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id	title	slug	type	status	content	archieml	archieml_update_statistics	published_at	updated_at	gdocSuccessorId	authors	excerpt	created_at_in_wordpress	updated_at_in_wordpress	featured_image	formattingOptions	markdown	wpApiSnapshot
3083	HIV / AIDS	hiv-aids	page	publish	<!-- wp:html --> <div class="blog-info">This article was first published in November 2014; last revised in August 2023.</div> <!-- /wp:html --> <!-- wp:paragraph --> <p>Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in a heightened risk of life-threatening infection and <a href="https://owid.cloud/cancer">cancers</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from mother to child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur by sharing injection equipment such as needles.</p> <!-- /wp:paragraph --> <!-- wp:owid/summary --> <!-- wp:list --> <ul><li><a href="#almost-1-million-people-die-from-hiv-aids-each-year-in-some-countries-it-s-the-leading-cause-of-death">Almost one million die from HIV/AIDS each year – in some countries it's the leading cause of death.</a></li><li><a href="https://ourworldindata.org/hiv-aids#in-some-countries-hiv-aids-is-the-cause-of-more-than-1-in-4-deaths">In some countries, HIV/AIDS is the cause of one quarter of deaths.</a></li><li><a href="https://ourworldindata.org/hiv-aids#death-rates-are-high-across-sub-saharan-africa">Death rates are highest across Sub-Saharan Africa.</a></li><li><a href="https://ourworldindata.org/hiv-aids#death-rates-are-highest-for-younger-adults-and-children-under-five-years-old">Death rates are highest for younger adults, and for children (when HIV is transmitted from a mother).</a></li><li><a href="https://ourworldindata.org/hiv-aids#global-deaths-from-hiv-aids-halved-within-a-decade">The world is making progress: over the past decade the number of global deaths has halved.</a></li><li><a href="https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa">The HIV epidemic had a major impact on life expectancy across Sub-Saharan Africa, and life expectancy is only now back to pre-epidemic levels.</a></li><li><a href="https://ourworldindata.org/hiv-aids#anti-retroviral-treatment-art">Antiretroviral treatment (ART) has been key to preventing deaths from AIDS. It is estimated that it now averts 1.2 million deaths per year – without it, global deaths would be more than twice as high.</a></li><li><a href="https://ourworldindata.org/hiv-aids#funding-to-support-efforts-against-hiv-aids">Funding for HIV treatment and prevention needs to increase if the world is to meet its 2030 targets.</a></li></ul> <!-- /wp:list --> <!-- /wp:owid/summary --> <!-- wp:heading --> <h2>HIV/AIDS is one of the world's most fatal infectious disease</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Almost 1 million people die from HIV/AIDS each year; in some countries, it's the leading cause of death</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>HIV/AIDS is one of the world's most fatal infectious diseases – particularly across Sub-Saharan Africa, where the disease has had a massive impact on health outcomes and life expectancy in recent decades.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The <em>Global Burden of Disease</em> is a major global study on the causes of death and disease published in the medical journal <em>The Lancet</em>.{ref}The latest study can be found at the website of the Lancet here: <a href="https://www.thelancet.com/gbd">TheLancet.com/GBD</a></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The 2017 study was published in the following publication: "Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., ... & Abdollahpour, I. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. <em>The Lancet</em>, 392(10159), 1736-1788", and is online <a href="http://www.healthdata.org/research-article/global-regional-and-national-age-sex-specific-mortality-282-causes-death-195">here</a>.{/ref} These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the "change country" toggle.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>According to the <em>Global Burden of Disease</em> study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from <a href="https://owid.cloud/malaria">malaria</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>It's <em>one of</em> the largest killers globally, but for some countries – particularly across Sub-Saharan Africa, it's the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique – which you can do on the interactive chart – we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of <a href="https://owid.cloud/cancer">cancer</a> deaths.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>The global distribution of deaths from HIV/AIDS</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>In some countries, HIV/AIDS is the cause of a quarter of all deaths</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Globally, around 1.5% of deaths are caused by HIV/AIDS.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher.<br> <br>In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>But the share is very high across some countries – focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/share-deaths-aids"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Death rates are high across Sub-Saharan Africa</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 – often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. </p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/hiv-death-rates"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Death rates are highest for younger adults and children under five years old</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Which population groups are most at risk from HIV/AIDS?