In occasione della Giornata mondiale contro l’Aids, istituita dall’Oms il 1° dicembre 1988 e nota a livello globale come World Aids Day, l’Istituto Superiore di Sanità ha diffuso i dati raccolti ed elaborati dal Coa relativamente al 2019. In base a tale rapporto emerge che nello scorso anno sono state segnalate 2.531 nuove diagnosi di infezione da Hiv pari a un’incidenza di 4,2 nuove diagnosi ogni 100.000 residenti. In leggero calo, dunque, rispetto al 2018, in cui un tale dato era pari a 2.847 unità.
Nel 2019 le incidenze più alte sono state registrate in Lazio e in Lombardia: le persone che hanno scoperto di essere Hiv positive erano maschi nell’80% dei casi. L’età mediana era di 40 anni per i maschi e di 39 per le femmine. L’incidenza più alta è stata osservata tra le persone di 25-29 anni (10,4 nuovi casi ogni 100.000 residenti) e di 30-39 (9,8 nuovi casi ogni 100.000 residenti): in queste fasce di età l’incidenza nei maschi era quattro volte superiore a quelle delle femmine.
Lo scorso anno, inoltre, la maggior parte delle nuove diagnosi di infezione da Hiv era attribuibile a rapporti sessuali non protetti da preservativo, che hanno costituto l’84,5% di tutte le segnalazioni: di queste il 42,3% fa riferimento a eterosessuali e il 42,2% a maschi che fanno sesso con maschi (Msm). Diversamente dagli anni precedenti, in cui erano preponderanti le diagnosi associate a trasmissione eterosessuale, nel 2019, per la prima volta, la quota di nuove diagnosi Hiv attribuibili a Msm era pari a quella ascrivibile a rapporti eterosessuali. I casi attribuibili a trasmissione eterosessuale erano costituiti per il 59,6% da maschi e per il 40,4% da femmine. Tra i maschi il 53% delle nuove diagnosi era rappresentato da Msm.
Dal 2017 aumenta invece la quota di persone a cui viene diagnosticata tardivamente l’infezione da Hiv: 2/3 dei maschi eterosessuali e oltre la metà delle femmine con nuova diagnosi Hiv sono stati diagnosticati in fase avanzata di malattia. Al contrario il numero di nuove diagnosi di infezione da Hiv in stranieri è in diminuzione dal 2016: l’anno scorso il 25,2% delle persone con una nuova diagnosi di Hiv era di nazionalità straniera.
Il rapporto del Coa mette inoltre in luce come sia in costante diminuzione il dato di persone con una diagnosi conclamata di Aids. Nel 2019 sono stati diagnosticati 571 nuovi casi di Aids (rispetto ai 661 del 2018) pari a un’incidenza di 0,9 nuovi casi per 100.000 residenti. Dal 1982, anno della prima diagnosi di Aids in Italia, a oggi sono stati notificati al Coa 71.204 casi di Aids. Nell’ultimo biennio 2018-2019 le Regioni che hanno presentato il maggior numero di diagnosi sono nell’ordine: Lombardia, Lazio, Toscana. L’età mediana alla diagnosi dei casi adulti di Aids mostra un aumento nel tempo sia tra i maschi che tra le femmine. Infatti, se nel 2001 l’età era di 39 anni per i maschi e di 36 per le femmine, nel 2019 si è saliti rispettivamente a 47 e 45 anni. I dati relativi alla distribuzione delle patologie indicative di Aids mostrano che negli ultimi anni sono diminuite le diagnosi di candidosi e di polmonite ricorrente. È aumentata, invece, la quota di diagnosi di sarcoma di Kaposi, di Wasting syndrome e tubercolosi polmonare.
Da tale quadro si evince come, in ogni caso, sia necessario non abbassare la guardia e continuare in un serio impegno di informazione, prevenzione e contrasto all’Hiv/Aids. I dati italiani vanno poi letti in un contesto globale secondo i rapporti dell’Oms e dell’Unicef: da essi fra l’altro emerge che, se già nel 2019 i progressi in tale lotta erano rallentati, la pandemia da Covid-19, con l’interruzione, almeno nella prima parte dell’anno, di molti servizi di terapia e diagnosi, ha dato la battuta finale d’arresto vanificando gli obiettivi previsti per il 2020. Nel 2019 sono state 1.700.000 le nuove diagnosi e 690.000 le persone morte per complicanze da Hiv/Aids. Un prezzo molto alto lo hanno pagato infanti e adolescenti, che sono maggiormente senza accesso alle terapie. L’anno scorso 320.000 minori sono risultati positivi all’Hiv, 1 ogni 100 secondi, ma come denunciato l’Unicef, poco più della metà di bambini e bambine nel mondo ha avuto accesso alle terapie antiretrovirali. Molto al di sotto, dunque, della copertura offerta alle madri (85%) e ad adulti sieropositivi (82%).
Alla luce di tutto ciò sono enormemente da elogiare le iniziative che, nella giornata odierna, nonostante le restrizioni imposte per il contenimento della pandemia da Covid-19, si terranno, nel pieno rispetto delle misure di sicurezza, da un capo all’altro del globo. In Italia è da segnalare #HIVisible – 2gether, flashmob che, ideato dalla dragactivista Paola Lovely e organizzato da Plus Onlus, avrà luogo a Bologna e Roma e, contemporaneamente, a Lisbona e Londra. «Come persone sieropositive da sempre – sottolinea Sandro Mattioli, presidente di Plus – paghiamo un prezzo alto in termini di emarginazione sociale, ma oggi viviamo in prima persona anche l’emarginazione sanitaria causata più che dalla crisi sars-cov2, da scelte politiche miopi che prima hanno relegato il mondo dell’Hiv nei reparti di malattie infettive per poi oggi cacciarci anche da lì come un giocattolo che non diverte più».
Bisogna poi ricordare che il 24 novembre è stato lanciato il documentario, realizzato da Lega Italiana per la Lotta contro l’Aids e intitolato Nome di battaglia LILA. In esso presenti anche stralci d’intervista a Franco Grillini, direttore di Gaynews.it e presidente di Gaynet.
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