| | | | December 2019 (Issue 19) |
Welcome to the December 2019 Sexual Health & HIV Policy EUROBulletin.
Our eFeature in this edition is an interview with Dr Cristian Furau, board member at the European Society for Contraception and Reproductive Health (ESC). We spoke to Cristian about The Madrid Declaration, a recent statement from ESC aimed at improving sexual and reproductive health care in Europe, and how he has used it as an advocacy tool in Romania. This edition also highlights the wealth of research presented at the European AIDS Clinical Society conference (EACS 2019) and the new European HIV treatment guidelines which were launched there. In the run-up to World AIDS Day on 1 December, the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO) also published the latest European HIV statistics. Other items to look out for in this edition include: reporting from the PrEP in Europe Summit and the European ChemSex Forum; WHO recommendations for rapid HIV testing; and an overview of European abortion laws. Not your copy of the bulletin? Click the link below to subscribe. > Sign up to receive future issues of the Sexual Health & HIV Policy EUROBulletin
 eFeature Dr Cristian Furau is a specialist gynaecologist and obstetrician in Arad, Romania, and a board member for the European Society for Contraception and Reproductive Health (ESC). In this eFeature interview, we spoke to Cristian about the recent ESC publication, ‘The Madrid Declaration: promoting evidence-based SRHR policies with respect for human rights’ and how he has used it as an advocacy tool. > Dr Cristian Furau – eFeature interview
Evidence, data & research
Half of all women with HIV are diagnosed late in Europe 
The latest data released by the World Health Organization
(WHO) and the European Centre for Disease Prevention and Control (ECDC) show
that 54% of women diagnosed with HIV in the European region are diagnosed
‘late’ (with a CD4 count below 350). Women in their 40s were more likely to be
diagnosed late than younger women.
This headline statistic comes from the new HIV/AIDS Surveillance
in Europe 2019 report, based on 2018 data, released ahead of World AIDS Day.
Over 140,000 new diagnoses were made in 2018. Trends seen in previous years continue,
with wide variation between countries and much higher rates of new transmissions
in eastern European countries (61% of all new diagnoses were in Russia). In the
last decade, several countries have seen a decline in new diagnoses, while
others report an increase of over 50%.
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Read the press release on the WHO website
>
Download the full report and infographics from the ECDC website
Progress on 90-90-90 HIV targets shows stark gap between eastern and western Europe 
The recent European AIDS Conference (EACS
2019) heard that the 90-90-90 targets for HIV diagnosis, treatment and viral
suppression will be missed in much of eastern Europe due to poor access to HIV
treatment. About 400 new HIV infections occur each day in the region. In 2014, UNAIDS adopted the 90-90-90 targets for 2020 – 90% of people with HIV diagnosed; 90% of diagnosed individuals on antiretroviral therapy; 90% of those on antiretrovirals achieving viral suppression. Although late diagnosis is a challenge across Europe, there is wide variation between eastern and western Europe in relation to linkage to care
after diagnosis. In eastern Europe, only 65% of people diagnosed
with HIV are on antiretroviral treatment.
>
Find out more on aidsmap.com
News from the 17th European AIDS Conference 
The 17th European AIDS Conference (EACS 2019), organised by the European AIDS Clinical Society, took place in Basel, Switzerland, from 6 to 9 November 2019. As the official online scientific news reporter for the
conference, aidsmap.com published news reports on research presented at the
conference and daily summary bulletins, which are available in English, French,
Italian, Portuguese, Russian and Spanish.
> Visit the EACS 2019 conference pages
on aidsmap.com
> Visit the official conference website
Treatment & service guidelines
New European HIV guidelines cater for multiple needs 
The tenth edition of the European AIDS Clinical Society guidelines for the treatment of adults with HIV in Europe was launched at the European AIDS Conference (EACS
2019), in Basel, Switzerland, last month.
It includes new sections on drug interactions, the
ageing patient, dose adjustment and HIV treatment during pregnancy. Two new
antiretrovirals, bictegravir and doravirine, have been added, and some older
medications have been removed.
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Find out more on aidsmap.com
>
Download the guidelines from the EACS website
WHO issues strong recommendation for rapid HIV testing The World Health Organization (WHO) has issued a strong recommendation
for services providing HIV testing to use rapid tests. Using rapid, point-of-care
test kits means that results can be given straightaway, avoiding the need for
people to return for test results.
