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A new project aimed at helping countries to incorporate recency testing into national HIV reporting systems has been launched by UNAIDS in seven countries of eastern Europe and central Asia.

A recency test is a laboratory-based test that detects whether an HIV infection is recent (less than six months) or not. The incorporation of HIV recency testing in national HIV case reporting systems will help to assess how HIV is being transmitted, describe behaviours that are facilitating HIV transmission and optimize HIV-related data collection and information on risk factors.

Many countries in eastern Europe and central Asia report that despite significant progress in the epidemiological surveillance, prevention and treatment of HIV, a substantial number of new HIV diagnoses are made late. In Armenia, for example, according to national data, almost 66% of all new diagnoses of HIV infection in 2019 were made at the stage when the CD4 count was less than 350 cells/mm3 (in Kyrgyzstan, the percentage was 53%, while in Tajikistan it was 56%).

“The average time from infection to the moment a person enters the health-care system in the region varies from five to seven years,” said Lev Zohrabyan, a UNAIDS Regional Strategic Information Adviser. “All those few years, a person could be putting at risk his or her own health and the health of a partner. Moreover, prevention measures are often based on old data on transmission.”

By determining recent infections among people newly diagnosed as living with HIV, countries can identify the geographic areas and subpopulations where HIV transmission is happening. They can then effectively interrupt HIV transmission by building evidence-informed policies, guiding resources to the right place and measuring the impact of HIV prevention programmes.

“We often understand the situation as it was—what happened five years ago. This test allows us to identify and characterize cases that occurred a maximum of six months ago. Thanks to this system, we may better understand where the latest cases of HIV infection occurred,” said Meerim Sarybaeva, UNAIDS Country Manager for Kyrgyzstan.

After a multicountry study, the testing has been thoroughly evaluated and discussed with national partners with the aim of developing the most effective way of incorporating HIV recency testing into national HIV case reporting systems. The innovative technology has been transferred to national experts through extensive training programmes provided by UNAIDS for epidemiologists and laboratory experts.

This innovative approach is being integrated into routine HIV surveillance in several countries in eastern Europe and central Asia in the framework of the UNAIDS Regional Cooperation Programme (RCP) for Technical Assistance on HIV and Other Infectious Diseases, funded by the Government of the Russian Federation. The RCP aims to strengthen health systems, ensure better epidemiological surveillance of HIV and promote the scale up of HIV prevention programmes among key populations at higher risk in Armenia, Belarus, Kyrgyzstan, Tajikistan and Uzbekistan.