In 2011, the EMCDDA and ECDC reported that new outbreaks of HIV were occurring in Greece and Romania despite an overall long-term declining trend in newly diagnosed HIV cases among injecting drug users (IDUs) in Europe. Reports received in 2012 continue to suggest increases in HIV prevalence and in rates of newly diagnosed cases among IDUs in these two countries. While in Greece prevention measures are being scaled up, in Romania coverage has declined.
A joint ECDC/EMCDDA risk assessment conducted in 2011 concluded that the data available for Greece and Romania were likely to reflect true increases in the incidence of HIV among IDUs. To follow up on the results of the risk assessment exercise, updated country reports were commissioned from both countries.
Data from these reports suggest there is no evidence of the outbreaks slowing down. Both in Greece (country report) and Romania (country report), increases in HIV prevalence (until 2012 and 2011 respectively) as well as in the rate of newly diagnosed cases (in 2012) are reported. In Romania, HIV prevalence increased from 4% in 2010 to around 12% in 2011 among IDUs in contact with services. In Greece (Athens), the increase in users in contact with services was from 1% to 4-5%, with preliminary data for 2012 suggesting prevalence of around 9%. In a study in a specific setting of users the prevalence was 23%. Numbers of newly diagnosed cases have also increased markedly in both countries, with the number reported during the January to August period almost doubling in Greece (from 161 in 2011 to 314 cases in 2012) while in Romania the number of cases reported in the first six months of 2012 (102 cases) is not far from the number of cases reported for the whole of 2011 (129 cases).
In Greece, a rapid scaling up of interventions is taking place despite the difficult economic situation, including a large increase in the coverage of opioid substitution treatment (OST) and an increase in the number of syringes distributed by needle and syringe programmes (NSPs). In Romania, the syringe coverage level achieved with external funding since 2007 dropped significantly from mid 2010 onwards due to lack of national funding. Although the legal conditions for implementing OST by GPs have been created, its actual implementation has faced obstacles and provision has remained limited.