<br><br>In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds – typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected. </p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/hiv-death-rates-by-age"></iframe></figure> <!-- /wp:html --> <!-- wp:heading --> <h2>Is the world making progress in its fight against HIV/AIDS?</h2> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>How have cases and deaths changed over time?</h4> <!-- /wp:heading --> <!-- wp-block-tombstone 29218 --> <!-- wp:paragraph --> <p>The 1990s saw a substantial increase in people infected with HIV and dying of AIDS. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it's now below 2 million, the lowest number of new infections since 1990.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/deaths-and-new-cases-of-hiv" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Global deaths from HIV/AIDS halved within a decade</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In the visualization, we see the global number of deaths from HIV/AIDS in recent decades – this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>You can explore this change for any country or region using the "change country" toggle on the interactive chart.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/deaths-from-hiv-by-age"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>HIV/AIDS once accounted for a large share of deaths in some countries, but rates are now falling</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher.<br><br>In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Over the past decade, this share has fallen as antiretroviral treatment has become more widely available.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/share-deaths-aids?tab=chart&country=ZAF+ZWE+NAM+OWID_WRL+Sub-Saharan%20Africa+MOZ+ZMB"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>HIV/AIDS has had a significant impact on life expectancy across Sub-Saharan Africa</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in <a href="https://owid.cloud/life-expectancy">life expectancy</a>. In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s — as progress has been made in tackling HIV — we see that life expectancy has been rising again.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In some countries, life expectancy is now higher than before the epidemic began.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/life-expectancy?country=BWA+NAM+ZAF+SWZ+TZA+ZMB"></iframe></figure> <!-- /wp:html --> <!-- wp:heading --> <h2>The prevalence of HIV/AIDS</h2> <!-- /wp:heading --> <!-- wp:heading {"level":3} --> <h3>Prevalence in the total population</h3> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Share of the population with HIV</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>You can explore the total number of people living with HIV/AIDS worldwide <a href="https://ourworldindata.org/grapher/number-of-people-living-with-hiv">here</a>.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Number of new infections each year</h4> <!-- /wp:heading --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/new-cases-of-hiv-infection" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Prevalence by gender</h3> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Is HIV/AIDS more common in men or women?</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex{ref}Greig, A., Peacock, D., Jewkes, R., & Msimang, S. (2008). Gender and AIDS: time to act. <em>AIDS (London, England)</em>, <em>22</em>(Suppl 2), S35. Available <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356155/">online</a>.{/ref}.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/share-of-women-among-the-population-living-with-hiv"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Prevalence in children</h3> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Share of children infected with HIV</h4> <!-- /wp:heading --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/share-of-children-under-five-years-old-with-hiv"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Children living with HIV</h4> <!-- /wp:heading --> <!-- wp-block-tombstone 27165 --> <!-- wp:paragraph --> <p>In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/children-living-with-hiv" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>New HIV infections of children</h4> <!-- /wp:heading --> <!-- wp-block-tombstone 27167 --> <!-- wp:paragraph --> <p>The map shows the total number of children newly infected with HIV yearly. Globally — with similar trends at national levels — the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/number-of-children-newly-infected-with-hiv" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Orphaned children from AIDS</h4> <!-- /wp:heading --> <!-- wp-block-tombstone 27169 --> <!-- wp:paragraph --> <p>Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/number-of-children-orphaned-from-aids" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>Tuberculosis among people living with HIV</h2> <!-- /wp:heading --> <!-- wp-block-tombstone 29049 --> <!