Update: Routine screening for antibodies to human immunodeficiency virus, civilian applicants for U.S. military service and U.S. Armed Forces, active and reserve components, January 2015-June 2020.

This report provides an update through June 2020 of the results of routine screening for antibodies to the human immunodeficiency virus (HIV) among civilian applicants for military service and among members of the active and reserve components of the U.S. Armed Forces. During January 2015- June 2020, full-year seroprevalences among applicants for service remained stable and ranged from 0.30 to 0.34 per 1,000 tested. Seroprevalences also peaked in 2015 for active component service members of the Army, Navy, and Air Force and among reservists of the Navy and Marine Corps. Overall, across the services, HIV antibody seroprevalences were highest among Army reservists, Army National Guard members, and Navy reservists and lowest among Air National Guard members, Marine Corps active component members, and Air Force reservists. Across active and reserve components of all services, HIV antibody seroprevalences continued to be higher among men than women.

Tendência temporal dos casos de HIV/aids no estado de Minas Gerais, 2007 a 2016 / Tendencia temporal de los casos de VIH/sida en el estado de Minas Gerais, Brasil, 2007-2016 / Temporal trend of HIV/AIDS cases in the state of Minas Gerais, Brazil, 2007-2016

Objetivo: analisar a tendência temporal dos coeficientes de incidência, detecção e mortalidade pelo vírus da imunodeficiência humana (HIV) e síndrome da imunodeficiência adquirida (aids) no estado de Minas Gerais, de 2007 a 2016. Métodos: estudo de séries temporais, com dados do Sistema de Informação de Agravos de Notificação (Sinan), por regressão de Prais-Winsten. Resultados: no período estudado, foram notificados 35.349 casos,entre os quais predominou a transmissão por via sexual (81,7%); destes, 50,3% foram entre heterossexuais e 22,8% entre homossexuais. Houve aumento da taxa de incidência de aids (variação anual 1,6%; IC95%0,0;3,3) e de detecção de HIV+ (variação anual 60,3%; IC95%22,9;109,0). A taxa de mortalidade foi estacionária. O percentual de notificações pelo critério HIV+ aumentou de 3,8% em 2007 para 65,1% em 2016. Conclusão: a tendência de crescimento da detecção de HIV coincide com a estratégia para identificação dos casos; a incidência de aids foi crescente.

Objetivo: analizar la tendencia temporal de los coeficientes de incidencia, detección y mortalidad por el Virus de la Inmunodeficiencia Humana (VIH) y Síndrome de Inmunodeficiencia Adquirida (Sida) en el estado de Minas Gerais, entre 2007-2016. Métodos: estudio de las series temporales de casos notificados del Sistema de Información de Agravamientos de Notificación (Sinan) por la regresión de Prais-Winsten. Se utilizó estadística descriptiva y análisis de series temporales. Resultados: había 35.349 casos y predominio de contaminación por vía sexual (81,7%), en heterosexuales (50,3%) y homosexuales (22,8%). Aumentó la tendencia de la incidencia de sida y detección de VIH +, con variación anual del 1,6% y del 60,3% (p <0,05), respectivamente. La mortalidad fue estacionaria. Aumentaron las notificaciones por el criterio de VIH +. Conclusión: el aumento de la tendencia de detección de VIH +, indica que la estrategia para identificación de portadores se ha mostrado apropiada, pero la incidencia de sida continua creciente.

Objective: to analyze the temporal trend of Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) incidence, detection and mortality coefficients in the state of Minas Gerais between 2007 and 2016. Methods: this was a time series study of data held on the Notifiable Health Conditions Information System (Sinan) using Prais-Winsten regression. Results: in the period studied, 35,349 cases were notified, with predominance of sexually transmitted cases (81.7%), 50.3% of which were heterosexual cases and 22.8% were homosexual cases. AIDS incidence increased (annual change 1.6%; 95%CI 0.0;3.3) as did HIV detection (annual change 60.3%; 95%CI 22.9;109.0). The mortality rate was stationary; HIV+ notifications increased from 3.8% in 2007 to 65.1% in 2016. Conclusion: the growing trend of HIV+ detection coincided with the government strategy to identify cases. AIDS incidence increased.

