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August 2019 (Issue 17)

Welcome

Welcome to the August 2019 Sexual Health & HIV Policy EUROBulletin.

Our eFeature in this edition is an interview with Andrew Amato-Gauci, head of the HIV, sexual transmitted infections and viral hepatitis programme at the European Centre for Disease Prevention and Control (ECDC). We spoke to Andrew about the recent report from ECDC which showed that syphilis diagnoses are up 70% since 2010, particularly affecting men who have sex with men.

Last month, the International AIDS Society Conference on HIV Science (IAS 2019) was held in Mexico City. Alongside the presentation of new scientific research, there were several announcements from international bodies. The Joint United Nations Programme on HIV/AIDS (UNAIDS) released its latest report on the status of the HIV epidemic and the global response. The World Health Organization (WHO) also released new guidelines recommending dolutegravir for everyone who starts HIV treatment in lower- and middle-income countries and updated its pre-exposure prophylaxis (PrEP) recommendations to include event-driven PrEP.

Following her election as the new President of the European Commission, 35 members of the European Parliament (MEPs) published a statement calling on Ursula von der Leyen to support sexual and reproductive health and rights.

Other items to look out for in this edition include: new guidelines on self-care interventions in sexual and reproductive health from WHO; a new website sharing best practice guidance on safe abortion and post-abortion care; and the launch of a survey on pharmacy access to emergency contraception.

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eFeature

Andrew Amato-Gauci is head of the HIV, sexual transmitted infections and viral hepatitis programme at the European Centre for Disease Prevention and Control (ECDC).

In this eFeature interview, we spoke to Andrew about the recent report from ECDC which showed that syphilis diagnoses are up 70% since 2010 and the evidence-based responses ECDC is sharing with member states.

> Andrew Amato-Gauci – eFeature interview

Reports & resources

Global update on HIV from UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has released its latest report on the status of the HIV epidemic and the global response. The report highlights the impact that community programmes have had in successfully expanding access to HIV treatment, supporting adherence and preventing new infections. However, it also shows that this progress is slowing and has been uneven, with some regions, including Eastern Europe and Central Asia, falling behind. UNAIDS calls for greater urgency in the response, and increased political leadership.

> Find out more

> Download the report

New website shares best practice on safe abortion

Marie Stopes International and several partner organisations have launched a website sharing best practice guidance on safe abortion and post-abortion care. Called SafeAccess, the website includes how-to guides, toolkits, videos and factsheets.

> Visit the SafeAccess website

Treatment & service guidelines

Self-care interventions in sexual and reproductive health

The World Health Organization (WHO) has published new guidelines on self-care interventions in sexual and reproductive health. The guidelines cover a variety of areas including antenatal care, fertility services, contraception and sexual health. Several new recommendations are made, including that:

  • Self-administered injectable contraception should be made available as an additional approach to deliver injectable contraception.
  • Over-the-counter oral contraceptive pills should be made available without a prescription.
  • Home-based ovulation predictor kits should be made available as an additional approach to fertility management.
  • Self-sampling for human papillomavirus (HPV) should be made available as an additional approach to sampling in cervical cancer screening services.
  • Self-collection of samples for gonorrhoea and chlamydia should be made available as an additional approach to deliver testing services for sexually transmitted infections.
  • Self-collection of samples for syphilis and trichomonas vaginalis may be considered as an additional approach.

> Find out more

> Download the WHO guidelines

Dolutegravir recommended for all in new WHO guidelines

Everyone who starts HIV treatment in lower- and middle-income countries should start treatment with a combination containing dolutegravir, WHO announced at the International AIDS Society Conference on HIV Science (IAS 2019). The new recommendations are intended to settle uncertainty over whether women of childbearing age should take dolutegravir.

> Find out more

> Download the new guidelines

WHO endorses event-driven PrEP for gay men

WHO has updated its recommendation for pre-exposure prophylaxis (PrEP) to include event-driven PrEP taken before and after sex – also called on-demand PrEP or the 2+1+1 schedule – as an HIV prevention option for men who have sex with men.

> Find out more

> Download the recommendations

Parliament & other European institutions

MEPs call on the European Commission to support sexual and reproductive health and rights

Members of the European Parliament (MEPs) have called on the newly elected President of the European Commission, Ursula von der Leyen, to protect and further strengthen gender equality and sexual and reproductive health and rights. The statement, signed by 35 MEPs, calls for the defence of women's rights and lesbian, gay, bisexual, trans and intersex (LGBTI) rights to be included in the European Commission's work programme for 2019-2024.

> Find out more

> Download the statement

PACE adopts resolution on gender equality

The European Parliamentary Forum for Sexual & Reproductive Rights (EPF) reports that the Parliamentary Assembly of the Council of Europe (PACE) has adopted a resolution which includes two key points relating to sexual and reproductive health and rights. The points are part of a broader resolution on the Council of Europe agenda for gender equality. The resolution calls for mainstream mandatory sexual and relationship education; and guaranteed access to affordable and modern methods of contraception.