-- wp:paragraph --> <p>Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/tb-patients-tested-positive-for-hiv" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/tb-patients-living-with-hiv-receiving-art" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/tb-related-deaths-hiv" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:heading --> <h2>What can be done to prevent HIV/AIDS?</h2> <!-- /wp:heading --> <!-- wp:heading {"level":3} --> <h3>Anti-retroviral treatment (ART)</h3> <!-- /wp:heading --> <!-- wp:paragraph --> <p>A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections. </p> <!-- /wp:paragraph --> <!-- wp-block-tombstone 28711 --> <!-- wp:heading {"level":4} --> <h4>Millions of lives are saved by ART</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths – 1.2 million – were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS. </p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/hivaids-deaths-and-averted-due-to-art" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>People who use ART are living longer</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.{ref}We should note, though, that the life expectancy for people living with HIV infection without ART can vary depending on the age when a person got infected with HIV, a person's immune status (e.g., CD4 count), and socioeconomic factors. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Babiker, A., Darby, S., De Angelis, D., Kwart, D., Porter, K., Beral, V., ... & Prins, M. (2000). <a href="https://www.sciencedirect.com/science/article/pii/S0140673600020614#tbl1">Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action.</a> Concerted Action on SeroConversion to AIDS and Death in Europe. <em>Lancet</em>, <em>355</em>(9210).</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Wandel, S., Egger, M., Rangsin, R., Nelson, K. E., Costello, C., Lewden, C., ... & Minga, A. (2008). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418/">Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies</a>. <em>Sexually transmitted infections</em>, <em>84</em>(Suppl_1), i31-i36.{/ref} </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years — well into their 60s.{ref}This number is based on a study that used European and North American countries. Few studies have systematically assessed the life expectancy of people living with HIV/AIDS in middle and low-income countries, but it is predicted to be significantly lower between 60-74% of the life expectancy of the general population (see Wandeler et <em>al. </em>reference). </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Multiple factors account for this difference, including a higher prevalence of other diseases, such as co-infections with hepatitis or tuberculosis, and a higher prevalence of opportunistic diseases. In addition, people tend to adhere to ART regimens less strictly because of poorer care for AIDS patients, less access to medical clinics, and social stigma. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Wandeler, G., Johnson, L. F., & Egger, M. (2016). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055447/">Trends in life expectancy of HIV-positive adults on ART across the globe: comparisons with general population</a>. <em>Current Opinion in HIV and AIDS</em>, <em>11</em>(5), 492.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Currently, no equivalent estimate for life expectancy is available for low and middle-income countries. However, we do know that with decreasing rates of HIV mortality in low and middle-income countries, the life expectancy of the general population has increased. Haris et al. discuss this, and you can read more about life expectancy and HIV <a href="https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa">here</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Harris, T. G., Rabkin, M., & El-Sadr, W. M. (2018). Achieving the fourth 90: healthy aging for people living with HIV. <em>AIDS (London, England)</em>, <em>32</em>(12), 1563.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). <a href="https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures">Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.</a> <em>The Lancet HIV</em>, <em>4</em>(8), e349-e356.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the <a href="https://ourworldindata.org/life-expectancy">life expectancy</a> of the general population, we are getting closer to this goal.{ref}Global average <a rel="noreferrer noopener" href="https://ourworldindata.org/grapher/life-expectancy?tab=chart&time=1543..latest&country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL" data-type="URL" data-id="https://ourworldindata.org/grapher/life-expectancy?tab=chart&time=1543..latest&country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL" target="_blank">life expectancy</a> in 2019 was 72.6 years. The average life expectancy in Europe is 78.6 years.{/ref} </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.{ref}Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). <a href="https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures">Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.</a><em>The Lancet HIV</em>, <em>4</em>(8), e349-e356.{/ref} This increase goes beyond the general increase in life expectancy in that period and reflects the improvements in ART — fewer side effects, more people following the prescribed treatment, and more support for the people in need of ART.</p> <!-- /wp:paragraph --> <!-- wp:heading {"level":4} --> <h4>ART prevents new HIV infections</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.