1. Sexual health in Europe Dr Keith Radcliffe European Regional Director International Union against Sexually Transmitted Infections (IUSTI)

2. European Union 27 countries 498 million people

3. GDP per inhabitant: the spread of wealth in the EU GDP per inhabitants in Purchasing Power Standards, 2007 Index where the average of the 27 EU-countries is 100 280 144 131 129 127 123 121 118 117 113 104 102 100 94 89 87 79 77 75 67 66 63 58 56 53 38 37 Luxembourg Ireland Netherlands Austria Denmark Belgium Sweden United Kingdom Finland Germany France Italy Spain EU-27CyprusGreece Slovenia Czech Republic Malta Portugal Estonia HungarySlovakia Lithuania Latvia Poland RomaniaBulgaria

4. WHO European Region 53 countries Population 881 million

5. WEST CENTRE EAST

6. STI are not under control Between 2000–2007 number of new cases of HIV has doubled in Europe Different patterns of spread - European Centres for Disease Prevention and Control

7. 27% unaware

8. HIV in France ( Bourdillon et al. www.cns.sante.fr) Diagnosed 72% Treated 61% Undetectable 46%

9. Young people Highest rates of STI Associated drug misuse Alcohol Unwanted pregnancy Mental health problems Barriers to accessing care

10. Migrants Major risk group for HIV Barriers to HIV testing –Fear –Language –Stigmatisation –Immigration status Internal migration Sex workers - trafficking

11. Paraskevis D et al. 2009

12. Men who have sex with men HIV transmission STI transmission –Syphilis –LGV (lymphogranuloma venereum) –Hepatitis C Internet Drug use

13. International Union against STI –Founded 1923 –Charity based in London –Global with 5 autonomous branches European Branch of the IUSTI –Non-profit association registered in Estonia –WHO European Region

14. Objectives –To promote high standards in diagnosis, treatment and prevention of STI –To raise awareness of the importance of STI –To improve public health

15. Scientific conferences –Annually –Bring together all agencies WHO European Regional Office European Centres for Disease Prevention and Control Research and development projects –Partner notification in Europe Dr Nicola Low, University of Bern –Eastern European Network of Sexual and Reproductive Health Dr Marius Domeika, University of Uppsala

16. Evidence-based European STI management guidelines

17. Professional issues –“Fog in Channel, Continent cut off” –Dermato-venereology Skin disease STI –UK, Ireland & Malta - specialty of genito-urinary medicine (GUM) STI HIV Sexual health e.g. contraception, psychosexual medicine

18. Professional issues –Dermatology dominates venereology Larger More financially rewarding More commercial interest (excluding HIV) Professional advocacy adversely affected Low priority for national governments