Luxembourg wins the ranking with 857 points followed by Malta (791) and Switzerland (775).

The poor Bulgarian conditions are explained foremost by weak access to care and support for people living with HIV.

“The marginalized groups of Roma, sex workers, drug users or LGTB (Lesbians, Gays, trans) face additional stigmatization and discrimination, not receiving treatment for free as other Bulgarian citizens do, which hinders their access to care, support and treatment.” states Dr. Beatriz Cebolla, the Euro HIV Index Director. “Additionally, there is also an urgent need to establish harm reduction programs in prisons.”

While the number of people living with HIV (PLWH) increases in every member state of the EU, budgets in several countries are reduced. Sexual risk behaviour is becoming more and more regular practice. Criminalization of HIV is a problem in many countries, and still HIV specific legislation exists in some countries; people can get prosecuted also for unintentionally and unknowingly transmitting the virus. The access to care for marginalized groups such as undocumented migrants is not guaranteed almost anywhere in Europe. Discrimination and stigma against PLWH is frequent at work and in schools. Harm reduction strategies in prisons are still weakly implemented, especially in the Eastern European countries.

There is a general lack of leadership in HIV management and no government seems to know the true number of HIV-infected inhabitants. The main conclusion of the HIV Index is that there is still a lot to do.

The EHIVI ranks the HIV situation across 28 indicators, covering 4 areas that are key to HIV: Involvement and rights, Access, Prevention, and Outcomes. The Euro HIV Index is compiled from a combination of public statistics, patient polls and independent research conducted by the founder, the Brussels-based think tank Health Consumer Powerhouse. The EHIVI 2009 takes a patient centred position. The Index is being held in association with the Swedish EU presidency of autumn 2009. It has received an unrestricted educational grant by Gilead Research.