The recommendation published by WHO follows an analysis of
the evidence around testing. A review compared using older western blot and line
immunoassay methods for confirmation of HIV diagnosis with the use of rapid tests
and enzyme immunoassays. The analysis is summarised in a policy brief, and new
consolidated testing guidelines were published ahead of World AIDS Day.
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Read the policy brief on the WHO website
>
Read the guidelines on the WHO website
Parliament & other European institutions
European Parliament condemns Polish bill on sexual education The European Parliament passed a resolution condemning a
draft law in Poland. The draft law would criminalise the provision of
relationship and sexuality education, including on contraception,
prevention of sexually transmitted infections, sexuality and consent. The
resolution from the European Parliament, voted through by 471 Members of the
European Parliament, reaffirms that relationship and sexuality education is
enshrined in human rights law.
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Find out more on the IPPF EN website
>
Read the resolution
Sexual health rights & advocacy
How do we deal with apparent cases of PrEP failure? The 17th European AIDS Conference (EACS 2019) heard details
about a man who acquired HIV despite taking PrEP (regular medication to prevent HIV infection). Dr Hans Hampel presented the
case and it prompted discussion of a need to better document possible
causes of PrEP failure, so they can be better understood.
>
Find out more
Criminalisation of HIV in Europe The European HIV Legal Forum (EHLF) has published
preliminary findings of its report on criminalisation of HIV in Europe. It
looks at the laws under which prosecutions have taken place; characteristics of
people being prosecuted; and media reporting around cases. The full report will be
published in the new year.
EHLF is part of AIDS Action Europe (AAE) and aims to bring
together legal and policy experts to improve access to HIV services.
Criminalisation was also the focus of a recent AAE meeting, from which presentations
are available online.
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Read the EHLF preliminary findings
>
Find out more about the AAE meeting
Policy development & guidance
Report provides overview of European abortion laws The Center for Reproductive Rights has published a comparative report of European abortion laws. It reveals that 95% of women live in countries where laws allow abortion. However, it also highlights that Europe remains at risk of attempts to rollback abortion rights. > Find out more
Evidence brief on PrEP in Europe and Central Asia The European Centre for Disease Prevention and Control (ECDC)
has published an evidence brief on key issues in PrEP access in Europe and
Central Asia. It found that, since 2016, there has been an increase in the number
of countries in the region implementing PrEP, either as national healthcare
provision or through research projects. It also found evidence of considerable 'informal' use
of PrEP, such as through people buying it online. It concludes that improved
data collection and monitoring of PrEP uptake and outcomes is needed to support
PrEP implementation.
>
Read the evidence brief
Campaigns & other news
AIDS Action Europe supports alternative community-led conference in Mexico in 2020 AIDS Action Europe, a regional network of more than 400 non-governmental organisations in Europe, has announced its support for HIV2020, a community-led conference planned to take place in Mexico in July 2020. The conference is being organised by an alliance of networks of people living with HIV and key populations, in response to the announcement that the next International AIDS Society conference (AIDS 2020) will be held in the USA. The conference aims to provide a safe alternative for individuals who cannot or will not enter the USA or who cannot afford to attend AIDS 2020. > Read the statement from AIDS Action Europe > Visit the HIV2020 website
Country-specific news
England HIV-positive gay men in England report highest chemsex rates
in four-country survey.
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Find out more
France French study finds one in six participants stops PrEP within 12 months,
one in three after 30 months.
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Find out more
Germany German study finds intermittent and lower-risk PrEP users may not be
testing for HIV and sexually transmitted infections.
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Find out more
Ireland Insurers urged to change their policies to prevent
discrimination of people in Ireland living with HIV.
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Find out more
Italy Italian-led study finds switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) is associated
with improvements in bone mineral density in people over 60.
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Find out more
Russia The World Health Organization and the Russian Federation are
working to strengthen collaboration to address HIV drug resistance.
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Find out more
Scotland Scotland's first addiction service treating people with pharmaceutical grade heroin is set to open in Glasgow. The service will work with the most at-risk heroin users who are in danger of a fatal overdose, or acquiring HIV and hepatitis C.
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Find out more
Slovakia Slovakia’s Parliament rejects harmful restrictions on safe abortion care.
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Find out more
Spain The first likely case of sexual transmission of dengue in Europe has been reported in Spain.
> Find out more
The Netherlands Rates of pneumonia and pneumococcal disease remain high
among people with HIV in The Netherlands.
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Find out more
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