The HepHIV2023 conference, held in Madrid, Spain, from 13th to 15th November, convened a diverse array of stakeholders committed to advancing the fight against HIV, viral hepatitis and sexually transmitted infections (STIs). The event was organized by EuroTEST, and our Senior Policy Officer, Roberto Pérez Gayo, also participated in its organising committee. The conference spotlighted pivotal themes in the realm of infectious diseases, with a focus on integrated testing, technological advancements, and equitable service delivery.
Rafaela Rigoni, C-EHRN’s Scientific Officer, offers key takeaways from the conference, emphasizing critical issues surrounding HIV, and highlighting the conference’s focus on testing, migration, and stigma.
Stigma emerged as a central point of discussion, drawing attention to the multifaceted dimensions impacting individuals living with HIV (PLHIV) and at-risk communities. The targets for 2025 established by UNAIDS to ensure that less than 10% of these groups would be subjected to stigma and discrimination spurred collaborative efforts to develop monitoring mechanisms. Notably, the collaboration between the European Centre for Disease Prevention and Control (ECDC), European AIDS Treatment Group (EATG) and AIDS Action Europe led to the creation of an instrument based on the HIV Stigma Index to measure stigma.
Insights in a recently published report using the HIV stigma survey showed that despite participants generally rating their overall quality of life as satisfactory, there is a prevalent connection between stigma and depression. This critical correlation between stigma and mental health, particularly depression, emphasises the need for enhanced mental health services tailored to the unique needs of the population living with HIV.
Moreover, the survey shed light on the alarming prevalence of self-stigma, indicating that individuals harboured negative perceptions about themselves, along with instances of stigma from family and friends. Notably, healthcare settings emerged as hotspots for heightened stigma. Those reporting lower life quality consistently reported more profound experiences of stigma, highlighting the pressing need for targeted interventions to address and mitigate these challenges. The need to understand the experiences of different key populations and research the intersectionality around stigma was highlighted.
The conference didn’t solely focus on HIV; the first attempts to develop a monitoring instrument to measure HCV-related stigma are also underway by ECDC, and C-EHRN was invited to be part of an expert group with an advisory role, fulfilled by our Senior Scientific Officer.
More about HepHIV
The conference brings together stakeholders from all levels of the health system, from community organisations to health care providers and policymakers to present and discuss new approaches for testing and linkage to care for HIV, viral hepatitis, sexually transmitted infections (STIs) and tuberculosis (TB), highlighting programmatic/ implementation issues and adaptation of testing services in response to emerging public health issues. Frontline workers constituted the majority of participants, highlighting the practical implications of the discussions for those directly involved in service delivery.
In summary, the conference illuminated the complexities surrounding stigma, emphasized the critical intersections between mental health and stigma, and underscored the importance of tailored interventions. Moreover, it highlighted the imperative need for integrated testing approaches and the adaptation of services to address emerging public health challenges.
The new website of BOOST, a project supporting community-based & community-led organisations in providing communicable diseases services, is now available online!
BOOST enhances the implementation of harm reduction interventions by supporting community-based and community-led services that work to counteract the prevalence of communicable diseases including HIV/AIDS and viral hepatitis.
Those interested can read about BOOST, its aims and activities on the new web platform. In later project phases, the resources produced throughout the project activities will also be published here, including an up-to-date overview of the quality of testing and linkage to care services offered by harm reduction organisations in the EU and selected neighbouring countries, good practice examples, webinars and training materials.
Co-funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union. Neither the European Union nor the granting authority can be held responsible for them.
When it comes to addressing drug consumption and its associated risks, the stigma surrounding people who use drugs negatively impacts their access to support and health services. When stigmatised, people feel discouraged from seeking the care they need due to feeling judged and degraded.
Harm reduction services approach drug use in all its complexity, upholding the rights of people who use drugs while searching for evidence-informed strategies of care and support. Harm Reduction aims to empower and support people who use drugs in regaining agency and leadership, contributing to their meaningful participation in reducing the potential harm of their drug use. Among others, examples of strategies to reduce stigma and improve access to treatment and support services include advocating for and contributing to the decriminalisation of drug use or the implementation of alternatives to incarceration.
For the International Day against Drug Abuse and Illicit Trafficking, we have collected some updates from the harm reduction field touching on addressing stigma.
→ 2023 #SupportDontPunish Global Day of Action
June 26th marks the 11th #SupportDontPunish Global Day of Action. The Support. Don’t Punish. Campaign unites initiatives working towards sustainable alternatives to the ‘war on drugs’ and supporting strategies to drug- and drug-policy-related challenges that are based on solidarity and the rights of the communities they represent. The campaign aims to connect and visibilise these local efforts as part of a global movement.
Find out more here.
→ Recommendations for tackling stigma and discrimination – joint statement by the EUHPP Thematic Network
The European Health Policy Platform Thematic Network on HIV, TB, viral hepatitis, and STIs, led in collaboration with the EU Civil Society Forum, is working to involve non-governmental organizations in policy development, implementation, and sharing of information. They released a joint statement in June that has been supported by 40 European organizations.
The statement points out the gaps in addressing the needs of individuals affected by HIV/AIDS, viral hepatitis, and tuberculosis in the EU. It also provides recommendations to tackle the stigma and discrimination faced by key populations, including people who use drugs.
You can read the statement here.
