The number of newly diagnosed HIV cases fell by 24% in Europe between 2019 and 2020, a new report has revealed.

This drop is largely due to reduced HIV testing during 2020 as a result of the Covid-19 pandemic, which disrupted healthcare services worldwide.

The report was published jointly by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization’s (WHO) Regional Office for Europe. It covers the WHO European Region, which is made up of 53 countries, including the 27 member states of the EU.

Both the ECDC and WHO have expressed concern about the figures in the report given that over the last decade, HIV infections had been increasing in the WHO European Region. They said that the figures suggest that the number of people in the region who are living with undiagnosed HIV is most likely on the rise again.

According to ECDC director, Dr Andrea Ammon, 2020 was a “key year for HIV, when we needed to be reaching the 90-90-90 testing, treatment and viral suppression targets to be on track to meet the Sustainable Development Goals by 2030”.

“While we have seen a decline in cases in 2020, it is likely that a substantial proportion of that decline is due to fewer cases detected early, given that HIV testing services were reduced or unavailable during a portion of 2020 due to COVID-19 measures. In this context, I think it is fair to say that most of Europe will not be reaching the 2030 targets, unless we address some major gaps in the prevention, testing and treatment continuum,” she commented.

She said that in the coming years, trends will have to be monitored closely “to ensure that the setbacks due to Covid-19 have not made the situation of late HIV diagnosis worse”.

“Also, we need to scale up primary prevention across the region, including pre-exposure prophylaxis (PrEP), scaled-up testing and making HIV treatments available immediately after diagnosis for as many people as possible. Finally, there is one additional aspect which I think has been overlooked and needs addressing - we really need to improve our understanding of HIV stigma,” Dr Ammon insisted.

Also commenting on the report, the WHO’s regional director for Europe, Dr Hans Henri P. Kluge said that while the Covid-19 pandemic has caused untold damage, “we cannot forget another deadly virus that has been devastating lives and communities for nearly 40 years”.

He noted that since the HIV virus was first identified in 1984, it has claimed over 35 million lives, “making it one of the most destructive pandemics in history”.

“In recent years, many countries of the European region have worked to increase testing and treatment while addressing social stigma. But new data gathered since the emergence of COVID-19 paint a worrying picture, suggesting that many people living with HIV are not being diagnosed in time, which could have long-term consequences on their quality of life,” he pointed out.

He warned that there is still too much stigma, discrimination and misinformation surrounding the HIV virus. There are also “huge disparities” in diagnoses and treatment within the European region.

Preliminary data from the ECDC show that several types of HIV services are being impacted by Covid-19, from prevention outreach and the provision of PrEP, to in-clinic and community-based HIV testing, treatment and care programmes.

The report noted that the mode of transmission varies across the region. Sexual transmission between men was the most common mode in the EU/EEA, while heterosexual transmission and injecting drug use were the main reported transmission modes in the eastern part of the region.

Some important groups and populations, including children and men, are not being sufficiently reached by HIV testing, prevention and care services. These inequalities have been further compounded by the Covid-19 pandemic.

The ECDC and WHO said that countries need to focus on user-friendly prevention and testing services, with a focus on reaching key populations.

According to EU health commissioner, Stella Kyriakides, while treatment advances have increased the life expectancy of people with HIV, more must be done to improve their quality of life.

“This includes bringing HIV services closer to our communities and tailoring healthcare provisions to the needs of patients. We must also invest in new approaches to prevention, treatment and care. Together, we will put the needs of patients first and end stigma and discrimination for so many people living with HIV every day,” she added.

The report, HIV/AIDS Surveillance in Europe 2021, which was released to coincide with World AIDS Day (December 1), can be viewed here.