Abstract
Reported incidence of human immunodeficiency virus (HIV) infection in the Czech Republic increased steeply over the past decade from 90 new cases in 2005 to 266 in 2015. This increase is almost exclusively attributed to sexual transmissions between men who have sex with men (MSM). In 2015, there were 79% (n=210) newly diagnosed cases among MSM, 17% (n=45) were attributed to heterosexual transmission and 1% (n=3) to people who inject drugs. Interventions targeted at MSM have not yet been prioritised in the broadly focused national HIV prevention strategy which this is envisaged to change in the programme set out for 2018 to 2022. The national budget for HIV prevention has been reduced, however, and this remains. Availability of voluntary counselling and testing has decreased substantially in the past decade. Post- and pre-exposure prophylaxis for sexual intercourse among MSM are not part of the HIV prevention policy and the concept of treatment as prevention is not fully recognised. Provision of a combined prevention strategy with a focus on MSM, reflecting the above factors including stigmatisation, should contribute to reverse the development of a concentrated HIV epidemic among MSM in the Czech Republic.
Highlights
Infection caused by human immunodeficiency virus (HIV) remains substantial public health concern worldwide associated with high mortality and morbidity, low quality of life, reduced life expectancy and high treatment costs, affecting certain vulnerable communities and subpopulations disproportionately [1]
Whereas heterosexual and people who inject drugs (PWID) transmission decreased over the last decade in the majority of European Economic Area (EU/EEA) countries, the number of newly reported HIV infections among men who have sex with men (MSM) has continuously increased [2]
Availability and accessibility of voluntary (anonymous) counselling and testing (VCT) for MSM is crucial for early detection of HIV infection, especially when analysis of CD4+ T cells at diagnosis shows that MSM have the lowest proportion of late diagnoses among all transmission groups in EU; this demonstrates higher testing rates and awareness in the MSM community compared with other at-risk populations [2]
Summary
Infection caused by human immunodeficiency virus (HIV) remains substantial public health concern worldwide associated with high mortality and morbidity, low quality of life, reduced life expectancy and high treatment costs, affecting certain vulnerable communities and subpopulations disproportionately [1].Despite public health measures, significant HIV transmission continues in Europe. Whereas heterosexual and PWID transmission decreased over the last decade in the majority of EU/EEA countries, the number of newly reported HIV infections among men who have sex with men (MSM) has continuously increased [2]. The Czech Republic with its 266 newly-diagnosed HIV cases in 2015 (2.5 per 100,000 population) ranks, together with Slovakia and Slovenia, among the EU/ EEA countries with the lowest reported incidence.
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