HIV Screening through the Nation-Wide Sexual Health Friendly Clinical Network: Taiwan Experiences

Pin-Hui LeeTaiwan Speaker HIV Screening through the Nation-Wide Sexual Health Friendly Clinical Network: Taiwan ExperiencesAs of the end of 2024, Taiwan has accumulated 45,255 HIV notifications since 1984. The number of people living with HIV has been more than 36000. Analysis by age group highlights that the majority of new HIV cases occur among individuals engaging in unsafe sexual behaviors, accounting for over 90% of transmissions. Despite ongoing efforts, undiagnosed HIV infections remain a public health challenge. Estimates using the CD4 depletion model, recommended by the U.S. CDC, show varying undiagnosed rates across age groups, especially for age of 13-35 years. Taiwan has made considerable progress toward the UNAIDS 95–95–95 targets for 2030. In 2024, estimated 92% of people living with HIV were aware of their status, 96% of those diagnosed were receiving treatment, and 95% of treated individuals had achieved viral suppression. To strengthen early diagnosis, Taiwan has implemented various HIV screening programs especially through the B1 program, which promotes comprehensive HIV screening for individuals with STIs, also including acute viral hepatitis A,B,C, or substance use disorders. Education and promotion of the B1 program through the medical professional societies to organize the sexual health friendly clinical network has substantially increased the accessibility of HIV testing. The diagnostic process involves a combination of antigen/antibody screening, immunochromatographic tests, and nucleic acid testing. Healthcare institutions are incentivized through the reimbursement system. The role of urology specialists is particularly emphasized. Between 2019 and 2024, urology clinics and hospitals contributed significantly to the B1 program of HIV testing. The highest HIV positivity rates in these settings were linked to patients diagnosed with syphilis, chlamydia, and condyloma acuminatum (genital warts). Physicians are encouraged to offer HIV testing and health education to at-risk patients and to invite their partners for screening and treatment. In summary, Taiwan continues to advance in its response to the HIV epidemic by improving diagnostic coverage, optimizing care pathways, and engaging frontline specialties such as urology. Emphasis on integrated care models and proactive partner notification are key strategies moving forward in achieving national and international targets for HIV control.