Europe is failing to diagnose HIV early enough, with new data showing that over half (54%) of all diagnoses in 2024 occurred at a late stage of infection. The figures, released by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe, raise fresh concerns over persistent gaps in testing and early detection. They are severely jeopardising the goal of ending AIDS as a public health threat by 2030.

The latest HIV/AIDS Surveillance Report shows that 105,922 HIV diagnoses were made in the WHO European Region in 2024, covering 53 countries across Europe and Central Asia. While overall reported numbers show a slight decrease compared to 2023, available data suggest that testing and diagnosis gaps remain. The high proportion of late diagnoses means that many people are not accessing life-saving antiretroviral treatment and healthcare early enough. This increases the risk of developing AIDS, death and onward HIV transmission.

Late diagnosis is defined as a person having a CD4 cell count below 350 cells/mm³ at the time of diagnosis. This indicates that their immune system is already compromised.

Nearly half of EU diagnoses occur too late

In the European Union and European Economic Area (EU/EEA), 24,164 HIV diagnoses were reported in 2024, representing a rate of 5.3 per 100,000 people. Within this group, 48% of diagnoses were classified as late.

Sex between men remains the most common mode of transmission in the EU/EEA, accounting for 48% of new diagnoses. However, infections attributed to heterosexual transmission are rising and now represent nearly 46% of HIV diagnoses reported in the EU/EEA.

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Dr Pamela Rendi-Wagner, Director of ECDC, said: “In the EU/EEA, nearly half of all diagnoses are made late. We must urgently innovate our testing strategies, embrace community-based testing and self-testing, and ensure rapid linkage to care. We can only end AIDS if people know their status.”

Across the wider WHO European Region, the proportion of late diagnoses was highest among people infected through heterosexual transmission, especially men, and among people who inject drugs.

Nearly half of all diagnoses are made late. We must urgently innovate our testing strategies, embrace community-based testing and self-testing, and ensure rapid linkage to care. We can only end AIDS if people know their status. – Dr Pamela Rendi-Wagner, Director of ECDC

Migrants heavily affected

Nearly one in three HIV diagnoses in 2024 occurred among people born outside the country where they were diagnosed. In the EU/EEA, migrants accounted for more than half of new HIV diagnoses. This highlights the need for tailored, accessible and culturally competent prevention and testing services.

Dr Hans Henri P. Kluge, WHO Regional Director for Europe, said the latest figures reveal both progress and persistent failure. “Our data paints a mixed picture,” he noted. Dr Kluge pointed to a post-pandemic rebound in testing across the region that has led to increased detection in several countries. Since 2020, he said, testing has recovered, resulting in “a higher volume of reported tests and a corresponding rise in HIV diagnoses in 11 countries in 2024.”

Yet alongside improved testing, Dr Kluge warned of a deepening hidden epidemic. “The number of people living with undiagnosed HIV is growing, a silent crisis that’s fueling transmission,” he said. Dr Kluge stressed that structural barriers continue to prevent timely diagnosis. “We are not doing enough to remove the deadly barriers of stigma and discrimination that prevent people from seeking out a simple test.”

He underlined that the consequences of delay go far beyond statistics. “An early diagnosis is not a privilege but a gateway to a long, healthy life. And the key to stopping HIV in its tracks,” he said, calling for renewed urgency in addressing testing gaps across Europe.

We are not doing enough to remove the deadly barriers of stigma and discrimination that prevent people from seeking out a simple test. – Dr Hans Henri P. Kluge, WHO Regional Director for Europe

Urgent call to scale up testing

ECDC and WHO/Europe are calling for urgent efforts to routinise, normalise and scale up HIV testing. Including wider access to self-testing and community-based options. These approaches are seen as essential for reaching people who do not access facility-based healthcare services.

The agencies stress that the 2030 goal to end AIDS as a public health threat remains within reach. But only if Europe acts now to eliminate the testing gap and ensure earlier diagnosis and rapid access to treatment.

Country-level disparities are stark and uneven

While some parts of the region are showing gradual improvement, others continue to record worrying trends. Late HIV diagnosis remains especially high in several countries. The proportion of people diagnosed at a late stage exceeds 60% in Croatia (68.3%), Sweden (66.7%), Bulgaria (63.1%) and Romania (62.3%). Much lower levels have been reported in Finland (26.9%) and Cyprus (40.7%), highlighting a sharp divide in early detection performance.

Trends in new diagnoses also diverge. While overall rates are declining in many countries, 11 out of 49 still reported an increase in 2024. Türkiye recorded a 67% rise, attributed primarily to strengthened surveillance and expanded testing rather than a true surge in transmission.

Over the longer term, countries such as Albania, Estonia, Latvia and Portugal have seen marked declines in diagnoses since 2015. Iceland, Ireland and Czechia have experienced significant increases over the same period, underscoring how uneven Europe’s HIV trajectory remains.

Political pressure mounts over Europe’s HIV response

The political debate has also reached the European Parliament. In a written question submitted on 8 September 2025, MEP Per Clausen (The Left) asked the Commission whether it would press Member States to trace unreported HIV infections. And ensure free, anonymous testing, as well as push for equitable access to pre-exposure prophylaxis (PrEP) across all EU/EEA countries, given the wide disparities in availability.

Clausen also asked the Commission if it will step up global health funding. Including by contributing to the Global Fund and the forthcoming framework programme for research and innovation.

In its response, delivered on 19 November 2025, the Commission reiterated that the organisation and delivery of healthcare remain the responsibility of Member States. Commissioner Várhelyi stressed the EU’s supporting role through ECDC guidance on HIV testing and prophylaxis and ongoing monitoring of progress towards SDG 3.3 via the Health Security Committee.

On funding, the Commissioner highlighted its continued backing of the Global Fund, recalling the €715 million pledge made in 2022 for the seventh replenishment cycle (2024–2026). He noted that options for further contributions under the forthcoming replenishment cycle are currently being assessed. This within the constraints of the EU’s multiannual financial framework.

Brussels set out its HIV ambitions on the global stage

Ahead of the parliamentary intervention, the EU had already reaffirmed its political positioning on HIV/AIDS at the global level. Speaking at the UN General Assembly’s annual review on HIV/AIDS on 5 June 2025, the EU and its Member States restated their “full commitment to ending AIDS as a public health threat by 2030”.

The statement underlined the need for a holistic response combining universal access to antiretroviral treatment with strengthened prevention. This includes long-acting PrEP, expanded testing, and efforts to combat stigma and discrimination, particularly among vulnerable groups and key populations.

The EU also reiterated its strong support for multilateral action, highlighting its €3.5 billion contribution to the Global Fund since 2002 and a further €715 million pledge for 2023–2025, while calling for sustained international financing and renewed political momentum ahead of the 2026 High-Level Meeting on HIV/AIDS.