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EPIDEMICS
Almost half of HIV infections worldwide undetected: WHO
By Nina LARSON
Geneva (AFP) Nov 29, 2016


HIV toll tops one million in Russia and keeps climbing
Moscow (AFP) Nov 29, 2016 - Russia's HIV infection rate is growing 10 percent a year and over one million Russian have been diagnosed with the disease in nearly three decades, the country's top AIDS expert said Tuesday.

The number of registered cases reached 1,087,339 on September 30, Vadim Pokrovsky, head of the national state AIDS centre, said at a news conference.

That number is a cumulative total of all those registered since 1987 and includes those who have since died.

According to the health ministry, around 820,000 Russians out of a population of 146 million are currently living with HIV.

In 2015, 110,000 new cases were officially registered in Russia, up from 85,252 new cases in 2014.

The real number of those infected is significantly higher -- 1.3 to 1.4 million or almost 1 percent of the population, Pokrovsky estimated.

A global AIDS study published in The Lancet HIV journal in July found that new infections have plateaued globally at around 2.5 million per year, with more than 75 percent of infections in sub-Saharan Africa.

In Europe, the highest rate of new infections was in Russia and Ukraine, the study found.

"The situation is just getting worse and today it is threatening national security," said Pokrovsky, warning of the risk of a huge epidemic breaking out by 2021.

Just over half of new cases in Russia -- 51 per cent -- result from injecting drugs, while 47 percent are infected by unprotected straight sex and only 1.5 percent say they got infected from gay sex.

"Russia is the only country in the world where drug users represent more than 50% of people with HIV," said Pokrovsky.

He slammed the lack of an HIV prevention campaign, such as handing out clean needles.

"The public funds aren't even enough to treat all those who are HIV positive. I'm not even talking about the prevention of new cases," he said.

Only one in three HIV positive people in Russia gets free medical treatment due to a lack of funding, while the medicines are often of low quality.

Russia's President Vladimir Putin has backed conservative values that align with those of the powerful Russian Orthodox Church, meaning health services have focused on AIDS treatment rather than prevention.

Russia has also banned supplying drug users with methadone as a substitute for heroin and has shifted its focus from information campaigns to those promoting abstinence.

The justice ministry blacklisted two major NGOs involved in HIV prevention in July under a controversial new law that labels them as "foreign agents."

The World Health Organization warned on Tuesday that nearly half of all people with HIV around the globe do not know they are infected, and called for broader access to at-home testing kits.

The UN health agency said that 40 percent of people with the virus that causes AIDS, or more than 14 million people worldwide, are unaware of their status, according to 2015 estimates.

However, that marks a huge improvement from a decade earlier when only 12 percent of people with HIV were estimated to know they had the virus.

But the continued lack of diagnoses remains a major obstacle to implementing WHO's recommendation for everyone with HIV to be offered anti-retroviral therapy (ART).

Today, more than 80 percent of those diagnosed with HIV are receiving ART, but that is still less than half of the 36.7 million people believed to be living with the virus.

"We still have a major treatment gap," Gottfried Hirnschall, head of WHO's HIV department, told reporters in Geneva, warning that "many people actually get to treatment late because they don't know they are HIV positive".

WHO chief Margaret Chan said that making home testing kits more easily available could make a dramatic difference.

"HIV self-testing should open the door for many more people to know their HIV status and find out how to get treatment and access prevention services," she said in a statement.

HIV self-testing allows people, in the privacy of their own homes, to use oral fluid or blood from a finger prick to determine their status in about 20 minutes, while new tests are being developed that work even faster.

- Record infections -

WHO urges anyone who tests positive to seek confirmatory tests at a health clinic, where they can receive information about the disease and how to get counselling, as well as rapid referral to prevention, treatment and care services.

Self-testing has been shown to nearly double the frequency of HIV testing among men who have sex with men, and recent studies in Kenya found that the male partners of pregnant women were twice as likely to get tested if they were offered self-testing, WHO said.

Twenty-three countries currently have national policies in place supporting HIV self-testing while others are developing such policies, but WHO warned that in much of the world wide-scale access to the tests remains limited.

And in countries where they are easily accessible they are often pricey, as in the United States where they can be bought in most chemists at around $40 (37.67 euros) a piece.

"We would really like to emphasise that they should ideally be free," said Rachel Baggaley of WHO's HIV prevention unit.

WHO said it was supporting a project in three southern African countries -- Malawi, Zimbabwe and Zambia -- aimed at making free home testing kits widely available, and said a number of other countries were interested in joining the initiative.

More testing is also needed in other regions, with the EU and WHO reporting on Tuesday that one in seven people with HIV in Europe is unaware of their infection, as 2015 marked another record year for new HIV cases in the region.

Europe registered 153,407 new cases, up from 142,000 in 2014, the WHO said, a jump driven by cases in Russia and immigrants who acquired the virus after arrival.

Hirnschall acknowledged on Tuesday that the rate of new HIV infections globally had stopped declining in recent years and had stagnated at around 2.1 million annually, voicing hope that increased testing could help turn that trend.


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