ADDRESSING THE ESCALATING HIV EPIDEMIC IN ALBANIA: POLICY EFFICACY, IMPLEMENTATION CHALLENGES, AND STRATEGIC PATHWAYS FOR IMPROVEMENT

Abstract

Albania, despite its historically low HIV prevalence, is experiencing a concerning and continuous rise in new infections, with reported cases doubling over the past decade. This trend necessitates a critical examination of the nation's public health response to HIV/AIDS within its unique socio-cultural and economic context.

This section outlines the methodological approach for reviewing grey literature. Due to its complexity and limited indexing, a structured search plan based on a systematic review protocol was developed, using four strategies: grey literature databases, customized Google searches, targeted websites, and expert consultation. Grey literature, including government, NGO, and institutional reports, which were assessed. This study conducted a qualitative policy analysis using national reports, global agency data (e.g., UNAIDS, WHO), and academic literature It critically examined the implementation and impact of Albania’s core legal frameworks: the “Prevention and Control of HIV/AIDS Law” (2008) and the “National Action Plan 2020–2025.”

Results indicate that 60–72% of new HIV cases are diagnosed at late stages, exposing serious gaps in early detection and access to testing. Key populations, such as men who have sex with men, people who inject drugs, and sex workers, remain underserved due to stigma, and traditional cultural values. Additionally, the withdrawal of major international donors, including the Global Fund, has led to critical shortages in testing supplies and awareness campaigns. While ART is available, it remains centralized in Tirana, limiting rural access.

Albania's progress in controlling its HIV epidemic is substantially impeded by deeply entrenched social stigma, systemic under-reporting, and an unsustainable reliance on external funding. To meet SDG Target 3.3 by 2030, Albania must decentralize HIV services, establish sustainable national funding mechanisms, and prioritize anti-stigma strategies through multi-sectoral collaboration.

Addressing these multifaceted challenges is paramount for improving public health outcomes and ensuring equitable HIV prevention and care in Albania.