More than half of people living with HIV in Europe were diagnosed too late for optimal treatment in 2024 — a “critical testing failure,” the World Health Organization (WHO) warns.
A new WHO report on HIV and AIDS across its 53-country European region reveals wide disparities. In 2024, almost 106,000 new diagnoses were reported across 49 countries with available data, including 24,000 in the European Economic Area (EEA — the 27 countries of the European Union plus Iceland, Liechtenstein and Norway).
Western Europe faces a hidden crisis: one in nine people living with HIV still do not know their status. While overall HIV prevalence in the EEA has edged downward — from 6.2 to 5.3 per 100,000 inhabitants between 2015 and 2024, a 14.5% fall — the number of undiagnosed infections continues to grow. This “silent crisis,” says WHO Regional Director Hans Henri P. Kluge, is fuelling ongoing transmission. “We are not doing enough to remove the deadly barriers of stigma and discrimination that prevent people from seeking out a simple test.”
Malta, Ireland and Cyprus have the highest AIDS prevalence in the EU
Although overall diagnoses fell by nearly 8% compared with 2023, 11 countries saw rising numbers, including Ireland, Germany, Malta, Bulgaria, the Czech Republic, Romania and Slovenia.
Across the wider WHO European region, the highest AIDS prevalence rates — above 15 cases per 100,000 inhabitants — were recorded in Russia, Ukraine, Moldova, Malta, Kazakhstan, Armenia, Ireland, Georgia and Kyrgyzstan. By contrast, Sweden, Slovenia, North Macedonia, Croatia, Austria, Hungary, Serbia, Slovakia and Bosnia and Herzegovina recorded the lowest rates.
EEA countries with the highest AIDS prevalence rates in 2024 (per 100,000 inhabitants):
Malta — 35.5
Ireland — 22.9
Cyprus — 20.8
Portugal — 13.9
Latvia — 13.4
Belgium — 12.6
Spain — 11.5
Estonia — 11.2
Iceland — 10.2
The United Kingdom, meanwhile, recorded a rate of 10.1 per 100,000.
Source: WHO.
Nearly half of EU cases are diagnosed too late
Almost half (48%) of HIV diagnoses in the EEA in 2024 were made late — defined as a CD4 cell count below 350 cells/mm³ — when treatment is less effective.
Sexual transmission between men remains the most common route in the EEA (48%), but heterosexual transmission continues to rise. Between 2015 and 2024, the share of cases involving heterosexual transmission increased from 40.9% to 45.6%.
A third of new diagnoses occur among those aged 30–39, but the age profile varies widely: in Romania and Cyprus, one in three new cases affects people under 30, while in countries such as Norway, Italy, Luxembourg, Iceland, Slovenia and Croatia, more than half of new cases are in people over 40.
UK recorded the fourth-highest number of new cases in Europe
Within the EEA, France reported the most new diagnoses in 2024 (3,056), followed by Spain (2,739), Germany (2,341), Italy (1,884) and Poland (1,532). In non-EEA countries, the largest numbers were seen in Russia (28,249), Ukraine (6,572), Turkey (5,089) and the United Kingdom (3,402) — the fourth-highest total in the European region.
Testing remains the urgent priority to prevent the “hidden crisis” represented by AIDS in Europe, including within the EU. “We must urgently innovate our testing strategies […] and ensure rapid linkage to care,” said Dr Pamela Rendi-Wagner, Director of the European Centre for Disease Prevention and Control (ECDC), which co-authored the WHO report. “We can only end AIDS if people know their status.”