Reproductive HealthReproductive Health of People Living with HIVof People Living with HIV

in Polandin Poland

Tomasz NiemiecTomasz Niemiec

Other STD’s

Neoplasmas

FamilyPlanning

Demography

PMTCT

HarmReduction

Treatment Policy &Testing

HIV/AIDS Epidemiology

Antwerpen, 6 May,2005

Global StatisticalGlobal StatisticalDataData

HIV Prevalence0,1/<0,1%

Maternal Mortality8/100.000

Live births

Infertility1,5mln

couples

Population38175000

2003

ContraceptivePrevalence

Modern methods19%

AdolescencePregnancy

16%

Infant mortality

8,6‰

Fertility rate

- 0,04%

Reproductive Health of People Reproductive Health of People Living with HIV in PolandLiving with HIV in Poland

Antwerpen, 6 May,2005

HIV epidemiologyHIV epidemiology

Reproductive HealthReproductive Health of People Living with HIVof People Living with HIV

in Polandin Poland

Antwerpen, 6 May,2005

Antwerpen, 6 May,2005

HIV/AIDS epidemics in Poland as of end SEPTEMBER 2004.

9.002 - total number of infections since the beginning of the epidemics (1985)

5.115 - number of infections due to drug injection

1.473 - number of AIDS cases

710 - number of AIDS deaths since the beginning of the epidemics

Estimated number of PLWH: 20 – 30.000

Antwerpen, 6 May,2005

Treatment policy Treatment policy and testingand testing

Reproductive HealthReproductive Health of People Living with HIVof People Living with HIV

in Polandin Poland

Antwerpen, 6 May,2005

Treatment and testing

Testing:Viral load HIV RNA

4 times/year Testing:CD4/CD8

4 times/year

Antenataltesting

Anonymoustesting

Diagnosis ofVertical

Transmission ofHIV

VaccinationChildren

HIV+ mothers

ARVResistance

TestingWith

No limits

Funds allocated for ARV

20011272 pt

10 mln Euro 20021626 pt

10,5 mln Euro

20032100 pt

14,7 mln Euro

20042244 pt

19,5 mln Euro

200522 mln Euro

MTCTProphylaxis

1,3 mln USD Antwerpen, 6 May,2005

PMTCT

Reproductive HealthReproductive Health of People Living with HIVof People Living with HIV

in Polandin Poland

Antwerpen, 6 May,2005

PMTCT

Number of deliveries

app. 360.000/year

No dataNumber of

PregnanciesIn HIV+

Ca100 – 200

HIV+ mothers/ year

NoAntenatal

HIV testing

Ca 110Children

Living with HIV

88 on ARV

12 died Antwerpen, 6 May,2005

Risk of vertical transmission Warsaw Study, 2004

*3 *3 infected children receivedinfected children received ZDV ZDV after delivery; no ARV for mother after delivery; no ARV for mother

Since 1994Since 1994 Children with Children with prophylaxisprophylaxis

Children Children without without prophylaxisprophylaxis

TotalTotal

Children HIV- Children HIV- infectedinfected

66 3636 4242

Children not infectedChildren not infected 131131 4242 173173

TotalTotal 137137 7878 215215

Risk of vertical Risk of vertical transmissiontransmission

6/137 6/137 4 %4 %**

36/7836/7846,15%46,15%

42/21542/21519,5%19,5%

Antwerpen, 6 May,2005

FamilyPlanning

& Infertility

ContraceptivesAre

Not refundedRestrictedAbortion

law

Lack ofEducatedMedical

staff

No refundFor

Assistedreproduction

DiscordantCouples?

Antwerpen, 6 May,2005

neoplasmas

HIV-infected women

at the highest

risk for cervical

cancer No activeCytologicalscreening

DifficultAccess:Cytology

colposcopy

DifficultAccess:Gyn dpt.

NoHPVTest

HighRate

Cervicalcancer Antwerpen, 6 May,2005

Thank You !!!

Antwerpen, 6 May,2005