evidence: North America and Western and Central Europe constitute the third most affected region by the HIV pandemic with 2.4 million people living with HIV. The United States accounts for the majority of people living with HIV in this region (56%). Four countries of Western Europe including France (8%), Spain (6%), United Kingdom (5%), and Italy (5%) contribute an additional quarter of this number [18]. The modes of transmission vary greatly between countries. For example, in 2014, MSM accounted for 44% of new HIV diagnoses in Western Europe and 28% in Central Europe. By comparison, PWID in Central Europe accounted for 5% of new HIV infections compared with 3% in Western Europe. Key affected populations in Western and Central Europe include MSM, migrants from sub-Saharan Africa, PWID and their sexual partners, transgender people, prisoners and sex workers are also at a heightened risk of HIV. In the USA, the majority of newly diagnosed HIV infections in 2013 among adult and adolescent males and females were attributed to MSM and PWID (68%). In contrast, heterosexual contact is thought to contribute 25% of new infections in the United States. African Americans are at a high risk of contracting HIV.