{ref} G Williams, B., Lima, V., & Gouws, E. (2011). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529404/">Modelling the impact of antiretroviral therapy on the epidemic of HIV.</a> <em>Current HIV research</em>, <em>9</em>(6), 367-382.{/ref} ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>In 2011, the journal <em>Science</em> named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its “Breakthrough of the Year”.{ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Science announcement: </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Cohen, J. (2011). <a href="https://science.sciencemag.org/content/334/6063/1628">HIV treatment as prevention</a>.<br></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Study that was awarded: </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., ... & Godbole, S. V. (2011).<a href="https://www.nejm.org/doi/full/10.1056/Nejmoa1105243"> Prevention of HIV-1 infection with early antiretroviral therapy.</a><em>New England journal of medicine</em>, <em>365</em>(6), 493-505.{/ref} Many other studies have now shown similar findings, with a range of reduction in transmission attributable to ART depending on location and groups studied.{ref}PARTNER study showed chances of transmission between gay couples with successfull virus suppression by ART are “effectively zero”. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Rodger, A. J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Degen, O., ... & Raben, D. (2019). <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30418-0/fulltext">Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.</a> <em>The Lancet</em>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Transmission rates in Madrid fell by 86% after ART became available</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Castilla, J., Del Romero, J., Hernando, V., Marincovich, B., García, S., & Rodríguez, C. (2005). <a href="https://journals.lww.com/jaids/Fulltext/2005/09010/Prevalence_of_Unsafe_Sexual_Behavior_Among.16.aspx?casa_token=4RZtew6owdYAAAAA:YrqHOyO0wmGz7hSrlm0r6loCZUtsZd1wVRVQvR2U0_XPeUnJpSC9ykITGg0bsGmB1IjAinXZbUd9hslCBo-DtYCk">Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV</a>. <em>JAIDS Journal of Acquired Immune Deficiency Syndromes</em>, <em>40</em>(1), 96-101.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>A study in San Francisco showing after ART became available, viral loads dropped to 40% and HIV infection rates fell by 60%.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p> Das, M., Chu, P. L., Santos, G. M., Scheer, S., Vittinghoff, E., McFarland, W., & Colfax, G. N. (2010). <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0011068">Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco</a>. <em>PloS one</em>, <em>5</em>(6), e11068.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>After ART became freely available in Taiwan transmission rates fell by 50%. Fang, C. T., Hsu, H. M., Twu, S. J., Chen, M. Y., Chang, Y. Y., Hwang, J. S., ... & Division of AIDS and STD, Center for Disease Control, Department of Health, Executive Yuan. (2004). <a href="https://academic.oup.com/jid/article-abstract/190/5/879/868453">Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.</a><em>Journal of Infectious Diseases</em>, <em>190</em>(5), 879-885.{/ref} A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.{ref} Hogg, R. S., Heath, K., Lima, V. D., Nosyk, B., Kanters, S., Wood, E., ... & Montaner, J. S. (2012). <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047260">Disparities in the burden of HIV/AIDS in Canada</a>. <em>PLoS One</em>, <em>7</em>(11), e47260.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:heading {"level":4} --> <h4>We need to increase ART coverage</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The number of people who receive ART has increased significantly in recent years, especially in African countries where the prevalence of HIV/AIDS is the highest.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>But many millions of people who could benefit from the life-saving treatment currently don’t. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>To increase ART coverage, we must first improve access to testing for HIV status. In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.{ref}The 79% figure is based on <a href="https://www.unaids.org/en/resources/fact-sheet">2019 UNAIDS estimates</a>.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The frequency of undiagnosed HIV/AIDS can be measured using observational studies. Measures of the expected rate of HIV infection, the actual number of people diagnosed with HIV, and delay in diagnosis are taken into account to predict the true expected prevalence of HIV in a population and the proportion of undiagnosed cases (see Singh et <em>al.</em> reference). </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The initial HIV infection is often followed by flu-like symptoms, which subside in a few weeks. The infected patient can then live without symptoms for months or years while their immune system may be slowly deteriorating. Hence, people infected with HIV may not even know they need to be tested due to the lack of symptoms. Models used to predict HIV incidence rate often use an expected 5-year lag between infection and diagnosis. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Singh, S., Song, R., Johnson, A. S., McCray, E., & Hall, H. I. (2018). <a href="https://annals.org/aim/fullarticle/2675979/hiv-incidence-prevalence-undiagnosed-infections-u-s-men-who-have">HIV incidence, prevalence, and undiagnosed infections in US men who have sex with men.