Through its past research initiatives, the COBATEST Network strengthened HIV testing, linkage to care, and treatment across Europe and Central Asia.
Reinforcement of the COBATEST Network in Eastern Europe and Central Asia (EECA)
Funding: Gilead Sciences
Implementation period: Phase I (2021–2022) and Phase II (2023–2025)
Coordinated by: CEEISCAT (representing COBATEST network)
By the end of 2021, CEEISCAT was approved to receive a Gilead grant for the first phase of the project “Reinforcement of the COBATEST Network by including testing services from Eastern Europe and Central Asia (EECA): Addressing Identified Needs.”
At that time, the expansion of the COBATEST Network into the EECA region had been identified as a necessity, as no other formal network for community-based testing existed there. The main goal of the project was to improve communication and data exchange among countries in Eastern Europe and Central Asia, while fostering long-term collaboration between existing COBATEST members from Central Europe and new members from the EECA region.
These collaborations were seen as highly valuable, as they could enhance the quality of CBVCT (Community-Based Voluntary Counselling and Testing) service delivery to populations most at risk for HIV by facilitating the exchange of best practices among members.
Phase I (2021–2022)
From the outset, the EECA project was envisioned as a multi-year initiative due to the complexity of the region and the work required to integrate new members into the network. The project also aimed to ensure continued support for standardized data collection and to increase the visibility of local CBVCTs’ work.
General Objective:
To improve the coverage and representativeness of the COBATEST Network through the inclusion of new Community-Based Voluntary Counselling and Testing (CBVCT) services from Eastern Europe and Central Asia.
Specific Objectives:
- Identify and engage existing services, networks, and stakeholders implementing community-based testing in EECA.
- Conduct a rapid assessment to identify the needs of testing centers in the region regarding service delivery, data collection, and reporting.
- Adapt standardized data collection instruments and evaluation tools to the regional context.
- Promote harmonization of monitoring and evaluation procedures and experience sharing.
- Facilitate the integration of testing centers from EECA into ongoing COBATEST Network activities.
- Disseminate data collected from the region through the COBATEST Network.
Following the outbreak of war in Ukraine, the importance of this initiative increased significantly. The resulting political and economic instability created additional challenges for community-based organizations delivering HIV/STI testing and care to key populations.
Transition to Phase II
Based on a comprehensive analysis of findings from Phase I, the second phase of the EECA project was planned. The Phase II objectives were informed by the needs assessment conducted during Phase I, not only among COBATEST’s new EECA members but also among other community testing centers in the region.
Despite challenges in reaching local CBVCTs due to the political situation, the team conducted informational interviews with CBVCT representatives to discuss barriers and untapped opportunities in HIV/STI testing and service delivery.
The insights gathered were used to design Phase II, which focused on:
- Continuing and strengthening standardized data collection among new EECA members.
- Developing a new data collection module tailored to the region’s specific needs.
- Creating an online platform for network members to interact and share best practices.
- Supporting small outreach or data collection projects initiated by new EECA members.
- Promoting the work of EECA CBVCTs, which remain largely underrepresented at regional and international levels.
Phase II (2023–2025)
General Objective:
To reinforce the COBATEST Network in Eastern Europe and Central Asia by integrating new CBVCT services, providing continued support to new members, and building upon the findings of previous needs assessments.
Specific Objectives:
- Continue identifying and engaging existing services, networks, and stakeholders implementing community-based testing in EECA.
- Conduct follow-up needs assessments to explore the evolving needs of testing centers regarding service provision, data collection, and reporting.
- Promote and facilitate the use of the standardized COBATEST online data collection tool by new EECA members, adapting it to regional needs.
- Promote harmonization of monitoring and evaluation procedures and the sharing of experiences.
- Facilitate the integration of EECA testing centers into ongoing COBATEST Network activities.
- Disseminate regional data through the COBATEST Network at both regional and international levels.
Impact
The EECA project has significantly strengthened the COBATEST Network’s regional presence and visibility, laying the foundation for a sustainable collaboration platform for CBVCTs across Eastern Europe and Central Asia. It continues to promote data-driven advocacy, knowledge exchange, and standardized approaches to HIV/STI testing and care in some of the regions most affected by HIV in Europe.
Community-Led and Community-Based HIV Services: A Key to Ending the HIV Epidemic in Europe and Central Asia
Funding: Gilead Sciences (Zeroing In – Ending the HIV Epidemic grant)
Implementation period: 2022–2024
Co-coordinating partners: CEEISCAT (representing COBATEST network), AIDS Action Europe (AAE), LILA Milano, and the COBATEST Network
Project Overview
Community-based voluntary counselling and testing services (CBVCTs) have long proven to be among the most effective approaches for reaching key populations and improving access to testing for HIV, tuberculosis, viral hepatitis, and other sexually transmitted infections (STIs). Their importance became even more evident during the COVID-19 pandemic, when barriers to healthcare access intensified and the role of community-led services was crucial.
