A new report has highlighted how Amsterdam in The Netherlands is successfully working to curb new transmissions of HIV.
New cases of the disease have almost been eliminated with just nine cases reported in 2022. Back in 2010 the city was reporting 201 new cases in a single year.
It is estimated that currently 98% of all people living with HIV have been diagnosed and are aware they are carrying the virus. The majority of those diagnosed, 98% are on anti-viral treatments and 95% of those people have archived viral suppression – meaning they are unable to transmit the virus to other people.
A report in Eurosurveillance, Europe’s journal of infectious disease surveillance, epidemiology, prevention and control, showed that there had been a 95% drop in new transmissions over the last decade.
Much of the success of the last decade is attributed to the creation of a specialised group, dubbed The H-Team, tasked with making a significant impact on the city’s response to the virus.
In an interview with AIDSmap Dr Godelieve de Bree, the Project Leader of The H-Team, spoke about the steps they took to make such a big impact.
Dr de Bree said the first step was bringing many stakeholders together.
“We started thinking about how to better use the city infrastructure in Amsterdam and to determine where the gaps in the HIV care continuum were. An important realisation was that we could improve the collaboration between the diverse stakeholders in HIV prevention and care, and therefore the first step was to bring everybody together.” Dr de Bree said.
The introduction of rapid testing that takes just an hour, alongside an effective promotional campaign, was credited with making inroads to reducing the numbers.
The team made sure that once people were diagnosed with HIV, they could see a hospital about their treatment pathway on the same day.
“If the test result is positive, then the clinic contacts one of the hospitals providing HIV treatment and the person can be seen the same day. In practice, the median time between diagnosis and starting treatment is around one day, so the majority of people who test positive start treatment very rapidly.” Dr de Bree shared.
The team also recognised that a quarter of new diagnoses were among heterosexual people, and often they were presenting with low CD4 counts, and AIDS-defining illnesses, indicating they have been living with the virus for a substantial amount of time before it is being detected.
The H-Team worked with GPs to create awareness and also to support GPs in understanding that there should be a low barrier to asking questions about sexual behaviour and offering HIV testing.
The introduction of PrEP treatment, a daily pill regime that protect people from contracting the virus, was also credited as having a major effect on the number of new cases.
Earlier this year the World AIDS Conference heard how a similar program in inner-City Sydney has also had great success in reducing new transmissions of HIV.
Both Amsterdam and Inner-city Sydney are on track to reach the United Nations goal of ending AIDS by 2030, but many other regions are still struggling to find success.
In November researchers at University College in London reported that their computer modelling suggested that the United Kingdom would fall short of the target despite success with PrEP treatments and a successful U=U promotional campaign.
U=U, Undetectable equals Untransmissible highlights that those getting treatment for HIV, and people taking PrEP treatment are respectively unable to pass on or pick up the virus.
Graeme WatsonÂ
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