Steps are being taken to advocate for appropriate health policies

Steps are being taken to advocate for appropriate health policies and surveillance data related to HIV throughout Europe. Also, the initiative has set up projects related to the barriers to testing, i.e. criminalization law, stigmatization and lack of offering of testing for people presenting with certain indicator diseases. The final results of ongoing projects will be published and widely disseminated in 2010 and beyond. The HIV in Europe Initiative will continue to reinforce collaboration, advocacy and networking activities in the field throughout Europe. In spite of the widespread availability of prevention tools such as condoms and combination antiretroviral therapy in most

countries in the IWR-1 cost European region, HIV infection remains a major public health and human rights challenge [1,2]. This is in spite of a strong commitment to universal access to HIV infection prevention, treatment, care and support, evidenced in the Dublin Declaration on Partnerships to Fight HIV/AIDS in the European Region in 2004 [3], the subsequent Vilnius (2004) Afatinib and Bremen declarations (2007) and the 2006 United Nations call for universal access [4]. In 2009, the European Commission further advanced the agenda with the release of the European Union Communication on combating HIV/AIDS in the EU and neighbourhood (2010–2014), which calls for a comprehensive response to HIV across all EU member states, with a clear focus on early

diagnosis and care

[5]. There has been progress in improving access to treatment across Europe, but challenges remain – for example, only 23% of those Y-27632 2HCl in need in the low- and middle-income countries in Europe and Central Asia are on combination antiretroviral therapy (compared with 44% in sub-Saharan Africa) [6]. Opioid substitution therapy, which facilitates adherence to HIV treatment, is not available in some European countries and there is low coverage in many others. Stigmatization, discrimination and other human rights abuses persist, with the situation varying widely both within and between countries. A lack of dialogue and understanding about the law, human rights, medical ethics and public health, compounded by a frequent lack of collaboration (illustrated by various, often poorly co-ordinated initiatives) persists. In 2007, European advocates, clinicians and policy-makers reached a consensus that earlier HIV diagnosis, treatment, care and support are essential, both for individuals and for societies [7], at the launch of the HIV in Europe Initiative [8]. In November 2008, the European Parliament adopted the ‘Joint Resolution on HIV/AIDS: early diagnosis and early care’ based on the call to action from the conference [9]. In November 2009, 100 key stakeholders from 25 countries met in Stockholm as a follow-up to the 2007 conference. The focus was to address five key issues that contribute to the barriers to testing identified in 2007.

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