Ahead of AIDS 2026 and as part of the Rethink. Rebuild. Rise. campaign, VirusOFF continues its series on what HIV prevention looks like in Central and Eastern Europe and Central Asia today — in the context of migration, war, stigma, unstable funding, criminalization and unequal access to services.
This time, we focus on HIV prevention in motion: when a person moves to another city or country, changes legal status, loses their usual contact with a doctor or counsellor, does not know the local language, does not have documents, fears disclosure of their HIV status or simply does not know where to start.
For our region, this is not an abstract issue. Europe remains one of the largest regions receiving people who have been forced to leave their homes: according to UNHCR, by the end of 2025 Europe hosted more than 20 million forcibly displaced and stateless people, including 5.2 million refugees from Ukraine.
At the same time, Eastern Europe and Central Asia remain a region where the number of new HIV cases continues to rise. According to UNAIDS, in 2024 there were around 130,000 new HIV cases in the region; around 2.1 million people were living with HIV and only 51% were receiving treatment.
This means that HIV prevention during migration is not an “additional” issue. It is about continuity of access, trust, safety and a person’s right not to lose connection with services precisely when their life is already changing too quickly.
What does it mean not to “fall out” of services?
“Falling out” of services does not always mean losing access to healthcare completely.
Sometimes it looks like this: a person knows they should have an HIV test but does not know where to do it confidentially. Or they were receiving antiretroviral therapy, but after moving they do not know how to reach a doctor. Or they previously used harm reduction services, but in a new country they do not know whether such services exist. Or they have heard about PrEP and PEP but are afraid to ask because they are not sure how a doctor will respond.
Sometimes a person does not seek support not because they “do not care”. They may fear stigma, disclosure of their HIV status, job loss, problems with documents, or judgement from a doctor, partner or community. They may not have insurance, may not speak the local language or may simply be exhausted after war, displacement, loss of home or instability.
That is why prevention continuity must mean more than simply “giving someone the address of a clinic”. It means helping a person navigate the pathway to services safely, clearly and without humiliation.
Why HIV testing after moving is especially important
HIV testing is not about fear. It is about information, control over one’s health and the opportunity to receive support in time.
After moving, people often postpone health “for later”. First, they need to find housing, work, school for their children, documents, and understand the language and rules of a new country. But these are also the moments when a person may lose their usual points of support: a doctor, a peer counsellor, a community organization, a testing service or access to prevention.
Late HIV diagnosis remains a serious challenge in the WHO European Region. According to ECDC and WHO/Europe, in 2024, 105,922 HIV diagnoses were reported in 49 of the 53 countries of the WHO European Region, including 24,164 in EU/EEA countries. WHO/Europe also emphasizes that in 2024, more than half of HIV diagnoses in the region — 54% — were late, meaning that people had already missed the benefits of early treatment.
For a person in migration, this is especially important: the earlier they know their status, the sooner they can access treatment, counselling, support, information about U=U — “undetectable = untransmittable” — and protect their health without panic or stigma.
How to find safe HIV testing and counselling without judgement
The first step is to look not just for the “nearest clinic”, but for a service where confidentiality, clear language, respect for the person and the possibility to ask questions without fear are part of the approach.
In Europe, one starting point can be the European Test Finder — a tool that helps people find places to test for HIV, viral hepatitis and other sexually transmitted infections.
Before contacting a service, it is worth checking:
• whether testing can be confidential or anonymous;
• whether pre- and post-test counselling is available;
• whether the result will be explained in plain language;
• whether the service can help with referral to a doctor or service organization;
• whether the service works with people without insurance or with temporary status;
• whether language support is available, or whether it is possible to communicate in English, Ukrainian or another language;
• whether there is a connection with community organizations or peer counsellors.
A safe service is not one where a person “perfectly fits the rules”. A safe service is one where a person’s options are explained and they are not made to feel ashamed of their life.
For Ukrainians who have been forced to move because of the war or change their country of stay, it is also important to know about HelpNow Service — a navigation and support service for people living with HIV, people from key communities and those who need help accessing treatment, testing, prevention or counselling after moving. Through HelpNow, people can receive information on where to turn in a specific country, how not to interrupt treatment, where to look for HIV service organizations, counselling or support without judgement.
