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The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges.

ABSTRACT: The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons.Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (?200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4.In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%-0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ?90% for all stages, and more than half had reached ?90% for at least 1 stage.European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge.

SUBMITTER: Gourlay A

PROVIDER: S-EPMC5447871 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges.

Gourlay Annabelle A Noori Teymur T Pharris Anastasia A Axelsson Maria M Costagliola Dominique D Cowan Susan S Croxford Sara S d'Arminio Monforte Antonella A Del Amo Julia J Delpech Valerie V Díaz Asunción A Girardi Enrico E Gunsenheimer-Bartmeyer Barbara B Hernando Victoria V Jose Sophie S Leierer Gisela G Nikolopoulos Georgios G Obel Niels N Op de Coul Eline E Paraskeva Dimitra D Reiss Peter P Sabin Caroline C Sasse André A Schmid Daniela D Sonnerborg Anders A Spina Alexander A Suligoi Barbara B Supervie Virginie V Touloumi Giota G Van Beckhoven Dominique D van Sighem Ard A Vourli Georgia G Zangerle Robert R Porter Kholoud K

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20170601 12

<h4>Background.</h4>The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons.<h4>Methods.</h4>Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of ...[more]

PMID: 28369283

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Project description:In the current era of globalization, a clean environment remains a crucial factor for the health of the population. Thus, improving air quality is a major focus of environmental policies, as it affects all aspects of nature, including humans. For these reasons, it is appropriate to take into account the health risks posed by greenhouse gas (GHG) emissions released into the atmosphere. With regard to global GHG emissions, there are concerns about the loss of protection of the ozone layer and it is very likely that climate change can be expected, which multiplies the environmental threat and has potentially serious global consequences. In this regard, it is important to pay increased attention to emissions that enter the atmosphere, which include countless toxic substances. The aim of this study was to examine the associations between selected GHG emissions and the health of the European Union (EU) population represented by disability-adjusted life years (DALYs). This aim was achieved using several analytical procedures (descriptive analysis, correlation analysis, cluster analysis, and panel regression analysis), which included five environmental variables (carbon dioxide (CO2), methane (CH4) in CO2 equivalent, nitrous oxide (N2O) in CO2 equivalent, hydrofluorocarbons (HFC) in CO2 equivalent, sulfur hexafluoride (SF6) in CO2 equivalent) and one health variable (DALYs). An emphasis was placed on the use of quantitative methods. The results showed that CO2 emissions have a dominant position among selected GHG emissions. The revealed positive link between CO2 and DALYs indicated that a decrease in CO2 may be associated with a decrease in DALYs, but it is also true that this cannot be done without reducing emissions of other combustion products. In terms of CO2, the least positive scores were observed in Luxembourg and Estonia. Germany had the lowest score of DALYs, representing the most positive health outcome in the EU. In terms of total GHG emissions, Ireland and Luxembourg were considered to be less positive countries compared to the other analyzed countries. Countries should focus on reducing GHG emissions in general, but from a health point of view, reducing CO2 emissions seems to be the most beneficial.

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The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges.

Publications

The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges.

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