世界愛滋病日：歐洲對興奮劑注射和愛滋病毒晚期診斷的擔憂
2023年11月30日 / 歐盟藥物及藥物成癮監測中心
在世界愛滋病日前夕，歐盟藥物及藥物成癮監測中心(EMCDDA) 展示了注射藥癮者 (PWID) 中愛滋病毒的最新數據，並探討了各國如何實現全球衛生部門應對愛滋病毒/愛滋病的目標。 這些數據凸顯出人們越來越擔心，興奮劑注射和愛滋病毒診斷延遲的潛在增加可能會危及該族群近年來在愛滋病毒預防和治療方面緩慢但持續的進展。
根據聯合國永續發展目標3（「良好的健康和福祉」），29 個EMCDDA 國家（歐盟27 國、土耳其和挪威）承諾到2030 年消除愛滋病毒/愛滋病流行。世界衛生組織的一項區域計畫設定了中期目標： 2025 年。
2022 年的數據顯示，歐盟和挪威與注射毒品有關的新愛滋病毒通報增加。 吸毒者中愛滋病毒傳播的風險仍然高於一般人群，並且在一些國家，注射引起的傳播率仍然很高。 此外，到 2022 年，歐盟和挪威超過三分之一的新愛滋病毒診斷發現較晚與注射毒品有關，增加了愛滋病毒相關併發症、死亡率和傳播的風險。
特別值得關注的是與注射興奮劑有關的當地愛滋病毒疫情，歐盟繼續記錄這種情況。 儘管阿片類藥物是歐洲注射的主要藥物，但近年來，興奮劑注射有增加的跡象。 歐洲毒品市場上更多的可卡因及其注射是愛滋病毒傳播的重要危險因子。
減害的方法，特別是提供無菌注射設備（包括在監獄中和透過藥房）現在被視為減少注射藥癮者中愛滋病毒傳播的基本組成部分。 EMCDDA-ECDC 關於預防和控制注射藥癮者傳染病的新指南對此進行了概述。 然而，最新數據顯示，許多國家的針頭和注射器供應覆蓋率和取得管道均不足。 新指南也強調需要採取更全面的方法來進行檢測和與照護的聯繫。
根據《2023 年歐洲毒品報告》，實現既定目標「需要加大投資以加強減害服務、檢測和與治療的聯繫」。 因此，需要付出更大的努力來預防未來的疫情爆發、降低傳播率並減輕疾病負擔。
EMCDDA 29 個國家在世衛組織為注射藥癮者所設定的目標中其表現如何？
• 與注射毒品有關的新感染人數
• 每年為每位注射藥癮者分發的針頭/注射器數量
• 新發愛滋病毒確診個案中晚期確診的百分比
• 注射藥癮者中愛滋病毒感染者達到病毒量抑制的百分比
• 愛滋病毒感染者和重點人群遭受恥辱和歧視的百分比
World AIDS Day: concerns over stimulant injecting and late HIV diagnoses in Europe
30.11.2023
On the eve of World AIDS Day, the EMCDDA showcases the latest data on HIV among people who inject drugs (PWID) and explores how countries are performing on global health sector objectives to tackle HIV/AIDS. The data underscore growing concerns that a potential rise in stimulant injecting and delayed HIV diagnoses could jeopardise the slow, but constant, progress seen in recent years in HIV prevention and treatment in this population.
Under the UN Sustainable Development Goal 3 (‘Good health and wellbeing’), the 29 EMCDDA countries (EU-27, Türkiye and Norway) have committed to eliminating HIV/AIDS epidemics by 2030. A World Health Organization regional plan sets interim targets for 2025.
2022 data showed an increase in new HIV notifications linked to injecting drug use in the EU and Norway. The risk of HIV transmission among PWID remains higher than for the general population, and transmission rates attributable to injecting are still high in some countries. Also, in 2022, more than a third of new HIV diagnoses linked to injecting drug use in the EU and Norway were detected late, increasing the risk of HIV-related complications, mortality and transmission.
Of particular concern are local HIV outbreaks linked to stimulant injecting which continue to be documented in the EU. Although opioids are the predominant drugs injected in Europe, in recent years, there have been signs of a rise in stimulant injecting. The greater availability of cocaine on the European drug market and its injection are significant risk factors for HIV transmission.
Harm reduction approaches, particularly the provision of sterile injecting equipment (including in prisons and through pharmacies) are now regarded as a basic component of reducing HIV transmission among people who inject drugs. This is outlined in new EMCDDA–ECDC guidance on the prevention and control of infectious diseases among people who inject drugs. However, latest data reveal insufficient coverage and access to needle and syringe provision in many countries. The new guidance also highlights the need for a more integrated approach to testing and linkage to care.
According to the European Drug Report 2023, achieving the targets set ‘requires greater investment to enhance harm reduction services, testing and linkage to treatment’. Greater efforts are therefore needed to prevent future outbreaks, decrease transmission rates and reduce the burden of disease.
How are the EMCDDA 29 countries performing in terms of WHO targets set for people who inject drugs?
- Number of new infections linked to injection drug use
- Number of needles/syringes distributed per year per person who injects drugs
- Percentage of new HIV diagnoses which are diagnosed at a late stage
- Percentage of people who inject drugs living with HIV achieving viral load suppression
- Percentage of people living with HIV and key populations experiencing stigma and discrimination
What are the latest data telling us about HIV among people who inject drugs?