On the eve of the 19th European AIDS conference Justyna Kowalska, Professor of Medicine at the Medical University of Warsaw and Senior Consultant at Warsaw's Hospital for Infectious Diseases, and Magdalena Ankiersztejn-Bartczak, CEO of the Foundation for Social Education talk about why it’s “time to revisit” Warsaw.
The EACS Conference is back in Warsaw after a 20-year hiatus. What does this mean?
Justyna: Warsaw symbolises the conference's focus on Central and Eastern Europe, a region that has seen significant HIV advances but still has many unmet needs. This conference first took place in Warsaw in 2003, and a lot has changed in the intervening years. We look forward to welcoming over 2000 delegates from all over Europe to reflect on past initiatives and plan for the future under the theme of “Time to revisit”.
How did Warsaw and Poland engage with the HIV epidemic historically?
Justyna: Initiatives like Opioid Substitution Therapy and needle exchange programs were among the first preventive strategies deployed in Poland. These early efforts successfully curbed HIV rates among injecting drug users, which was a significant achievement. Subsequently, the Hospital for Infectious Diseases in Warsaw played a pioneering role in integrating HIV care with harm reduction programs.
Magdalena: On top of those successes, we managed to nearly eliminate mother-to-child HIV transmission. However, it’s clear that we need new strategies to deal with the current landscape of HIV transmission, which has changed significantly over time.
What’s the current situation in Poland?
Justyna: Between 2012 and 2021, the number of people diagnosed with HIV and under specialist care increased by 84%. Between 2012 and 2019, new diagnoses in Poland significantly outpaces eight out of 11 comparable countries in Europe. This is concerning and is why we are calling for more investment in better prevention programmes.
What are the kinds of prevention programmes needed?
Magdalena: Education is instrumental in any prevention strategy. School programmes that offer comprehensive education, including information on HIV, can equip the younger generation with the knowledge they need to protect themselves. These should be factual, free from stigma, and designed to stimulate open dialogue.
In many countries across Europe PrEP is being rolled out. How is this happening in Poland?
Magdalena: PrEP has shown significant efficacy in preventing new HIV infections. Not enough people – even healthcare professionals - know about it. There are hurdles such as cost and availability. We need to create awareness about PrEP as a prevention method and work on making it easily available. Public funding and insurance coverage for PrEP would greatly encourage its uptake.
How can we ensure that prevention programmes reach those considered to be at higher risk?
Justyna: Tailored interventions are essential. Populations at higher risk may require different methods of outreach and education. For instance, programmes for men who have sex with men might focus on different aspects of prevention compared to those for heterosexual couples or drug users.
Stigma around HIV is a persistent issue. Will the conference address this?
Magdalena: One of the conference's objectives is to look at how to lessen the societal and institutional stigmas related to HIV. In doing so, we aim to create an environment that facilitates easier access to care and promotes widespread preventive education.
Justyna: Stigma is a critical barrier to care and treatment. It's often tied to late diagnoses and can put patients off staying on treatment. It impacts on patients’ mental health. One activity that will be discussed at the conference is a current survey by EACS, together with ECDC, to measure knowledge and attitudes towards HIV amongst healthcare professionals across Europe.
Will the Conference address care of Ukrainian refugees living with HIV?
Justyna: Yes, the recent 15% population growth in Warsaw, largely attributed to Ukrainian war refugees, places the city at the forefront of new challenges in HIV care. Ukraine has the second-largest AIDS epidemic in the Eastern Europe and Central Asia region. Across Europe, there is concern about the impact of migration on refugees living with HIV and about how healthcare providers treat them effectively.
What impact will the Conference have on your city?
Magdalena: This is not just a behind closed doors event – we want to engage the people of Warsaw and generate pride and openness towards people living with HIV. We’re organised range of activities aimed at the local community. These include a Red Ribbon display on city buildings, a HIV awareness week at the Medical University of Warsaw, a mobile harm reduction service carrying out free and anonymous tests for HIV, Hepatitis C and STIs, and a special group run "Living Free with HIV". All are welcome to join!