thing of the past provided you receive treatment.

Therefore, the Danish AIDS Foundation has chosen to focus on knowledge in their World AIDS Day campaign, both with respect to a more up-to-date perception of life with HIV and to get the message out that well-treated HIV is not infectious. We hope that the stigma that enshrouds HIV may be reduced, not least if the target groups understand that a HIV-positive person who is in treatment cannot pass on HIV to anyone else Therefore, the first step is to get HIV tested if you belong to a group that is at a special risk of HIV, and/or if you believe that you may have become infected.

Not everyone needs to be tested equally often, though. Immigrants coming to Denmark from countries with a high HIV incidence also have a comparatively high risk of having HIV when they arrive in Denmark. Therefore, they should be offered an HIV test when arriving to Denmark. The national monitoring of HIV in Denmark shows that immigrants from areas with a high HIV incidence do not have a very high risk of becoming infected with HIV in Denmark. Similarly, heterosexual immigrants only rarely pass on their infection to Danes. For this group, testing is therefore important when they arrive, but not particularly often after that.

Men who have sex with men (MSM) is the group that most frequently becomes infected by HIV in Denmark. This applies whether they were born in Denmark or abroad. Therefore, MSM should be tested for HIV at least once annually.

Studies from other countries have shown that MSM who lead a very active sex life with several concurrent and/or shifting partners and who do not consistently use condoms should be tested more often than the rest of MSMs. If you get tested for HIV and the other sexually transmittable diseases, e.g. every third month, the risk of passing on the infection is substantially reduced, and infection chains can be broken.

The international MSM dating app, Grindr, offers its users a notification that they can turn on in the app. Those who do are then reminded that they should get an HIV test, e.g. every third or sixth month.

If you test negative, the app can also remind you to get PrEP (Pre Exposure Prophylaxis, HIV medicine taken preventively, before exposure). PrEP is currently available only on a trial basis in Denmark. Nevertheless, PrEP is expected to become available to anyone who is at special risk of becoming infected with HIV.

Who must be offered HIV testing?

Doctors should offer testing to the following three groups, in particular, even if the person in question fails to bring up HIV testing him- or herself.

• Men who have sex with men should be tested at least once annually, and more frequently if they have condom-free sex.
• Immigrants from Sub-Saharan Africa, Asia and Eastern Europe should be tested upon arrival or the first time they come into contact with Danish healthcare, regardless of the cause for such contact.
• Finally, patients who present with unexplainable symptoms or with signal conditions should also undergo HIV testing.

Additionally, all pregnant women are automatically offered an HIV test when they attend their first pregnancy check-up with their GP.

Facts about HIV and AIDS worldwide

• 37 million people live with HIV worldwide.
• 1.8 million people became infected with AIDS in 2017.
• Nearly 1 million people died from AIDS in 2014.
• Worldwide, approximately half of those who have HIV are unaware that they have become infected.
• 22 million HIV-infected people are being treated with HIV medicine worldwide.
• Since 2010, AIDS-related mortality has declined by 34%, thanks to effective medication.
• In Sub-Saharan Africa, Latin America, the Caribbean and South-East Asia, the number of new HIV infections is declining.
• In Eastern Europe and Central Asia and also in the Middle East and in North Africa, the number of new HIV infections is increasing.

(source: http://www.unaids.org/sites/default/files/media_asset/unaids-data-2018_en.pdf)

(S. Cowan, Department of Infectious Disease Epidemiology and Prevention)

PLEASE NOTE - This weekend, the SSI will launch its new website

In the weekend of 1-2 December, the SSI launches a new website. Therefore, it will not be possible to order goods from Friday 30 November at 12.00 a.m. to Sunday 2 December at 12.00 a.m.

Thereafter, we will once again be taking orders from the menu item “Products and Services - Orders”.

We will provide a more detailed description of the new website in a news article on www.ssi.dk once the site is launched. Feel free to visit the new site and learn more about all that is new.

(The Communication Section)