The committee advocates continued complementary strategies in prevention, including information campaigns and actions, particularly those targeting IDUs outside treatment or care centres National AIDS surveillance committee

The committee advocates continued complementary strategies in prevention, including information campaigns and actions, particularly those targeting IDUs outside treatment or care centres National AIDS surveillance committee

Nearly 75% of the new cases were male patients.  The main mode of contamination was heterosexual sex (39 cases), followed by homosexual or bisexual sexual relations (32), and intravenous drug use (IDU, 21 cases).

A European Centre for Disease Prevention and Control modeling tool estimates that up to 13% of individuals could potentially be living with HIV yet be undiagnosed.

New IDU trends

As the report details, there has been a strong increase in the prevalence of HIV among intravenous drug users, with 67 new cases identified between 2013-2016. More specifically, cocaine injection has become “increasingly popular” in Luxembourg, being used either with or without heroine, and its use has been associated with sharing and poly-drug use.

"The breeding ground for this epidemic within the epidemic is, on the one hand, the use of cocaine by injection,” explains Dr Vic Arendt, president of the committee, adding:

“On the other hand, [it is] social withdrawal: it’s largely within a subset of intravenous drug users who have lost their social situation, housing and health insurance that the epidemic is spreading.”

Health minister Lydia Mutsch agrees that the increase is of “great concern, especially given that Luxembourg has…a wide range of successful risk reduction offerings.”

Prevention strategies

The committee states that it “welcomes the decision” of the ministries of health and social security to take on the pre-exposure prophylaxis (PrEP) pilot project, underway in the grand duchy since April.

PrEP is an anti-HIV medication which, when taken regularly, interferes with HIV’s ability to copy itself if a person has been exposed to the virus--in short, helping HIV-negative individuals remain so.

Through this project, Luxembourg is the third country in Europe, after France and Norway, to make the prevention tool available.

The committee advocates continued complementary strategies in prevention, including information campaigns and actions, particularly those targeting IDUs outside treatment or care centres. Screening tests are also available and quick.

Nevertheless, as Dr Arendt adds, “Improving the management of social hardships and dependency seems to me to be the most pressing urgency.”