Rate of HIV Infections on the Rise in Israel, but Declines Among Gay Men

Health Ministry report shows substantial increase in 2018 among women and heterosexual men ■ UN notes 'worrying increases' in eastern Europe and central Asia

Ido Efrati
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HIV-1 virus on a cell surface.
HIV-1 virus on a cell surfaceCredit: AP
Ido Efrati

The global fight against HIV/AIDS is stalling due to insufficient resources and higher rates of new HIV infections in some countries, including Israel.

According to a report by United Nations agency UNAIDS, more than half of all new HIV infections in 2018 were among sex workers, drug users, men who have sex with men, transgender people, prisoners and the sexual partners of these groups.

In Israel, 431 people, including 6 babies, were diagnosed in 2018, according to a report by the Health Ministry released on Tuesday. This follows the resurgence of cases in 2017, when 405 new HIV carriers were diagnosed after four years of continuous decline between 2012 and 2016.

In 2018, there was a substantial increase of cases among women - 142 compared with 115 in the previous year. The number of infected people in the heterosexual population also increased significantly - 136 cases this year compared to 87, while the rate of infection among gay men declined.

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The report notes the increase in the number of diagnosed cases is correlated to continued immigration from Eastern Europe, with 38% of new patients coming from the former Soviet. The overrepresentation of this specific group might be due to testing becoming more available for populations at risk, rather than an actual increase in infections. Medical sources underlined that obligatory HIV tests prior to the prescription of Hepatitis C has helped detect new cases.

In Israel, efforts in recent years have focused on reducing the rate of transmission in the LGBTQ community. The Health Ministry, the Israel AIDS Task Force and the Israel Gay Youth organization have campaigned for accessible testing and the formal introduction of preventative drugs, known as pre-exposure prophylaxis (PrEP). PrEP, given upon prescription, is yet to be subsidized by public healthcare, but has been added in recent years to supplemental insurance policies at a monthly cost of 300 Shekels (85 Dollars).

Dr. Margalit Lorver, who specializes in HIV care at the Hillel Yafe Medical center, noted that in 2018, two of the six babies who were born with HIV had mothers who did not know they were carrying the virus. “There is no HIV testing for pregnant women in Israel,” she said, noting that Israel is one of just four countries internationally who do not perform the test.

The Israel AIDS Task Force welcomed the news of reduced rate of infection among men who have sex with men, but called for a reduction in the cost of treatment and care, which currently stands at hundreds of Shekels a month. It added that according to its research, 70% of the population in Israel has never been tested for HIV and that the indicated increase in infections among the general population necessitates increased governmental budgets and resources.

Truvada, the drug used to treat HIV.Credit: NIAID

The UNAIDS report noted “worrying increases” in new infections in eastern Europe and central Asia, where HIV cases rose by 29%, as well as in the Middle East, North Africa and Latin America.

“Ending AIDS is possible if we focus on people not diseases,” said UNAIDS executive director Gunilla Carlsson.

She said now was the time to “create road maps for the people and locations being left behind (and) take a human rights-based approach to reaching people most affected by HIV.”

This would need greater political leadership, she said, starting with adequate and well-targeted investment.

Global funding for the AIDS fight dropped off significantly in 2018 – by nearly $1 billion – as international donors gave less and domestic investments did not grow fast enough to plug the gap. Around $19 billion was available for the AIDS response in 2018, UNAIDS said - falling $7.2 billion short of the total $26.2 billion it says is needed by 2020.

Globally in 2018, some 770,000 people died of AIDS and almost 38 million people were living with the human immunodeficiency virus (HIV) that causes it.

A man gets an HIV awareness campaign ribbon.Credit: Reuters

HIV cannot be cured but the infection can be kept in check by AIDS drugs known as antiretroviral treatment.

Around 23.3 million of the 37.9 million people with HIV worldwide currently get the AIDS drugs they need.

Around 1.7 million people were newly infected, the UNAIDS report said, a 16% decline since 2010, driven mostly by steady progress in parts of eastern and southern Africa.

South Africa, for example, has cut new HIV infections by more than 40% and AIDS-related deaths by around 40% since 2010.

But the report warned there is still a long way to go in many parts of eastern and southern Africa – the regions most affected by HIV.

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