Global HIV epidemic persists despite progress: Urgent need for community engagement and anti-stigma efforts

HIV prevention, continuum of care and eradicating discrimination remain critical to tackle the ongoing global public health crisis, says EESC

The European Economic and Social Committee (EESC) is backing the efforts of the Spanish Presidency of the Council of the EU to put the goal of eliminating HIV-related stigma and discrimination by 2030 high on the EU agenda.

In an opinion adopted at its plenary session in June, the EESC said it agreed that European institutions should issue a high-level declaration on ending the stigma and discrimination against people infected with HIV. This declaration  should be presented to the European Parliament on 1 December 2023.

The EESC also called for a more ambitious new target for preventing and controlling the spread of HIV, aiming for coverage levels as high as 95% for testing, treatment, and virological suppression across all nations.

We want to help the Spanish presidency in their efforts, which should lead to the adoption of the high-level declaration, said rapporteur of the opinion Pietro Barbieri. He added that the EESC was committed to supporting and taking part in the declaration in every possible way, using all available means and forums.

We are now trying to assess the current state of the HIV epidemic after a gap of more than a decade. The issue has been neglected for too long, Mr Barbieri said.

What we need is the greatest possible commitment, we need to work together with communities, doctors, schools and at workplaces, Mr Barbieri said, adding that the EESC was also stressing the importance of providing equal opportunities for individuals with HIV in the workplace, including flexible working hours and extended leave for medical visits, while maintaining confidentiality.

To overcome stigma, discrimination and stereotypes, it is essential to promote awareness raising, training and information campaigns, especially in schools, and through involving organised civil society and youth organisations. We at the EESC are very committed and ready to do our part, said co-rapporteur of the opinion, Nicoletta Merlo.

Despite the decline in the number of HIV diagnoses, we must not let our guard down. In order to control the spread of infection, early diagnosis, early start of treatment and continuum of care are essential, Ms Merlo said.

HIV continues to be a major public health concern across the world, affecting more than 36 million people, of which 2.3 million live in the WHO European Region. Eastern regions of the European continent are particularly affected, with Ukraine having the second-largest AIDS epidemic in the Eastern Europe and Central Asia region.

Available data unequivocally show that HIV mostly affects people who are marginalised or whose behaviour is already socially stigmatised, such as people who use intravenous drugs and their sexual partners, men who have sex with men, transgender people, migrants and prisoners.

Stigma and fear surrounding HIV discourage individuals from seeking necessary services, leaving them unaware of available preventive tools. This leads to their delayed testing and late diagnoses, which not only negatively impacts their health but also increases the risk of further transmission.

Despite progress, many people still lack access to comprehensive HIV prevention measures, leading to continued spread and preventable deaths, particularly in areas without adequate AIDS treatment. Late HIV diagnoses remain a challenge, with over 50% of individuals being diagnosed at an advanced stage of the infection.

To combat the HIV epidemic effectively, the EESC highlighted the need for comprehensive strategies that combine care and prevention. Innovative approaches such as expanded and diverse HIV testing methods, including rapid testing, self-testing and integrating HIV and hepatitis B and C testing, would improve early detection.

The EESC emphasised the importance of pre-exposure prophylaxis (PrEP) as an effective biomedical approach to HIV prevention. It recommended integrating PrEP into existing HIV prevention programmes, particularly for the most affected groups and those at higher risk.