Sound Policy makes for Safer Sex: why Sexual Health is central to Europe’s long-term health and budget
Record STI numbers and a stalled HIV response show Europe's sexual health strategy is missing. The forthcoming EU budget talks are the moment to bring it back.
A recent study by The Economist warns that STIs are surging in Europe, with patchy testing and monitoring across the continent leading to devastating consequences if not caught quickly/in time.
For millions of people across Europe, sexual health still depends on where they live, who they are, and whether their body was ever part of the plan.
On this year's World Sexual Health Day, HIV Outcomes and the HIV Prevention Alliance are calling on the EU to treat sexual health as what it actually is: a public health emergency hiding in plain sight.
The State of Sexual Health in Europe
The data is clear, and there is no room for complacency: bacterial STIs are at their highest levels in over a decade. ECDC's latest annual surveillance figures, released in May, shows gonorrhoea notifications have more than quadrupled since 2015, syphilis cases have more than doubled, congenital syphilis has nearly doubled, and chlamydia remains the most commonly reported infection in the EU/EEA.
HIV tells a parallel story. New infections in the EU/EEA have fallen only 35% since 2010, against a 75% reduction target due this year. Nearly half of all diagnoses are still made late, missing the window for the most protective treatment.
It’s been 30 years since science made it possible to live with HIV. And yet, one in five people living with HIV in Europe are still not virally suppressed. Obtaining HIV medication still depends heavily on where you live, and persistent stigma in healthcare settings further hinders access to life-saving drugs.
This is not for lack of tools and tireless efforts from communities across Europe. Advances in HIV innovation are one of the century’s most consequential public health advances, with the slogan “Undetectable = Untransmittable” underlines how sound innovation in antiretroviral treatment has allowed for safe sex. In prevention, PrEP prevents HIV with near-total effectiveness. And yet, complete and equal coverage is no longer a matter of science, but one of policy and decision-making.
The Final (policy) Frontier
STIs and HIV point to a similar policy gap: the absence of a dedicated EU framework to address these challenges. The EU's last dedicated Action Plan on HIV expired in 2016, and there’s still no successor holding Member States accountable.
That’s why the next EU’s next long-term budget, the 2028-2034 Multiannual Financial Framework matters so much. The next budget will determine where HIV, STIs and sexual health get a well-funded, well-coordinated and well-managed home for the next 7 years, or whether they’ll continue to be an afterthought, a footnote to be revisited only when the numbers and pressures on healthcare systems become impossible to ignore.
The question, therefore, isn’t whether we can prevent, test and treat HIV and STIs – it’s whether we will make the choice to promote equity and fairness in sexual health.
Safe sex shouldn't be a policy afterthought. The cost of inaction is measured not only in preventable infections and deaths, but also in growing pressure on health systems and avoidable healthcare spending. The distinct lack of sexual health policy tools is political choice European decision-makers keep deferring. Europe needs to be honest and confront the rising issue of STIs and sexual health by first admitting the existence of the threat.
Stigma, not science, is the final barrier.
Sexual and reproductive health and rights (SRHR) must be integral to a coherent health and social policy agenda. They determine whether people can make informed decisions about their bodies, access healthcare without discrimination, prevent illness, and exercise their rights on an equal basis.
HIV Outcomes – Beyond Viral Suppression and the HIV Prevention Alliance call on the upcoming MFF to:
Recognise that sexual and reproductive health and rights (SRHR), including HIV prevention and care, are a strategic investment that strengthens economic resilience, workforce productivity and the long-term sustainability of public finances, and ensure adequate funding to support these objectives;
Take immediate action to strengthen prevention and care efforts across all population groups, with a particular focus on at-risk and underserved communities, through targeted use of MFF financial instruments, including Cohesion Policy funds, Instrument for Pre-Accession Assistance and Global Europe;
Adequately reflects emerging challenges, ensuring that health – including SRHR services, HIV prevention and care – is recognised as a core pillar of resilience, security, and economic sustainability;
Coordinate an EU27-level HIV response, underpinned by renewed political commitment and sustained, strategic financing, to achieve HIV transmission reduction by 2030.
Signed
HIV Outcomes – Beyond Viral Suppression & the HIV Prevention Alliance
About HIV Outcomes – Beyond Viral Suppression
Founded in 2016, HIV Outcomes is a pan-European multi-stakeholder initiative aiming to enhance the long-term wellbeing and health-related quality of life (HRQoL) of people living with HIV through policy and clinical advancements, bringing together patient organisations, medical professionals, academics, public institutions and the private sector.
HIV Outcomes also operates at national level in Italy, the Netherlands, Poland, the United Kingdom and Romania.
About the HIV Prevention Alliance
The HIV Prevention Alliance was launched in April 2025 as a diverse coalition of stakeholders aimed at revitalising political leadership and accelerating action on HIV prevention in the EU and its close neighbourhood, in line with the EU’s commitment to achieving the Sustainable Development Goal 3.3: ending the AIDS epidemic by 2030. By bringing together over 27 representatives from the communities most affected by HIV, including LGBTQI+, women, migrants, youth, people who use drugs, people experiencing homelessness and sex workers, alongside leading clinical and public health experts, researchers and industry partners, the Alliance serves as a unifying platform for dialogue, collaboration and action.