A review of differentiated HIV testing services in the Eastern Mediterranean Region.

Background: HIV infection rates are increasing among key populations in the Eastern Mediterranean Region, due to low diagnosis and treatment coverage.

Aim: To review HIV service policies and assess the uptake of testing services in the Eastern Mediterranean Region.

Methods: We reviewed HIV/AIDS data for the 22 Eastern Mediterranean Region Member States, including data from the routine global, regional and national surveillance systems, as well as information from policy documents, strategic plans and guidelines. We analysed the data using R statistical package version 4.5.2.

Results: As of 2023, the region had an estimated 530 000 people living with HIV: 38% were diagnosed, 28% were on treatment and 24% had achieved viral suppression. Only Saudi Arabia met the 95% diagnosed target, with 95% diagnosed on treatment and 95% on treatment achieving viral suppression. The annual average number of tests conducted between 2019 and 2023 in the region was 5 million. Eight percent of these tests were among key populations. All the Member States offered facility-based testing as part of their national policies, 77% offered community-based services, 45% HIV selftesting, 32% social-network-based testing, and 77% provider-assisted referral. Eighty-six percent of them offered routine antenatal testing and 45% allowed testing by lay providers.

Conclusion: There are critical gaps in HIV testing and treatment coverage by Eastern Mediterranean Region countries, indicating an urgent need for innovative approaches, including political commitment backed by adequate resources, to scale-up services to achieve the 2030 goals.