With around 30 000 newly diagnosed HIV infections reported each year over
the last decade, the HIV epidemic remains a significant public health problem
in the 31 countries of the European Union and European Economic Area (EU/EEA).
‘The rate of newly reported cases of HIV increased by 2% each year among older adults since 2004.’
Based on data reported to ECDC between 2004 and 2015, 312 501 new HIV
diagnoses were reported in younger adults (15 to 49 years of age) in the
EU/EEA, resulting in an average reported incidence of new diagnoses of 11.4 per
100 000 population.
During this 12-year period, 54 102 cases were reported among older adults
aged over 50 years translating into 2.6 per 100 000 population. The rate of
newly reported cases increased by 2% each year among older adults since 2004,
when 3 132 diagnoses were notified in this age group. By 2015, around every one
in six (17%) of newly diagnosed HIV in Europe were among people aged over 50,
accounting for 5076 reported cases.
"Increasing new HIV diagnoses among older adults point towards the
compelling need to heighten awareness among health-care providers and deliver
more targeted prevention interventions for this age group and the total adult
population", the authors said.
Late diagnosis among older adults at 63%
The study also showed that those aged 50 or older are more likely
to be diagnosed late than younger adults with heterosexual transmission as main
route of infection
while sex between men is the main transmission
mode among younger adults.
Despite increasing evidence of the benefits of early HIV treatment, 63%
of the newly reported HIV cases (compared to 47% overall) in older adults were
diagnosed late or presented with indication of advanced infection
This means that their immune system is already starting to fail and suggests
persistent problems with access to, and uptake of, HIV testing and counselling
in many countries.
The study findings suggest that the HIV epidemic is evolving in new
directions which potentially is a result of low awareness of HIV and how it is
transmitted among older people, which leads to misconceptions and low
perception of their own risk of infection.
According to existing evidence, the most significant factor influencing
testing patterns among older adults appears to be the active offer of an HIV
test by service providers. The offer of HIV testing triggered by specific
health conditions (i.e. indicator-condition guided testing) is a very effective
and promising approach that could successfully target older adults if more
Similarly, other promising approaches, which may warrant scaling up, are
testing in primary health care or in emergency departments.
Diversifying and complementing testing opportunities is probably the best
strategy to reach older adults. Testing in community setting and self-testing
could be valuable additions to increase access and promote normalisation of HIV
test among the older individuals and the adult population at large.