OBJECTIVES: HIV/AIDS surveillance methods are under revision as the diversity of HIV epidemics is becoming more apparent. The so called "2nd generation surveillance (SGS) systems" aim to enhance surveillance by broadening the range of indicators to prevalence, behaviors and correlates, for a better understanding and a more complete and timely awareness of evolving epidemics. METHODS: Concepts of HIV SGS are reviewed with a special focus on injecting drug users, a major at-risk and hard to reach group in Europe, a region with mainly low or concentrated epidemics. RESULTS: The scope of HIV/AIDS surveillance needs to be broadened following principles of SGS. Specifically for IDUs we propose including hepatitis C data as indicator for injecting risk in routine systems like those monitoring sexually transmitted infections and information on knowledge and attitudes as potential major determinants of risk behavior. CONCLUSIONS: The suggested approach should lead to more complete and timely information for public health interventions, however there is a clear need for comparative validation studies to assess the validity, reliability and cost-effectiveness of traditional and enhanced HIV/AIDS surveillance systems.
In 2015, the infection caused by human immunodeficiency virus (HIV) (HIV infection) dominated among life-threatening infections in Russians: it was first diagnosed in 98,177 Russians and 15,530 citizens of the Russian Federation died from HIV/AIDS, amounting to 45% of all deaths from infectious diseases in Russia. By the mid-2016, there were a total of 1,062,476 identified HIV-positive Russians, of whom 225,992 people died. The estimated number of HIV-infected patients in Russia approximated to 1% of the population, the highest prevalence of HIV being found in the age group of 30-40 years. The most active and expensive measures against HIV/AIDS in Russia are to examine the population for anti-HIV antibodies (29 million screenings per year) and to use in HIV-positive people antiretroviral therapy that was free of charge to more than 200,000 patients, i.e. nearly 25% of the registered Russians living with the HIV-infected. However, treatment coverage and quality are far from the target indicators that the international experts consider needed to reduce HIV prevalence and mortality. A wider program on HIV/AIDS, which includes a number of preventive measures with proven efficiency, as well as a program of promising researches and developments should be introduced in Russia.
Acquired immunodeficiency syndrome (AIDS) is believed to have begun in Rwanda with the transmission of green monkey virus to humans; the virus spread among prostitutes and truck drivers along the highways and then to the cities. In the most threatened areas, for example, Kinshasa in Zaire, 20% of the inhabitants are infected. 8% of pregnant women are human immunodeficiency virus (HIV)-positive. Social conditions are important. In Kenya prostitutes who work along the highways are carriers of socially transmitted diseases and genital sores. They are 60-80% HIV-positive. The better-off prostitutes at bars and hotels enjoy better health and fewer contacts and are 30% HIV-positive. It should be possible to develop a vaccine against the AIDS virus, but only a few virologists believe that this can be done within 10 years. Because HIV virus mutates rapidly, many different vaccines would have to be prepared. About 80 countries are cooperating with the World Health Organization to combat HIV and AIDS in Africa. Traveling and working abroad is beginning to be a problem. 15 countries have introduced restrictions on foreign visitors. Swedish midwives have an important role to play in fighting HIV. Their youth counseling activities can spread information about HIV and AIDS. Children who are in early stages of sexuality are probably the most important group to be influenced. It is already too late to begin informing 15-17 year olds about the disease. Midwives should probably be starting much sooner, perhaps even with 10-year olds.
Since the first case of AIDS was diagnosed in 1982, there have been over 2,300 cases, as of February 1989, in Canada. The epidemiological pattern of the cases in Canada follows that of the United States with the exception of intravenous drug users. In 1983, the federal government created a National Advisory Committee which is active in advising the Minister of National Health and Welfare on issues for the control and management of AIDS in Canada. In 1985, a $39 million program was announced. An enhanced program of AIDS control was established in July of 1987 with the creation of the Federal Center for AIDS (FCA). This has involved a substantial increase in financial and personnel resources. Canada plays a significant role internationally vis-à-vis AIDS; $10 million has been provided to the World Health Organization. The FCA is a WHO Collaborating Centre. In June of 1989, Canada will host the Vth International Conference on AIDS in Montreal.