Access to highly active antiretroviral therapy (HAART) in the WHO European Region 2003

Abstract

Aims: To assess changes in access to highly active antiretroviral therapy (HAART) between the end of 2002 and the end of 2005, and to review the capacity for further HAART scale-up in the then 52 Member States of the WHO European Region. Methods: Analysis of data from four surveys evaluating access to HAART, supplemented by regional estimates of the number of people receiving HAART. Changes in access to HAART are evaluated in terms of changes in the number of people receiving HAART over time and changes in country-level HAART coverage. Results: During 2003—2005, the total number of individuals receiving HAART increased by an estimated 101,000, from 242,000 to 343,000 (a 42% increase); 85,000 were in the west region (a 36% increase) and 16,000 in the centre and east regions (a 229% increase). The number of countries providing "high'' coverage with HAART (>75% of those in need receiving it) increased from 29 to 38, and the number of countries providing no HAART declined from eight to four. Conclusions: Despite high and increasing coverage in many European countries, access to HAART remained inequitable in terms of geographical location. By the end of 2005, all countries in the west provided "high'' HAART coverage as compared with half of countries in the centre and east. Six east countries still provided poor or no HAART coverage. Countries must address how to further equitably increase the number of people receiving HAART.

Keywords

Antiretroviral therapy access HIV/AIDS Europe

Get full access to this article

View all access options for this article.

References

Mocroft A. , Ledergerber B. , Katlama C. , Kirk O. , Reiss P. , d'Arminio Monforte A. , et al. Decline in the AIDS and death rates in the EuroSIDA study: an observational study . Lancet 2003;362:22—9.

Sterne JAC , Hernán MA , Ledergerber B. , Tilling K. , Weber R. , Sendi P. , et al. Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study . Lancet 2005;366:378—84.

Mannheimer SB , Matts J. , Telzak E. , Chesney M. , Child C. , Wu AW , et al. Quality of life in HIV-infected individuals receiving antiretroviral therapy is related to adherence . AIDS Care 2005;17:10—22.

Liu C. , Weber K. , Robison E. , Hu Z. , Jacobson LP , Gange SJ Assessing the effect of HAART on quality of life among HIV-infected women . AIDS Res Ther 2006;3:6—16.

European Centre for the Epidemiological Monitoring of AIDS (EuroHIV) , HIV/AIDS Surveillance in Europe: End-year report 1999. No. 62. Saint-Maurice: Institut de Veille Sanitaire; 2000.

European Centre for the Epidemiological Monitoring of AIDS (EuroHIV) , HIV/AIDS Surveillance in Europe: End-year report 2005. No. 73. Saint-Maurice: Institut de Veille Sanitaire; 2007.

Global HIV Prevention Working Group. HIV prevention in the era of expanded treatment access. Available at: http://www.gatesfoundation.org/nr/downloads/globalhealth/aids/PWG2004Report.pdf (accessed 5 April 2006).

Porco TC , Martin JN , Page-Shafer KA , Cheng A. , Charlebois E. , Grant RM , et al. Decline in HIV infectivity following the introduction of highly active antiretroviral therapy . AIDS 2004;18:81—8.

World Health Organization and UNAIDS , Treating 3 million by 2005: making it happen. Geneva: WHO; 2003.

10.

Dublin Declaration on Partnership to fight HIV/AIDS in Europe and Central Asia, Available at: http://ec.europa.eu/comm/health/ph_threats/com/aids/keydocs_aids_en.htm (accessed 26 May 2006).

11.

World Health Organization and UNAIDS Progress on global access to HIV antiretroviral therapy: a report on ``3 by 5'' and beyond. March 2006. Geneva: WHO; 2006.

12.

World Health Organization and UNAIDS ``3 by 5'' Progress Report. December 2004. Geneva: WHO ; 2005.

13.

Aceijas C. , Oppenheimer E. , Stimson GV , Ashcroft RE , Matic S. , Hickman M. , the Reference Group on HIV/AIDS Prevention and Care among IDUs in Developing and Transitional Countries. Antiretroviral treatment for injecting drug users in developing and transitional countries 1 year before the end of the ``Treating 3 million by 2005 . Making it happen. The WHO strategy'' (``3 by 5'') Addiction 2006;101:1246—53.

14.

Donoghoe MC , Bollerup AR , Lazarus JV , Nielsen S. , Matic S. Access to highly active antiretroviral therapy (HAART) for injecting drug users in the WHO European Region 2002—2004 . Int J Drug Policy 2007;18:271—80.

15.

WHO Regional Office for Europe. HIV/AIDS treatment and care: clinical protocols for the WHO European Region . Available at: http://www.euro.who.int/aids/treatment/20060801_1 (accessed 12 December 2006).

16.

Stover J. Projecting the demographic consequences of adult HIV prevalence trends: the Spectrum Projection Package . Sex Transm Infect 2004;80(Suppl 1):4—8.

17.

WHO Regional Office for Europe. Scaling up the response to HIV/AIDS in the European Region of WHO (EUR/RC52/ R9). Available at: http://www.euro.who.int/Governance/resolutions/2002/20021231_4 (accessed 26 May 2006).

18.

Boerma JT , Stanecki KA , Newell ML , Luo C. , Beusenberg M. , Garnett GP , et al. Monitoring the scale-up of antiretroviral therapy programmes: methods to estimate coverage . Bull World Health Organ 2006;84:145—50.

19.

Grassly NC , Morgan M. , Walker N. , Garnett G. , Stanecki KA , Stover J. , et al. Uncertainty in estimates of HIV/AIDS: the estimation and application of plausibility bounds . Sex Transm Infect 2004;80(Suppl 1):i31—i38.

20.

World Health Organization. WHO's Contribution to universal access to HIV/AIDS prevention, care and treatment . Available at: http://www.who.int/hiv/universalaccess2010/UA2010document._en_12may06.pdf (accessed 26 May 2006).

Access to highly active antiretroviral therapy (HAART) in the WHO European Region 2003—2005

Abstract

Keywords

Get full access to this article

References