Welcome
Welcome to the June 2018 Sexual Health & HIV Policy EUROBulletin.
Our eFeature in this edition is with Dr Shema Tariq. Shema is the lead researcher for the PRIME study (Positive transitions through the menopause), looking at the menopause in women living with HIV. We spoke to Shema about the study and its findings – and the critical importance of meaningful involvement of women living with HIV in the research.
The European Parliamentary Forum on Population and Development (EPF) has uncovered and published evidence of a strategic plan put together by ultra-conservative groups in Europe aiming to roll back reproductive and LGBT rights in Europe. The report gives useful insight for anyone seeking to understand the anti-choice movement in Europe.
In this difficult political context, the positive result in the Irish referendum on repealing the 8th amendment was a welcome highlight of the last few months.
Earlier in the year, the PrEP in Europe Summit brought together stakeholders aiming to build a united approach to delivering pre-exposure prophylaxis (PrEP) across the European region.
Other items to look out for in this edition include: research into sexuality education in Europe; public health guidance from the European Centre for Disease Prevention and Control (ECDC) on sexual health in prison settings; and the 2018 Contraception Atlas.
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eFeature
Dr Shema Tariq is the lead researcher for the PRIME study (Positive transitions through the menopause), looking at the menopause in women living with HIV.
In this eFeature interview, we spoke to Shema about the study and its findings – and the critical importance of meaningful involvement of women living with HIV in the research.
> Dr Shema Tariq – eFeature interview
Reports & resources
Understanding Europe’s anti-choice movement
The European Parliamentary Forum on Population and Development (EPF) has published a report detailing the strategies of Agenda Europe, a network working across Europe to roll back human rights. The network’s list of aims includes prohibiting provision of contraceptives and abortion, repealing laws on same-sex partnerships, and abolition of equality legislation. The report gives useful insight into the organisation and its strategies. EPF says, “Being aware and understanding this ultra-conservative movement is essential for those who want to safeguard a modern, inclusive and tolerant Europe.”
> Read the EPF press release about the report’s launch
New publication – training sexuality educators
The German Federal Centre for Health Education (Die Bundeszentrale für gesundheitliche Aufklärung – BZgA), has released a new publication dedicated to the competencies and training of people working in sex and relationships education with young people (sexuality educators). BZgA is a World Health Organization collaborating centre for sexual and reproductive health.
The publication is called Training matters: A framework for core competencies of sexuality educators, and it is freely available to download in English, with a Russian translation to follow.
> Download the publication in English (PDF)
> Read the recently updated UN International technical guidance on sexuality education
Research grants from ESC
The European Society of Contraception and Reproductive Health (ESC) offers grants for research projects and courses relating to contraception, sexual and reproductive health. The deadline for applications for the first half of 2018 is 30 June.
Sexual health rights & advocacy
Voters in Ireland support access to abortion
The Irish Government held a referendum in May on whether to repeal its constitutional ban on abortion. Known as the 8th amendment, campaigners successfully led a movement to encourage voters to come out in support of ‘repeal the 8th’. The resounding ‘yes’ vote was welcomed by campaigners across Europe, paving the way for safe, compassionate, legal care to be implemented in Ireland.
> Read ‘Ireland’s Yes vote ushers in a new era for women’s rights in Europe’ on Euractiv.com
> Read the Irish Family Planning Association’s reaction to the result
> Read the press release from the International Planned Parenthood Federation welcoming the result
> Read the press release from The Center for Reproductive Rights celebrating the result
Community-based HIV testing
AIDS Action Europe (AAE) has published a report and advocacy tool on community-based voluntary counselling and testing (CBVCT) for HIV. Called CBVCT services - current obstacles and opportunities, the report brings together diverse opinions from around Europe and sets out recommendations for improvement.
Empowering LGBTI sex workers
The European Region of the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA-Europe) has published a new position paper, Empowering LGBTI sex workers towards the full respect of their fundamental rights. It follows a process of listening and learning within the organisation, and highlights three key steps: combatting structural discrimination; calling for decriminalisation; and working towards full inclusion.
> Read a blog from ILGA-Europe's Executive Director on the story of the policy
The PrEP in Europe Summit
The first PrEP in Europe Summit was held earlier this year in Amsterdam. It brought together health and public health commissioners and policy directors, researchers and clinicians, and PrEP (pre-exposure prophylaxis) users and advocates with an aim to help build a more united and more equal approach to providing PrEP within the WHO European region.
> Visit the PrEP in Europe Summit website
> Download presentations and watch recordings
Evidence, data & research
First cases of extensively drug-resistant gonorrhoea
The European Centre for Disease Prevention and Control (ECDC) reports that three cases of gonorrhoea have been detected in Europe and Australia that are resistant to the recommended first-line antibiotic treatment and also show resistance to several other antibiotics. The cases were not linked. ECDC has published a Rapid Risk Assessment and highlighted the importance of prevention, management and partner notification.
