Last year, 662 people in Belgium were diagnosed with the HIV virus that may cause the disease AIDS. That’s a slight increase of 2 per cent compared to 2023. The figures come from a new report by the Sciensano health institute. The increase is greatest among men with Belgian nationality.
In 2024, 50 per cent of newly registered HIV infections were diagnosed in heterosexual men and women (332 diagnoses) and 44 per cent in men who have sex with men (289 diagnoses). Injecting drug use was reported in connection with 3 per cent of HIV diagnoses.
The increase in infections is greatest among men of Belgian nationality, both among men who have sex with men and among heterosexuals. ‘In general, we are seeing a stabilisation, but then a further increase. There is no clear explanation for this,’ says Jessika Deblonde of Sciensano.
The high figures among Belgian heterosexual men (an increase of 33% compared to 2023) are particularly striking. ‘We are very keen to find out who these men are,’ says Veerle Doossche, STI and HIV policy officer at Sensoa, the Flemish centre of expertise for sexual health.
Do they only have sex with women, or do they also have sex with men and find it difficult to discuss this? That could be the case, but we don't yet know. We also see that heterosexuals are less well informed. Campaigns have always focused on men who have sex with men and on African communities, because historically most diagnoses were made in these groups. As a result, heterosexuals often underestimate their own risk, as do doctors, which means they do not automatically test for HIV."
Among women, HIV transmission through heterosexual contact is mainly reported among people from sub-Saharan Africa. ‘That too is traditionally a key population,’ says Deblonde.
The fact that there has been no decline for four years is a cause for concern for Sciensano. Initially, it was thought that there would be a catch-up effect after the COVID period, but that is now behind us. Additional efforts are needed, it seems.
‘It shows that the virus continues to spread. HIV is an incurable disease that requires lifelong medication. It is essential that people are well informed about the available prevention options, know their own risk and also use the appropriate prevention method,’ says Deblonde.
She emphasises the importance of early detection. ‘This is not only good for the health of the person themselves. Because once someone is treated making the virus no longer detectable, they can no longer transmit it!’
Prevention and sex education
Sensoa, the Flemish centre of expertise for sexual health, wants even more to focus on prevention among specific target groups, but is also looking to the governments.
‘Among other things, we advocate easier availability of PreP, medication that prevents the transmission of HIV,’ says Boris Cruyssaert of Sensoa. ‘In addition, we believe that relationship and sex education should be compulsory in schools, so that people are well informed about sexually transmitted diseases from an early age.’
‘People also find it difficult to talk about condom use; they are afraid of being rejected and sometimes find it awkward’ Doossche adds.
But the price of condoms can also be a barrier. ‘They used to be handed out to young people everywhere, in pubs, at festivals, but that's much less common now. In our condom survey, 31% of young people said they had sometimes not used one because it was too expensive. We definitely want to try and do something about that with Sensoa.’
What is HIV and when does someone get AIDS?
HIV stands for human immunodeficiency virus. The virus attacks the immune system that defends the body against bacteria, viruses, fungi and cancer cells. The virus is mainly transmitted through unprotected sex. You can also contract the virus through infected blood, for example through a blood transfusion or an infected needle. At the end of 2023, there were an estimated 18,700 people living with HIV in Belgium.
With appropriate medication, HIV can be suppressed to the point where it is no longer detectable. This also means that you can no longer transmit the virus to others. If HIV is not treated correctly, in the long term the virus causes AIDS. The immune system is then so weakened that it can no longer protect you. Relatively trivial parasites or viruses can then cause life-threatening conditions.