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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