Objective: Slovakia belongs to EU countries with the lowest prevalence of HIV, hepatitis and sexually transmitted infections (STI). Problems with prevention, testing and treatment of these infections mainly concern vulnerable groups, such as men having sex with men (MSM), people who inject drugs (PWID), sex workers (SW), transgenders (TG), migrants (Mi) and homeless people. The aim of this work is to reflect on the advantages and pitfalls of integrated prevention of these infections in the context of attitudes and knowledge of medical community as well as the currently valid legislation in Slovakia.

Results: Several studies of integrated HIV, hepatitis and STI testing using rapid test were realized in streets and check points in Slovakia. Study in 2019 revealed HIV, HCV and T. pallidum infections in 0.4 %, 2.4 % and 1.8 % clients, respectively. The highest prevalence of HIV (4.2 %), HCV (30.8 %) and syphilis (7.1 %) was found among MSM/Mi, PWID and SW/PWID, respectively. Pilot study in 2025 revealed HCV infection and T. pallidum infection in 15.27% and 3.08% homeless people, respectively. Additionally, just few clients in both studies underwent successful treatment. It was also found low level of knowledge and attitudes of health workers on key HIV prevention concepts – U=U (Undetectable = Untransmittable), PEP (post-exposure prophylaxis) and PrEP (pre-exposure prophylaxis) (42.9%, 37.9%, and 20.9%, respectively). A total of 25.4% of respondents reported a preference to avoid providing care to PWID, followed by lower proportions for SW (12.4%), TG (7.3%), and MSM (5.7%).

Conclusion: Integrated HIV, hepatitis and STI testing facilitates access to prevention and treatment for vulnerable groups. There is a need to reduce fear and prejudice against people living with HIV (PLHIV) and other vulnerable groups and to implement targeted measures and policies to reduce stigma and improve care of PLHIV in Slovakia.

Danica Valkovičová Staneková, PhD, is a Slovak immunologist, clinical microbiologist, and researcher with more than three decades of experience in HIV/AIDS diagnostics, epidemiology, prevention, and public health. She earned her PhD in general biology from Comenius University, faculty of medicine, institute of immunology, and was appointed associate professor of immunology in 2009. From 2003 to 2024, she served as head of the National Reference Centre for HIV/AIDS at the Slovak Medical University in Bratislava. Since September 2024, she has been a scientist at St. Elizabeth University of Health and Social Work in Bratislava. She has led national research projects on HIV prevalence, risk behaviour, and prognostic markers in HIV/AIDS and coordinated Slovakia’s participation in numerous European projects addressing HIV/AIDS, sexually transmitted infections, viral hepatitis, prevention, surveillance, and linkage to care. She has authored or co-authored 88 scientific and other publications, with 286 citations and an H-index of 18. She has served on national and European scientific and public-health committees, including ECDC advisory and coordination groups. Her contributions have been recognized with the Bronze, Silver, and Gold Medals of the Slovak Medical Society “Propter Merita.”