HIV and Aids in Italy in 2022, ISS data: more infections among heterosexuals and women

HIV and Aids in Italy in 2022, ISS data: more infections among heterosexuals and women

New HIV diagnoses (1888) and AIDS cases (403) in Italy in 2022, according to data just published by the Istituto Superiore di Sanità, compared to pre-Covid (the year 2019) there are fewer but the trend that has been decreasing since 2017 is being reversed. Commenting on the data is Bruno Marchini, President of Anlaids Onlus: “Reading beyond just the numbers, the trend which, since 2017 indicated a decrease in new diagnoses, is, albeit slightly, going back up. It still cannot be said whether this is due to the Covid effect: certainly in 2020 and 2021 there were fewer accesses to diagnostics (tests) and perhaps, during the lockdown periods there were even fewer opportunities for transmission of the virus. The picture will probably be clearer with the 2023 data. To understand the data would serve, as we have been saying for years together with the other Associations, the numbers of tests carried out, i.e. the denominator. Unfortunately, due to the differences in the counting and return of data that exist between each Region, this is not yet possible. Among the information we have, the worrying numbers are the ‘late presenters’, i.e. people who present a late diagnosis; these are probably people who do not get tested because they do not feel at risk: we need to encourage prevention, access to tests and to treatment, explain that ‘Undetectable’ means ‘Untransmittable’ or that thanks to treatment, people reach undetectable viral load and do not transmit the virus. One more reason to test yourself and, possibly, know in advance.’ It is also important to remember that we now also have PrEP (pre-exposure prophylaxis) as a tool, reimbursable by the NHS.”

Late diagnoses are on the rise

In fact, ‘late presenters’ are on the increase, i.e. late diagnoses of people who are tested when the presence of symptoms of the disease has already appeared. “It is a phenomenon that many doctors close to our Association have often reported to us in recent times” explains Marchini further.

According to the new data, 58% of new diagnoses are people who have a CD4 count (the cells of the immune system that are attacked by the virus) lower than 350 mm per microliter of blood. 42% of these ‘late presenters’ already have infections defining acquired immunodeficiency syndrome.

Furthermore, if in numerical terms, the age group most affected is the 40-49 age group, if we add the percentages, the age group from 50 upwards shows approximately 30% of new diagnoses.

More cases of transmission between heterosexuals than between homosexuals

Without prejudice to the fact that the mode of transmission is now almost always sexual (83.9%), compared to 40.9% of relationships between MSM, we have 43% of transmission among heterosexuals, if we add together males and females females, who in the COA bulletin (AIDS Operations Center of the Higher Institute of Health) are kept separate for epidemiological reasons).

Finally, among the reasons why the test was taken, the 41.2% of people who do it because they have experienced symptoms stand out. Probably because they are already hospitalized; and here it must be said that, even today, it happens that the HIV test is offered by the doctor only after many other tests. While 24.3% did so because they believed they had engaged in risky behaviour.

The objectives of the WHO

There is also good news. Speaking of ‘continuum of care’, the famous 95-95-95 objectives that the WHO has indicated for 2030 (i.e. being able to have 95% diagnosis by this date, the same percentage in pharmacological treatment and always 95% with the viral load suppressed), in our country we can say that we have 95% of HIV+ people with a diagnosis received, 95% of these in treatment, and 93% in viral suppression.

“This is a very important fact also because we need scientific evidence well summarized in U=U, or Undetectable = Untransmittable. An HIV-positive person who is taking an effective therapy that persistently keeps his viral load at non-measurable levels does not transmit the virus to other people. An important scientific evidence also for the elimination of stigma. In recent months all the Italian associations involved in the fight against the virus have joined together to launch the ‘U=U, impossible to make mistakes’ campaign, a slogan able to undermine decades of scientifically incorrect information” – says president Bruno Marchini of Anlaids Onlus.

Free PrEP

40 years after the isolation of the virus, in 2023, an important turning point in the field of HIV and AIDS has come with the free PrEP, the pill that prevents HIV infection. In fact, last April the Prices and Reimbursement Committee of the Medicines Agency (AIFA) gave the OK to reimbursement for Pre-Exposure Prophylaxis which prevents HIV. The drug is now reimbursable by the National Health System.

A podcast about the history of the virus

Anlaids Onlus once again puts the importance of communication at the center: “The solution is always the same, knowing to prevent and not stigmatize. We have been in schools since 1994. This year we held meetings in over 100 schools in 9 regions, reaching around 1,000 classes and almost 20,000 students. Every year we strive to be increasingly present and bring sexuality education and the culture of prevention into school programmes, not only to learn about HIV but also all other infections sexually transmitted” says Marchini.

In view of December 1st, World AIDS Day, Anlaids Onlus and Emons Records are publishing a podcast that traces the history of the virus that revolutionized the very concept of treatment. From November 28th the podcast “Positive stories: HIV from AIDS to U=U” will be available on all platforms.

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