Despite their effectiveness, many CBVCTs across Europe and Central Asia continue to face significant obstacles — including limited funding, restrictive legal frameworks, and the high cost of testing kits and self-tests. To address these challenges, AIDS Action Europe (AAE), CEEISCAT, LILA Milano, and the COBATEST Network joined forces under the project “Community-Led and Community-Based HIV Services: Key to Ending the HIV Epidemic in Europe and Central Asia,” supported by Gilead’s Zeroing In grant program.
COBATEST’s Role and Contribution
As a European network uniting community-based testing services, COBATEST played a central role in ensuring that the project reflected the real-world experiences, challenges, and data of community testing centers. Through its coordination and technical support, COBATEST helped strengthen collaboration between partners and facilitated the direct involvement of CBVCT members from across the region.
Within the framework of the project:
- AIDS Action Europe assessed the legal and policy barriers affecting CBVCTs and HIV self-testing across COBATEST member countries. The results were compiled into a legal report and a policy brief with recommendations for advocacy and reform. Six COBATEST member organizations operating in the most restrictive environments also received small grants to support their local advocacy efforts.
- CEEISCAT, as the coordinating institution of the COBATEST Network, developed a new online scheduling and follow-up tool to enhance members’ data collection, analysis, and reporting capacity.
- LILA Milano, one of COBATEST’s long-standing members, implemented a national pilot campaign to distribute free HIV self-tests across Italy. The initiative aimed to raise awareness, increase the acceptability of self-testing, and serve as a model for other countries.
Knowledge Exchange and Capacity Building
To promote knowledge sharing and practical application of project findings, COBATEST and its partners organized a series of webinars beginning in 2023, covering key topics such as:
- Advocacy for CBVCT services and HIV self-testing
- Using the COBATEST data collection and reporting tool
- Good practice exchange: lessons learned from Italy’s self-testing campaign
These webinars provided opportunities for members across the network to exchange experience, strengthen technical capacity, and replicate successful practices in their local contexts.
Impact and Alignment
Through this collaborative initiative, COBATEST contributed to expanding, adapting, and improving community-based HIV testing services in Europe and Central Asia. The project supported the promotion and scale-up of HIV self-testing — particularly among populations where diagnosis and linkage to care remain below national averages.
This project directly aligns with the Global AIDS Strategy 2021–2026: “End Inequalities. End AIDS.” By empowering community-based services and strengthening cross-country collaboration, COBATEST and its partners continue to advance the shared goal of ending the HIV epidemic in the European region.
Utility evaluation of Point of Care Tests in non-Clinical Settings for the Screening of HIV and Syphilis in Men who have Sex with Men
This study aims to provide WHO Member States and other relevant public health institutions on the performance and operational characteristics of commercially available STI diagnostic tests that can be used at the point-of-care, and is currently in progress. A utility evaluation of SD BIOLINE HIV/Syphilis Duo (Alere) and DPP® HIV-Syphilis Assay (Chembio) for the screening of HIV & syphilis in men who have sex with men will take place in the non-clinical settings of four COBATEST Network members (Gais Positius Barcelona, Legebitra Ljubljana, Baltic HIV Association, Alliance Global Kiev) and one associated member (HF Prévention Paris).
COBA-Cohort
This COBA-Cohort is a pan-European prospective and multicentre cohort of HIV-negative men who have sex with men (MSM) attending 1 of the 15 participating CBVCT services, led by five COBATEST Network members: AIDES, AIDS-Fondet, CheckpointLX and Legebitra, from France, Denmark, Greece, Portugal and Slovenia, respectively. The COBA-Cohort is active and has around 4,000 persons enrolled. More information
Read the report on the first results
Validation and Analysis of HIV Testing Data in the Community Setting – COBATEST Network
This report, commissioned by the European Centre for Disease Control and Prevention, aims to provide a common approach for assessing and improving overall data quality collected by the CBVCT services participating in the COBATEST network. It assessed the transcription validity, completeness and consistency of the data submitted to the COBATEST Network in order to provide recommendations to ease integration of CBVCT data with the national surveillance system.
Economic evaluation of HIV testing for men who have sex with men in community-based organizations
This study incorporated six COBATEST Network members (GAT Portugal, AIDES Paris, AIDES Lyon, Positive Voice Greece, AIDS Fondet Denmark and Legebitra Slovenia) and was funded by GILEAD, in partnership with the University of Lisbon.
Investigators performed an economic evaluation of HIV testing for MSM at CBVCT services in the year 2014 and compared them across six European cities. The results highlight that there is a common CBVCT model, the cost of which is comparable regardless of the epidemiological context and prices. The CBVCT services represent an effective and “worth it” experience, to be continued and expanded in future public health strategies towards HIV.