Seroprevalence and risk factors for HIV, HCV, HBV and syphilis among blood donors in Mali.

BACKGROUND: HIV, HBV and HCV remain a global public health concern especially in Africa. Prevalence of these infections is changing and identification of risk factors associated with each infection in Mali is needed to improve medical care. METHODS: We conducted a cross-sectional study of all individuals donating blood (n = 8207) in 2018 to the blood bank at university hospital in Bamako, Mali, to assess prevalence and risks factors associated with HIV, HBV, HCV and syphilis infections. RESULTS: HIV-seroprevalence was 2.16% and significantly increased with age, being married and decreasing education level. In multivariate analysis, after adjustements with age, marital status and geographical setting, only education level was associated with HIV-infection (OR, 1.54 [95% CI, 1.15-2.07], p = 0.016). HBsAg prevalence was 14.78% and significantly increased with to be male gender. In multivariate analysis, adjusting for age, marital status and type of blood donation, education level (OR, 1.17 [95%CI, 1.05-1.31], p = 0.02) and male gender (OR, 1.37 [95%CI, 1.14-1.65], p = 0.005) were associated with HBV-infection. HCV-prevalence was 2.32% and significantly increased with living outside Bamako. In multivariate analysis, adjusting for gender, age and education level, living outside Bamako was associated with HCV-infection (OR, 1.83 [95% CI, 1.41-2.35], p < 0.001). Syphilis seroprevalence was very low (0.04%) with only 3 individuals infected. Contrary to a prior study, blood donation type was not, after adjustments, an independent risk factor for each infection. CONCLUSIONS: Overall, HIV and HBV infection was higher in individuals with a lower level of education, HBV infection was higher in men, and HCV infection was higher in people living outside of Bamako. Compared to studies performed in 1999, 2002 and 2007 in the same population, we found that HIV and HCV prevalence have decreased in the last two decades whereas HBV prevalence has remained stable. Our finding will help guide infection prevention and treatment programs in Mali.

Recent levels and trends in HIV incidence rates among adolescent girls and young women in ten high-prevalence African countries: a systematic review and meta-analysis.

BACKGROUND: The roll-out of antiretroviral therapy (ART) has changed contexts of HIV risk, but the influence on HIV incidence among young women is not clear. We aimed to summarise direct estimates of HIV incidence among adolescent girls and young women since ART and before large investments in targeted prevention for those in sub-Saharan Africa. METHODS: We did a systematic review and meta-analysis. We searched MEDLINE, Embase, Web of Science, Global Health, and CINAHL for studies reporting HIV incidence data from serological samples collected among females aged 15-24 years in ten countries (Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe) that were selected for DREAMS investment in 2015. We only included articles published in English. Our main outcome was to summarise recent levels and trends in HIV incidence estimates collected between 2005 and 2015, published or received from study authors, by age and sex, and pooled by region. FINDINGS: 51 studies were identified from nine of the ten DREAMS countries; no eligible studies from Lesotho were identified. Directly observed HIV incidence rates were lowest among females aged 13-19 years in Kumi, Uganda (0·38 cases per 100 person-years); and directly observed HIV incidence rates were highest in KwaZulu-Natal, South Africa (7·79 per 100 person-years among females aged 15-19 years, and 8·63 in those aged 20-24 years), among fishing communities in Uganda (12·40 per 100 person-years in females aged 15-19 years and 4·70 in those aged 20-24 years), and among female sex workers aged 18-24 years in South Africa (13·20 per 100 person-years) and Zimbabwe (10·80). In pooled rates from the general population studies, the greatest sex differentials were in the youngest age groups-ie, females aged 15-19 years compared with male peers in both southern African (pooled relative risk 5·94, 95% CI 3·39-10·44) and eastern African countries (3·22, 1·51-6·87), and not significantly different among those aged 25-29 years in either region. Incidence often peaked earlier (during teenage years) among high-risk groups compared with general populations. Since 2005, HIV incidence among adolescent girls and young women declined in Rakai (Uganda) and Manicaland (Zimbabwe), and also declined among female sex workers in Kenya, but not in the highest-risk communities in South Africa and Uganda. INTERPRETATION: Few sources of direct estimates of HIV incidence exist in high-burden countries and trend analyses with disaggregated data for age and sex are rare but indicate recent declines among adolescent girls and young women. In some of the highest-risk settings, however, little evidence exists to suggest ART availability and other efforts slowed transmission by 2016. Despite wide geographical diversity in absolute levels of incidence in adolescent girls and young women, risk relative to males persisted in all settings, with the greatest sex differentials in the youngest age groups. To end new infections among the growing population of adolescents in sub-Saharan Africa, prevention programmes must address gender inequalities driving excessive risk among adolescent girls. FUNDING: This work was conducted as part of a planning grant funded by the Bill & Melinda Gates Foundation.

