Stability of the HIV cascade of care throughout the COVID ‐19 pandemic in Europe: Results from the multinational EuroSIDA cohort study (2016–2022)

BACKGROUND: Prior to the COVID-19 pandemic, antiretroviral therapy (ART) coverage and viral suppression were improving across Europe; however, the impact of the pandemic on HIV care remains uncertain. METHODS: In-person visits, ART coverage and viral suppression among those on ART were described in the EuroSIDA cohort for each calendar year from 2016 to 2022 and compared across five European regions. Multivariable logistic regression was used to assess factors associated with having an in-person visit and with viral suppression. RESULTS: Among 6740 participants, 71.9% were men, 34.9% were MSM, and the median age was 50 years (IQR: 42-56) at baseline (2016). The proportion of in-person visits dropped from 75.0% in 2019 to 67.8% in 2020, increased to 74.5% in 2021 and was 72.3% in 2022. We observed a consistent increase in ART uptake over the years and a slight increase in missing HIV-RNA data in 2020. The odds of attending clinic in person were lower in 2020 compared with 2016 (aOR: 0.81, 95% CI 0.75-0.87) but not in 2021 or 2022, while viral suppression increased over calendar time (p < 0.0001). Compared to Central-Western Europe, the other regions had lower odds of in-person visits (p < 0.0001, most prominently for Southern Europe, aOR: 0.18) and viral suppression (p < 0.0001, most prominently for Eastern Europe, aOR: 0.07). CONCLUSIONS: Our study confirmed the resilience of HIV care across Europe during the COVID-19 pandemic, whereas the regional and country differences in clinic attendance and viral suppression highlighted the need to address persisting gaps in HIV care on a national level.

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Journal
HIV Medicine
Published
2026-09-29
DOI
https://doi.org/10.1111/hiv.70305
Primary Topic
HIV/AIDS Research and Interventions
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article
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article

Stability of the HIV cascade of care throughout the COVID ‐19 pandemic in Europe: Results from the multinational EuroSIDA cohort study (2016–2022)

David Jilich, Jean‐Paul Viard, Giovanni Guaraldi, Marta Boffito et al.
HIV Medicine
HIV/AIDS Research and Interventions
article

Stability of the HIV cascade of care throughout the COVID ‐19 pandemic in Europe: Results from the multinational EuroSIDA cohort study (2016–2022)

David Jilich, Jean‐Paul Viard, Giovanni Guaraldi, Marta Boffito, Bartosz Szetela, Wendy P. Bannister, Johannes Richard Bogner, Justyna Dominika Kowalska, Antonella Castagna, Robert Zangerle, Olga Fursa, José María Miró, Peré Domingo, Katharina Kusejko, Thomas Benfield, Piotr Nowak, Lars Peters, Claire Mackintosh, the EuroSIDA study group
article en

Abstract

BACKGROUND: Prior to the COVID-19 pandemic, antiretroviral therapy (ART) coverage and viral suppression were improving across Europe; however, the impact of the pandemic on HIV care remains uncertain. METHODS: In-person visits, ART coverage and viral suppression among those on ART were described in the EuroSIDA cohort for each calendar year from 2016 to 2022 and compared across five European regions. Multivariable logistic regression was used to assess factors associated with having an in-person visit and with viral suppression. RESULTS: Among 6740 participants, 71.9% were men, 34.9% were MSM, and the median age was 50 years (IQR: 42-56) at baseline (2016). The proportion of in-person visits dropped from 75.0% in 2019 to 67.8% in 2020, increased to 74.5% in 2021 and was 72.3% in 2022. We observed a consistent increase in ART uptake over the years and a slight increase in missing HIV-RNA data in 2020. The odds of attending clinic in person were lower in 2020 compared with 2016 (aOR: 0.81, 95% CI 0.75-0.87) but not in 2021 or 2022, while viral suppression increased over calendar time (p < 0.0001). Compared to Central-Western Europe, the other regions had lower odds of in-person visits (p < 0.0001, most prominently for Southern Europe, aOR: 0.18) and viral suppression (p < 0.0001, most prominently for Eastern Europe, aOR: 0.07). CONCLUSIONS: Our study confirmed the resilience of HIV care across Europe during the COVID-19 pandemic, whereas the regional and country differences in clinic attendance and viral suppression highlighted the need to address persisting gaps in HIV care on a national level.

HIV Medicine
University of Modena and Reggio Emilia (IT), University of Copenhagen (DK), Real Academia Española (ES), Centre National de la Recherche Scientifique (FR), Innsbruck Medical University (AT), Vita-Salute San Raffaele University (IT), Inserm (FR), King's College London (GB), University of Zurich (CH), Université Paris Cité (FR), Charles University (CZ), Medical University of Warsaw (PL), Western General Hospital (GB), Amager Hospital (DK), Hotel Dieu Hospital (CA), Instituto de Salud Carlos III (ES), Hospital de Sant Pau (ES), Hvidovre Hospital (DK), Copenhagen University Hospital (DK), Karolinska Institutet (SE), LMU Klinikum (DE), Wroclaw Medical University (PL), University Hospital of Zurich (CH), Hospital Clínic de Barcelona (ES), Reial Acadèmia de Ciències i Arts de Barcelona (ES), Hôtel-Dieu de Paris (FR), IRCCS Ospedale San Raffaele (IT), Chelsea and Westminster Hospital (GB), Institut Cochin (FR), Centre of Excellence for Health, Immunity and Infections (DK), Centro de Investigación Biomédica en Red Enfermedades Infecciosas (ES), Ludwig-Maximilians-Universität München (DE)
Good health and well-being
Openalex Percentile: Top 12%
HIV/AIDS Research and Interventions
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