New surveillance data from the European Centre for Disease Prevention and Control and the WHO Regional Office for Europe show shifting patterns in human immunodeficiency virus (HIV) diagnoses across the region in 2024, with notable implications for diagnostic practice and laboratory medicine.
The report documents 105,922 HIV diagnoses across 49 countries, corresponding to a rate of 11.8 per 100,000 population – a 7.8 percent decrease from 2023. Despite this overall decline, 11 countries reported increases, reflecting persistent variation in testing capacity, surveillance coverage, and epidemic dynamics.
Eastern Europe continued to report the highest burden, with a rate of 27.2 per 100,000, more than five times the rate in the west and the EU/EEA. Across the region, 54 percent of diagnoses occurred at a late stage, defined by a CD4 cell count below 350 cells/mm³. Late diagnosis remained most common among people infected through heterosexual contact, people who inject drugs, and adults aged 50 years and older. These patterns highlight ongoing challenges in test uptake and timely clinical identification, suggesting that many infections remain undetected for prolonged periods before diagnosis.
Heterosexual contact accounted for 70 percent of diagnoses with a known mode of transmission, continuing the long-term shift away from transmission dominated by men who have sex with men (MSM) or injecting drug use. However, in the EU/EEA specifically, MSM remained the single largest transmission group, making up 48.3 percent of diagnoses with known modes of transmission. Injecting drug use represented 14 percent of diagnoses
The report also notes that a significant proportion of cases involve migrants: nearly 30 percent of all new diagnoses in Europe and over half of new diagnoses in the EU/EEA. This diversity in patient backgrounds places continued demand on diagnostic services for confirmatory testing, staging, and resistance assessment.
A total of 7,161 AIDS diagnoses were reported in 2024, with the highest rates in eastern countries. Although the overall AIDS rate has fallen by 53 percent since 2015, the persistence of advanced disease at diagnosis points to the need for strong diagnostic pathways and sustained surveillance. Among the 13 countries that consistently reported HIV testing activity from 2015 to 2024, testing volumes increased by 16.9 percent between 2022 and 2024, indicating progress in restoring testing capacity following COVID-19-related disruptions.
Taken together, the findings support the central role of diagnostic services in meeting regional HIV goals. Expanded approaches – including community-based testing, self-testing, and indicator-condition testing – remain essential for reducing late diagnosis and improving care engagement.
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