Bloodborne HIV: Don't Get Stuck!

During  1986-2020 and continuing, investigations of unexplained HIV infections in 11 countries found 12 large outbreaks with hundreds to thousands of HIV infections from unsafe skin-piercing healthcare procedures. HIV epidemics after investigations have been limited. In Romania, for example, only 0.2% of adults were HIV-positive in 2023. As of 2023, in eight of 11 countries with large investigated outbreaks, not more than 0.3% of adults were HIV- positive. In the other three, an estimated 0.4% of adults were infected in Mexico, 0.5% in Cambodia, and 0.8% in Russia.

As of 2023, more men than women were infected in all of the 11 countries. In 10 of 11 countries, many more men than women are infected, demonstrating a major contribution to their continuing epidemics from male-male sex and injection drug use. Cambodia is the exception: as of 2023, UNAIDS estimates just slightly more men than women infected. Cambodia’s 2014-15 investigation alerted people to risks to get HIV in health care, which has no doubt reduced those risks. If health care has gotten safer after 2014-15, this will likely change the sex ratio in coming years as fewer women and men get HIV from health care, while low numbers of men will continue to get HIV from injection drug use and sex between men.

Table: What happened after investigation discovered large HIV outbreaks from medical procedures?

Sources: Percentages of adults aged 15-49 years HIV-positive are from UNAIDS (HIV estimates with uncertainty bounds 1990-2023. The estimate for China is from Zhang et al, Curr HIV/AISA Rep 2020; 17: 151-160. The estimate for Russia is from Ogarkova et al, Viruses 2023; 15: 2156 (figure 3.1 reports just under 0.6% prevalence among all ages in 2022; I adjust that up to 0.8%, considering circa 20% of the population is <15 years old).