Presentation (CTI)

OBJECTIVES: Despite progress in tackling the HIV epidemic in the WHO European region, the disease remains highly prevalent. In 2023, there were an estimated 1.3m new HIV infections; more than three times the 2025 UNAIDS target. This study highlights the economic consequences of continued HIV transmission (which we label the ‘cost of complacency’) in eight European countries.
METHODS: We examined ECDC data on country-specific trends in total diagnoses between 2014-2023 across eight European countries (France, Germany, Italy, Spain, UK, Belgium, Ireland, Poland). Additionally, we examined UNAIDS modelled incidence data to provide further context on new infection rates. Linear projections based on historical trends were applied to estimate future HIV diagnoses through to 2030. Healthcare system and lifetime costs were applied separately to new diagnosis projections to calculate the cost of complacency. Additionally, we carried out a targeted literature review and expert interviews to explore barriers to progress and potential solutions.
RESULTS: Based on linear projections of the 2014-23 trends in new diagnoses across all eight countries, an estimated 98,405 new diagnoses between 2025-2030 will incur €4.4bn in additional healthcare costs across the seven countries with available data, with lifetime costs reaching €35.6bn. We observe a sharp uptick in diagnoses in many countries since 2021 (particularly Ireland, UK, Poland). Based on these projections, no country will reach the UNAIDS target of zero new diagnoses by 2030. Several key solutions for progress were identified, including expanding access to services; engaging community organisations; combating stigma; diversifying treatment options; and strengthening data collection.
CONCLUSIONS: Europe is at a pivotal point in managing the trajectory of the HIV epidemic. Failure to reduce transmission and achieve UNAIDS targets carries consequences for individual lives, population health, healthcare systems and economies across the continent. While barriers to progress remain, a range of solutions can be prioritised to get Europe back on track.