OBJECTIVES: The aim of this survey was to describe the current status of HIV care in the countries of Central and Eastern Europe and to investigate how close the region is to achieving the UNAIDS 2020 target of 90-90-90. METHODS: In 2014, data were collected from 24 Central and Eastern European countries using a 38-item questionnaire. RESULTS: All countries reported mandatory screening of blood and organ donors for HIV. Other groups subjected to targeted screening included people who inject drugs (PWID) (15/24, 62.5%), men who have sex with men (MSM) (14/24, 58.3%), and sex workers (12/24, 50.0%). Only 14 of the 24 countries (58.3%) screened pregnant women. The percentages of late presentation and advanced disease were 40.3% (range 14-80%) and 25.4% (range 9-50%), respectively. There was no difference between countries categorized by income or by region in terms of the percentages of persons presenting late or with advanced disease. The availability of newer antiretroviral drugs (rilpivirine, etravirine, darunavir, maraviroc, raltegravir, dolutegravir) tended to be significantly better with a higher country income status. Ten countries reported initiating antiretroviral therapy (ART) regardless of CD4+ T cell count (41.7%), five countries (20.8%) used the threshold of <500 cells/μl, and nine countries (37.5%) used the threshold of <350cells/μl. Initiation of ART regardless of the CD4+ T cell count was significantly more common among high-income countries than among upper-middle-income and lower-middle-income countries (100% vs. 27.3% and 0%, respectively; p=0.001). Drugs were provided free of charge in all countries and mostly provided by governments. There were significant discrepancies between countries regarding the follow-up of people living with HIV. CONCLUSIONS: There are major disparities in the provision of HIV care among sub-regions in Europe, which should be addressed. More attention in terms of funding, knowledge and experience sharing, and capacity building is required for the resource-limited settings of Central and Eastern Europe. The exact needs should be defined and services scaled up in order to achieve a standard level of care and provide an adequate and sustainable response to the HIV epidemic in this region.

'Victor Babes' Clinical Hospital for Infectious and Tropical Diseases 'Carol Davila' University of Medicine and Pharmacy Bucharest Romania

AIDS Control Centre Baku Azerbaijan

Central Scientific Research Institute of Epidemiology of Rospotrebnadzor Russian Federal AIDS Centre Moscow Russian Federation

Centre for HIV AIDS Clinic of Infectious Diseases University Hospital Bratislava Slovakia

Clinic for Infectious Diseases and Febrile Conditions Skopje Former Yugoslav Republic of Macedonia

Clinical Centre Infectious Diseases Clinic University of Sarajevo Sarajevo Bosnia and Herzegovina

Community Development Fund Prishtina Kosovo

Department of HIV Infection and Infection Control Kazakh National Medical University Almaty Kazakhstan

Department of Infectious and Travellers Diseases Charles University Medical Faculty Pilsen Czech Republic

Department of Infectious and Tropical Diseases 1st Faculty of Medicine Charles University and Na Bulovce Hospital Prague Czech Republic

Department of Infectious Diseases and Clinical Microbiology Faculty of Medicine Ege University Izmir Turkey

Department of Infectious Diseases Division of Medicine Kyrgyz Russian Slavonic University Bishkek Kyrgyzstan

Hospital for Infectious Diseases in Warsaw Medical University of Warsaw Warsaw Poland

Infectious Disease Department Faculty of Medicine University Hospital Centre of Tirana Tiran Albania

Infectious Diseases AIDS and Clinical Immunology Research Centre Tbilisi Georgia

Institute of Microbiology and Immunology Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Institute of Public Health Podgorica Montenegro

Institute of Virology Ministry of Public Health of Uzbekistan Tashkent Uzbekistan

National Centre for Disease Control and Prevention of Armenia Yerevan Armenia

National Institute for Health Development Tallinn Estonia

National Institute of Public Health of Kosovo Prishtina Kosovo

National Reference Laboratory of Immunology National Centre of Infectious and Parasitic Diseases Sofia Bulgaria

Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases Sofia Bulgaria

State Medical and Pharmaceutical University Nicolae Testemitanu Department of Infectious Diseases and Medical Parasitology Chisinau Republic of Moldova

Szent Laszlo Hospital Budapest Hungary

University of Belgrade School of Medicine Infectious and Tropical Diseases Hospital Clinical Centre Serbia HIV AIDS Unit Belgrade Serbia

University of Zagreb School of Medicine University Hospital for Infectious Diseases Zagreb Croatia

Yunus Emre State Hospital Eskişehir Turkey

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