Best practices for migrants - testing, linkage and retention in care for HIV, TB, hepatitis & STIs

Background

Migrant populations in Europe face disproportionate burdens of HIV, TB, hepatitis B & C and STIs alongside barriers to timely testing and sustained care. Evidence on effective, transferable service models addressing the full care cascade for migrant populations remains fragmented.

Methods

We identified models of care from across the EU/EEA with an open call (September 2025 - March 2026). Submissions were collected via REDCap and assessed using a structured assessment tool developed based on a Delphi process with 31 international experts. The evaluation was done with predefined criteria covering domains: health impact across the care cascade; sustainability and transferability; community engagement; and other outcomes. Each model was independently scored by two reviewers (scale 0-10, with 0.5 points scoring possible). Models scoring in the top 20th percentile of the total possible score in one or more domain were classified as best practice. If multiple models scored similarly within the cut-off, all were included.

Results (preliminary)

Of 41 submitted models, 37 from 14 EU/EEA countries met the inclusion criteria and were evaluated. Best practices were identified across testing (n = 7), linkage to care (n = 8), and retention in care (m = 6), with several addressing multiple steps of the cascade. Eight models demonstrated high sustainability and transferability, most integrated into public health systems. Strong community engagement characterized eight models, while ten addressed structural barriers such as stigma and service accessibility. Nine models scored within the 20th percentile in more than one domain.

Conclusions

High performing European models combine convenient testing, rapid linkage and tailored community-engaged support to improve care cascade outcomes for migrants. These transferable approaches offer actionable lessons for scaling up equitable, integrated infectious disease services across EU/EEA settings.

Key messages

• High performing European models combine integrated and convenient testing, rapid linkage and tailored community-engaged support to improve care cascade outcomes for migrants.

• Transferable,equitable and integrated best practices were identified that address structural barriers and that offer actionable lessons for scale-up within public health systems across EU/EEA settings.