Epidemiological aspects of HIV infection and AIDS among indigenous populations.

OBJECTIVE: To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS: This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS: The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS: HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.

Epidemiological aspects of HIV infection and AIDS among indigenous populations / Aspectos epidemiológicos da infecção pelo HIV e da aids entre povos indígenas

ABSTRACT OBJECTIVE To describe the epidemiological aspects of HIV infection and AIDS among indigenous peoples of the state of Mato Grosso do Sul, Brazil. METHODS This is a descriptive epidemiological study on the occurrence and distribution of HIV infection and AIDS in the indigenous population assisted by the Distrito Sanitário Especial Indígena (Indigenous Special Health District) Mato Grosso do Sul between 2001 and 2014, based on three secondary databases. Annual rates of HIV and AIDS detection and prevalence were calculated, considering case distribution according to village, Health Base Pole and sociodemographic variables. Accumulated rates of detection, mortality and case fatality were calculated by ethnic group and for the Health Base Pole with the highest number of cases. RESULTS The HIV detection rate fluctuated between 0.0 and 18.0/100 thousand people in the study period. For AIDS, there was no notification before 2007, but in 2012 its rate reached 16.6/100 thousand. HIV prevalence grew between 2001 and 2011, and it continuously grew for AIDS starting from 2007. The highest HIV detection rates occurred among Guarani peoples (167.1/100 thousand) and for AIDS, among the Kaiowá peoples (79.3/100 thousand); mortality and fatality rates were higher among the Kaiowá. Regarding the Dourados Health Base Pole, the AIDS detection rate increased, and the mortality and fatality rates decreased. CONCLUSIONS HIV infection and AIDS have been increasing among indigenous peoples, with distribution of the disease mainly in the Health Base Poles of the southern region of the state, where greater economic and social vulnerability are also observed. The endemic character of HIV and AIDS can become epidemic in some years given the existence of cases in other villages in the state. Its occurrence among the Guarani and Kaiowá populations indicates the need for expanded diagnosis, access to treatment and prevention measures.

RESUMO OBJETIVO Descrever os aspectos epidemiológicos da infecção pelo HIV e da aids entre povos indígenas do Mato Grosso do Sul. MÉTODOS Estudo epidemiológico descritivo sobre ocorrência e distribuição da infecção pelo HIV e aids na população indígena assistida pelo Distrito Sanitário Especial Indígena Mato Grosso do Sul, entre 2001 e 2014, a partir de três bases de dados secundários. Calcularam-se as taxas anuais de detecção e de prevalência de HIV e aids, com distribuição dos casos segundo aldeia, Polo Base e variáveis sociodemográficas. As taxas acumuladas de detecção, mortalidade e letalidade foram calculadas por etnia e para os Polos Base com o maior número de casos. RESULTADOS A taxa de detecção de HIV flutuou entre 0,0 e 18,0/100 mil pessoas no período. Para a aids, não houve notificação antes de 2007, mas em 2012 sua taxa chegou a 16,6/100 mil. A prevalência de HIV indicou crescimento entre 2001 e 2011, e para a aids observou-se aumento contínuo a partir de 2007. As maiores taxas de detecção de HIV ocorreram entre os Guarani (167,1/100 mil) e de aids, entre os Kaiowá (79,3/100 mil); as taxas de mortalidade e letalidade foram superiores entre os Kaiowá. Para o Polo Base de Dourados, observou-se elevação da taxa de detecção de aids e diminuição das taxas de mortalidade e letalidade. CONCLUSÕES A infecção pelo HIV e a aids mostraram-se crescentes entre povos indígenas, com distribuição da doença principalmente nos Polos Base da região sul do estado, onde observa-se também maior vulnerabilidade econômica e social. O caráter endêmico do HIV e da aids pode se tornar epidêmico em alguns anos, considerando a existência de casos em outras aldeias do estado. Sua ocorrência entre os Guarani e Kaiowá sinaliza a necessidade de ampliação do diagnóstico, do acesso ao tratamento e de medidas de prevenção.

