Of the more than 2 million people infected with HIV in Eastern Europe and Central Asia, nearly a third are unaware of their status, and of those who are aware, only half receive treatment. This grim situation is highlighted in the latest UNAIDS report “AIDS, CRISIS AND THE POWER TO TRANSFORM“.
The number of new HIV infections in EECA continues to rise. In 2024, 130,000 new cases were registered in the region, 7% more than in 2010. This indicates a serious lag in achieving the global goal of ending the AIDS epidemic by 2030. In addition, the region, which accounts for 7% of new HIV cases worldwide, is the only one in the world where AIDS-related deaths continue to rise. Last year, this figure reached 48,000, which is 48% more than in 2010.
Treatment: only half of HIV-positive people receive therapy
Only 51% of people living with HIV in the region receive antiretroviral therapy. Even more alarming is that 28% are still unaware of their status. Inadequate treatment coverage is associated with late diagnosis, low retention in the health system, and barriers such as stigma and discrimination.
Key populations remain vulnerable
HIV prevalence is highest among people who inject drugs, sex workers, transgender people, gay men and men who have sex with men. But it is these groups that face the greatest difficulties in accessing health services. On average, only half of them reported receiving at least two HIV prevention services in the last three months.
The report indicates that gender-based and sexual violence is widespread in the region: between 15% and 22% of key populations have experienced physical or sexual violence in the last year alone.
Legal barriers and repression
UNAIDS notes that criminalisation and repressive laws in 16 countries in the region create additional barriers to combating the epidemic. In particular, sex work, HIV status and drug use are criminalised, and laws against LGBTQ+ communities and civil society organisations are being introduced, such as laws on ‘foreign agents’.
This legal environment discourages people from seeking help, reduces trust in medical institutions, and hinders an effective response to HIV.
Impact of war and instability
The report also notes that the HIV situation in the region is worsening due to the war in Ukraine, other conflicts, political crises, and pressure on civil society. These factors complicate the work of health systems, while migration and economic instability exacerbate the burden of the epidemic.
Funding: mismatch between needs and costs
Despite significant investments in antiretroviral therapy, current funding only covers treatment for 60% of people who will need it by 2030. In some countries (e.g. Serbia), the cost of annual treatment per person reaches $6,778, compared to $120 in Armenia.
Prevention services and community support are still largely funded by international donors — the Global Fund and the US government. However, this model is becoming unstable due to changing external priorities and political constraints in countries in the region.
A new approach is needed
The report emphasises the need for sustainable HIV strategies. Priorities include creating an enabling legal environment, increasing domestic funding, expanding access to treatment and prevention, and supporting community-led initiatives.
UNAIDS calls on countries in Eastern Europe and Central Asia to change course immediately to avoid further deepening the crisis and to move closer to the goal of eliminating AIDS as a health threat by 2030.
Recently, UNAIDS released its 2025 Global AIDS Report, titled “AIDS, CRISIS AND THE POWER TO TRANSFORM”, which warns of a serious threat to years of progress in the fight against HIV due to a global funding crisis. The report calls on countries to urgently strengthen measures to combat the epidemic, otherwise millions of lives will be at risk. Cuts in international aid have caused serious disruptions to health systems, particularly in countries most affected by HIV. If US-supported programmes are completely discontinued, UNAIDS predicts 6 million new HIV infections and 4 million additional AIDS deaths by 2029.