</a> <em>Annals of internal medicine</em>, <em>168</em>(10), 685-694.{/ref} And awareness is also not enough. In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.{ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>WHO eligibility criteria are based on CD4 counts, which go down as the illness progresses. A healthy person’s CD4 counts are >500/mm3. WHO recommends ART for anyone with HIV diagnosis and CD4 count >350 cells and ≤500/mm3, regardless of clinical symptoms. All children, people with TB, HBV, and pregnant women diagnosed with HIV regardless of their CD4 status, should get ART. <a href="https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/">https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/</a></p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). <a href="https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383">Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub‐Saharan Africa: a systematic review.</a> <em>Journal of the International AIDS Society</em>, <em>15</em>(2), 17383.{/ref} Of those who should start ART, only 66% did.{ref}For some countries, eligibility for ART treatment is determined by the so-called CD4+ counts, which go down as the illness progresses. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p> Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). <a href="https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383">Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub‐Saharan Africa: a systematic review.</a> <em>Journal of the International AIDS Society</em>, <em>15</em>(2), 17383.{/ref} </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>Stigmatization of people who have HIV/AIDS also leads to a decrease in engagement with care, treatment, and prevention services.{ref}Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates, T. J. (2008). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/">Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. </a><em>AIDS (London, England)</em>, <em>22</em>(Suppl 2), S67.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/antiretroviral-therapy-coverage-among-people-living-with-hiv" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Prevention of mother-to-child transmission (PMTCT)</h3> <!-- /wp:heading --> <!-- wp-block-tombstone 27176 --> <!-- wp:paragraph --> <p>Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.{ref}World Health Organization (WHO)<a rel="noreferrer noopener" aria-label=" (opens in a new tab)" href="https://www.who.int/hiv/topics/mtct/about/en/" target="_blank"> 'Mother-to-child transmission of HIV' </a>[accessed November 2019]{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection. </p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The visualization shows the number of child infections averted from ART coverage in mothers.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world <a href="https://ourworldindata.org/grapher/new-hiv-infections-averted-due-to-pmtct">here</a>.</p> <!-- /wp:paragraph --> <!-- wp:html --> <iframe src="https://ourworldindata.org/grapher/number-of-new-hiv-child-infections-vs-number-of-infections-averted-due-to-pmtct" style="width: 100%; height: 600px; border: 0px none;"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Coverage of ART in pregnant women</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy – a vital intervention to prevent the transmission from mother to child.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/art-coverage-for-pregnant-women"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Safe sex</h3> <!-- /wp:heading --> <!-- wp:heading {"level":4} --> <h4>Unsafe sex is a leading risk factor for death in Sub-Saharan Africa</h4> <!-- /wp:heading --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor?country=~Sub-Saharan+Africa+%28WB%29" loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Share of people practicing safe sex</h4> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The majority of HIV infections are transmitted through sexual activity.<br> <br>Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of 'high-risk sex', which is that with a non-marital, non-cohabiting sexual partner.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/condom-use-at-last-high-risk-sex"></iframe></figure> <!-- /wp:html --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/condom-use-during-last-high-risk-sex"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Education on HIV/AIDS</h3> <!-- /wp:heading --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/young-people-with-knowledge-on-hiv-prevention"></iframe></figure> <!-- /wp:html --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/knowledge-hiv-prevention-in-males-vs-females"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":3} --> <h3>Funding to support efforts against HIV/AIDS</h3> <!-- /wp:heading --> <!-- wp:paragraph --> <p>You can explore the breakdown of funding resources by source for each country <a href="https://ourworldindata.org/grapher/hivaids-funding-by-source">here</a>.</p> <!-- /wp:paragraph --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/hiv-expenditure"></iframe></figure> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Future funding needs to meet HIV targets</h4> <!-- /wp:heading --> <!