In many European countries, HIV testing efforts are insufficient to identify new HIV infections early enough, leaving substantial proportions of HIV positive people unaware of their infection.

It’s been estimated that a third of individuals living with HIV in Europe are unaware of their infection, whilst up to 50 per cent may be diagnosed well after they should have started receiving treatment and care.

In response, Professor John de Wit and Dr Stephen Bell, both from the Centre for Social Research in Health, were commissioned by HIV in Europe – an initiative started in Brussels in 2007 – to review the HIV testing and counselling guidelines and practice across European countries.

The duo completed the project in April this year and published a comprehensive report and four plain language summary sheets. In addition, four papers resulting from the project were published in peer-reviewed journals. Two of these papers report on the guidelines regarding the HIV pre-test and HIV post-test process in Europe, respectively, two report on practices regarding HIV pre-test and post test processes in Europe. HIV-pre-test processes encompass delivery of HIV pre-test information and obtaining informed consent, while HIV post-test  process included delivery and discussion of test results, and referral to specialist health services.  

The research undertaken as part of this project consists of a review of international guidance documents of relevance to countries in the WHO European region to examine similiarities and differences, as well as the evidence for HIV testing and counselling recommendations. This was complemented by a review of the research literature to appraise the current evidence base.

Also, a stakeholder survey was undertaken with 338 HIV testing experts from 53 European countries, including policy makers, health service providers and NGO staff. This survey collected information regarding current HIV testing processes across Europe and how this aligned with recommendations.

Findings of the guideline review and stakeholder survey were discussed with HIV testing experts through the HIV in Europe Steering Committee, resulting in a set of recommendations contained in the research report.

Related Reading

HIV testing services summary report (PDF)

HIV pre-test practices (PDF)

HIV post-test practices (PDF)

Delivery of HIV test results, post-test discussion and referral in health care settings (PDF)

Delivery HIV pre-test information (PDF)