Europe's Plan to Tackle Undiagnosed HIV

While HIV infection rates are relatively low in Europe compared to other parts of the world, a new report shows that one in seven people with HIV living in Europe does not know they are HIV-positive.

The HIV/AIDS epidemic is largely concentrated in sub-Saharan Africa, where about two-thirds of all HIV cases can be found according to the World Health Organization (WHO). HIV prevalence affects about 4% of the population in the African region and drops significantly where it’s next most prevalent in the Americas, where only 0.5% of the population is infected with HIV. In Europe, about 0.4% of people have the HIV virus. While public health efforts to fight the epidemic have been largely concentrated in the 21 sub-Saharan countries hit hardest by HIV — where the Joint United Nations Programme on HIV/AIDS (UNAIDS) has implemented programs such as increasing access to antiretroviral therapy drugs — the pandemic is a global issue.

A new surveillance report from the European Center for Disease Prevention and Control (ECDC) highlights the problem of HIV in the European Union (EU) and countries in the European Economic Area (EEA). Of the 2.1 million new HIV cases that occurred worldwide in 2015, the report noted that 29,747 occurred in the 31 countries of the EU/EEA. Estonia, Latvia, and Malta reported the highest rates of new HIV cases while Slovakia, Slovenia, and the Czech Republic saw the lowest rates. The overall rate of new HIV diagnoses has dropped only slightly over the last decade, from 6.6 cases per 100,000 people in 2006, to 6.3 cases per 100,000 in the new report. However, the ECDC noted that an estimated 122,000 people in the region are currently unknowingly living with HIV and the average time between infection and diagnosis is four years.

“ECDC’s estimate that one in seven people living with HIV are unaware of their status is particularly worrying: people who do not know they are infected cannot benefit from life-saving treatment, and can continue to transmit the virus to others,” said European Commissioner for Health and Food Safety, Vytenis Andriukaitis in a recent ECDC press release. “This is why easy and accessible testing is so important. The European Commission supports HIV testing by working together with Member States and civil society on joint projects, funded by the EU Health Programme, on prevention and linkage to care."

The report noted that new strategies for expanded HIV testing services are needed to decrease the number of people who receive a late diagnosis or are unaware of their HIV infection. Earlier this year, WHO released new guidelines on self-testing, noting that people who are undiagnosed are missing out on the important antiretroviral treatment recommended by the agency. The ECDC report cited these guidelines to call for more innovative self-testing approaches as part of an overall strategy to make it easier for undiagnosed individuals to access HIV testing services in European countries.

“To reach the estimated 15% who are not aware of their infection, we need to increase efforts to promote and facilitate more testing for HIV. And link those diagnosed to care,” said ECDC Acting Director Andrea Ammon. “A simple and quick blood test allows people to determine their HIV status. It’s best to know your HIV status so you can take care of your own health - and also protect others. ECDC is currently supporting Member States to standardise and improve their national estimates regarding the number of people living with HIV. This should lead to a more effective HIV response, because it enables better targeting of resources at the populations they identify as being most at risk in that country.”

The report also calls for better prevention efforts and intervention strategies to control the HIV epidemic in Europe, and to help those who are diagnosed with HIV gain access to treatment.