It seems that the European Healthcare System is much backwards than even Asia when it comes to HIV
. Many women in the WHO European Region, particularly those in their 40s, are diagnosed at a late stage of HIV
infection when their immune system is already starting to fail. They are three to four times more likely to be diagnosed late than younger women.
From data for 2018 released last week by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe, women accounted for one-third of the 141 000 new HIV
diagnoses in the Region, indicating that this population needs more attention in Europe's prevention and testing efforts.
The European HIV
epidemic is driven by a persistent problem with late diagnosis, and this affects 54% of known cases among women. Such proportions of late diagnoses are partly a result of relatively low HIV
testing coverage and uptake in the Region, and are an indication that sexual risks, including HIV
and other sexually transmitted infections, are not being adequately addressed with older adults.
60% of the HIV
diagnoses among women in 2018 were in the age group 30-49 years old. Heterosexual sex was the most commonly reported HIV
transmission mode (92%) among women in the Region.
The European Commissioner for Health and Food Safety highlights, Vytenis Andriukaitis, told Thailand Medical
News, "Too many people living with HIV
are still not aware of their status. The sooner women and men know of their HIV
status, the sooner they can be put on antiretroviral treatment and halt transmission of HIV
sexually. This makes a major difference in the lives of people living with HIV
and those around them. It is all the more important, therefore, for public health services to support easy access to testing and fast linkage to care, especially for those at risk of HIV
, in order to bring people faster to the stage where they are no longer infectious. We must all ramp up our efforts to halt and reverse the HIV
epidemic in order to achieve our Sustainable Development Goals by 2030."
Dr. Andrea Ammon, ECDC Director stresses that "Women are generally diagnosed with HIV
later than men and the older they are, the longer they live with undiagnosed HIV
. We do not know why but it seems current systems and testing efforts in Europe are failing women and older adults". "One strategy to reach older adults is to diversify and complement HIV testing opportunities. One of the most significant factors that influences testing patterns among older adults is quite simple: actively offer an HIV
test as a health service provider."
WHO Regional Director for Europe ad interim, Dr. Piroska Östlin, said: "Late diagnosis in women indicates that gender-sensitive counselling and testing, including information about sexual health, is not reaching this population. It's time to end the silence about sexual health, especially when it comes to HIV
, and ensure that women are well informed and enabled to protect themselves. If we are to achieve universal health coverage, we need to improve prevention, treatment and care for women and reduce missed opportunities for testing those vulnerable to HIV
in health facilities and in the community."
Many countries in central Europe reported almost six times fewer diagnoses among women compared to men in 2018, and three times fewer diagnoses among women than men were reported in the European Union and European Economic Area (EU/EEA). The only exception is the eastern part of the Region, where there is a more even distribution between women and men, and where 86% of the almost 50 000 cases among women were reported in 2018.
Typically, early diagnosis of HIV
allows people to start HIV
treatment sooner, which in turn increases their chances of living a long and healthy life. In addition, it reduces the risk of transmitting HIV
to others, since effective treatment results in an undetectable viral load, meaning that the virus can no longer be transmitted to others.
Improved and enhanced strategies and systems, making HIV
testing more widely available and user-friendly, are required to ensure early diagnoses. The WHO consolidated guidelines on HIV
self-testing and partner notification and ECDC's evidence-based guidance on integrated testing for HIV
and viral hepatitis recommend innovative approaches that include self-testing and community-based testing by lay providers as part of overall HIV
Improved and enhanced strategies to diagnose women earlier include:
- increasing awareness among women and health-care providers;
- offering counselling and testing services adapted to the needs of women;
- notifying partners of men who are diagnosed with HIV
- providing HIV
testing based on specific health conditions, such as other sexually transmitted infections, viral hepatitis,tuberculosis or certain cancers;
- providing testing and treatment services in the community, closer to populations in need