World AIDS Day: concerns over stimulant injecting and late HIV diagnoses in Europe

On the eve of World AIDS Day, the EMCDDA showcases the latest data on HIV among people who inject drugs (PWID) and explores how countries are performing on global health sector objectives to tackle HIV/AIDS. The data underscore growing concerns that a potential rise in stimulant injecting and delayed HIV diagnoses could jeopardise the slow, but constant, progress seen in recent years in HIV prevention and treatment in this population.

Under the UN Sustainable Development Goal 3 ('Good health and wellbeing'), the 29 EMCDDA countries (EU-27, Türkiye and Norway) have committed to eliminating HIV/AIDS epidemics by 2030. A World Health Organization regional plan sets interim targets for 2025.

2022 data showed an increase in new HIV notifications linked to injecting drug use in the EU and Norway. The risk of HIV transmission among PWID remains higher than for the general population, and transmission rates attributable to injecting are still high in some countries. Also, in 2022, more than a third of new HIV diagnoses linked to injecting drug use in the EU and Norway were detected late, increasing the risk of HIV-related complications, mortality and transmission.

Of particular concern are local HIV outbreaks linked to stimulant injecting which continue to be documented in the EU. Although opioids are the predominant drugs injected in Europe, in recent years, there have been signs of a rise in stimulant injecting. The greater availability of cocaine on the European drug market and its injection are significant risk factors for HIV transmission.

Harm reduction approaches, particularly the provision of sterile injecting equipment (including in prisons and through pharmacies) are now regarded as a basic component of reducing HIV transmission among people who inject drugs. This is outlined in new EMCDDA–ECDC guidance on the prevention and control of infectious diseases among people who inject drugs. However, latest data reveal insufficient coverage and access to needle and syringe provision in many countries. The new guidance also highlights the need for a more integrated approach to testing and linkage to care.

According to the European Drug Report 2023, achieving the targets set 'requires greater investment to enhance harm reduction services, testing and linkage to treatment'. Greater efforts are therefore needed to prevent future outbreaks, decrease transmission rates and reduce the burden of disease.

How are the EMCDDA 29 countries performing in terms of WHO targets set for people who inject drugs?

  • Number of new infections linked to injection drug use
  • Number of needles/syringes distributed per year per person who injects drugs
  • Percentage of new HIV diagnoses which are diagnosed at a late stage
  • Percentage of people who inject drugs living with HIV achieving viral load suppression
  • Percentage of people living with HIV and key populations experiencing stigma and discrimination

Find out more in our FactsheetWhat are the latest data telling us about HIV among people who inject drugs?

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