Hundreds of thousands of people in the World Health Organization European region are not getting living with undiagnosed HIV, according to new data, published for World AIDS Day.
A new report, jointly published by the WHO Regional Office for Europe and the European Centre for Disease Prevention and Control (ECDC), shows that since at least 2018 until 2021 more people became infected with HIV in the European region than had been diagnosed.
By contrast, in the EU/EEA, there were slightly more diagnoses than HIV infections during the last decade, which indicates the number of people living with undiagnosed HIV is likely to be decreasing in many of those countries.
Dr Hans Henri Kluge, WHO regional director for Europe, said: “We should all be deeply concerned by the data on HIV testing, treatment and care in Europe and Central Asia. Continuing, widespread stigma around HIV is deterring people from getting tested and is steering us dangerously off course from meeting our 2030 goal of ending AIDS.
“If we are to deliver on our promise, we must make access to HIV services equitable. We must work together to make sure that no one feels afraid of getting tested, nor shame, despair or isolation about their status. Everyone, everywhere should be able to get the services and respectful care they need.”
In 2021, nearly 300 new HIV diagnoses were made every day across 46 of the 53 countries in the European region, including 45 each day from EU/EEA countries.
However, there was a sharp decline in reported numbers during 2020, the first year of the COVID-19 pandemic, and new HIV diagnoses reported in the WHO European region in 2021 remained almost 25% fewer than pre-pandemic levels.
Just over half of those newly diagnosed in 2021 had a CD4 cell count of less than 350 per mm3 at the time of diagnosis, which indicates they had been living with undiagnosed HIV for eight to 10 years. Of those, just over one third had more advanced HIV infection with a CD4 cell count less than 200/mm3.
The report says under-diagnosis and under-reporting mean late HIV diagnosis remains a major challenge in the European region.
Heterosexual transmission has decreased substantially in the EU/EEA and the West in recent years, particularly among women, as has the number of cases due to sex between men in selected countries in the EU/EEA and the West. Transmission through injecting drug use has declined steadily since 2012, although it remains high in the East.
The WHO Regional Office for Europe and ECDC, together with member states and partners, will monitor the long-term impact of COVID-19 and that of the war in Ukraine on HIV surveillance and continuity of HIV services.
ECDC director Dr Andrea Ammon said: “In the absence of regular HIV testing for those most at risk, there can be a long period of time between HIV infection and diagnosis. This is not good for individuals, as they have higher chances of severe illness and even death if diagnosed late. It is also not good for public health, as untreated positive individuals can unknowingly pass on HIV to their sexual partners.
“For this reason, we want to decrease the number of people living with undiagnosed HIV through early testing and rapid linkage to HIV treatment. Unfortunately, we see things moving in the opposite direction, with large numbers of people living with undiagnosed HIV.”
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