Proportion and factors associated with recent HIV infection in a cohort of patients seen for care in Italy over 1996-2014: Data from the ICONA Foundation Study cohort.

In Italy the prevalence of recent HIV infection (RHI) isn't currently monitored. Early diagnosis is crucial to allow introduction of antiretroviral therapy (cART) in the recent phase of infection. We aimed to estimate the proportion and the determinants of RHI among patients enrolled in the ICONA cohort; we explored differences in the median time from HIV diagnosis to cART initiation and in the viro-immunological response between RHI and Less Recent HIV infections (NRHI). We included antiretroviral-naïve HIV-positive patients enrolled in the cohort with documented dates of HIV-negative and positive antibodies tests, grouped in RHI (estimated date of seroconversion within 12 months of enrolment) and NRHI. Proportion of RHI and the trend of this proportion by calendar period (1996-2014) were investigated (Chi-square test). Logistic regression analysis was employed to identify factors associated with RHI. The time from seroconversion to cART initiation was compared in RHI and NRHI overall and after stratification by calendar period (survival analysis). We finally explored the time from starting cART to HIV-RNA <50 copies/mL and to CD4+ gain ≥200 cells/mmc by Cox regression. HIV seroconversion could be estimated for 2608/12,616 patients: 981/2608 (37.6%) were RHI. Proportion of RHI increased in recent calendar periods and was associated with younger age, baseline higher HIV-RNA and CD4+ count. There wasn't difference in the 2-year estimates of cART start between RHI and NRHI, regardless of calendar period. Rates and hazards of virological response were similar in RHI versus NRHI. RHI showed a 1.5-fold higher probability of CD4+ gain, also following adjustment for calendar period and cART regimen, and for age, HCV and smoking; the difference in probability was however attenuated after further controlling for baseline HIV-RNA and CD4+ T-cells. The increased proportion of RHI over time suggests that in recent years in Italy HIV infections are more likely to be detected earlier than before. The similar rates of cART introduction and viro-immunological response in RHI and NRHI probably reflect the efficacy of the modern cART regimens. An improvement of the prevention services is warranted to allow an early cART access, also in the perspective of therapy as prevention.

Reduction in undiagnosed HIV infection in the European Union/European Economic Area, 2012 to 2016.

It is well-documented that early HIV diagnosis and linkage to care reduces morbidity and mortality as well as HIV transmission. We estimated the median time from HIV infection to diagnosis in the European Union/European Economic Area (EU/EEA) at 2.9 years in 2016, with regional variation. Despite evidence of a decline in the number of people living with undiagnosed HIV in the EU/EEA, many remain undiagnosed, including 33% with more advanced HIV infection (CD4 < 350 cells/mm3).

Update: Routine screening for antibodies to human immunodeficiency virus, civilian applicants for U.S. military service and U.S. Armed Forces, active and reserve components, January 2012-June 2017.

