Chronic drug-related harms: HIV declines but local outbreaks continue

Drug users, particularly those who inject drugs, are at risk of contracting infectious diseases through the sharing of drug use material and through unprotected sex. Drug injection continues to play a central role in the transmission of blood-borne infections such as the hepatitis C virus (HCV) and, in some countries, the human immunodeficiency virus (HIV). In 2015, 1 233 new HIV diagnoses in people infected through injecting drug use were notified in the European Union, representing 5 % of diagnoses for which the route of transmission is known. This proportion has remained low and stable for the last decade. New HIV infections among people who inject drugs have declined in most European countries, with an overall decrease of 41 % between 2007 and 2015. However, injecting drug use remains an important mode of transmission in some countries: in 2015, a quarter or more of newly diagnosed HIV cases were attributed to injecting drug use in Lithuania (34 %), Latvia (32 %), Luxembourg (27 %) and Estonia (25 %).

Newly diagnosed HIV cases related to injecting drug use: overall and selected trends and most recent data

While a majority of countries reported decreases in injecting-related HIV cases between 2014 and 2015, Germany, Ireland and the United Kingdom reported rises to levels not seen for 7 to 8 years. In Ireland and the United Kingdom, this was in part related to localised outbreaks of new HIV infections among people who inject drugs. Luxembourg also reported an outbreak in 2014. Increased stimulant injection, alongside high levels of user marginalisation, have been common factors in these outbreaks. In addition, the injection of stimulant drugs in a sexual context (‘slamming’) among small groups of men who have sex with men has been linked to an increased risk of infection transmission.

In 2015, 14 % of new AIDS cases in the European Union, for which the route of transmission was known, were attributed to injecting drug use. The 479 injection-related notifications represent just over a quarter of the number reported a decade ago. Many of the cases were reported in Greece, Latvia and Romania, where HIV testing and treatment responses require further strengthening.