On World AIDS Day, HaDEA-managed projects share their stories on supporting vulnerable communities affected by HIV in Europe

The human immunodeficiency virus (HIV) remains one of the most serious communicable diseases in Europe. Despite being preventable, cases of HIV transmission persist in Europe. According to the European Centre for Disease Prevention and Control (ECDC), about 800 000 people in EU countries are living with HIV and require life-long treatment. Moreover, an estimated one in eight people living with HIV is unaware of their infection.

In this context, certain vulnerable groups are particularly affected due to the lack of access to systematic prevention initiatives, limited awareness about tuberculosis and sexually transmitted infections (STIs), including HIV and hepatitis B and C, and challenges in accessing information about biomedical interventions for HIV transmission.

On World AIDS Day, we are highlighting the HaDEA-managed projects tackling HIV. EU4Health projects and initiatives are focusing on providing support to vulnerable groups in Europe, including increasing access to testing. Projects funded under Horizon Europe, the EU research programme, are researching ways to mitigate infections and increase responses to vaccines and treatments.

EU4Health

The EXPAND project (EXPANDing access to Community-based testing for HIV, viral hepatitis and STIs in Slovenia) aims to address the insufficient accessibility and availability of HIV, viral hepatitis and STI testing for vulnerable groups all while recognising the challenges faced, such as limited availability of services, stigma and lack of awareness of patients’ rights. The project also focuses on training peer counsellors and raising awareness among target groups about the importance of testing and safe practices.

The project's objectives are grounded in its extensive experience accumulated over many years of working with vulnerable populations, particularly sex workers, migrants and people who use drugs. In addition to its primary objectives, the Expand project has fostered collaboration among various non-governmental organisations. By conducting study visits, the team members have been able to exchange on best practices with these organisations and learn more about innovative approaches to testing services. 

TOGETHERHIVSTI (Crossing Countries, Crossing Communities (4C)) aims to strengthen community-based organisations (CBOs) in Greece, Spain and the Netherlands to scale-up best practices, such as voluntary testing, early diagnosis, referrals, counselling and treatment, to protect people and communities at risk from HIV, STIs and viral hepatitis.

The project particularly focuses on supporting persons facing high infection risks and discrimination based on their sexual activities and gender identity and also works closely with asylum seekers and refugees. The project team recalls its recent efforts in providing support to a young woman, who while 27 weeks pregnant, arrived at the refugee camp Lesvos in Greece. After she tested positive for HIV and hepatitis B, the TOGETHERHIVSTI team, in collaboration with public agencies and other NGOs, immediately transferred her to Athens. There, her case was followed up by a dedicated infections department at the city hospital, allowing specialised doctors to closely monitor her pregnancy.  

By 2024, the project aims to:

• Upscale access to community-based services for these vulnerable groups;
• Improve the quality of health services through dissemination of e-learning and toolkit material that will reach 84 organisations within local and European networks as well as health care professionals working on HIV, STIs and viral hepatitis in Europe.

The REACH-OUT project works on improving outreach services, particularly focusing on migrants, refugees and asylum seekers, to prevent and detect HIV, STIs and tuberculosis in Italy, Malta and Greece. To maximise its outreach and impact, the project is providing services to vulnerable communities by developing targeted communication campaigns on social media used by these communities.

To ensure that best practices are standardised across Europe, the project actively involves and engages with key social actors - from vulnerable persons and health professionals to local authorities and NGOs - during info days and formal meetings. These events:

• Help to identify beneficiaries’ health needs and existing access barriers;
• Allow for exchange of expertise;
• Help create an efficient referral pathway with existing systems and services;
• Promote capacity building among staff directly involved in the implementation of services. 

The CORE (COmmunity REsponse to End Inequalities) project collaborates closely with regional, national, and local organisations to address inequalities within vulnerable communities and among EU countries, aiming to strengthen community responses and share best practices, including innovative data monitoring.

During its first year, CORE’s implementing partners collaborated on scaling up services, planning capacity-building activities, and enhancing the community data collection tool – COBATEST. Stemming originally from a prior EU Joint Action, COBATEST has evolved into a powerful instrument for comprehensive data collection on testing and services.   

The BOOST project works on implementing high-quality, community-based communicable services targeting vulnerable populations who lack access to health services. It focuses on collecting data on community-based services provided to these groups as well as on organising capacity-building programmes in the field of communicable diseases.

During its first year, the BOOST project assessed health service delivery for people who use drugs in 30 European countries with input from over 60 partners. Key findings highlight:

• Gaps in services for women;
• Underservice in rural areas;
• Low treatment rates;
• Outdated knowledge on drug trends;
• Persistent stigma;
• A need for improved understanding of the principles of harm reduction¹. 

With the data collected in 2023, the project aims to concentrate in the coming years on capacity-building for service providers and community-based organisations. It will also organise trainings across Europe, including tailored mentoring programmes.

^{1. Harm reduction principles include strategies for safer and managed use of and abstinence from drugs.}

Horizon Europe

The MISTRAL project is researching the potential role of gut microbiome in HIV-1 infection, aiming to mitigate infections and enhance responses to vaccines and therapies by identifying microbiome biomarkers². 

The project will also create a public database for patient screening and a cloud-based tool for microbiome interpretation in research and clinical applications.

^{2.  As defined by EMA, a biological marker is an objective and quantifiable measure of a physiological process, pathological process or response to a treatment (excluding measurements of how an individual feels or functions). Biomarkers can serve as early warning systems for your health.}

Background

HIV/AIDS, hepatitis and tuberculosis – European Commission 

EU4Health is the fourth and largest of the EU health programmes. The programme provides funding to national authorities, health organisations and other bodies through grants and public procurement, contributing to a healthier Europe.

HaDEA manages the vast majority of the total EU4Health budget and implements the programme by managing calls for proposals and tenders from 2021 to 2027.

Horizon Europe is the research and innovation programme of the EU for the period 2021-2027. The aims of Cluster 1 ‘Health’ include improving and protecting the health and well-being of citizens of all ages by generating new knowledge, developing innovative solutions and integrating where relevant a gender perspective to prevent, diagnose, monitor, treat and cure diseases. Horizon 2020 (H2020) was the EU’s multiannual funding programme between 2014 and 2020.