Romania ranks 4th in the EU for late HIV diagnoses, according to ECDC data

Romania is among the European countries with the highest rates of late HIV diagnosis, according to data discussed recently at a European debate on the goal of eliminating HIV/AIDS as a public health threat by 2030.

Over 60% of people diagnosed with HIV in Romania learn of their infection at an advanced stage, when the immune system is already compromised. This places our country fourth in the European Union in terms of the proportion of late diagnoses, behind Croatia, Sweden and Bulgaria.

Across the European Union as a whole, the situation is not much better: according to the European Centre for Disease Prevention and Control (ECDC), 48% of HIV diagnoses reported in 2024 across member states were made late.

What a late diagnosis means

The ECDC defines an HIV diagnosis as late when, at the time the infection is confirmed, the person has a CD4 cell count below 350 cells/mm³. This indicator is used to measure how early or late the disease is identified, and excludes children under 15 as well as patients who were already aware of their HIV-positive status.

Romania and Bulgaria are the only countries where the proportion of late-detected cases exceeds 60%, one of the highest figures in Europe. This information was presented at the Euractiv event "Ending HIV in Europe – Are we moving fast enough to achieve the 2030 targets?", held on 10 September and supported by Gilead.

The discussion was attended by MEPs Marc Angel and Kristian Vigenin, Mary Horgan (Chief Medical Officer at the Department of Health in Ireland), Nicoletta Policek (co-chair of the HIV Prevention Alliance), and Lithuanian specialist Giedrius Likatavicius.

Bulgarian MEP Kristian Vigenin, a member of the European Parliament's Public Health Committee, stressed that late diagnosis is one of the main obstacles to meeting Europe's commitments on combating HIV.

Why early diagnosis matters

When an infection is detected at an advanced stage, the body may be more susceptible to opportunistic infections and certain types of cancer, and managing complications becomes more difficult. Furthermore, a person who is unaware they have HIV may transmit the virus before being diagnosed.

Specialists note that timely testing allows antiretroviral treatment to be started sooner, which reduces the viral load and the risk of transmission to others.

Around 24,000–25,000 new HIV diagnoses are reported annually across the EU and the European Economic Area. The downward trend observed in previous years appears to have stalled, and approximately 800,000 people are currently living with HIV in this region.

Testing still overshadowed by stigma

One of the conclusions of the debate was that HIV testing must be removed from the realm of stigmatisation. Participants warned that the automatic association of testing with certain behaviours or social groups can discourage people from checking their status.

MEP Kristian Vigenin recounted that, during routine medical investigations, he requested an HIV test but was discouraged by a doctor, who reportedly cited the possible consequences of a positive result and the risk of the information reaching other people's knowledge. The example was used to illustrate that barriers to testing arise not only within the community, but also in people's relationship with the healthcare system.

Nicoletta Policek drew attention to the fact that the problem is not necessarily that certain individuals are "hard to reach", but that healthcare services can be hard to access. In her view, health systems should bring testing closer to the population, including through community services, home testing and self-testing.

Prevention: from condoms to PrEP

Participants in the debate discussed broadening access to testing, self-testing and screening within routine medical consultations, as well as expanding community-based testing, where services can be more accessible and less stigmatising.

HIV prevention encompasses condom use, regular testing and pre-exposure prophylaxis (PrEP) — a method intended for people at higher risk of exposure to the virus. Modern antiretroviral treatment can effectively control HIV and achieve viral suppression; however, access to PrEP, PEP, testing and medical care remains unequal across European countries.

ECDC data show that heterosexual transmission accounts for a significant proportion of cases in the EU: in 2024, nearly 46% of diagnoses with a known transmission route were associated with heterosexual contact, and 48% with sexual contact between men. Specialists insist that prevention measures must be tailored to higher-risk groups, without creating the false impression that HIV exclusively affects certain communities.

The 95-95-95 target for 2030

The international goal set for 2030 stipulates that 95% of people living with HIV should know their status, 95% of those diagnosed should be receiving treatment, and 95% of patients on treatment should achieve viral suppression.

The European debate also touched on the possibility of a fourth objective, dedicated to prevention. Participants argued that investment in early testing, education, access to treatment and tackling stigma can reduce the number of new infections and the costs borne by health systems. A timely diagnosis can prevent serious complications, hospitalisations and costly long-term treatments, which is why funding for HIV programmes is seen not merely as a medical expense, but as an investment in public health, social inclusion and economic productivity.