ECDC calls for better knowledge of HIV among professionals and health centres

The European Centre for Disease Prevention and Control (ECDC) and the European AIDS Clinical Society (EACS) have published a report assessing HIV-related stigma and discrimination in health care settings in Europe and Central Asia. identifies serious gaps in knowledge about HIV transmission and prevention among health care workers.

This lack of knowledge is associated with higher levels of stigma and discrimination against people living with HIV, “which hinders efforts to achieve the Sustainable Development Goal of ending AIDS by 2030.”

One in four healthcare workers did not know the concept of “undetectable equals untransmittable” (U=U), which means that people with HIV who have achieved and maintain an undetectable viral load cannot transmit the virus to others. 44% did not know about post-exposure prophylaxis (PEP), and almost 60% did not know about pre-exposure prophylaxis (PrEP). Less than a third of respondents had correct knowledge of the three statements regarding HIV transmission and prevention.

Teymur Noor, HIV expert at ECDC and coordinator of the study, believes that “there is an urgent need for robust and multifaceted interventions, including facility-level training and guidance, to address stigma, improve HIV knowledge among health workers, and ensure equitable and non-stigmatising care for all people living with HIV. Addressing these issues is essential to achieving the global goal of ending the AIDS epidemic by 2030.”

A small but significant percentage of health workers (8%) reported that they would avoid physical contact, and a quarter said they would wear double gloves when providing care to a person living with HIV.

Some health workers too expressed doubts about providing assistance to key populations at increased risk of HIV infectionsuch as people who inject drugs, men who have sex with men, sex workers, or transgender people. This attitude is likely influenced by a lack of training and a perception of greater risk.

Despite the presence of HIV protection and discrimination prevention protocols and guidelines in many settings, there was still a significant lack of awareness or implementation of these policies in some settings. Discriminatory practices were also reported: more than one in five respondents had witnessed reluctance to provide care to people living with or at risk of HIV. In addition, almost a third of respondents had observed discriminatory or negative comments about people living with HIV, and almost twenty percent had witnessed their HIV status being disclosed without consent.

“It is necessary to understand how and in what contexts HIV-related stigma manifests itself in health-care settings in order to intervene and address the individual and institutional factors that contribute to stigma and discrimination against people living with HIV,” the paper says.

The report is part of ECDC’s ongoing work to assess progress in implementing the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia through a series of thematic reports and evidence summaries.

The report findings will also be presented at the 25th International AIDS Conference in Munich, Germany, on 26 July 2024.