HIV infection remains one of the most important communicable diseases in Europe, associated with serious consequences, persistently high costs of treatment and care, significant number of deaths and shortened life expectancy. EU Member States have committed themselves towards the goal of universal access to comprehensive HIV prevention programmes, treatment, care and support by 2010. As for tuberculosis, EU countries are increasingly recognising the aggregation of cases among particular vulnerable populations and understanding the need of developing a better insight into the TB/HIV co-epidemic. Undeniably, diagnosing persons who are HIV infected is a prerequisite to the provision of treatment, care and support, but there is evidence that many opportunities are being missed to diagnose HIV and TB infections in EU, particularly among most-at-risk groups.The project's general objective is to improve the access to HIV and TB testing, prevention, treatment and care for two risk groups, such as problem drug users and migrants drug users. DUs, particularly migrants, have specific needs and encounter specific challenges for testing, care and treatment.

They are 'hard to reach' groups for health care providers, which need to offer innovative services tailored to their specific needs. The main and partners will experiment the provision of rapid HIV test and TB testing (through clinical screening and sputum smear collection) to DUs and migrants DUs in street units and drop-in centres, to assess the effectiveness of such kind of interventions in terms of percentage of persons tested and number of new diagnosed cases.

The HIV and TB positive cases will be referred to specialized clinics (project collaborating partners) for diagnosis confirmation and treatment.A common methodology will be developed and used by all the partners, both for the implementation of the testing and for the assessment of its effectiveness. At this regard, the project will contribute to identify specific determinants of late presentation for testing and care by most-at-risk groups, and main determinants of timely diagnosis and entry into care.

Specific guidelines will be developed under the project, which will include all aspects of testing, including access, uptake, pre and post counselling, linkage to treatment and care. The development of such guidelines will be useful in order to improve and promote a wider access to testing and care for those segments of the EU population that are vulnerable to HIV and TB and at an increased risk of contracting the disease.