HIV/AIDS in Romania Versus Europe: An Epidemiological and Public Health Perspective, 2024 Update

Background/Objectives: Human Immunodeficiency Virus (HIV) remains a major public health concern globally and across Europe. Romania’s epidemic has historically followed unique patterns, particularly due to pediatric infections in the late 1980s, but has since evolved to mirror broader European trends. This study provides an updated epidemiological and public health perspective on HIV in Romania compared with Europe, focusing on 2022–2024. Methods: We analyzed national surveillance data from the National Institute of Infectious Diseases “Prof. Dr. Matei Balș” and European Centre for Disease Prevention and Control (ECDC) reports. Key indicators included incidence, mortality, transmission routes, age and gender distribution, and treatment coverage. Comparative analyses were performed between Romania and European Union (EU)/Eastern Europe data. Results: Between 1985 and 2024, Romania registered 28,793 HIV/AIDS cases, with 18,768 people currently living with HIV/AIDS. In 2024, 810 new cases were reported, reflecting a slight increase from 2022–2023. Heterosexual transmission remained predominant (59.4%), followed by MSM (30.5%) and IDU (5.2%). Men accounted for over 75% of new diagnoses. Mortality fluctuated, with 193 HIV/AIDS-related deaths in 2024, compared to 125 in 2023. Despite this, treatment coverage improved, with 16,464 patients on ART by the end of 2024. Compared with Europe, Romania’s incidence (2.51/100,000) remained below the continental average (3.5/100,000), though MSM-related transmission rose sharply, aligning with Eastern European patterns. Conclusions: Romania has made significant progress in HIV care and treatment access, transforming HIV into a manageable chronic condition. However, persistent challenges include the rising burden among MSM, fluctuating mother-to-child transmission, and enduring stigma. Strengthened prevention strategies, expanded testing, and targeted interventions are essential to align Romania with successful European models and sustain progress toward HIV elimination.