Written Answers. - HIV-AIDS Spread.
Ivor Callely
Question:
180
Mr. Callely
asked the
Minister for Health
if he will outline the measures and research which has been funded by his Department since the onset of HIV-AIDS in Ireland; whether the increasing spread of the HIV virus is due to sexual intercourse and the sharing of dirty needles; and if he will make a statement on the matter.
The current epidemiology of AIDS emphatically states that abusing intravenous drugs particularly by sharing needles and sexual intercourse with an infected person are high risk behaviours. The epidemiological development of AIDS and HIV infection in Ireland is similar to that experienced in other Western European countries. From 1981 to 1985 cases were reported in homosexuals and haemophiliacs and the condition was seen as a largely imported disease. When sero-prevalence monitoring became possible in 1985 it was apparent that the HIV virus was indigenous in the country and that a particular problem existed in relation to the spread of HIV infection in IV drug abusers.
To date we have 276 cases of AIDS reported which meet CDC-WHO definition. Some 1,214 people have tested HIV positive. In common with other countries in the EC the spread of transmission in homosexuals is slowing down, presumably due to changes in the lifestyle of homosexuals in the mid eighties. The percentage of IV drug related cases is now 40 per cent of all cases as compared to 10.5 per cent in 1986. This movement of the epidemic towards the drug abuser has led to a steady increase in the number of heterosexual cases. The figures for heterosexual cases show a rise from 6.6 per cent in 1986 to 9.4 per cent in 1989 in the EC countries. Nine per cent of Irish cases are heterosexual. In 1986 we had no heterosexual case in Ireland.
In the context of the evolving epidemiology of the disease in Ireland the National AIDS Strategy Committee have recently adopted a series of recommendations under the following headings:
— the care and management of persons with HIV-AIDS;
— HIV-AIDS surveillance;
— education and prevention strategies;
— measures to avoid discrimination.
These recommendations are now being implemented and investment in this process is on-going. As the Deputy is aware the Government have made available substantial additional resources services this year totalling £3.3 million. The measures being implemented build upon the AIDS strategy which has been progressively implemented since the 1980s. This strategy consists of:
— research into the prevalence of the disease through monitoring of AIDS cases, deaths from AIDS and prevalence of HIV;
— research into paediatric AIDS cases
— education and prevention programmes on AIDS through a range of programmes implemented primarily by my Department's health promotion unit;
— specific services for the care and management of persons with AIDS or HIV;
— general services provided and funded by my Department through the allocations to health agencies.
Evaluation of prevention, treatment and care programmes is on-going and an essential ingredient of current strategies. Such evaluation ensures that services are effective, are adequately tested and in line with best international practice and developments.
My Department are also supporting the research and development unit in primary care for HIV and AIDS of the Royal College of Surgeons which is currently assessing the strength and difficulties associated with the provision of a comprehensive primary care service in Dublin to persons with HIV and AIDS. Evaluation of the community care service will provide important assessment on costs, manpower and quality of care of primary care services.