→ Statement from UN experts addresses stigma and discrimination and calls for people-centred alternatives to the ‘war on drugs’
A recent statement by United Nations experts underscores the detrimental effects of stigmatization and urges the exploration of alternative approaches to address the global challenge of drug-related issues. The experts advocate for a comprehensive and restorative justice framework, alongside inclusive and community-based measures. By challenging the paradigm of the ‘war on drugs,’ they emphasize the importance of adopting a more compassionate and efficient response. For further insights, you can access their statement here.
→ New toolbox to initiate harm reduction in prisons will be available by October
A toolbox to give guidance on the application of harm reduction approaches in prisons is under development. The toolkit, developed by C-EHRN in consultation with relevant stakeholders and experts, will be launched in October and presented at the C-EHRN Member and Expert Meeting in Budapest in December.
→ Civil society involvement in Finland, Ireland, Hungary and Greece – What stage are we at?
In 2023, C-EHRN and the Rights Reporter Foundation will conduct a study to assess the level and quality of civil society involvement in four EU countries, Finland, Ireland, Hungary and Greece. The case studies will reflect on the application of quality standards based on the Quality Standards for Civil Society Involvement in Drug Policy, developed in 2021 as part of the Civil Society Forum on Drugs (CSFD) Project. The study will also address how CSO are involved in the implementation of drug policies in each country.
The Central and Eastern European Summit 2023 on Hepatitis C, HIV and other infections – screening, linkage to care and treatment took place in Prague on the 15-16th of June and gathered over 200 participants from Czechia and Central and Eastern Europe. The aim was to facilitate knowledge exchange, share good practices and improve care for hard-to-reach communities, particularly people who use drugs.
The EU Health Policy Platform Annual Meeting took place on the 19th of April. The event was a hybrid conference with nearly 300 participants in Luxembourg and online. The first part of the event was dedicated to showcasing the Joint Statements prepared by the 2022 Thematic Networks, which culminate several months of exchange and research, each in a particular area of public health.
During the event, the Coordination Team of CSF on HIV/AIDS, VH & TB presented its Joint Statement, which explores outstanding challenges and good practices specific to dealing with these conditions. Special attention was brought to the importance of nurturing collaboration among stakeholders to ensure continuity of prevention, treatment and care and better quality of life for all people living with or most affected by HIV/AIDS, viral hepatitis, tuberculosis (especially drug-resistant) and sexually transmitted infections, including an adapted response for displaced and mobile people and other migrant populations. The statement also highlights how HIV, viral hepatitis (VH) and STIs are increasingly becoming concentrated in key and vulnerable populations and provides recommendations on how to overcome the stigma and discrimination against these key populations that are often at the intersection of multiple axes of marginalisation.
Additionally, three other Joint statements were presented:
You can find the statements and presentations here.
Since its creation in 2005, the EU Civil Society Forum on HIV/AIDS (hereafter CSF) and since 2017,
the EU CSF on HIV/AIDS, TB and viral hepatitis has been instrumental in providing and sharing critical
information and evidence, in undertaking joint actions, and creating synergies between its members.
The report contains current standards of care, challenges in implementation, good practice examples of implementation, and cross-border healthcare.
The main aim of the BOOST project is to enhance the implementation of high-quality community-based & community-led communicable disease services as part of a comprehensive, people-centred and integrated harm reduction approach. To ahieve its goal, over the next three years, together with our partners we will focus on four key areas:
INFORM – providing a collection of up-to-date information and data on current practice and quality of community-based and community-led services.
IMPROVE – supporting the organisation of capacity building activities in the field of communicable diseases, indluding the use of digital tools.
SUPPORT – enhancing the scale-up of integrated community-based good practices building up existing models of good practice.
CONNECT & ACT – strenghtening and consolidating existing civil society networks and fostering advocacy interventions for the improved implementation comunity-based and community-led good practices oriented towards the needs of people who use drugs at European, national and local levels.
BOOST Project is founded by the EU4Health programme of the European Union, under the Action Grants to support the implementation of best practices in community-based services for HIV, AIDS, viral hepatitis and sexually transmitted infections. Partners include the Eurasian Harm Reduction Association, EuroNPUD, Free Clinic, Podane Ruce, LILA Milano, Asociacion Bienestar y Desarrolo, IGTP/ICO, ISGlobal, Foundazinone Villa Maraini. Supporting the projects work, the project with count with Scientific Advisory Board and the collaboration of organizations such as DPNSEE, ReGeneration, ARAS Foundation, AIDS Action Europe, among others.
In 2023, C-EHRN will start to implement the European Union (EU) co-financed BOOST project, aiming to strengthen and support community-based and community-led harm organisations in providing high-quality communicable disease services to people who use drugs. These include the scaling-up of good practices in communicable disease awareness, prevention, screening/testing and linkage to care, delivered as an integrated part of people-centred harm reduction interventions. The project consortium includes, among others, the Eurasian Harm Reduction Association (EHRA) and the European Network of People Who Use Drugs (EuroNPUD).
The publication also contains information from the presentation by Roberto Perez Gayo (C-EHRN Policy Officer) on the BOOST project at INHSU 2022.
As well as this, Free Clinic in Belgium, Podane ruce in Czechia, Villa Maraini in Italy, and the A-Clinic Foundation in Finland are discussed as examples in harm reduction for an integrated HIV/HCV approach.