This is especially important when a person does not know the local system, does not speak the language of the country where they are staying, does not have all documents or fears disclosure of their HIV status. In such situations, the first safe contact with a navigator or peer counsellor can become the bridge that helps a person not to “fall out” of services.
How to ask about PrEP and PEP
During migration, access to PrEP and PEP may be unequal. According to the latest ECDC report on PrEP in Europe and Central Asia, published in November 2025 and based on 2024 data, 344,596 people received PrEP in 36 countries of the WHO European Region. This was around 60,000 more than in 2023, but still below the regional target of 500,000 people on PrEP by 2025.
This means that access is expanding, but it is still not equal. In one country, PrEP may be available free of charge or through insurance; in another, it may be paid out of pocket, available only in selected clinics or practically inaccessible for people without documents or with unstable legal status.
Possible questions to ask a doctor or counsellor:
“I would like to understand whether PrEP could be relevant for me. Where should I go?”
“Is PrEP available free of charge in this country, or through insurance?”
“Can I access PrEP confidentially?”
“What should I do if I do not have a permanent family doctor or insurance?”
“Less than 72 hours have passed since a situation that may have led to HIV transmission. Where can I urgently access PEP?”
“Can you refer me to a service that works without judgement and respects confidentiality?”
How not to lose connection with treatment after moving
For people living with HIV, the most important thing is not to be left alone with questions about treatment.
Moving may mean changing country, doctor, language, prescription system, insurance, rules for receiving medicines and laboratory monitoring. But antiretroviral therapy needs to be continuous. If a person is already on treatment, it is important, where possible, to find out in advance how to receive the next supply of medicines and where to register for medical follow-up in a new country or city.
It is useful to have with you, or save on your phone:
• the names of the medicines you take;
• a photo of the package or prescription;
• the latest viral load result, if available;
• contact details of your previous doctor or counsellor;
• the date of the last medicine pick-up;
• information about allergies or other important health conditions;
• any document confirming your right to healthcare services, if available.
If documents are missing or have been lost, this does not mean that help is impossible. It is worth contacting a community organization, migrant organization, HIV service or social worker and saying directly: “I do not have all the documents, but I need to avoid interrupting my treatment. What options are available?”
If there are no documents or there is fear of status disclosure
People without documents or with unstable legal status are often the most afraid to seek help. And this fear has real grounds: rules on access to healthcare differ across countries, and experiences of stigma, discrimination or contact with state institutions can be deeply traumatic.
In its 2024 report on HIV and migrants in the EU/EEA, ECDC notes that access to healthcare services for undocumented people is not universally guaranteed across EU/EEA countries, which hinders HIV prevention, testing and treatment for this group.
This is why low-threshold, community-based and confidential services are especially important for people without documents. They can help a person understand:
• whether anonymous testing is possible;
• whether free or emergency medical care is available;
• whether services exist for people without insurance;
• whether counselling can be accessed without personal data being shared with third parties;
• whether there is an organization that can help with translation, navigation or accompaniment.
Three first steps you can take today
1. Find one safe point of contact
This may be an HIV service organization, a community-based centre, a peer counsellor, a family doctor, a sexual health service, a harm reduction organization, a migrant organization or a hotline.
You do not need to solve everything at once. It is enough to find one person or one service that can explain the pathway.
2. Save your key medical information
If you are living with HIV or taking PrEP, PEP, opioid agonist therapy or other essential medicines, save the names of your medicines, photos of packages, prescriptions, test results and contacts of your doctor or counsellor on your phone.
This can help if you need to explain your situation quickly in a new country or a new service.
3. Ask one direct question
For example:
“Where can I get a confidential HIV test?”
“How can I access PrEP in this country?”
“Less than 72 hours have passed since a possible exposure to HIV. Where can I get PEP?”
“I am on HIV treatment and have moved. How can I avoid interrupting therapy?”
“I do not have documents or insurance. What support options are available?”
A direct question often helps shorten the pathway. And if the answer is unclear or judgemental, it is a sign to look for another service.
And remember: asking for medical help is not shameful. Asking about confidentiality is normal. Asking where your data will go is your right.