-- wp:html --> <figure><iframe src="https://ourworldindata.org/grapher/resource-needs-to-meet-hiv-targets"></iframe></figure> <!-- /wp:html --> <!-- wp:separator --> <hr class="wp-block-separator"/> <!-- /wp:separator --> <!-- wp:heading --> <h2>Data quality and definition</h2> <!-- /wp:heading --> <!-- wp:heading {"level":3} --> <h3>Terminology and definitions</h3> <!-- /wp:heading --> <!-- wp:paragraph --> <p>The following terminology and definitions are sourced from the UNAIDS organization.{ref}UNAIDS (2015). Terminology guidelines. Available <a href="http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf">online</a>.{/ref}</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>HIV</strong>: Human Immunodeficiency Virus. HIV is a virus that weakens the immune system, ultimately leading to AIDS.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>AIDS</strong>: acquired immunodeficiency syndrome.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment</strong>: "Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term "highly active" antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. "Highly active" is not needed as a qualification, and the term is no longer commonly used.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use."</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>ARV-based prevention</strong>: "ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention)."</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Epidemic</strong>: "An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic."</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>HIV-negative (seronegative)</strong>: "A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative."</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>HIV-positive (seropositive)</strong>: "A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies."</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Incidence</strong>: "HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15–49 years and 0–14 years."</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Mother-to-child transmission (MTCT)</strong>: "MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4).</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>PMTCT is often mistakenly referring to only prong 3— the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT)."</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Prevalence</strong>: "Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15–49 years."</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p><strong>Tuberculosis (TB)</strong>: "Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se.</p> <!-- /wp:paragraph --> <!-- wp:paragraph --> <p>The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria."</p> <!-- /wp:paragraph --> <!-- wp:heading {"level":3} --> <h3>Comparisons of UNAIDS and IHME estimates</h3> <!-- /wp:heading --> <!-- wp:paragraph --> <p>Several sources publish estimates on HIV and AIDS - two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources' relationship/consistency in prevalence estimates.</p> <!-- /wp:paragraph --> <!-- wp:heading {"level":4} --> <h4>Prevalence of HIV</h4> <!-- /wp:heading --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/prevalence-of-hiv-unaids-vs-ihme-estimates" width="300" height="150"></iframe> <!-- /wp:html --> <!-- wp:heading {"level":4} --> <h4>Incidence/new cases of HIV</h4> <!-- /wp:heading --> <!-- wp:html --> <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/new-cases-of-hiv-unaids-vs-ihme" width="300" height="150"></iframe> <!-- /wp:html -->	{ "id": "wp-3083", "slug": "hiv-aids", "content": { "toc": [], "body": [ { "type": "text", "value": [ { "text": "This article was first published in November 2014; last revised in August 2023.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). 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It is estimated that it now averts 1.2 million deaths per year \u2013 without it, global deaths would be more than twice as high." }, { "slug": "funding-to-support-efforts-against-hiv-aids", "text": "Funding for HIV treatment and prevention needs to increase if the world is to meet its 2030 targets." } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "url": "#all-charts", "children": [ { "text": "See all interactive charts on hiv / aids \u2193", "spanType": "span-simple-text" } ], "spanType": "span-link" } ], "spanType": "span-bold" } ], "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "HIV/AIDS is one of the world's most fatal infectious disease", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Almost 1 million people die from HIV/AIDS each year; in some countries, it's the leading cause of death", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "HIV/AIDS is one of the world's most fatal infectious diseases \u2013 particularly across Sub-Saharan Africa, where the disease has had a massive impact on health outcomes and life expectancy in recent decades.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The ", "spanType": "span-simple-text" }, { "children": [ { "text": "Global Burden of Disease", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " is a major global study on the causes of death and disease published in the medical journal ", "spanType": "span-simple-text" }, { "children": [ { "text": "The Lancet", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ".