The state of the HIV epidemic in the high-income
region of western and central Europe and North
America shows what is possible when sufficient
resources and strong health systems implement
combination HIV prevention strategies, including
antiretroviral therapy, condom promotion, harm
reduction and PrEP. For example, comprehensive
harm reduction and the decriminalization of drug use
have contributed to low rates of HIV infection among
people who inject drugs in Czechia and Portugal. PrEP
is being aggressively rolled out in the United States
and some countries in western Europe, and data from
some cities show that it is contributing to declines in
new diagnoses of HIV infection among gay men and
other men who have sex with men.