This report contains an update through June 2017 of the results of routine screening for antibodies to the human immunodeficiency virus among civilian applicants for military service and among members of the active and reserve components of the U.S. Armed Forces. During the surveillance period, annual seroprevalences among civilian applicants for military service peaked in 2015 (0.33 per 1,000 tested) and then decreased slightly in 2016. Seroprevalences among Marine Corps reservists, Navy active component service members, and Navy reservists also peaked in 2015. Overall (1 January 2012 through 30 June 2017) seroprevalences were highest for Army reservists, Army National Guard members, Navy reservists, and Navy active component members. Among active and reserve component service members, seroprevalences continue to be higher among males than females.

Trends in HIV and HCV Risk Behaviors and Prevalent Infection Among People Who Inject Drugs in New York City, 2005-2012.

BACKGROUND: We assess trends in HIV and hepatitis C virus (HCV) risk behaviors and prevalent infection among people who inject drugs (PWID) in New York City (NYC). METHODS: PWID in NYC were sampled using respondent-driven sampling in 2005, 2009, and 2012 (serial cross sections) for the Centers for Disease Control and Prevention-sponsored National HIV Behavioral Surveillance study. Participants were interviewed about their current (≤12 months) risk behaviors and tested for HIV and HCV. The crude and adjusted risk ratio (RR) and 95% confidence interval (95% CI) for linear time trends were estimated using generalized estimating equations regression with a modified Poisson model. RESULTS: The sample comprised 500, 514, and 525 participants in 2005, 2009, and 2012, respectively. Significant (P < 0.05) linear trends in risk behaviors included a decline in unsafe syringe sources (60.8%, 31.3%, 46.7%; RR = 0.86, 95% CI: 0.81 to 0.92), an increase in all syringes from syringe exchanges or pharmacies (35.4%, 67.5%, 50.3%; RR = 1.15, 95% CI: 1.09 to 1.22), and an increase in condomless vaginal or anal sex (53.6%, 71.2%, 70.3%; RR = 1.14, 95% CI: 1.09 to 1.19). Receptive syringe sharing (21.4%, 27.0%, 25.1%), sharing drug preparation equipment (45.4%, 43.4%, 46.7%), and having ≥2 sex partners (51.2%, 44.0%, 50.7%) were stable. Although HIV seroprevalence declined (18.1%, 12.5%, 12.2%), HCV seroprevalence was high (68.2%, 75.8%, 67.1%). In multivariate analysis, adjusting for sample characteristics significantly associated with time, linear time trends remained significant, and the decline in HIV seroprevalence gained significance (adjusted RR = 0.76, 95% CI: 0.64 to 0.91, P = 0.003). CONCLUSIONS: This trend analysis suggests declining HIV prevalence among NYC PWID. However, HCV seroprevalence was high and risk behaviors were considerable. Longitudinal surveillance of HIV and HCV risk behaviors and infections is needed to monitor trends and for ongoing data-informed prevention among PWID.

Trends in Sero-Epidemiology of Human Immunodeficiency Virus in Voluntary Blood Donations in Iran, 2008-2013.

BACKGROUND: Various strategies are implemented to increase blood safety. However, there is always a small amount of residual risk. The amount of risk is associated with the incidence and prevalence of infection in the community. Since increases in the prevalence and changing the pattern of HIV transmission have been observed in the community, monitoring of HIV prevalence among general population and blood donors is necessary. This study aimed to determine the prevalence of HIV in Iranian blood donations. Demographic status and donation type were also investigated in HIV positive blood donors. METHODS: In the time frame of this study (2008 - 2013), the records of 11,504,231 donations were analyzed and all relevant data were extracted from the central database of the Iranian Blood Transfusion Organization. Demographic characteristics and type of donations were investigated. Descriptive and analytical statistics were used to summarize the obtained data. RESULTS: A total of 421 blood donations were HIV sero-positive. Trends in HIV prevalence from 2008 to 2013 per 100000 donations were found as follows: 3.8, 4.3, 3.8, 3.8, 3, and 2.9, respectively. The average prevalence was 3.6 per 100000. The prevalence rate showed a fluctuation from 3.8 to 2.9 per 100000. Gradual reduction has occurred in HIV sero-prevalence but the difference is not statistically significant. The risk of HIV sero-positivity was higher in single and female blood donors. The prevalence of HIV was much higher among donations from first-time than from regular and lapsed donors. CONCLUSIONS: The low prevalence rate of HIV in Iranian blood donations suggests the effectiveness of current safety strategies. However, implementing new strategies or improving the existing ones are advisable.

