In most European Union (EU)/European Economic Area (EEA) countries, between 2010 and 2012, reports of new human immunodeficiency virus (HIV) diagnoses among people who inject drugs have been stable or declining. HIV outbreaks in Greece and Romania, first reported in 2011, continue and economic conditions hinder provision of effective response coverage. When measured against some established thresholds, prevention coverage remains inadequate in at least one-third of EU/EEA countries. Urgent consideration to scale up prevention efforts is merited.

In response to sharp increases in human immunodeficiency virus (HIV) notifications reported among people who inject drugs (PWID) in Greece and Romania, a risk assessment of HIV transmission among PWID was carried out in the European Union/European Economic Area (EU/EEA), Croatia and Turkey, in 2011. The report, covering 31 countries, confirmed outbreaks among PWID in Greece and Romania and noted a potential for outbreaks elsewhere [1,2]. This update, based on a survey conducted in mid-2013, summarises developments in HIV transmission and injecting risks among PWID since 2010 and identifies areas where scale-up of evidence-based preventive measures is needed to avoid further outbreaks.

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