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Western Europe
   Last updated: 18.06.04
 
There are an estimated 570,000 people living with HIV/AIDS in Western Europe, as of the end of 2002. The adult HIV prevalence rate in this region is 0.3%. Women constitute 25% of the total infected adult population. In 2002, 30,000 people were newly infected in this region and 8,000 deaths due to AIDS were recorded.

The epidemic in the Northern European countries such as the United Kingdom, the Netherlands, Germany and Scandinavia has been primarily concentrated among gay and bisexual men. Although several countries have reported an increase in the number of heterosexually acquired infections over time, some of this may be a reflection of migrant populations from Africa and other regions where heterosexual transmission is dominant, rather than heterosexual transmission in-country. In Norway, Sweden, Switzerland and United Kingdom a higher proportion of new infections diagnosed in 1999 were acquired through heterosexual sex rather than through homosexual activity. Seven countries in Europe provide data on heterosexual transmission subcategories. These data revealed that the majority (60%) of the HIV cases acquired heterosexually occured in persons originating from a country where the epidemic is generalised.

Since the data for 1999 are not yet available for France, and are incomplete for Belgium, analyses presented in the HIV/ AIDS Surveillance in Europe from the European Centre for the Epidemiological Monitoring of AIDS have not included either of these countries.

Analysis of the data already available reveals; the decrease in AIDS incidence which began after the introduction of new and effective antiretroviral combination therapies in 1996 has continued, but at a slower pace. Across Europe, AIDS had declined by 27% compared to the previous year in 1997, by 24% in 1998 and by 13% in 1999.

Decreasing AIDS incidence was observed in all transmission groups. Between 1995 and 1999, AIDS incidence decreased at an average annual rate of 25% in gay and bisexual men, 22% in injecting drug users and 9% in people infected through heterosexual sex.

In countries where aggressive HIV prevention efforts targeted at injecting drug users have been implemented, the HIV prevalence rate among injecting drug uers has been contained at below 5%. Many high income countries who feel that the political cost of implementing needle exchanges is too high have maintained high prevalence rates among injecting drug users. In Spain, for example, a recent study in Barcelona found a prevalence rate of 51% among injecting drug users.

The worst affected countries are;

France
It is estimated that 130,000 people are living with HIV/AIDS, or 0.44% of the adult population.
To date, 55,000 AIDS cases have been reported. Accurate figures are unavailable for France because testing is anonymised. In September 1999 French doctors recommended to the Health Ministry that anonymised reporting of HIV diagnoses should become mandatory in order to improve surveillance.

In France, HIV prevalence among injecting drug users rates ranged between 10% and 23% in 2000.

Spain
120,000 people living with HIV/AIDS, or 0.58% of the adult population. In 1999 there were 71 cases of AIDS per million population reported. In total there have been 63,000 cases of AIDS reported to the end of 1999.

Although injecting drug use remains the main mode of transmission in Spain, about one-quarter of all HIV infections have been heterosexually transmitted.

Reported HIV prevalence among injecting drug users in Spain in 2000 was 20–30% nationwide.

Italy
95,000 people living with HIV/AIDS, or 0.35% of the adult population. The epidemic in Italy is largely centred around injecting drug users. To the end of 1999 there had been 45,605 cases of AIDS reported.

Portugal
36,000 people living with HIV/AIDS, or 0.74% of the adult population. Decreases in AIDS incidence were observed in all countries across Europe, except Portugal, where the epidemic began later. Portugal now has the highest AIDS incidence in Europe (88 cases per million population in 1999. Portugal is the only country in Europe to report a significant number of cases of HIV-2 infection. To the end of 1999 there had been 6,558 cases of AIDS reported.

Portugal’s serious epidemic among injecting drug users accounted for more than half the newly diagnosed HIV infections in both 2000 and 2001, though the number of reported HIV infections among injecting drug users declined significantly in 2001.

Further information on AIDS in Europe can be obtained from the European Centre for the Epidemiological Monitoring of AIDS, Hopital National de Saint-Maurice, 14 rue du val d'Osne, F-94410, France. Quarterly European HIV & AIDS statistics are also available on-line at http://www.ceses.org This site and other statistical sources are included in the Statistics links selection at NAM's website aidsmap.com

United Kingdom
In the United Kingdom, as in some other European countries, a large share of heterosexually transmitted HIV infections are being diagnosed in persons who originate from, or who have lived in or visited, areas where HIV prevalence is high. Prevention, treatment and care activities need to become more culturally appropriate and socially relevant if they are to reach and benefit such diverse communities.