Could Circumcision of HIV-Positive Males Benefit Voluntary Medical Male Circumcision Programs in Africa? Mathematical Modeling Analysis.

BACKGROUND: The epidemiological and programmatic implications of inclusivity of HIV-positive males in voluntary medical male circumcision (VMMC) programs are uncertain. We modeled these implications using Zambia as an illustrative example. METHODS AND FINDINGS: We used the Age-Structured Mathematical (ASM) model to evaluate, over an intermediate horizon (2010-2025), the effectiveness (number of VMMCs needed to avert one HIV infection) of VMMC scale-up scenarios with varying proportions of HIV-positive males. The model was calibrated by fitting to HIV prevalence time trend data from 1990 to 2014. We assumed that inclusivity of HIV positive males may benefit VMMC programs by increasing VMMC uptake among higher risk males, or by circumcision reducing HIV male-to-female transmission risk. All analyses were generated assuming no further antiretroviral therapy (ART) scale-up. The number of VMMCs needed to avert one HIV infection was projected to increase from 12.2 VMMCs per HIV infection averted, in a program that circumcises only HIV-negative males, to 14.0, in a program that includes HIV-positive males. The proportion of HIV-positive males was based on their representation in the population (e.g. 12.6% of those circumcised in 2010 would be HIV-positive based on HIV prevalence among males of 12.6% in 2010). However, if a program that only reaches out to HIV-negative males is associated with 20% lower uptake among higher-risk males, the effectiveness would be 13.2 VMMCs per infection averted. If improved inclusivity of HIV-positive males is associated with 20% higher uptake among higher-risk males, the effectiveness would be 12.4. As the assumed VMMC efficacy against male-to-female HIV transmission was increased from 0% to 20% and 46%, the effectiveness of circumcising regardless of HIV status improved from 14.0 to 11.5 and 9.1, respectively. The reduction in the HIV incidence rate among females increased accordingly, from 24.7% to 34.8% and 50.4%, respectively. CONCLUSION: Improving inclusivity of males in VMMC programs regardless of HIV status increases VMMC effectiveness, if there is moderate increase in VMMC uptake among higher-risk males and/or if there is moderate efficacy for VMMC against male-to-female transmission. In these circumstances, VMMC programs can reduce the HIV incidence rate in males by nearly as much as expected by some ART programs, and additionally, females can benefit from the intervention nearly as much as males.

Estimating HIV incidence and number of undiagnosed individuals living with HIV in the European Union/European Economic Area, 2015.

Since 2011, human immunodeficiency virus (HIV) incidence appears unchanged in the European Union/European Economic Area with between 29,000 and 33,000 new cases reported annually up to 2015. Despite evidence that HIV diagnosis is occurring earlier post-infection, the estimated number of people living with HIV (PLHIV) who were unaware of being infected in 2015 was 122,000, or 15% of all PLHIV (n=810,000). This is concerning as such individuals cannot benefit from highly effective treatment and may unknowingly sustain transmission.

