Before the war in Ukraine started, Dmytro Skirhiko worked as a General Practitioner in his home country. In the course of his work, he prescribed HIV treatment, including pre- and post-exposure prophylaxis. Now, living in Czechia, he is the Ukraine Programme Coordinator of the Czech AIDS Help Society in Prague, where he focuses on HIV counselling and support for Ukrainian refugees and migrants from other countries who are living with or are at risk from HIV. Since 2022, with financial support from the Asia-Europe Foundation, the WHO Country Office in Czechia has been supporting the organization’s activities.
Early diagnosis for better outcomes
According to new data from the European Centre for Disease Prevention and Control (ECDC) and WHO/Europe, 54% of HIV diagnoses in the WHO European Region were late.
This proportion was highest among people infected through heterosexual contact (especially men) and people who inject drugs. Moreover, nearly 1 in 3 HIV diagnoses in 2024 were among people born outside the country where they were diagnosed. Migrants accounted for a significant proportion of new diagnoses in the European Union/European Economic Area (nearly 56%), highlighting the need for tailored, accessible and culturally competent prevention and testing services.
The high proportion of late diagnoses seen across the WHO European Region means that many people are not accessing life-saving antiretroviral treatment and health care early enough, which increases their risk of onward HIV transmission, developing AIDS and the risk of death.
“HIV, like several other sexually transmitted infections, does not have specific symptoms in the early stages. That is why a specific HIV test is needed,” says Dmytro. “Unfortunately, sometimes people are initially unwilling to take a test, which means that by the time they do, we see the later stages of HIV or even the AIDS stage of the disease.”
Stigma-free testing and treatment
At the Czech AIDS Help Society, tests are provided anonymously and free of charge. Across the country, efforts are also being made to offer pre-exposure prophylaxis at a range of hospitals and nongovernmental organizations, to increase access and reduce stigma.
“Unfortunately, stigma is a big problem. We need to provide more information on HIV for both medical staff and at-risk populations,” says Dmytro.
To increase knowledge of the risks of HIV and other sexually transmitted infections among Ukrainian refugees and other migrant populations in Czechia, the organization has distributed leaflets and HIV prevention kits to clients, sexual health checkpoints and directly to clubs and venues across the country. It has also conducted social media campaigns, provided mobile testing and conducted webinars for intercultural social workers.
Dr Hans Henri P. Kluge, WHO Regional Director for Europe, said: “Since 2020, HIV testing across the European Region has rebounded, resulting in a higher volume of reported tests and a corresponding rise in HIV diagnoses in 11 countries in 2024. In 2024 alone, 105 922 people were diagnosed with HIV, with an overall 2.68 million diagnoses reported since the 1980s. However, the number of people living with undiagnosed HIV is growing – a silent crisis that is fuelling transmission. We are not doing enough to remove the deadly barriers of stigma and discrimination that prevent people from seeking out a simple test. An early diagnosis is not a privilege, but a gateway to a long, healthy life and the key to stopping HIV in its tracks.”
The ECDC and WHO/Europe are calling for urgent efforts to routinize, normalize and scale up testing, which includes providing wider access to self-testing and community-based options, which can reach people who do not access facility-based health-care services.