In this study we show that fewer than half of the HIV indicator condition guidelines recommended HIV testing. These findings highlight clinically relevant gaps throughout Europe in the representation of HIV testing recommendations in disease-specific guidelines for HIV indicator conditions.

These missed opportunities to recommend HIV testing, contribute to the high levels of undiagnosed HIV and late HIV presentation that are observed across Europe. Given the influence of guidelines on clinical practice, inclusion of HIV testing recommendations should improve HIV awareness and HIV testing practices among physicians, which allows earlier linkage to care for people living with HIV and leads to reductions in late HIV presentation and HIV transmission.