Increasing early HIV diagnosis: extended testing opportunities

Late HIV diagnosis - when the infection has already begun to damage the immune system - is a particular problem for people who inject drugs. In 2015, 58 % of newly notified injecting-related transmissions were diagnosed late. This compares with an EU average of 47 % diagnosed late for all routes of transmission. Late HIV diagnosis is associated with increased morbidity and mortality, and delays in initiation of anti-retroviral therapy. The policy of ‘test-and-treat’ for HIV, whereby anti-retroviral therapy is started directly after a HIV diagnosis, results in a reduction of transmission and is especially important among groups with higher risk behaviours, such as people who inject drugs. Early diagnosis and initiation of antiretroviral therapy, offers those infected a normal life expectancy.

In many countries, community-based and low-threshold drug services are providing and extending HIV testing opportunities with the aim of increasing testing uptake and earlier detection of infections. EU minimum quality standards promote voluntary testing for blood-borne infectious diseases at community agencies alongside counselling on risky behaviours and assistance to manage illness. However, stigma and marginalisation of drug users remain important barriers to uptake of testing and treatment.