REVIEW – April 2009

Spread of HIV in Estonia and possible prognostications for the future

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Abstract

The size of HIV-positive population in Estonia has been estimated to range from a couple to several tens of thousands while there are slightly less than seven thousand registered cases. The aim of the current study was to update and validate the estimates using epidemiological models. The results of our study allowed to estimate that there are 11–12 thousand HIV-positive persons currently in Estonia. We tested the hypothesis that the HIV epidemic started earlier and spread more slowly compared to the current assumption based on registration data. Slower spread would lead to 5-10% higher number of HIV-positive people in 2015 compared to faster spread scenarios assuming that other characteristics remain the same. Taking into account the size of HIV-positive population, estimated on the basis of models and the number of persons on antiretroviral treatment at present, only less than 50% of the persons who actually need treatment are receiving it, and approximately additional 2 000 persons could still benefi t from it. Furthermore, there is high probability that tuberculosis (TB) incidence will increase almost twofold by 2015, triggered by the HIV epidemic. The first indication of this in the era of declining TB incidence can be seen in the constantly increasing proportion of HIV positive persons among TB patients.