Over the last 10 years, the average age of an HIV diagnosis in Estonia has increased from 31.6 to 40.8, data from the Health Board shows. There has also been an increase in the number of women and gay men being diagnosed and the virus is now more likely to be spread by sexual intercourse than injectable drugs.
ERR looked at the last 10 years of HIV statistics in Estonia to get an understanding of how the disease spreads in Estonia and the most recent trends.
There were 178 new cases of HIV in Estonia in 2019, of which 113 were men (63 percent) and 65 women (37 percent). 53 percent of new cases were diagnosed in Tallinn and 25 percent in Ida-Viru County.
Of the new cases diagnosed in 2019, one was a blood donor, six were pregnant women, four were in detention facilities, and 167 in anonymous healthcare services.
In the last few years, among blood donors, single cases have been discovered (less than five a year). The number of cases diagnosed in detention facilities has dropped significantly, in 2010 there were 72 diagnoses compared to four this last year.
Narva and Tallinn at the forefront
Looking at cities in Estonia, the highest number of new cases per 100,000 inhabitants was Narva with 38 cases per 100,000 people in 2019. In 2019, there were 22 infections per 100,000 people in Tallinn.
But in absolute terms, Tallinn had the highest number of new infections at 95 while Narva had 21 cases. The number of new cases in Narva has been declining for several years.
Over the last 10 years, new diagnoses in Narva have decreased three times from 71 cases to 21 per year, and in Tallinn less than twice from 167 to 95.
During the same time period, a total of 452 new HIV cases were diagnosed in Narva, which is 16 percent of all new HIV cases detected during this period.
In a total of 1,357 HIV cases were diagnosed in Tallinn between 2010 and 2019, which is half of all new HIV cases detected during this period.
Since 2010, more than half of new cases have been detected among those aged 30 and over, and in 2019, the proportion of those over 30 was 87 percent of all infections.
The increase in the share is primarily due to a significant decrease in younger people, as there is a decrease in absolute numbers among them as well. There are similar trends for both men and women.
Increase in women and average age
While almost 70 percent of all new HIV cases are discovered among men, there has been an increase in the number of women being diagnosed with new cases.
In 2001, a total of 20 percent of the total number of new cases were diagnosed among women, but by 2019 this number had almost doubled to 37 percent. The percentage of new cases diagnosed among women has hovered around 36 percent for the last five years.
The average age to be diagnosed with HIV has also increased. In 2010, it was 31.6 years and in 2019 it was 40.8 years.
The average age of women's diagnosis has increased during the last 10 years from 30.5 years to 39.9 years.
The reasoning behind the increase in average age is not so much the overall increase in cases among older people, but rather the decrease in the number of cases among younger people.
The average age for people infected with HIV through injected drugs has generally been lower, and was 34.3 years in 2019, than sexually transmitted infections.
Among homosexuals, the average age for being diagnosed with HIV is 35.9 years, but among heterosexuals, it is 40.4 years.
The number of HIV cases has decreased among children and the young. In 2019, there were no new cases among children aged 10-14, but two new cases were diagnosed in 19-year olds.
An increasing amount of diagnoses among the elderly
An increase in newly diagnosed cases over the last 10 years can be seen among people aged 50 and older. The total number of cases has increased, while the number of cases among people 50 years and younger has consistently decreased.
The largest drop in cases has been among people aged 15-29. The largest increase in new diagnosed cases has been that of people aged 70 and up.
Transmission in that age group is rare. Since 2016, there have been nine cases of HIV diagnosed in people aged 70 or older. The oldest person diagnosed in Estonia is an 80-year old.
Transmitted mostly through heterosexual intercourse
According to data from the Health Board (Terviseamet), the amount of new HIV cases via injection drugs in 2019 was 11 percent and are highest among 16-39 year olds. There have been no cases diagnosed from injectable drugs among people aged 50 and older.
Transmission through heterosexual intercourse in 2019 was 45 percent. Additionally, the share of the number of cases transmitted through heterosexual intercourse has doubled over the last decade.
Last year, 43 men and 37 women were infected through heterosexual intercourse. Many other European countries see a trend of more women being diagnosed with HIV through heterosexual intercourse than men.
So there is the possibility that some men who claim to have gotten the virus through heterosexual intercourse, have instead gotten the virus through homosexual intercourse or via injection.
Regional data shows that the percentage of infections through heterosexual intercourse is higher in Ida-Viru County, including Narva, than in Tallinn and Harju County. The number of new cases in other parts of Estonia is low and there are no noticeable trends.
The number of cases passed through homosexual intercourse has also increased, last year the percentage of new cases was 9 percent. Going back five years to 2014, the share of new cases via homosexual intercourse was just one percent and has gradually increased since then.
The number of new cases decreasing
Since 1988, there has been a total of 10,079 new diagnosed cases of HIV in Estonia. There is no precise info on how many have of those infected have died and if there are some people who have been registered twice.
Between 2010 and 2019, the total number of new cases a year dropped by 52 percent. Testing capacity has increased, which points to a natural decrease due to controlling the spread of the virus.
The number of total tests has increased year-to-year. Women tend to be tested more because they are checked when pregnant, the share of tested men is significantly lower, but high in Ida-Viru County.
The data related to new cases of HIV shows an overall stabilization of transmission in Estonia.
In 2019, AIDS was diagnosed in three of about ten percent of all diagnosed with HIV. A fast progressing virus shows that most diagnoses were done in the late stages of the virus.
Statistics related to diagnoses and deaths are more complicated.
Data on known deaths due to AIDS is available up to 2018. The Health Board has registered 539 people with AIDS, according to Statistics Estonia (Statistikaamet) there have been 681 deaths up to 2018.
Additionally, according to Statistics Estonia, there have been 567 people diagnosed with AIDS, and 28 new cases in 2019.
Data from the Estonian Health Insurance Fund (Haigekassa), the Health Board, and prisons show by 2017, 50 percent (3,881 people) of people diagnosed with HIV had progressed to AIDS, and 30 percent (1,150) of people had died.
According to the National Institute for Health Development (Tervise Arengu Instituut), the discrepancies in statistics show a lack of notifying central registries.
Editor: Kristjan Kallaste