Andrew Stillman

Europe has seen a rise in undiagnosed HIV infections — the World Health Organization (WHO) and European Center for Disease Prevention and Control (ECDC) reported that between at least 2018 to 2021, there have been more HIV infections than diagnoses.

The full report showed that testing rates fell during the COVID-19 pandemic and has hindered progress toward eliminating new HIV transmissions by 2030.

“We should all be deeply concerned by the data on HIV testing, treatment and care in Europe and Central Asia,” said Dr. Hans Henri P. Kluge, WHO Regional Director for Europe. “Continuing, widespread stigma around HIV is deterring people from getting tested and is steering us dangerously off course from meeting our 2030 goal of ending AIDS.”

A model used to predict the estimated number of infections and comparing that to testing data from 46 of the 53 countries in the WHO’s European region estimated that one in eight people living with HIV in those regions remain undiagnosed.

A disruption in testing and treatment matter. The longer the time period between infection and diagnosis, the higher the probability of death or severe illness. Additionally, it raises the risk of unknowingly passing on the virus to other partners.

The report further discusses the overstretched resources during the pandemic, which ultimately led to many countries struggling to test and report new infections during the pandemic. Under-diagnosis and under-reporting make late HIV diagnosis a major challenge in the region.

Moving forward, new strategies are required to improve early diagnosis. Expanding diversified and user-friendly approaches to HIV testing is thought to help make more people aware of their infection.

Treating HIV symptoms in “clusters” could help improve a patient’s overall quality of life, according to a study presented at the Association of Nurses in AIDS Care 2022 annual meeting.

The evidence, according to Medscape, showed that the four main symptom clusters for HIV include pain, body psychological, gastrointestinal, and body image. These symptoms were also more common in HIV-positive people older than 45.

Natalie Wilson, PhD, assistant professor of community health systems at the UCSF School of Nursing, and a group of colleagues performed a study that also suggested that the elderly population experienced more distress from their symptoms, with the exception of anxiety.

“The symptom burden is still high in people living with HIV,” said Wilson. “The medications got better but the symptoms remain.”

Higher symptom burdens are also linked to a lower adherence to antiretrovirals. Treating groups of symptoms together could lead to targeted interventions, Wilson said, “instead of treating one symptom at a time and increasing the pill burden for people living with HIV.”

In the full study, previously published in The Journal of Pain and Symptom Management, 2,000 HIV-positive participants completed the 20-item HIV Symptom Index. They then reported their symptoms on their first visit to one of six national HIV Centers of Excellence, rating the presence of the symptom from 1 (doesn’t bother me) to 4 (bothers me a lot.)

The younger population reported more anxiety and were more distressed by it, where the older generation found stressors caused more by muscle aches and joint pain.

While this initial study paves way for further studies over time, the current findings have raised some important questions. One of the more important findings in the study was the accelerating aging process HIV-positive patients experienced.

Cheryl Netherly, an HIV nurse and clinical educator for CAN Community Health, said that people living with HIV and dying from age-related comorbidities is something “we never thought would happen. Unfortunately, now we’re losing them to the different things like kidney issues, heart disease, and diabetes.”