Drug-related infectious diseases
A more detailed
insight into this issue is provided in Chapter
3, Selected issues - Drug-related infectious diseases.
As available data are from
different sources (sometimes local), only a general
impression of HIV prevalence in injecting drug users
(IDUs) can be given. However, large differences are
apparent between, as well as within, countries. Available
data indicate levels of infection among different subgroups
of IDUs that roughly vary from about 1 % in the United
Kingdom to 32 % in Spain. This overall picture has not
changed in recent years. However, there are indications
of new increases of HIV transmission in (subgroups of)
IDUs in some countries (see box).
Data on prevalence of infection with
hepatitis C virus (HCV) are less available and, where
available, are subject to the same limitations as the
HIV data. However, the overall picture is clear
HCV prevalence is extremely high in the data from all
countries of the EU, with infection rates of between
40 and 90 % in different subgroups of IDUs (Figure
9). As far as they are available, data on prevalence
in IDUs aged under 25 indicate levels of HCV infection
from 20 % (Belgium, treatment, 1998) to over 74 % (Portugal,
Coimbra treatment, 2000) (see
Figure 27, in Chapter 3, Selected issues, Drug-related
infectious diseases). This suggests that HCV transmission
continues at high levels in several countries, although
some studies indicate that introducing prevention measures
might have reduced transmission (United Kingdom).
increases in HIV transmission among IDUs in some
data suggest that increases in HIV infection may
have occurred among subgroups of IDUs in some
EU countries. The limitations of using routine
data for detecting changes in transmission should
be taken into account (see Chapter
3). For example, the increase in Ireland may
partly be due to increased testing of IDUs. However,
it is important to carefully monitor these possible
increases and take appropriate action if necessary.
Increases in HIV transmission may have occurred
in Austria, Luxembourg, Ireland, the Netherlands,
Portugal and Finland.
HIV prevalence among opiate overdoses increased
to 5 % in 1999 (from 3 % in 1996, 2 % in 1997
and 1 % in 1998).
notified HIV infections in IDUs rose, from 2-3
per year in 1995-97 to 6Ð7 per year in 1998 and
the number of IDU-related HIV positive tests tripled
to 69 in 1999 (from 20-26 per year in the period
data are from local sources. In Coimbra, prevalence
among IDUs in treatment increased from 9 to 13%
between 1999 and 2000, while this was mainly among
females and from 9.5 to 18 % in the age group
25-34. A street-based study among 250 homeless
heroin users in a very problematic area in Lisbon
found a prevalence of 48 % in 1998-99.
a large increase in IDU-related HIV notifications
occurred from 0-5 yearly cases during 1990-97,
to 20 cases in 1998 and 84 cases in 1999. Prevalence
among needle exchange attendees asking for an
HIV test also increased, from 0 % in 1997 to 3
% in 1998, 8 % in 1999 and decreased back to 3
% in 2000.
the Netherlands, HIV infection rose from 11 to
22 % between 1994 and 1998/99 among IDUs in the
city of Heerlen, southern Netherlands.