Correction to HIV case study in Greece featured in WHO/Europe report on social determinants of health

In September 2013, WHO/Europe published “Review of social determinants and the health divide in the WHO European Region”. The report incorrectly states that, in Greece: “HIV rates and heroin use have risen significantly, with about half of new HIV infections being self-inflicted to enable people to receive benefits of €700 per month and faster admission on to drug substitution programmes”.

In fact, what is accurate to say is that slightly more than half of Greece’s new HIV cases are among those who inject drugs. WHO recognizes that there is no evidence suggesting that deliberate self-infection with HIV goes beyond a few anecdotal cases. The statement is the consequence of an error in the editing of the report, for which WHO apologizes.

The original source is correspondence published in the “Lancet” by Alexander Kentikelenis and colleagues in September 2011. Kentikelenis et al. mention “accounts of deliberate self-infection by a few individuals to obtain access to benefits of €700 per month and faster admission onto drug substitution programmes”, based on the report of the “Ad hoc expert group of the Greek focal point on the outbreak of HIV/AIDS in 2011” (Athens: Greek Documentation and Monitoring Centre for Drugs; 2011).

Greece reported a significant increase (52%) in new HIV infections from 2010 to 2011, largely driven by infections among people who inject drugs. The causes for this increase are multifaceted and WHO welcomes the work of the ad hoc expert group and other entities to improve understanding of them and to recommend appropriate measures to extend the benefits of the comprehensive package of interventions for harm reduction to all people who inject drugs.

Information sources

Kentikelenis A, Karanikolos M, Papanicolas I, Basu S, McKee M, Stuckler D. Health effects of financial crisis: omens of a Greek tragedy. Lancet. 2011;378(9801):1457−8 ( 

Paraskevis D, Hatzakis A. An ongoing HIV outbreak among intravenous drug users in Greece: preliminary summary of surveillance and molecular epidemiology data. Lisbon: European Monitoring Centre for Drugs and Drug Addiction; 2011.

Paraskevis D, Nikolopoulos G, Fotiou A, Tsiara C, Paraskeva D, Sypsa V et al. Economic recession and emergence of an HIV-1 outbreak among drug injectors in Athens metropolitan area: a longitudinal study. PLOS one. 2013;doi:10.1371/journal.pone.0078941.g005
WHO, United Nations Office on Drugs and Crime, Joint United Nations Programme on HIV/AIDS. Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users, 2012 revision. Geneva: World Health Organization, 2012