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Observational Study
. 2019 Nov;24(48):1900078.
doi: 10.2807/1560-7917.ES.2019.24.48.1900078.

HIV infections and HIV testing during pregnancy, Germany, 1993 to 2016

Ulrich Marcus  1
Affiliations
Observational Study

HIV infections and HIV testing during pregnancy, Germany, 1993 to 2016

Ulrich Marcus. Euro Surveill. 2019 Nov.

Abstract

BackgroundElimination of mother-to-child transmission (MTCT) of HIV by 2020 is a goal of the World Health Organization (WHO) action plan for the European Region. However, data to monitor progress towards MTCT elimination are not readily available in Germany.AimWe aimed to estimate the number of pregnant women with HIV and MTCT rates in Germany.MethodsWe triangulated retrospectively obtained data from: (i) healthcare reimbursement for HIV screening tests, (ii) a statutory health insurance subsample of prevalent and incident HIV diagnoses among pregnant women, (iii) a mathematical model of the German HIV epidemic with number, region of origin and risk factors for women of childbearing age, and (iv) the statutory anonymous HIV registry on children infected through HIV MTCT.ResultsThe number of women aged 15-49 years with HIV increased from ca 6,000 in 1993 to ca 11,000 in 2016. Risk of injecting drug use (IDU) declined from 65% in 1993 to 16% in 2016. The annual proportion of women living with HIV giving live birth increased from a mean of 1.9% during 1993 to 1998 to 4.9% in 2011 to 2015. HIV screening rates during pregnancy increased from ca 50% in 2001 to ca 90% in 2016. The HIV MTCT rate dropped from 6.8% in 2001 to 1.1% in 2016.ConclusionsThe population of women living with HIV in Germany shifted from predominantly IDU-associated infections to predominantly sexually acquired infections, while fertility rates more than doubled. MTCT rates dropped, mainly because of improved detection and management of HIV in pregnancy.

Keywords: Germany; HIV; HIV pregnancy screening; mother-to-child transmission.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Number of pregnancies resulting in live birth and estimated proportion screened for HIV, Germany, 2001–2016 (n = 11,107,882)
Figure 2
Figure 2
HIV testing rates in women giving live birth, by age group, statutory health insurance subsample, Germany, 2011–2015 (n = 203,160)
Figure 3
Figure 3
Composition of the 15–49 year age group of women living with HIV, by transmission risk factor and region of origin, and estimated proportion becoming pregnant per year, Germany, 1993–2016
Figure 4
Figure 4
Estimated HIV screening rates in pregnancy and HIV mother-to-child transmission rates, Germany, 2001–2016
See this image and copyright information in PMC

References

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