Amsterdam, 23 November 2023

In 2022 a total of 393 people were diagnosed with HIV in the Netherlands. Of these, 54% were men who have sex with men (MSM), while the remaining 46% were other men, women and trans people. The decline in new diagnoses among MSM was greater than among other men, women and trans people. As a result, the relative proportion of other men, women and trans people who were diagnosed with HIV, increased. Within these three population groups HIV is also often diagnosed at a late stage. In 2022 a total of 21 people died from AIDS-related illnesses. These findings are presented in the latest report published by the HIV Monitoring Foundation in the Netherlands (SHM), released today, leading up to World AIDS Day.

The number of HIV diagnoses in the Netherlands has fallen steadily since 2010. To date, stichting hiv monitoring has recorded 393 HIV diagnoses for the year 2022. This comprises 213 men who have sex with men (MSM) (54%), 96 other men (24%), 70 women (18%) and 14 trans people (4%). The number of new hiv-diagnoses in 2022 fell by 67% compared with 2010, but the decrease seems to slowing down in recent years. In 2019, 2020 and 2021, new HIV diagnoses amounted to 614, 432 and 410 respectively.   

HIV in men who have sex with men (MSM)
The greatest decrease in new HIV diagnoses was recorded among MSM (down from 768 in 2010 to 213 in 2022; a drop of 72%). Within this group, the steepest decline was for those between 30 and 50 years of age, while it was much less marked for young MSM (up to 30 years of age) and those aged 50 years and older. The proportion of MSM up to 30 years of age increased from 24% in 2010 to 31% in 2022, while the proportion of MSM older than 50 years of age increased from 16% to 30% in the same period.

“This could signal that younger and older men who have sex with men are less aware of the various ways to prevent HIV, or that they find preventative measures more difficult to access than men aged 30 to 50 years old,” said professor Marc van der Valk, member of the board of stichting hiv monitoring.

HIV in other men, women and trans people
In 2022, 46% of new HIV diagnoses were recorded for other men, women and trans people. While the number of absolute diagnoses within these groups also continues to decrease (down from 391 in 2010 to 180 in 2022), the decline is less steep than found for MSM. As a result, the number of new diagnoses within these groups proportionally increased, up from 33% of all new diagnoses in 2010. 

Late diagnoses detrimental to health
Between 2020-2022, 48% of all new HIV diagnoses were late diagnoses*. This amounted to a total of 575 people. The proportion of other men (69%) and women (57%) who entered care with a late-stage HIV diagnosis between 2020-2022, was much higher than MSM (38%).

Of these 575 people with a late-stage diagnosis between 2020-2022, 206 (36%) were admitted to hospital with an HIV-related illness within a year, and 16 (3%) died as a direct result of HIV. Of the 622 people who received a timely HIV diagnosis during the same period, only 19 (3%) were admitted to hospital within the first year following diagnosis, and none died as a direct result of HIV.

“In this day and age, that’s a needlessly high number of late-stage hiv-diagnoses for a country like the Netherlands. When HIV is detected early on, we can prevent further damage to health and ensure people can continue to live a healthy life. A timely diagnosis and treatment plan can also help to prevent the spread of HIV,” explained Van der Valk.

Population
At the end of 2022 there were estimated 24,400 people with HIV in the Netherlands, of which 21,978 had started antiretroviral therapy. Of these, 21,094 (96%) had successfully suppressed the virus; they could no longer transmit the virus to others as a result. In addition to this known group there are an estimated 1,390 people in the Netherlands with an as-yet undiagnosed HIV infection. Using a mathematical model, stichting hiv monitoring calculated that the number of new HIV infections** in 2022 will reach 140, a drop of 85% compared with 2010.

Social-economic and demographic factors
A new feature in this year’s report is that a number of analyses used microdata from Statistics Netherlands. This provides a greater insight into the social-economic and demographic circumstances of people with HIV in the Netherlands. Among other things, these analyses reveal that among MSM there is a correlation between the level of income and successful viral suppression: the lower the income, the lower the percentage of people with successful viral suppression after starting antiretroviral therapy.

^*A late diagnosis is defined as a CD4 cell count <350 cells/mm³, and/or a simultaneous AIDS diagnosis where the HIV test does not indicate an acute infection and there is no HIV-negative test in the twelve months preceding the HIV diagnosis.

^**A new HIV infection is not the same as the reported number of people with a new HIV diagnosis. In practice, often many years elapse between the moment of HIV infection and HIV diagnosis. The number of HIV infections is calculated from number of HIV diagnoses, using a mathematical model and information about the course of the infection. Therefore, these are always reported as an estimated number of new infections.