In Latvia, the emergence of a human immunodeficiency virus (HIV) epidemic in the late 1990s was attributed mainly to injecting drug use. Since 2001, the proportion of people who inject drugs (PWID) among newly diagnosed HIV-positive individuals has gradually decreased, and, in 2015, approximately one out of five new HIV infections was associated with injecting drug use. Nevertheless, injecting remains the second most common route of transmission of HIV in Latvia. Overall, approximately half of all HIV cases reported in Latvia between 1987 and 2015 were attributed to injecting drug use. However, in approximately one third of new HIV cases, the mode of transmission remained unreported.
The overall prevalence of HIV among PWID tested in needle and syringe programmes has remained stable in recent years with fewer than 1 in 10 clients testing positive for HIV. HIV prevalence is higher among females, those older than 25, those having injected for at least two years and those who report opioids as their primary drug of use. Recent findings from a PWID cohort study initiated in 2012 indicate that the prevalence of HIV infection in 2014 was 28.6 %
Monitoring of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections indicates that injecting drug use is a significant risk factor in the transmission of these viruses; however, the route of transmission is unspecified in a large proportion of diagnosed cases. In 2015, almost half of harm reduction services’ clients tested positive for HCV, which is significantly less than in 2014, while only a small proportion tested positive for HBV (HBsAg). The cohort study reported HBV and HCV prevalence rates among PWID of 3.0 % and 84.2 %, respectively, in 2014.
There is no national reporting system on drug-related emergencies in Latvia, though some data on acute drugrelated emergencies can be extracted from the State Emergency Medical Service (SEMS) database, which is based on incoming calls. SEMS data indicate that in 2015 around 1 000 calls were linked to illicit drugs or psychoactive substances, while almost 1 100 additional calls were attributed to the intoxication with substances primarily influencing the central nervous system. In addition, inpatient treatment is reported in the ‘Register of Patients with Particular Disease, who Suffered Injuries and Poisonings’. The register suggested that 120 hospitalisations were linked to overdose with illicit drugs in 2015.
Newly diagnosed HIV cases attributed to injecting drug use
NB Year of data 2015, or latest available year. Source: ECDC.
Prevalence of HIV and HCV antibodies among people who inject drugs in Latvia
NBYear of data 2014/2015.
Characteristics of and trends in drug-induced deaths in Latvia
NB Year of data 2015.
In 2015, 18 drug-induced deaths were recorded in the national mortality register in Latvia — all but two victims were male. Opioids were the main substances involved in half of those deaths. The mean age of the deceased was around 33 years, and an increase in the age of fatal overdose victims has been observed in the last decade, indicating an ageing opioid-using population.
According to another source, the special register of the State Centre for Forensic Medical Examination of the Republic of Latvia, toxicological tests identified the presence of illicit drugs in 25 deaths examined. In the majority of cases, the presence of opioids was reported.
Comparison of the Latvian overdose data with data from other countries should be done with caution, as the number of reported cases continues to be small and probably does not realistically reflect the existing situation in the country.
The drug-induced mortality rate among adults (aged 15-64 years) was 13.8 deaths per million in 2015, which is lower than the European average of 20.3 deaths per million.
Drug-induced mortality rates among adults (15-64)
NB Year of data 2015, or latest available year.