Monitoring the HIV response for trans people in Europe and Central Asia

This paper aims to present available data on national responses to HIV for trans populations related to national policies, legal environments and prevention programmes, as reported by European and Central Asian countries.

Between February and April 2024, the European Centre for Disease Prevention and Control disseminated an online questionnaire to nominated National HIV Focal Points in Europe and Central Asia to monitor implementation of the Dublin Declaration on partnership to fight HIV/AIDS. This included questions on national HIV policies, legal environments, prevention programmes, the continuum of HIV care and avoidance of healthcare.

Twenty-three of 50 countries involve trans people in the content and development of national HIV strategies and policies related to their health. Two of 47 countries enact punitive legislation against trans people, and there is some evidence of healthcare seeking avoidance among trans people due to stigma in healthcare settings. In half of reporting countries (23/46), trans people have free (no cost) access to sexually transmitted infection testing and treatment. Limited availability and quality of national HIV data on the number of trans people diagnosed, treated and virally suppressed prevent the accurate measurement of progress towards global HIV targets for this key population.

Trans people are to a lesser extent than other key populations addressed in national HIV policies and strategies, and the data available from countries suggest lower levels of access to services because of costs, unsupportive legal environments and avoidance of seeking healthcare services. Without comprehensive and trans-inclusive data collection, national and regional HIV responses may risk neglecting the specific needs of trans people in HIV prevention.