HIV infection by transmission group and origin in EU/EEA countries, 2004–09

1. Commission Communication `on combating HIV/AIDS in the EU and neighbouring countries, 2009 – 2013´- Implementation of the Action Plan- HIV testingWolfgang PhilippEuropean CommissionDG Health and ConsumersHealth Determinants UnitLuxembourg

2. HIV infection by transmission group and origin in EU/EEA countries, 2004–09 Men who have sex with men Heterosexual contacts Other/undetermined Heterosexual contacts from countries with generalised epidemics Injecting drug use Mother-to-child transmission Predominant transmission group: men who have sex with men Data were not included from: Austria, Estonia and Poland. Source: ECDC/WHO. HIV/AIDS Surveillance in Europe, 2009 2

3. Major challenges to an effective HIV response Ineffective policies, insufficient political support/leadership Involvement of civil society and communities Insufficient treatment programmes Key populations Insufficient prevention programmes Resources Targets Content Reaching young people

4. Response to HIV/AIDS in Europe Effective policies HIV testing of target groups Key populations Resources cooperation Prevention, Treatement, Care - … Complementary to other international HIV policies Blueprint ….

5. The focus of the Communication Prevention Priority groups Priority regions Knowledge base and dissemination Timeline: end 2013 Broad involvement of Civil Society and other stakeholders

6. EXPECTED OUTCOME (i) Improve the education, knowledge and awareness on HIV/AIDS (ii) A decrease of HIV transmission (iii) A real improvement of the quality of life of PLWHA (iv) Strengthen the solidarity towards an unambiguous response to HIV/AIDS

7. Where do we stand? • Political leadership • cooperation on international level • civil society • Health programme: 6,5 million € co-funding (2009/2010)for 15 projects across all priorities • Research FP7: 82 million € on prevention and treatment • Surveillance and epidemiology • Dublin declaration monitoring report • ECDC currently running 1st M+E of action plan

8. Prevention: HIV testing Commission supportive since 2007 (HIV in Europe conference in Brussels, WAD 2010 etc.) key populations Commission communication on HIV 2009 Projects funded: health programme Promotion in Think Tank and CSF ECDC´s guidance on HIV testing

9. „HIV testing“ in COM 569/2009 HIV/AIDS associated stigma and discrimination create barriers to access HIV testing, treatment and care. The Commission will further address this issue on a political level and inits equal treatment policies. Prevention should be linked to voluntary and counselled HIV testing, universal access to treatment, care and support. Targetedprevention programmes and effective solutions should include adapted communication, access to confidential, anonymous and, ideally, free testingand timely high-quality treatment HIV testing (along with effective screening and treatment for sexually transmitted infections) needs to be intensified for MSM and risk populations Access to … HIV testing and counselling and to health and social services needs to be promoted supports … HIV prevention including improved access to voluntary and counselled HIV testing to most at risk populations and in areas with high prevalence of HIV infection PLWHA and most at risk populations should have general access to testing

10. HIV infections: need for action (ECDC) • Levels of late diagnoses and undiagnosed HIV infections are high: • An estimated 30% of people infected with HIV in Europe are unaware of their infection. • Reported rates of HIV testing vary across countries: • among injecting drug users: up to 84% • among men who have sex with men: up to 70% • A considerable proportion of the patients are diagnosed late which is a missed opportunity for timely access to treatment and care 10

11. HIV testing: a matter of time (ECDC) • Early diagnosis is essential: timely referral of patients for treatment and care. • Early treatment reduces morbidity and mortality. • People diagnosed early may be less likely to transmit the virus. • As such: Early diagnosis remains a critical public health priority. 11

12. ECDC HIV testing guidance: Core principles Voluntary, confidential, undertaken with informed consent Access to treatment, care and prevention services Political commitment Reduce stigma Remove legal and financial barriers Access to HIV testing is an integral part of national strategies Involvement of stakeholders

13. ECDC HIV testing guidance: developing a national strategy Whom to test? Know your epidemic: which groups are most at risk? Where to test? Make testing available in a variety of settings. When to test? Provide guidance on testing frequency. How to test? Raise public and professional awareness, ensure confidentiality; train the workforce; provide pre-test discussion to ensure informed consent, etc. Ensure access to HIV treatment, care and prevention 13

14. Full reports are available from: www.ecdc.europa.eu 14

15. Where to go? Access to prevention and HIV testing Improve access to ARV treatment Reaching out to the neighbourhood Less HIV infections AND a better quality of life for PLWHA

16. Thank you! and ECDC, EMCDDA, EAHC colleagues!