In 2020, according to Sciensano, there was a significant decrease in the number of HIV diagnoses in our country (-21 percent compared to 2019), which was strongly linked to the impact of the Covid-19 epidemic and the containment measures imposed. The global trend of the last decade therefore remains downward, says Sciensano.
The number of new HIV diagnoses increased among people of Belgian nationality, both among men who have sex with men and among heterosexual men and women, while among non-Belgians there was a decrease or stabilization in the number of HIV diagnoses.
Intravenous drug use
In 2021, 48 percent of newly registered HIV infections were diagnosed in men who have sex with men and 48 percent in heterosexuals. Intravenous drug use was reported for 2 percent of HIV diagnoses, perinatal transmission (transmission at birth) represented 1 percent of new diagnoses. Last year, 694,792 HIV tests were performed, an increase of 10 percent compared to 2020.
“It seems that HIV transmission among Belgian men who have sex with men has increased again in 2021 despite the increasing use of preventive HIV treatment (PrEP). This is suggested by the rising number of acute HIV infections in 2021, which reached the same number as in 2019,” it reads.
Diagnosis may be delayed in some individuals due to limited access to testing facilities during the 2020 lockdown periods due to the coronavirus pandemic. “However, the fact is that there was only a slight increase in late diagnoses in 2021, only among Belgians.”
Sciensano sees that the number of new HIV diagnoses continues to fall among non-Belgians, in particular among people with sub-Saharan African nationalities. “Various factors, such as migration dynamics and HIV prevalence in the countries of origin, influence the number of diagnoses in this group. As a result, it is difficult to pinpoint the exact reason for this downward trend.”
’95-95-95′ targets
In 2021, an estimated 19,177 people were living with HIV in Belgium. Of these, 94 percent were diagnosed, 89 percent received antiretroviral treatments, and 97 percent had a suppressed viral load. “This means that 81 percent of all persons living with HIV in our country had a suppressed viral load. Belgium is therefore well on its way to the UNAIDS “95-95-95” targets for 2025. Nevertheless, about one in five people living with HIV in Belgium has an unsuppressed viral load, which means that the virus can still be transmitted. be transferred. This is mainly due to delayed diagnosis or interruption of HIV care.”
“Despite the progress made in recent years, the HIV epidemic in Belgium is not yet under control. It is vital to make further progress in early diagnosis and the effective use of the full range of prevention strategies, including PrEP, by those at risk for HIV. The National HIV Plan undoubtedly provides an appropriate policy framework for coordinated collaboration and communication between health authorities and HIV actors to optimize the HIV response. As such, it is an essential tool for Belgium to achieve the UNAIDS targets for 2025,” the report said.
Vandenbroucke: “Belgium really needs to step up its game”
In response to the research by Sciensano, Minister of Health Frank Vandenbroucke (Vooruit) said that the federal government is providing an additional budget of 1 million euros for an HIV plan to bring the HIV epidemic in Belgium under control. “Belgium really needs to step up its game,” he says.
The budget is part of an HIV plan intended to meet the United Nations’ goal of ending the HIV epidemic by 2030, says Vandenbroucke. The money is used, among other things, to offer preventive HIV treatment to extra vulnerable people.
The Interministerial Conference (IMC) Public Health approved the national HIV plan last month after consultation with stakeholders and HIV patients. The plan includes preventive measures, but also, for example, systematically contacting patients who do not show up for their follow-up. In addition, preventive HIV treatment (PrEP) must be made more easily accessible to people with a high risk of HIV infection and work is being done on a legal framework for screening for HIV and STIs by non-medical healthcare providers.
According to Vandenbroucke, Belgium “really needs to step up a gear” when it comes to reducing the number of new HIV infections and diagnosing infected people quickly. “The latter makes it possible to start HIV treatment quickly.”