> Find out more

> Read the resolution

Committee for Medicinal Products for Human Use

At its meeting in July, the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) recommended approval of a new treatment for HIV, ibalizumab (Trogarzo), for people with drug-resistant HIV.

> Read the summary of opinion for Trogarzo

Evidence, data & research

Syphilis notifications up 70% in Europe

A new report from the European Centre for Disease Prevention and Control (ECDC) shows that syphilis notifications are up 70% since 2010, mostly affecting men who have sex with men living in urban areas. An accompanying study has investigated the factors behind the rise and shares evidence-based responses.

> Find out more

> Download the most recent epidemiological report

> Download the technical report

> Read our eFeature interview with the lead author

Research presented at IAS 2019

The 10th International AIDS Society Conference on HIV Science (IAS 2019) was held in Mexico City from 21 to 24 July 2019. As an official scientific media partner for the conference, NAM aidsmap published extensive reporting on the research presented.

> Visit our IAS 2019 webpages for full coverage

> Visit the IAS 2019 website

PrEP services could enhance STI control, says World Health Organization

The roll-out of pre-exposure prophylaxis (PrEP) provides an opportunity to bring down the incidence of sexually transmitted infections (STIs), provided that PrEP and STI programmes are better co-ordinated and integrated, representatives from the World Health Organization said at IAS 2019.

> Find out more

Policy development & guidance

New HIV laws and policies website

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has launched a new website which maps national laws and policies related to the HIV response. It aims to support people to better understand the legal and policy environment and UNAIDS hopes it will be a useful tool in analysing and shaping the HIV response.

> Find out more

> Visit the Laws and Policies Analytics website

Sexual health rights & advocacy

Shrinking space for civil society

The Swedish Association for Sexuality Education (RFSU) has published a report based on research it conducted into the obstacles faced by advocates of sexual and reproductive health and rights (SRHR). Internationally, space for civil society is shrinking, but the research identified that this is not definitively linked to the experience of SRHR activists. In some countries, space for SRHR work is widening, but in others there is a negative trend – particularly in relation to abortion rights.

> Find out more

> Download the report

When harm reduction expansion stifles activism: a lesson from Europe

What happens to user-led activism when harm reduction services are run professionally or brought into mainstream healthcare? A US activist has written about their tour of several European harm reduction services and their surprise to find little trace of the activist roots.

> Find out more

Call to end HIV-related travel restrictions

The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Development Programme (UNDP) are urging countries to remove all forms of HIV-related travel restrictions. They say that around 48 countries and territories still have restrictions that include mandatory HIV testing and disclosure as part of requirements for entry, residence, work or study permits. Since 2015, four countries have taken steps to lift their HIV-related travel restrictions: Belarus, Lithuania, the Republic of Korea and Uzbekistan.

> Find out more

Campaigns & other news

Help research pharmacy access to emergency contraception

The European Youth Network on Sexual and Reproductive Rights (YouAct) and the European Consortium for Emergency Contraception (ECEC) have launched a participatory survey on pharmacy access to emergency contraception. They are asking people to investigate access to emergency contraception in pharmacies they visit, and fill in what they find out in an online survey, available in English and Spanish.

> Find out more

> Visit the survey in English

> Visit the survey in Spanish

Country-specific news

Belarus

Most people in Minsk acquire HIV from injecting drugs. An organisation, Positive Movement, has set up mobile HIV testing clinics, drop-in centres and peer counselling to establish trust with people who often shy away from official health services.

> Find out more

France

France is testing safe drug consumption rooms for people addicted to opioids.

> Find out more

Ireland

Welcoming government proposals to remove cost as a barrier to access to contraception, the Irish Family Planning Association (IFPA) has warned against any contraception policy that steers women towards less reliable methods and away from long-acting reversible contraceptives. IFPA emphasised that any proposed reforms must include all forms of contraception.

> Find out more

Romania

An investigation has found that over 30% of hospitals in Romania are refusing legal abortions.

> Find out more

Russia

The European Court of Human Rights has found Russia’s refusal to register three associations set up to promote and protect the rights of lesbian, gay, bisexual and transgender (LGBT) people unjustified and discriminatory.

> Find out more

Serbia

The Serbian association for sexual and reproductive health (SRH Serbia) has published a shadow report on Serbia's progress towards the implementation of the sustainable development goals.

> Find out more

Spain

A study in Spain found that young adults with vertically transmitted HIV and hepatitis C virus co-infection can easily be cured with direct-acting antivirals, but some already have advanced liver damage by the time they are treated.

> Find out more

The Netherlands

No HIV infections occurred over two years of follow-up among individuals taking event-driven pre-exposure prophylaxis (PrEP) in a demonstration study conducted in Amsterdam, investigators report in The Lancet HIV. The study recruited men who have sex with men and transgender individuals.

> Find out more

United Kingdom

Parliament in Westminster has backed moves to introduce same-sex marriage and abortion reform in Northern Ireland, if the devolved Northern Ireland Assembly is not reconvened in the autumn.

> Find out more