30 November 2022

HIV: time to boost detection in Europe

Widening HIV Screening Could Boost Early Detection

As we are phasing out of the COVID-19 emergency mindset, it can be easy to forget the other viruses that have been disrupting people’s lives long before. Indeed, ahead of World AIDS Day on 1 December, a keen eye must be kept on the HIV epidemic. Despite the fact that current global targets are resolved to eliminating AIDS as a public health threat by 2030, global progress on reducing HIV mortality is faltering.

Back in May, the 75th World Health Assembly approved, not without struggle, the Global HIV, Hepatitis and STIs Programme, but the world is off-track on achieving global targets. In fact, countries did not reach their 90-90-90 UNAIDS targets by 2020 - aiming at having 90% of people with HIV know their status, be on treatment and be virally suppressed. 

But not all news is bad. On a more positive note, for example, UNAIDS, UNICEF, WHO and partners have launched over the summer a global alliance to end AIDS in children by 2030, to ensure that no child living with HIV is denied treatment and to prevent new infant HIV infections.

Moreover, as the 24th International AIDS Conference showed in August, the time is right to take a closer look at HIV/AIDS policy in Europe. In 2020 alone, 14.971 new HIV diagnoses and 519 AIDS-related deaths were reported in the EU/EEA by the European Centre for Diseases Prevention and Control – data which could be even higher considering the disruption that the COVID-19 pandemic caused on healthcare systems monitoring. As we are now headed towards 2025 with the new and more ambitious 95-95-95 UNAIDS targets, it is perhaps time to revisit our approach to fighting the virus.

In this context, boosting early detection is another way to move forward and make progress on eliminating HIV/AIDS. In order to achieve the first of the UNAIDS’ 95-95-95 goals – ensuring that 95% of people living with the virus have received a diagnosis - HIV screening programmes need to reach individuals who are not viewed as belonging to a risk group, and who may be overlooked but might nonetheless be living with the virus, as recommended by European HIV testing guidelines

As suggested during the latest European AIDS Conference in 2021, the implementation of these guidelines is currently being hindered by medical guidelines not recommending screening for people with AIDS-defining conditions, such as cervical cancer or tuberculosis, or other HIV-related illnesses, like sexually transmitted infections. Not only are healthcare professionals unaware of HIV-testing recommendations, but most of the specialty medical guidelines do not even mention HIV testing. 

By widening HIV screening to people with ‘indicator conditions’, coupled with improved education and training, EU countries could boost early detection of HIV and therefore make a leap forward in eliminating AIDS a public health threat by 2030. The time to act is now. Indeed, the COVID-19 pandemic has fostered an unprecedented wave of innovation in terms of communicable diseases control, but how can we make sure that we address the backlog created by the pandemic and we do not unravel the progress made so far? A joint effort is needed from both policymakers and healthcare professionals to make sure the need for wider HIV screening is addressed.

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