Expert Group on HIV/STI Report 22.4 2008

Meeting in Tallinn 3.-4.4 2008 Approval of thematic report Evaluation of country reports Evaluation of projects (ongoing and planned) Development of indicators Site visit to Narva

Registered new HIV cases per million inhabitants in selected European countries in 2006 (Data source: www.eurohiv.org)

Reported cases of HIV-infection among injecting drug users Nordic countries1990-2007

Trends in newly diagnosed HIV infections by mode of transmission and year of diagnosis

Thematic report/Priority topics for projects: Regional collaboration Integration of social and health care for HIV-infected individuals Prevention of HIV among drug users Enhancing cross-border bilateral activities Promoting harm reduction policies among drug users

Thematic report/Priority topics for projects/2: Prevention of HIV/TB dual infections Prevention of HIV among MSM Prevention of MTCT Enhancing implementation of common best practices

Other areas to be covered: Surveillance and analysis of risk factors HIV prevention in prisons Prevention of social exclusion of people living with HIV Integration of social and health care for people living with HIV Laboratory collaboration

Example of a successful project following the priorities Development of low-treshold services for injecting drug users to prevent the spread of HIV in Murmansk and adoption and implementation of the principles and experience to Leningrad oblast

Дозорные исследования Реализация международных проектов по профилактике ВИЧ/СПИДа в Мурманской области Дозорные исследования Норвегия Финляндия Швеция 1999-2001 2002- 200… 2002-200… 2004 2005- 200… 2007-2000…

Legacy for LTCS Properly implemented non-discriminating LTCS is challenging but could demonstrate the heritage of promoting social well-being and solidarity in the society

Project status in the end of 2007 Ongoing projects - 21 Projects involving Russia - 18 Projects involving Norway – 12 Projects involving Finland – 6 Projects involving Sweden – 1 Projects involving Estonia, Latvia and Lithuania – 3 Projects involving France - 1

Project status 2 Project proposals – 15 Completed projects - 4

Financing ITA and coordination financed through a project in 2008-2010 by the Ministry for Foreign Affairs, Finland Chairmanship financed by the Ministry of Social Affairs and Health at least through 2008 Additional possibilities offered by the Finnish financing in the project pipeline

Indicators/Important targets Epidemiological situation Changes in risk behaviour Impact of interventions Coverage in risk groups

Suggestions for indicators in the NDPHS HIV Annually reported HIV cases by transmission category Annual newly reported AIDS cases Annual deaths among HIV-infected Annual reported HIV-cases in 15-19 years old and 20-24 years old Annual HIV and TB cases in correctional facilities

Suggestions for indicators in the NDPHS HIV/2 Percentage of estimated HIVpositive incident TB cases that received treatment for HIV and TB Percent of HIV-positive pregnant women who received antiretrovirals to reduce the risk of mother-to-child transmission Percent of adults and children with advanced HIV infection receiving ART

Regional differences (Data sources: Statistics Estonia, National HIV Reference Laboratory)

TB Incidence and TB+HIV cases by Year, Estonia, 1989–2007 (Data source: National TB Registry)

Observations from Narva Extremely high prevalence (7% of young adult population, 15-39) and incidence Strong link with injecting drug use Little understanding of the role of CSW Little information about the situation and developments in Ivangorod Strong interest in developing collaboration accross the border

Observations from Narva/2 What is needed: Common meeting between the health authorities (and other stakeholders?) in both cities. More permanent structures in the future? Support to projects dealing with CSW vs HIV Support to projects implementing low-treshold services on both sides of the border