An estimated 2.5 million people were living with HIV in the WHO European Region at the end of 2019, hereof two thirds in eastern Europe and central Asia (EECA) . EECA is one of three regions globally where the HIV epidemic continues to grow. According to data from UNAIDS, estimated new HIV infections have increased 72% in EECA between 2010 and 2019 . Over 140 000 people were newly diagnosed with HIV in 2018, including 79% in EECA, where the rate of new HIV diagnoses has doubled in two countries and increased between 30% and 81% in five other countries over the past decade . Prevention services are insufficient and there is a large gap between HIV testing and treatment initiation: Just 63% [52–71%] of people living with HIV who know their HIV status were receiving antiretroviral therapy at the end of 2019, leaving only 41% [34–46%] of all people living with HIV being virally suppressed in EECA. Estimated AIDS deaths have increased by 24% between 2010 and 2019 .
Key populations (people who inject drugs, men who have sex with men, transgender people, sex workers, prisoners and migrants) and their sexual partners are disproportionately impacted and high levels of stigma and discrimination impede the provision of effective HIV services along the continuum of care, from prevention, testing, linkage to care to treatment and viral suppression.
Scientific and context specific programmatic evidence is needed to reverse current trends and inform the practical implementation of clinical and programmatic interventions tailored to the local health-system settings. Investigating and addressing barriers that limit quality, efficiency and effectiveness of HIV clinical care, including testing and prevention, and determining which service delivery strategies would yield most impact, is key to improving outcomes. Supporting local research capacity building is essential to ensure a sustainable and evidence-informed response to the HIV, hepatitis and TB epidemics in the decades to come.
- UNAIDS. Global AIDS Update 2020. Geneva: UNAIDS; 2020.
- European Centre for Disease Prevention and Control/WHO Regional Office for Europe. HIV/AIDS surveillance in Europe 2019 – 2018 data. Stockholm: ECDC; 2019.