Wesat2104

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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

    1. 1. HIV and Co-infections in Germany Strategies for Prevention Osamah Hamouda Robert Koch-Institute, Berlin, Germany Dept. Infectious Disease Epidemiology www.rki.de
    2. 2. Robert Koch-Institut, Berlin
    3. 3. Germany <ul><li>Population: 82 Million (235/km2) </li></ul><ul><li>Federal Republic with 16 States </li></ul><ul><li>450 Counties (pop.: 35 000 - 1.7 Million) </li></ul><ul><li>1 local health department per county </li></ul><ul><li>Mainly private health care providers </li></ul><ul><li>Health services reimbursed by health insurance system </li></ul>
    4. 4. HIV Epidemic in Germany <ul><li>3,000 new HIV-Infections in 2007 </li></ul><ul><li>650 HIV/AIDS related deaths </li></ul><ul><li>60,000 Estimated HIV prevalence </li></ul><ul><li>80% male </li></ul><ul><li>70% MSM </li></ul>
    5. 5. Estimated HIV/AIDS Incidence, Prevalence and Deaths in Germany, End 2007 (modell)
    6. 6. HIV and Co-infection in Germany <ul><li>Hepatitis B </li></ul><ul><li>Hepatitis C </li></ul><ul><li>TB </li></ul><ul><li>STIs </li></ul><ul><ul><li>Syphilis </li></ul></ul>
    7. 7. 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
    8. 8. % Co-infection /risk factors among TB patients DZK Study 2002-2004 (n=2,364)
    9. 9. Newly diagnosed HIV-infections in Germany (02/2008) by transmission group and year of diagnosis
    10. 10. 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
    11. 11. 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
    12. 12. 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
    13. 13. Newly diagnosed Syphilis in men by agegroup, 1997-2006
    14. 14. Newly diagnosed HIV-infections in men by agegroup, 1999-2006
    15. 15. Syphilis – HIV overlap in MSM in Germany <ul><li>Approximately 50% of syphilis cases among MSM currently in HIV+ MSM </li></ul><ul><li>Self-reported incident syphilis in previous year (2005/06) in </li></ul><ul><ul><li>3% of HIV- </li></ul></ul><ul><ul><li>15% of HIV+/ART+ </li></ul></ul><ul><ul><li>19% of HIV+/ART- </li></ul></ul>
    16. 16. 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
    17. 17. HIV/STI-Coinfection in Germany Strategies for prevention Action Plan 2007-2010
    18. 18. Future plans <ul><li>Safe Environment Prevention in MSM bars and clubs </li></ul><ul><li>Expand HIV-testing, VCT, rapid tests, Street workers </li></ul><ul><li>Prevention campaign aiming at behaviourial change towards a respectful and responsible sexual life </li></ul><ul><li>To strengthen the knowledge on STI among patients and practitioners </li></ul><ul><li>Establishing routine STI-screening for risk goups, (MSM) </li></ul>

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