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HIV Infection in Lithuania
– Reported, June 14, 2013
Lithuania could potentially influence mother-to-child transmission. The majority of women with HIV of child-bearing age and it is well known that a woman with HIV can infect the foetus during pregnancy, during delivery and through breast-feeding. Perinatal HIV prevention is regulated by legislative acts of the Ministry of Health. These legislative acts recommend that HIV counselling and testing is provided to all pregnant women during the first and third trimesters of pregnancy. HIV testing is available for all pregnant women and provided free-of-charge due to the risk of perinatal transmission.
HIV infection has primarily predominated among persons aged 25-29 (26 %) and 30-34 (18%) years, while 77 % of cases were identified in the age group of 20-39 years. The youngest patient in Lithuania was 15 and the oldest 68 years of age at the time of HIV diagnosis. The average age differs according to mode of transmission. Among persons infected via sexual intercourse the average age is 37 years and among IDU is 30 years.
The first HIV-positive IDU in Lithuania was diagnosed in 1994. Two years later 4 HIV-positive IDUs were reported in the Klaipeda harbour area. Starting from 1997, HIV has been mainly spread via sharing contaminated needles within the IDU community. In 1997, IDUs accounted for 70 % of all registered cases of HIV. Annually, this mode of transmission accounts for 70-77% of all new cases of HIV infection in Lithuania. The estimated number of IDUs in Lithuania is more than 7000, but accurate data are still lacking due to inadequate resources needed to perform the necessary investigation.
The first case of heterosexual HIV transmission was reported in Lithuania in 1988. In 1993-1996 heterosexual transmission prevailed and HIV infection was predominantly registered among seamen who acquired the virus in Africa and the Far East. During 1988-1996, 50% of all new cases were due to heterosexual transmission while the number dropped to only 8% between 1996-2005. In recent years, the proportion of cases resulting from heterosexual transmission has steadily increased from 9% in 2001 to 18% in 2004, and 17% in 2005.
WHO and UNAIDS experts participating in a workshop that took place during 2003 estimated the number of MSM in Lithuania to be from 17 000 up to 44 000. The first HIV positive cases in Lithuania were diagnosed in the MSM community in 1989. We believe that the virus entered this community in 1980-1983. There were seven HIV cases registered in 1990. These cases were traced mostly by partner notification.
Lithuania is a country with low HIV prevalence and the epidemic is similar to that in other Eastern and Central European countries. The first cases were detected among MSM, then among IDUs and, recently, infection has been spreading more rapidly among heterosexuals. The prevailing mode of transmission is still injecting drug use among men. The prevalence of HIV infection is highest in the seaport and capital cities. The HIV epidemic peaked in Lithuania during the year 2002 due to an HIV outbreak in one correctional facility and, until recently, the incidence rate declined. During 1996-2005 the incidence rate has increased from 0.33 per 100 000 to 3.51 per 100 000. Though HIV infection among the male IDUs prevails, a rise in new cases among women is being observed. To date, no cases of perinatal HIV transmission have been reported. 77% of cases were identified in the age group 20-39 years.
CREDITS.
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