> Download the Rapid Risk Assessment
Sexuality education in Europe and Central Asia
The German Federal Centre for Health Education (Die Bundeszentrale für gesundheitliche Aufklärung – BZgA) and the European Network of the International Planned Parenthood Federation (IPPF) have published the results of their research into sexuality education in Europe and Central Asia. The research covers 25 countries and looks at laws and policy, implementation, sexuality education outside of formal school settings, and good practice.
Age difference and HIV transmission
A European study of men who have sex with men shows that age makes a considerable difference to whether a person is more likely to acquire or pass on HIV. Though it confirmed that younger gay men are more likely to acquire HIV from men a number of years older than them, it also found that in gay men over 40, the risk was reversed: gay men who are still HIV negative at that age are more likely to acquire HIV from partners younger than they are, rather than from partners of the same age or older. The study has implications for what might be the most effective HIV prevention interventions for different age groups.
> Read this news report in full on aidsmap.com
Treatment & service guidelines
Sexual health in prison settings
The European Centre for Disease Prevention and Control (ECDC) has published public health guidance relating to communicable diseases in prison settings. Rates of chlamydia, gonorrhoea, syphilis and HIV, among others, are higher in prison settings and the new guidance sets out evidence-based advice on active case finding.
Health care for girls and women living with FGM
The World Health Organization has published a clinical handbook for healthcare providers on providing care for girls and women living with female genital mutilation (FGM).
> Read more about the handbook
EMA warning on dolutegravir
The European Medicines Agency (EMA) has warned that women living with HIV who might become pregnant should not use the integrase inhibitor dolutegravir (Tivicay, also in Triumeq and Juluca) without effective contraception. EMA is conducting a review and when that is concluded, the advice will be updated if necessary. The warning was prompted by a study in Botswana which found a higher frequency of birth defects in babies born to mothers who became pregnant while taking dolutegravir.
> Read this story in full on aidsmap.com
> Read the warning on the EMA website
Policy development & guidance
Annual LGBTI rights benchmarking tool shows slowdown in Europe
The European Region of the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA-Europe) has released its 2018 Rainbow Europe Package. Rainbow Europe ranks countries according to LGBTI rights, assessing the legal and political landscape in each country and making recommendations for continued progress. A dedicated website presents the Rainbow Europe data in graphic form. ILGA highlighted that the stagnation of progress is taking place in the context of a difficult political climate and called for governments to "pick up the pace".
> Visit the Rainbow Europe website
European Chemsex Forum
The second European Chemsex Forum was held earlier this year in Berlin. Read reports from the forum at the links below.
> Read 'Loneliness and community are key to chemsex' on aidsmap.com
> Read 'Non-consensual sex is a recurrent problem in the chemsex environment' on aidsmap.com
> View and listen to presentations
2018 Contraception Atlas: ranking European countries by access to contraception
The European Parliamentary Forum on Population & Development (EPF) has published the second edition of the Contraception Atlas, a map that ranks European countries on access to contraception. The rankings are based on policies on access to contraceptive supplies, family planning counselling and online information.
Parliament & other European institutions
Committee for Medicinal Products for Human Use
At meetings in March and April, the European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) made recommendations for approval of two treatments for HIV: Juluca, which combines dolutegravir and rilpivirine; and Biktarvy, which combines bictegravir, emtricitabine and tenofovir alafenamide.
> Read the summary of opinion for Juluca (PDF)
> Read the summary of opinion for Biktarvy (PDF)
ECHR rules in favour of children’s right to sexuality education at school
The European Court of Human Rights (ECHR) recently considered a case brought from Switzerland, in which a parent wished to exempt their child from a class relating to sexuality and reproductive health. The ECHR agreed with the Swiss court ruling that it was in the best interests of the child to have access to the information.
> Find out more on the IPPF blog
> Read the ruling on the Strasbourg Consortium website
Country-specific news
England
NHS England saved £10 million by switching to generic anti-HIV drugs in 2016.
> Read this news report in full on aidsmap.com
France
HPV16, a strain of the human papillomavirus, is highly prevalent among men who have sex with men (MSM) living with HIV in France and strongly associated with high-grade pre-cancerous anal lesions.
> Read this news report in full on aidsmap.com
Germany
HIV self-testing kits to go on sale in Germany.
Moldova
The Republic of Moldova has become one of the first countries in the World Health Organization European Region to adopt a national programme on sexual and reproductive health and rights.
Poland
Rising support for abortion in Poland.
Romania
Video: When young people are denied contraceptive care.
> Watch the animation in English
Scotland
HIV outbreak among people who inject drugs in Glasgow now involves over 100 infections, many homeless.
> Read this news report in full on aidsmap.com
Spain
Video: Why access to contraception is still an issue in Spain
> Watch the video (in Spanish with English subtitles)
Sweden
Swedish Supreme Court decriminalises condomless sex for people living with HIV on treatment.
Switzerland
Reproductive health of women living with HIV in Switzerland being neglected, says study.
> Read this news report in full on aidsmap.com
Ukraine
Ukraine to finance expanded opioid substitution therapy programme.