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  • Liebe Kolleginnen und Kollegen Ich freue mich sehr Ihnen heute die Arbeit des Fachgebiet 34, HIV/AIDS und andere sexuell oder durch Blut übertragbare Infektionen vorstellen zu können

Wesat2104 Wesat2104 Presentation Transcript

  • HIV and Co-infections in Germany Strategies for Prevention Osamah Hamouda Robert Koch-Institute, Berlin, Germany Dept. Infectious Disease Epidemiology www.rki.de
  • Robert Koch-Institut, Berlin
  • Germany
    • Population: 82 Million (235/km2)
    • Federal Republic with 16 States
    • 450 Counties (pop.: 35 000 - 1.7 Million)
    • 1 local health department per county
    • Mainly private health care providers
    • Health services reimbursed by health insurance system
  • HIV Epidemic in Germany
    • 3,000 new HIV-Infections in 2007
    • 650 HIV/AIDS related deaths
    • 60,000 Estimated HIV prevalence
    • 80% male
    • 70% MSM
  • Estimated HIV/AIDS Incidence, Prevalence and Deaths in Germany, End 2007 (modell)
  • HIV and Co-infection in Germany
    • Hepatitis B
    • Hepatitis C
    • TB
    • STIs
      • Syphilis
  • 72,2 % 3,9% 0 10 20 30 40 50 60 70 80 90 100 antiHBc (n=72/81) antiHCV (n=/113) Percentage Source: RKI: KABaSTI 2007/8 Hepatitis Co-Infections among HIV-positive MSM KABaSTI survey participants
  • % Co-infection /risk factors among TB patients DZK Study 2002-2004 (n=2,364)
  • Newly diagnosed HIV-infections in Germany (02/2008) by transmission group and year of diagnosis
  • HIV Incidence Pilot Study in Berlin, 2005 - 2007: Recency of HIV Infections by Age Groups in MSM Level of significance, Pearson Chi²-Test: p=0.01 0,0 10,0 20,0 30,0 40,0 50,0 60,0 70,0 20 - 29 30 - 44 >44 Age Groups (years) Proportions crude and adjsuted (%) crude proportion of recent infections adjusted proportion of recent infections
  • Behaviour Trends: Number of sexual partners based on MSM aged 25 years or older, living in cities with more than 500,000 inhabitants Source: Axel J. Schmidt, Stefanie Grote, Michael Bochow: Results of a Follow Up Survey on HIV Risk Reduction & Risk-Taking Among Men Who Have Sex with Men in Germany EACS 2007 P 16.2 / 02
  • Syphilis and HIV co-epidemics in MSM in Germany HIV incidence 1985-2007 estimated based on back-calculation and newly diagnosed infections; Syphilis incidence 1985-2000 estimated, 2001-2007 reported
  • Newly diagnosed Syphilis in men by agegroup, 1997-2006
  • Newly diagnosed HIV-infections in men by agegroup, 1999-2006
  • Syphilis – HIV overlap in MSM in Germany
    • Approximately 50% of syphilis cases among MSM currently in HIV+ MSM
    • Self-reported incident syphilis in previous year (2005/06) in
      • 3% of HIV-
      • 15% of HIV+/ART+
      • 19% of HIV+/ART-
  • Incidence of bacterial STIs (previous 12 months) *genital manifestation only 33,6 45,7 8,6 0 5 10 15 20 25 30 35 40 45 50 HIV+/HAART + (n=280) HIV+/HAART- (n=173) HIV- (n=2110) % any bacterial STI
  • HIV/STI-Coinfection in Germany Strategies for prevention Action Plan 2007-2010
  • Future plans
    • Safe Environment Prevention in MSM bars and clubs
    • Expand HIV-testing, VCT, rapid tests, Street workers
    • Prevention campaign aiming at behaviourial change towards a respectful and responsible sexual life
    • To strengthen the knowledge on STI among patients and practitioners
    • Establishing routine STI-screening for risk goups, (MSM)