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HIV seroprevalence in five key populations in Europe: a systematic literature review, 2009 to 2019
- Annemarie Rinder Stengaard1 , Lauren Combs1 , Virginie Supervie2 , Sara Croxford3 , Sarika Desai3 , Ann K Sullivan4 , Stine Finne Jakobsen1 , Quenia Santos1 , Daniel Simões5,6 , Jordi Casabona7,8 , Jeffrey V Lazarus9 , John B F de Wit10 , Frank M Amort11 , Anastasia Pharris12 , Lina Nerlander12,* , Dorthe Raben1,*
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View Affiliations Hide AffiliationsAffiliations: 1 Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark 2 Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France 3 Independent consultant, London, United Kingdom 4 Directorate of HIV and Sexual Health, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom 5 EPIUnit–Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, Porto, Portugal 6 Grupo de Ativistas em Tratamentos (GAT), Lisboa, Portugal 7 Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Spain 8 Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain 9 Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain 10 Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands 11 FH JOANNEUM, University of Applied Sciences, Bad Gleichenberg, Austria 12 European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden* These authors contributed equally to this article and share last authorshipCorrespondence:Annemarie Rinder Stengaardannemarie.rinder.stengaard regionh.dk
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Citation style for this article: Stengaard Annemarie Rinder, Combs Lauren, Supervie Virginie, Croxford Sara, Desai Sarika, Sullivan Ann K, Jakobsen Stine Finne, Santos Quenia, Simões Daniel, Casabona Jordi, Lazarus Jeffrey V, de Wit John B F, Amort Frank M, Pharris Anastasia, Nerlander Lina, Raben Dorthe. HIV seroprevalence in five key populations in Europe: a systematic literature review, 2009 to 2019. Euro Surveill. 2021;26(47):pii=2100044. https://doi.org/10.2807/1560-7917.ES.2021.26.47.2100044 Received: 08 Jan 2021; Accepted: 04 Jul 2021
Abstract
In Europe, HIV disproportionately affects men who have sex with men (MSM), people who inject drugs (PWID), prisoners, sex workers, and transgender people. Epidemiological data are primarily available from national HIV case surveillance systems that rarely capture information on sex work, gender identity or imprisonment. Surveillance of HIV prevalence in key populations often occurs as independent studies with no established mechanism for collating such information at the European level.
We assessed HIV prevalence in MSM, PWID, prisoners, sex workers, and transgender people in the 30 European Union/European Economic Area countries and the United Kingdom.
We conducted a systematic literature review of peer-reviewed studies published during 2009–19, by searching PubMed, Embase and the Cochrane Library. Data are presented in forest plots by country, as simple prevalence or pooled across multiple studies.
Eighty-seven country- and population-specific studies were identified from 23 countries. The highest number of studies, and the largest variation in HIV prevalence, were identified for MSM, ranging from 2.4–29.0% (19 countries) and PWID, from 0.0–59.5% (13 countries). Prevalence ranged from 0.0–15.6% in prisoners (nine countries), 1.1–8.5% in sex workers (five countries) and was 10.9% in transgender people (one country). Individuals belonging to several key population groups had higher prevalence.
This review demonstrates that HIV prevalence is highly diverse across population groups and countries. People belonging to multiple key population groups are particularly vulnerable; however, more studies are needed, particularly for sex workers, transgender people and people with multiple risks.
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