In Portugal, global estimates of the prevalence of infectious diseases among drug users are not available. However, data based on clients of some treatment facilities are available, and these can provide information on rates among some sub-groups of drug users: (i) those demanding treatment for the first time at the public network of outpatient treatment facilities; (ii) those admitted to public detoxification treatment units or certified private detoxification units; or (iii) those in treatment in public or certified private therapeutic communities.
In general, a decreasing trend in the total number of notifications of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) cases has continued to be registered since the early 2000s in Portugal. In 2015, a total of 990 new HIV-positive and 238 new AIDS-infected individuals were reported for all risk groups together.Approximately 5 % (44 cases) of HIV and 14 % (33 cases) of AIDS were associated with injecting drug use. Similarly, there has been a large decline in the incidence of HIV and AIDS associated with injecting drugs in this risk group since 1999-2000.
In 2015, 12 % of drug users who had ever injected drugs and who were tested at outpatient treatment services were HIV positive. This downward trend has continued since 2012, following a period of stability. The prevalence was higher in sub-groups of ever-injectors than in those who had never injected, ranging between 5 % and 27 % in different treatment settings; the maximum value was registered among licensed therapeutic communities and detoxification units.
This decreasing trend of new cases of HIV infection associated with injecting drug use, despite the improvements in the screening coverage, suggests a decrease in ‘recent infections’ in this risk group.
Among injecting drug users admitted to treatment, the rate of chronic hepatitis B virus (HBV) infection varies across studies in different settings, from 1 % to 11 %. In the case of hepatitis C virus (HCV), the prevalence of antibodies was 83.5 % among patients in drug treatment, and varied between 66 % and over 80 % in studies conducted among different populations.
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 Portugal
NBYear of data 2015.
Characteristics of and trends in drug-induced deaths in Portugal
NB Year of data 2015.
Drug-induced deaths are deaths directly attributable to the use of illicit drugs (i.e. poisonings and overdoses).
According to data from the special registry of the National Institute of Forensic Medicine, there have been consecutive increases in reported drug-induced deaths in the last two years, although the number of deaths has remained below those reported for the period 2008-10. In 2015, the majority of deaths occurred among males. The mean age of victims in Portugal was 43, which is older than the European average. Opioids were detected in the majority of drug-related deaths, with heroin mentioned in 18 cases; however, in the majority of cases more than one substance was detected, and many cases recorded the presence of alcohol and benzodiazepines.
The drug-induced mortality rate among adults (aged 15- 64 years) was 5.8 deaths per million in 2015, which is lower than the most recent 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.