Many people in Latvia do not know they have HIV. Several RSU studies on HIV

Author: Toni Angelo Fernandes,
Senior Laboratory Assistant, Senior Researcher and Lecturer at the RSU Institute of Public Health

The Institute of Public Health at Riga Stradiņš University (RSU) is re-examining the current situation. At the same time, only one third of the population in Latvia has been tested, and many believe that the diagnosis does not apply to them. Can they really rely on it?

"HIV doesn't apply to me"

HIV is a stigmatised and mythical topic in Latvia. Myths about it circulate not only in society, but also among people living with HIV themselves. As with any other health issue, it all starts with ourselves. When working with people attending HIV prevention clinics and looking at society, we often come across a rather typical myth - "HIV is not about me". Analysing data from the RSU survey on sexual and reproductive health in Latvia, 55.6% of women and 56.6% of men aged 15-64 rate their risk of contracting HIV as low, although more than half have not used a male condom during sexual intercourse in the last year. Furthermore, there is a trend towards an increase in the proportion of the population not using any method of contraception, including the male condom, with increasing age.

Of course, menopause completely prevents pregnancy, but it does not eliminate the risk of contracting HIV and other sexually transmitted diseases.

In both the national and global context, HIV has for several years now no longer differentiated between people on the basis of gender, age or sexual orientation. 

In Latvia, heterosexual transmission is the most common mode of HIV transmission. HIV can affect anyone.

The need for annual HIV testing has been widely and frequently voiced. Unfortunately, this message does not reach many people, especially those who have never been tested for HIV before. Only one third of the Latvian population has been tested for HIV, because most people aged 15-64 do not think HIV applies to them. It is also true that among European countries we have one of the lowest rates of testing.

A valuable reminder: HIV infection can be very silent and unnoticeable for at least a decade after infection. More than half of new HIV cases in Europe, including Latvia, are detected late. A study on mathematical modelling and triangulation, published in 2021, found that in Latvia about 30 % of HIV cases are still undiagnosed or undetected, i.e., almost 2000 people do not know that they are HIV positive. The RSU Institute of Public Health is repeating this study to find out the real situation at the moment and to obtain new results.

Yes, we may feel well and not notice any symptoms or signs, but that does not mean that we should not pay preventive attention to our health. This is not just about getting tested for HIV, but also about going for cancer screenings, annual visits to the family doctor and other preventive measures.

How else can I be tested?

Free testing at HIV prevention points is not the only way to get tested for HIV. Often people go to a laboratory for a paid HIV test or are referred by a specialist. Every blood donor is also tested for HIV. Self-testing is a less common method. Like Covid-19, HIV self-testing is only available in pharmacies or online, but demand is very low in Latvia. This is probably due to the high cost of the HIV self-test, which ranges from around €20 to €40. Another explanation could be the complexity of the self-tests currently available in the country, as you have to prick your own finger.

In order to find solutions for future possibilities to make HIV self-testing more convenient in practice, in 2023 the RSU Institute of Public Health implemented a pilot project to determine the feasibility and acceptability of HIV self-testing. The pilot project offered HIV saliva self-tests that were not available in Latvia before. Almost 70 % of the 183 participants in the pilot project reported that the HIV saliva self-test was convenient or very convenient and did not require any effort. Pilot participants stressed that they would be happy to use this option in the future, paying on average €5.25 per HIV saliva self-test.

Is there a future for convenient and easy HIV self-testing in Latvia? Certainly, the HIV situation in the country could be improved if self-tests were available at an affordable price in vending machines along with other hygiene products, in nightclubs, pharmacies, and possibly in GP surgeries.

Read more about RSU research on HIV in the full article on LSM in Latvian