The evolving HIV landscape in Central and Eastern Europe: progress, gaps, and future directions-Part I

Area of Science:

• Public Health
• Epidemiology
• Infectious Diseases

Background:

• Central and Eastern Europe is experiencing a rise in new Human Immunodeficiency Virus (HIV) infections, a trend contrary to global declines.
• The region exhibits significant diversity in healthcare systems and socioeconomic factors impacting HIV epidemic control.

Purpose of the Study:

• To provide a narrative review of the HIV epidemic's evolution in Central and Eastern Europe over the past 15 years.
• To highlight epidemiologic trends, care disparities, and challenges in achieving UNAIDS 95 95 95 targets.
• To discuss elements of HIV care, including testing, guidelines, services, and the cascade of care.

Main Methods:

• Narrative review of the HIV epidemic in Central and Eastern Europe.
• Analysis of epidemiologic trends, healthcare disparities, and challenges in HIV care.
• Examination of testing, treatment access, and progress towards UNAIDS targets.

Main Results:

• While Central Europe shows progress in testing and treatment, Eastern Europe faces a rapidly growing epidemic.
• Key populations are disproportionately affected due to socioeconomic instability, limited funding, and stigma.
• Late diagnosis, unequal access to care, and low viral suppression rates persist as major barriers.

Conclusions:

• Effective HIV response requires acknowledging regional diversity and tailoring interventions to local contexts.
• Addressing gaps in testing, treatment access, and viral suppression is essential for reversing the epidemic's course.
• Continued efforts in public health policy, diagnostics, and antiretroviral therapy are vital for improving outcomes.