HIV and AIDS in Poland in 2014

AIM: The aim was to analyze the epidemiological situation of newly diagnosed HIV infections and AIDS cases in Poland in 2014 and years earlier. MATERIALS AND METHOD: Descriptive analysis of newly detected HIV cases and AIDS cases was performed based on routine notifications by clinicians and laboratories. Data on the number of HIV tests from annual survey among laboratories were also used. RESULTS: In 2014 there were 1,157 HIV cases diagnosed in Poland (incidence rate 3.01 per 100,000 population), including 14 among non-Polish citizens. The rate of new cases rose by 4.4% compare to last year and increased by 20% compare to median in 2008 - 2012. The total number of AIDS cases was 148 (incidence 0.38 per 100,000) and 40 AIDS patients died (0.10 per 100,000). HIV infection was mainly detected among people aged 20 to 39 years (72.0%) and among males (82.2%). Among men 64.5% of newly diagnosed infections with known transmission category were acquired by men who have sexual contacts with men (MSM). The percentage of infected men in this group decreased by 4.1% compare to previous year, but there were the increase in the percentage of infected person who take heterosexual contacts, from 20.4% to 24.7% (person with known transmission category). The percentage of late presenters (defined by the time between HIV and AIDS diagnoses of less than 3 months) increased in comparison with year 2013 by almost one percentage (from 8.4% to 9.2% of newly diagnosed HIV infections). CONCLUSIONS: HIV epidemic continues to develop among MSM in Poland. However, assessment of epidemiological situation is limited by the missing data on the probable transmission route in a large percentage of reported newly detected HIV infection.

Update: Routine screening for antibodies to human immunodeficiency virus, civilian applicants for U.S. military service and U.S. Armed Forces, active and reserve components, January 2011-June 2016.

This report contains an update through June 2016 of the results of routine screening for antibodies to the human immunodeficiency virus (HIV) among civilian applicants for military service and among members of the active and reserve components of the U.S. Armed Forces. During the surveillance period, annual seroprevalences among civilian applicants for military service peaked in 2015 (0.31 per 1,000 tested), up 29% from 2014 (0.24 per 1,000 tested). Seroprevalences among Marine Corps reservists, Navy active component service members, and Navy reservists also peaked in 2015. In the Army National Guard and the reserve component of the Marine Corps, full-year seroprevalences have trended upward since 2011. Overall (January 2011-June 2016) seroprevalences were highest for Army reservists, Army National Guard members, Navy active component members, and Navy reservists. Among active and reserve component service members, seroprevalences continue to be higher among Army and Navy members and males than their respective counterparts.

Trends in human immunodeficiency virus seroprevalence in blood donors in northern Pakistan.

OBJECTIVE: To study trends in human immunodeficiency virus (HIV) seroprevalence in blood donors in northern Pakistan. STUDY DESIGN: Analysis of annual data from blood transfusion centre. PLACE AND DURATION OF STUDY: Data records from people who had donated blood at the Armed Forces Institute of Transfusion (AFIT) between 1998 and 2013 were retrieved and analysed. METHODS: All blood donations were tested for the presence of HIV antibodies using Abbott Inc's AxSYM from 1998 to 2006, and Abbott Inc's Architect 2000i with chemiluminescence microplate immunoassay from 2007 to 2013. RESULTS: Over the 16-year study period, 66 donors tested positive for HIV antibodies out of 626,413 donations (0.01%, i.e. 10 per 100,000 donations). From 1998 to 2006, 16 HIV-positive cases were detected out of 280,245 donations (0.0057%, i.e. 5.7 per 100,000 donations). However, from 2007 to 2013, 50 HIV-positive cases were detected out of 346,168 donations (0.0144%, i.e. 14 per 100,000 donations). The difference in HIV positivity between the two groups was found to be significant (0.0057% vs 0.0144%, χ(2) = 10.4, P = 0.008). CONCLUSION: A gradual and persistent increase in the number of HIV-positive cases among blood donors in northern Pakistan was seen over the study period. The HIV-positive cases reported one or more high-risk activities in the past which predisposed them to HIV infection.

Providing ART to HIV Seropositive Persons Who Use Drugs: Progress in New York City, Prospects for "Ending the Epidemic".

New York City has experienced the largest HIV epidemic among persons who use psychoactive drugs. We examined progress in placing HIV seropositive persons who inject drugs (PWID) and HIV seropositive non-injecting drug users (NIDU) onto antiretroviral treatment (ART) in New York City over the last 15 years. We recruited 3511 PWID and 3543 NIDU from persons voluntarily entering drug detoxification and methadone maintenance treatment programs in New York City from 2001 to 2014. HIV prevalence declined significantly among both PWID and NIDU. The percentage who reported receiving ART increased significantly, from approximately 50 % (2001-2005) to approximately 75 % (2012-2014). There were no racial/ethnic disparities in the percentages of HIV seropositive persons who were on ART. Continued improvement in ART uptake and TasP and maintenance of other prevention and care services should lead to an "End of the AIDS Epidemic" for persons who use heroin and cocaine in New York City.

