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HIV situation in Norway in 2014

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In 2014, there were 249 new cases of HIV diagnosed in Norway, a moderate increase from 2013. The increase is among men who have sex with men (MSM) and heterosexually-infected people living in Norway. The trend of fewer diagnosed cases of HIV infection continued among immigrants who were infected heterosexually before arrival in Norway.


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COLOURBOX kondom. Foto: Colourbox.com
COLOURBOX kondom. Foto: Colourbox.com
 
Illustration photo: colourbox.com 
Of the 249 HIV cases reported in 2014, there were 184 (74 per cent) men and 65 women.  In 2013, there were 234 HIV cases. Overall, there are now 5622 people diagnosed with HIV in Norway, 3803 men and 1819 women.
 
The HIV situation in Norway has remained relatively stable in recent years. It is characterised by persistently high numbers of newly diagnosed cases among MSM and among immigrants who  make up almost 50 per cent of diagnosed HIV cases each year. In addition, heterosexual men who are infected abroad, particularly in Thailand, make up a significant proportion of newly infected cases.
 
There is still a low number of HIV cases among injecting drug users, women born in Norway and adolescents. Increased testing activity, condom use and more HIV positives on treatment are still the most important preventive measures.
 
There is an increasing tendency for more immigrants to be tested in Norway who had previously tested HIV positive in their home country, and some of these have already started HIV treatment. In 2014, of the 120 immigrants that were infected before arrival in Norway, 46 already knew their HIV status from their homeland. Of these, 28 were infected heterosexually and 14 were infected homosexually. In addition, six people born in Norway tested HIV positive during long stays abroad. Since these cases are retested in Norway and therefore included in the laboratory and health service annual statistics for diagnosed HIV positive infection, they are included in the Norwegian HIV statistics.
 
Table 1. HIV infection reported to the Norwegian Surveillance System for Communicable Diseases (MSIS) 1984-2014 by year of diagnosis and transmission route

Transmission route

Before 2010

2010

 2011

 2012

 2013

2014

 Total

%

Heterosexual

 2229

157

 155

142

 124

 130

2937

52.2

- infected while living in Norway

691

57

46

46

31

 47

918

- infected before arrival in Norway

1538

 100

109

96

 93

 83

2019

Homosexual

1369

 85

97

 76

 98

 107

1832

32.6

Injecting drug use

564

11

10

11

 8

7

 611

 10.9

Via blood / blood products

47

0

 0

 0

 0

 1

48

0.9

From mother to child

 63

1

4

 7

 1

3

79

 1.3

Other / Unknown

 99

4

 2

 6

 3

1

115

2.1

Total

4371

258

268

 242

234

249

5622

100.0

MSM

107 cases of HIV among MSM were diagnosed in 2014, the highest number in any year among this group in Norway. However, the increase is due to homosexually-infected immigrants arriving in Norway and not because of an increase in new infections among MSM in Norway. Among MSM born in Norway, HIV figures have remained relatively stable over the last 10 years. The proportion of immigrant  HIV positive MSM has been increasing in recent years. In 2014, MSM with a migrant background accounted for about 50 per cent of notified cases among MSM.

The most concerning HIV development in Norway over the last 10 years is among MSM, with a threefold increase in the number of reported HIV cases since the increase began in 2003 until today. A similar development is seen in many other western countries.  This has resulted in a high HIV prevalence among MSM in some MSM communities, both at home and abroad, and a persistent high infection burden as a result. The infection burden among MSM is increased by a significant number of newly infected people with high viral loads who are not aware of their HIV status. The number of cases of gonorrhoea among MSM continued to increase in 2014 and the incidence of syphilis remained at a persistently high level, which also indicates unsafe sex among MSM both in Norway and on trips abroad.

In addition to increased condom use, early diagnosis is a prioritised goal in prevention. The importance of increased testing in this group is supported by the  significant number of MSM that every year are diagnosed after they have developed AIDS or another advanced HIV disease. MSM should be offered regular examination for sexually transmitted infections when they are in contact with their doctor or other health services.Sexually active MSM are encouraged to have an annual check-up, and men with multiple partners should be tested even more frequently.

 
HIV.
HIV.
Figure 1. Number of cases of HIV infection in Norway per 100 000 reported to MSIS 1984-2014 by year of diagnosis.