HIV evolves into midlife crisis

Illustration: graafika: Silver Alt

HIV used to mainly spread among the youth. Now, increasingly, it is caught by people in their 30ies and older. At that, two thirds of victims are men.

«The age of those newly infected is going up, the percentage of those over 29 years of age has increased,» said Kristi Rüütel, senior research fellow at National Institute for Health Development.

At the start of the epidemic exploding in Estonia (in 2000–2001) 78 percent of new cases were diagnosed among those aged 15–24; last year, the said age group only amounted to 14 percent of fresh cases. For example: among young males, only three persons were HIV diagnosed last year, while among those over thirty the amount was 126.

According to Ms Rüütel, the tendency has several possible explanations. «Our main risk group – injecting drug addicts – is aging,» she listed. Secondly, quite a few HIV cases are currently being diagnosed, the infection thereof being caught a couple of years ago. «Partly, it may also be due to HIV indeed spreading among older age-groups of general population where awareness of HIV risks is low and use of condom rare,» explained Ms Rüütel.

During a study done among young men recruited into defence forces two years ago, not a single case of HIV infection was detected. «Even with the young men studied had previously undergone thorough health check, the results still serve to show that HIV is going down among young men aged18–24,» said Ms Rüütel.

As a positive trend, she noted decrease of HIV among children and teens. Last year, 11 cases of HIV were diagnosed among those aged 15–19. «For comparison’s sake: in 2001 i.e. the peak of the epidemic, that age-group had 560 cases,» said the research fellow.

Despite the encouraging figures, Estonia still holds top position in EU regarding new cases of HIV. «For comparison, we have the 2012 data, with Estonia having 23.5 new HIV cases per 100,000 inhabitants,» said Ms Rüütel. Estonia was followed by Latvia (16.6), Belgium (11.1), Luxemburg (10.3), and the UK (10.3 cases).

In countries close to Estonia, the per-100,000-cases remain under ten: Finland 2.9; Lithuania 5.3; Norway 4.9; and Sweden 3.8.

While, at the start of the epidemic, HIV mostly spread among injecting drug-addicts, for years now the main spread has been sexually.

«This is the so-called natural way with the epidemic. In the first wave, it was first and foremost the injecting drug-addicts that got infected; in the second wave, it’s the sex partners of the injecting drug addicts,» explained the research fellow.

Among the ordinary population, without neither personal neither indirect sexual contact with injecting drug-addicts, still do have cases of infection (including being infected abroad, sex tourism etc). «People infected in this way, and the partners of drug addicts, are the ones through whom the infection is spreading among the ordinary population; and, as shown by data, such cases are increased somewhat, but surely not in epidemic proportions,» said Ms Rüütel.

In Estonia, a third of those infected are women, and two thirds men – except for the age group 15–24, where women are more numerous. «The infected drug-addicts that got infected at the beginning of 2000ies, have now grown up to be men, and are infecting their partners,» said Ms Rüütel.

Over the past years, percentage of women has increased in all age-groups.

As before, HIV is mostly registered in Ida-Viru County and Tallinn. Elsewhere in Estonia, only some single cases happen (2.2 cases per 100,000 inhabitants).