A sharp rise in HIV cases in the Republic in recent months is a reminder that despite the significant advances in treatment since the virus was first identified, it continues to pose a public health challenge. The increase mirrors the latest European surveillance data, which show that 142,197 people had HIV newly diagnosed in 2014, the highest number recorded since reporting began in the 1980s. Some three-quarters were diagnosed in eastern Europe.
According to Niall Mulligan, chief executive of HIV Ireland, more than 7,000 people have been diagnosed with HIV here since the 1990s, and about 3,500 are living with the condition. Men who have sex with men accounted for half of all cases last year. But despite increased testing, some 30 per cent of people with HIV do not know they are carrying the virus. Renaming the Dublin Aids Alliance as HIV Ireland reflects the reality that for the majority of people living with HIV, progression to Aids is no longer inevitable.
HIV/Aids has come a long way since the first cluster of cases was identified in California in 1981. The 1982 introduction of the term Aids (acquired immune deficiency syndrome) was followed a year later by the identification of the HIV virus. As well as its impact on healthcare, HIV has had significant societal reverberations, not least in terms of discrimination and stigma. These continue to affect employment prospects and access to health services for carriers of the virus.
HIV/Aids has devastated parts of Africa; without access to antiretroviral treatment (ART), large numbers died from Aids-related complications. But the latest figures from the World Health Organisation (WHO) show much progress: some 11 million people in Africa received ART in 2014, compared with just 11,000 in 2000. The decline in the number of new HIV infections in Africa from 2.3 million to 1.4 million over the same period is also encouraging. Life expectancy is also recovering.
Recent increases in HIV diagnosis in Europe buck a global trend which saw the annual number of adults and children newly infected with HIV fall from 3.1 million in 2000 to 2.1 million in 2014. However the number of people in WHO’s European region dying from HIV-related causes rose by 150 per cent in the same 15 -year period.
The reasons for this must be identified. Is it because a younger generation is no longer influenced by the safe- sex messages adopted by their predecessors? With HIV now a chronic disease and Aids no longer a death sentence, has complacency replaced caution? The particular increase in HIV diagnosis in Ireland among young men who have sex with men must be tackled. And public health campaigns aimed especially at intravenous drug users, men who have sex with men and other at-risk groups must be prioritised within the Government’s new sexual health strategy.