There has been another spike in HIV cases in Ireland, with 512 new diagnoses in 2016.
With diagnoses up 6% across the State in the last year, the majority of the newest cases of HIV have arisen in the greater Dublin area, according to the Health Protection Surveillance Centre (HPSC).
Most affected were males aged 30 to 39 years old, who accounted for 43% of new diagnoses.
The risk group most affected were ‘men who have sex with men’ (MSM), accounting for 51% of new cases.
In response to the upsurge in new cases, a national outbreak response group has been established to address the escalating situation.
“Consistently the main increase remains amongst MSM. This is not unique to Ireland and can be linked to lack of awareness, homophobia, stigma, discrimination and lack of services,” Niall Mulligan, executive director of HIV Ireland, said. “It can also be linked to the fact that HIV prevention initiatives have not been prioritised over the last number of years and need greater investment and political will”, Mulligan added.
A recent online survey on the sexual behaviours of a large number of MSM found that 37% have never been tested for HIV.
The World Health Organisation estimates that 30% of people worldwide living with HIV are unaware they are infected. In Europe, the latest estimate is 15% of people living with HIV are unaware they are infected.
Mulligan said: “The figures [of those infected] are undeniably higher than the data we capture. This is a crucial point, as someone living with HIV unknown to themselves can unwittingly transmit the virus to others.”
Dr Derval Igoe, a specialist in public health medicine for the HPSC, said: “HIV infection doesn’t cause symptoms in the early stages; it’s very important for those at risk of acquiring HIV to be tested regularly.”
“Once diagnosed, treatment not only maintains the health of the infected person, but the risk of transmitting HIV to others is vastly reduced.”
The HPSC’s national surveillance system includes cases already diagnosed abroad, which are counted as new cases in Ireland. “This is forming an increasing proportion of cases, and overall 27% of new diagnoses had previously tested positive in another country,” Dr Igoe said.
“The increases in HIV have mainly been among Latin American MSM, who have either come to Ireland already infected with HIV, or who acquired infection following their arrival,” she explained.
To access treatment, even though people may already have been receiving treatment for HIV in their country of origin, they are still required to have a HIV test in Ireland.
In 2015, there was an outbreak of HIV amongst vulnerable people who are intravenous drug users in Dublin, with 491 drug users newly diagnosed. The majority of these cases were homeless polydrug users, who were injecting the synthetic drug ‘snowblow’. However, this outbreak died down early in 2016.
Mulligan said: “The most effective way to raise awareness is to target specific interventions to specific key populations. A general national HIV awareness campaign will get the message across to a certain section of the public but will have little impact on, for example, intravenous drug users.”
“Thought also needs to be given to the introduction of any new laws. For example, the new law criminalising the purchase of sex and increasing fines on sex workers will drive them further away from health and HIV services, so it becomes more difficult for us to engage with them around safer sex, provision of condoms, access to testing.”
He added: “The sector has suffered significant funding cuts since 2008, and such cuts in resources will ultimately impact on the capacity to deliver services. There needs to be greater investment in this area of work before we see figures reducing.”
The HSE’s provisional figures for 2016 and an in-depth report will be available from autumn of this year.