No 47/48 - 2021

World AIDS Day 2021

1 December is the 33rd World Aids Day. On this day, organisations, associations and individuals across the world will mark World AIDS Day (WAD).

As for nearly everything else, the COVID-19 pandemic has had a negative impact on the fight against HIV in the course of 2021 as well. And, as is the case in so many other contexts, those with fewest resources suffer the most.

Denmark has a strong healthcare sector that remains capable of providing optimal treatment for HIV-positive people despite the considerable pressure caused by COVID-19.

This is not the case in poorer countries around the world. Thus, in various countries, a multitude of challenges make it impossible to diagnose and treat HIV as otherwise routinely done. These challenges include reorganisation of healthcare workforces, closure of specialised clinics, social lockdowns and ensuing limitations on free movement, lack of public transport, unstable supply lines, reorganisation of funds and re-allocation of funding, etc.

In Denmark, the positive trend continues towards fewer new HIV diagnoses. Thus, in 2020, a total of 110 newly diagnosed HIV infectees were notified in Denmark; the lowest number recorded since the HIV pandemic started. For more information, please read below and the 2020 annual HIV report.

There are three important reasons why you should be tested for HIV if you belong to a risk group, e.g., MSM:

1. The sooner you are diagnosed, the sooner you can start receiving effective treatment, thereby ensuring that your immune system is not damaged.
2. If you are HIV positive and well treated, you do not transmit the condition to other people.
3. If you are an HIV-negative MSM, you can be offered preventive HIV treatment, PrEP (Pre-Exposure Prophylaxis), which is currently the most effective prevention against HIV infection.

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

HIV 2020

2020 saw a total of 164 notified cases of HIV, including 134 men and 30 women. Among these 164 notified cases, 54 persons (33%) had previously been diagnosed with HIV abroad, including eight persons born in Denmark.

For a detailed epidemiological description of the 2020 incidence, please see the 2020 annual HIV report.

Reflects a decline in test activity due to COVID-19

An 8% decline in the number of HIV tests was observed from 2019 to 2020. Even so, the decrease in the total number of HIV notifications and the number of newly diagnosed patients is larger than the test decline; 14% and 24%, respectively, from 2019 to 2020. This indicates that the decline in the number of new HIV diagnoses is real. This is underpinned by the fact that both the number of notified cases of syphilis and the number of notified and laboratory-registered cases of gonorrhoea have increased from 2019 to 2020, because it is assumed that tests for sexually transmitted conditions share largely the same cadence (syphilis and HIV, in particular).

Furthermore, is seems reasonable to assume that both the decline observed for HIV and the increase seen for syphilis and gonorrhoea among MDM are linked to the introduction of PrEP in Denmark, meaning that the use of PrEP produces a decline in the prevalence of HIV. Conversely, the increased syphilis and gonorrhoea testing activity, which is a prerequisite to dispensing PrEP, may indicate that the occurrence of these condition is more prevalent in MSM. Additionally, PrEP may theoretically give rise to an increased occurrence of syphilis, gonorrhoea, etc. due a declining use of condoms.

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

1 December 2021