Rights of PLWHA in Rights of PLWHA in HungaryHungary

Application of Patients’ Rights in Application of Patients’ Rights in Cross-Border Health CareCross-Border Health Care

Regional meeting and workshopRegional meeting and workshop bby Ferenc Bagyinszkyy Ferenc Bagyinszky

Hungarian Civil Liberties UnionHungarian Civil Liberties UnionApplication of Patients’ Rights in Cross-Border Application of Patients’ Rights in Cross-Border

Health CareHealth CareRegional meeting and workshopRegional meeting and workshop

HIV-prevalence in HungaryHIV-prevalence in Hungary::

number of registered PLWH: 1,583 (184 number of registered PLWH: 1,583 (184 unknown)unknown)

number of PLWA: 567number of PLWA: 567 number of AIDS-deaths: 293number of AIDS-deaths: 293 HIV-prevalence: < 0,1%HIV-prevalence: < 0,1%

MSM-drivenMSM-driven epidemicepidemic

PLWH: PLWH: 805805 PLWA: PLWA: 380380 AIDS-deaths: 2AIDS-deaths: 21414 MSM-population: 500,000MSM-population: 500,000 HIV-prevalence in MSM-population: 0,HIV-prevalence in MSM-population: 0,1616%% share of MSM among PLWH: share of MSM among PLWH: 6868%%

MSM-targeted preventionMSM-targeted prevention

2 organizations in this field2 organizations in this field targeted VCTtargeted VCT information bookletinformation booklet HIV telephone helplineHIV telephone helpline

Estimated figuresEstimated figures

Total number of PLWH: 8,000-10,000Total number of PLWH: 8,000-10,000 Hungarian HIV-prevalence: 0,1%Hungarian HIV-prevalence: 0,1%

Total number of PLWH in MSM-Total number of PLWH in MSM-population: 7,000population: 7,000

Hungarian HIV-prevalence in MSM-Hungarian HIV-prevalence in MSM-population: 1,4%population: 1,4%

IDU-targeted preventionIDU-targeted prevention 22 HIV-cases (19 foreign citizens)22 HIV-cases (19 foreign citizens) Hepatitis C prevalence: 25%(!)Hepatitis C prevalence: 25%(!) targeted VCTstargeted VCTs 27 needle exchange programs by 15 27 needle exchange programs by 15

NGOsNGOs over 2,000 IDUs reachedover 2,000 IDUs reached over 213,000 needles handed outover 213,000 needles handed out

Anonymous VCT servicesAnonymous VCT services Act CLIV/1997 on Health Care (Health Act CLIV/1997 on Health Care (Health

Care Act) Paragraph 59, section (5) Care Act) Paragraph 59, section (5) ensures anonymity at any stage of testing ensures anonymity at any stage of testing asked by the patientasked by the patient

7 testing facilities in Budapest7 testing facilities in Budapest 15 testing facilities in the country 15 testing facilities in the country STI centSTI centreress problems in practiceproblems in practice

Care of PLWHACare of PLWHA

1 care centre in Budapest: Szent László 1 care centre in Budapest: Szent László Hospital Immunology DepartmentHospital Immunology Department

3 HIV-specialists3 HIV-specialists 880 patients on outpatient care880 patients on outpatient care 503 on ART503 on ART

Outpatient careOutpatient care

every 3 months visit to the hospitalevery 3 months visit to the hospital blood test: cd4 cells, viral load (only every blood test: cd4 cells, viral load (only every

6 months), general laboratory tests (blood-6 months), general laboratory tests (blood-sugar, enzymes, cholesterol etc)sugar, enzymes, cholesterol etc)

Visit to the doctorVisit to the doctor Prescription of medication for 3 monthsPrescription of medication for 3 months

Guidelines for ARTGuidelines for ART

AIDS is defined by the appearance of the AIDS is defined by the appearance of the first opportunistic infection and/or tumourfirst opportunistic infection and/or tumour

ART is usually started when cd4 count ART is usually started when cd4 count drops under 250 and/or first opportunistic drops under 250 and/or first opportunistic infections and/or tumours appearinfections and/or tumours appear

National Health InsuranceNational Health Insurance

All examinations and hospital stay are All examinations and hospital stay are coveredcovered

ART is covered by the NHIART is covered by the NHI HUF300 (cca.1euro) charged for each HUF300 (cca.1euro) charged for each

container prescribedcontainer prescribed

Medical dataMedical data

Act CLIV/1997 on the Handling and Act CLIV/1997 on the Handling and Protecting Medical and Personal DataProtecting Medical and Personal Data and and Ministry of Health Decree 18/2002 Ministry of Health Decree 18/2002 Paragraph 6, section (1) Paragraph 6, section (1) regulate the regulate the registry and report of new HIV/AIDS cases registry and report of new HIV/AIDS cases in Hungaryin Hungary

Anonymous HIV register and Anonymous HIV register and reportingreporting

New HIV/AIDS-cases are reported without New HIV/AIDS-cases are reported without personal identifiers for the National Centre personal identifiers for the National Centre of Epidemiologyof Epidemiology

Blood samples for cd4/viral load are sent Blood samples for cd4/viral load are sent to the laboratory without personal to the laboratory without personal identifiersidentifiers

Problems of PLWHAProblems of PLWHA

Discrimination:Discrimination: Health careHealth care

• When to disclose your statusWhen to disclose your status• Refusal of treatment by doctors (esp. dental care, Refusal of treatment by doctors (esp. dental care,

and other invasive care)and other invasive care) Work, education and other fields of social lifeWork, education and other fields of social life