8th International AIDS Conference Amsterdam, Netherlands — July 19-24, 1992

Int Conf AIDS 1992 Jul 19-24; 8:We62 (abstract no. WeC 1095)
Reinking DP, Albers CE, Postma MJ, Jager JC, van den Boom FM; Netherlands Institute of Mental Health (NcGv), Utrecht.

OBJECTIVES: To assess the necessity, purposiveness and effectiveness of AIDS-prevention activities for the years 1992-2000.

METHODS: (1) integrative research (literature study and consultation of experts) on developments in HIV-infections, size of risk groups, riskful behavior and the impact of AIDS-prevention so far; (2) elaboration of scenarios, exploring the future spread of HIV in the Netherlands among varying risk groups, based on simulations with mathematical models; (3) assessment of the required level and intensity of AIDS-prevention for the period 1992-2000 RESULTS: In a reference scenario, exploring continuation of existing epidemiological trends, the AIDS-incidence in the period 1992-2000 is estimated at 5,700. This trendextapolation corresponds to an HIV-incidence in the period 1990-2000 of more than 3,000 infections. Thus the necessity of continued and intensified AIDS-prevention the next decade is obvious, especially when the underlying assumptions of this scenario are considered: (1) improved effectiveness of prevention, (2) no substantial spread of HIV outside known risk groups; (3) no effects of increased mobility. Scenarios exploring developments in riskful behavior give additional support for the conclusions from the reference scenario. Among relatively small groups of (a) 20,000 men with homosexual contact, (b) 8,000 ivdu and their heterosexual partners and (c) 15,000 prostitutes and their clients, scenario analysis shows a possible HIV-incidence on a short term up to 8,000 HIV-infections among group (a) due to relapse, up to 1,000 HIV-infections among female non ivdu heterosexual partners of ivdu and up to 700 HIV-infections among group (c). Furthermore scenario analysis indicates that a substantial spread of HIV among the heterosexual population seems unlikely within a few years, but might not be excluded on a long term.

CONCLUSIONS: For known risk groups continuation of targeted AIDS-prevention is essential and intensification of it must be considered. For the heterosexual population at large a reflection is recommended on an effective AIDS-prevention, combining factual information of current risk and the consequences of neglect on the long run.

Copyright © 1992 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.