Update: routine screening for antibodies to human immunodeficiency virus, civilian applicants for U.S. military service and U.S. Armed Forces, active and reserve components, January 2010-June 2015.

This report contains an update through June 2015 of the results of routine screening for antibodies to the human immunodeficiency virus (HIV) among civilian applicants for military service and among members of the active and reserve components of the U.S. Armed Forces. Seroprevalences among civilian applicants in 2014 and the first half of 2015 (0.21 and 0.22 per 1,000 tested, respectively) were markedly lower than in 2012 (0.28 per 1,000 tested). In nearly every component of every military service, seroprevalences in 2014 and 2015 were either lower than, or relatively similar to, prevalences in prior years; however, in the Army National Guard, seroprevalences increased each year and approximately doubled from 2010 (0.18 per 1,000 tested) to 2014-2015 (0.36-0.39 per 1,000 tested). Among active and reserve component service members, seroprevalences continue to be higher among Army and Navy members and males than their respective counterparts.

HIV and AIDS in Poland in 2013.

AIM: The aim is to analyze the epidemiological situation of newly diagnosed HIV infections and AIDS cases in Poland in 2013 and years earlier. MATERIALS AND METHODS: Descriptive analysis of newly detected HIV cases and incident AIDS cases was performed based on routine notifications by clinicians and laboratories. Data on the number of HIV tests were derived from annual survey among laboratories. RESULTS: In 2013 there were 1,098 HIV cases diagnosed in Poland (detection rate 2.85 per 100,000 population), including 23 among non-Polish citizens. The rate remained at the same level as in 2011, but 14.7% higher than median in 2007-2011. The total number of AIDS cases was 163 (incidence 0.42 per 100,000) and 46 AIDS patients died (0.12 per 100,00). HIV infection is mainly detected among people aged 20 to 39 years (73.3%) and among males (85.6%). Aproximately 68.4% of newly diagnosed infections with known transmission category were acquired by homosexual contacts (MSM). The number of infections in this group decreased by 2.2% compared to previous year. The percentage of late presenters (defined by the time between HIV and AIDS diagnoses of less than 3 months) increased in comparison with year 2012 (8.4% of newly diagnosed HIV infections). CONCLUSIONS: HIV epidemic continues to develop among MSM in Poland. However, assessment of epidemiological situation is limited by the missing data on the probable transmission route in a large percentage of reported newly detected cases of HIV infection.

Twenty years trends and socio-demographic characteristics of HIV prevalence in women giving birth in Catalonia (Spain).

BACKGROUND: Studies of the prevalence of HIV in sentinel populations are one of the key strategies to monitor the HIV epidemic. We describe HIV prevalence trends and identify differences across time in the sociodemographic characteristics of HIV-infected women giving birth in Catalonia. METHODS: We used dried blood specimens, residual to newborn screening, which have been collected in Catalonia every 2 months since 1994. The total number of samples obtained until 2009 and in 2013 represented half of yearly newborns. From 2010 to 2012, the total number of samples obtained represented a quarter of yearly newborns. We studied the prevalence by year and place of current residence (Barcelona-city, cities>200,000 inhabitants and cities ≤ 200,000 inhabitants) and by the mother's birth country. A total of 624,912 infants were tested for HIV antibodies from January 1994 to December 2013. RESULTS: HIV prevalence trends among women giving birth in Catalonia decreased until 2007. Thereafter, there was a change to a steady trend until 2013. However, among foreign women giving birth and living in cities ≤ 200,000 inhabitants, the prevalence of HIV increased from 2007 to 2013. CONCLUSION: To ensure early identification and treatment of HIV-infected mothers, it is essential to maintain HIV surveillance programs and pre- and post-natal screening programs, both in Barcelona and in cities with 200,000 inhabitants or less, especially in immigrant women.