[The spread of HIV in Greenland. Heterosexual epidemic--risk or reality? A 10-year review of HIV transmission and preventive care].

With the first report of an HIV-positive Inuit in 1985 Greenland was considered a high risk area for a self-sustained heterosexual HIV-epidemic, due to high incidences of sexually transmitted diseases. In 1986 a national HIV-intervention programme began with two major aims: Firstly, improved STD treatment and incitation to change of sexual high-risk behaviour, secondly, close monitoring of HIV-antibody test activity, partner notification and repeated surveys of knowledge and sexual behaviour in selected populations. Very early the spread of HIV in Greenland became heterosexually transmitted and self-sustained, with repeated local small-scale epidemics in a subpopulation characterized by frequent STD's, alcoholism, lack of education and vulnerable social and economic resources. From 1994 to 1997 a marked increase in new cases was reported, and in November 1997 the total number was 76 HIV-positives in the Greenlandic population of 50,000 Inuits. The successful defeat of STD's, such as gonorrhoea and syphilis has not been followed by a change in sexual behaviour among the youth in Greenland. High incidences of genital chlamydial infections, early sexual debut and high frequencies of excessive promiscuity render Greenland an alarming potential for a future HIV-epidemic. This threat calls for an intensified national prevention programme, with close monitoring of the known HIV-positives and the potentially infected persons in the population at risk, and new campaigns to reduce high-risk sexual behaviour among the youth.