{ref}The latest study can be found at the website of the Lancet here: ", "spanType": "span-simple-text" }, { "url": "https://www.thelancet.com/gbd", "children": [ { "text": "TheLancet.com/GBD", "spanType": "span-simple-text" } ], "spanType": "span-link" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The 2017 study was published in the following publication: \"Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., ... & Abdollahpour, I. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. ", "spanType": "span-simple-text" }, { "children": [ { "text": "The Lancet", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", 392(10159), 1736-1788\", and is online ", "spanType": "span-simple-text" }, { "url": "http://www.healthdata.org/research-article/global-regional-and-national-age-sex-specific-mortality-282-causes-death-195", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref} These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the \"change country\" toggle.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "According to the ", "spanType": "span-simple-text" }, { "children": [ { "text": "Global Burden of Disease", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/malaria", "children": [ { "text": "malaria", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "It's ", "spanType": "span-simple-text" }, { "children": [ { "text": "one of", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " the largest killers globally, but for some countries \u2013 particularly across Sub-Saharan Africa, it's the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique \u2013 which you can do on the interactive chart \u2013 we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/cancer", "children": [ { "text": "cancer", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " deaths.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "The global distribution of deaths from HIV/AIDS", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "In some countries, HIV/AIDS is the cause of a quarter of all deaths", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Globally, around 1.5% of deaths are caused by HIV/AIDS.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "But the share is very high across some countries \u2013 focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-deaths-aids", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Death rates are high across Sub-Saharan Africa", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 \u2013 often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/hiv-death-rates", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Death rates are highest for younger adults and children under five years old", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Which population groups are most at risk from HIV/AIDS?", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds \u2013 typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/hiv-death-rates-by-age", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Is the world making progress in its fight against HIV/AIDS?", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "How have cases and deaths changed over time?", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The 1990s saw a substantial increase in people infected with HIV and dying of AIDS. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it's now below 2 million, the lowest number of new infections since 1990.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/deaths-and-new-cases-of-hiv", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Global deaths from HIV/AIDS halved within a decade", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In the visualization, we see the global number of deaths from HIV/AIDS in recent decades \u2013 this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "You can explore this change for any country or region using the \"change country\" toggle on the interactive chart.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/deaths-from-hiv-by-age", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "HIV/AIDS once accounted for a large share of deaths in some countries, but rates are now falling", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Over the past decade, this share has fallen as antiretroviral treatment has become more widely available.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-deaths-aids?tab=chart&country=ZAF+ZWE+NAM+OWID_WRL+Sub-Saharan%20Africa+MOZ+ZMB", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "HIV/AIDS has had a significant impact on life expectancy across Sub-Saharan Africa", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in ", "spanType": "span-simple-text" }, { "url": "https://owid.cloud/life-expectancy", "children": [ { "text": "life expectancy", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s \u2014 as progress has been made in tackling HIV \u2014 we see that life expectancy has been rising again.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In some countries, life expectancy is now higher than before the epidemic began.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/life-expectancy?country=BWA+NAM+ZAF+SWZ+TZA+ZMB", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "The prevalence of HIV/AIDS", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Prevalence in the total population", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "text": [ { "text": "Share of the population with HIV", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "You can explore the total number of people living with HIV/AIDS worldwide ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/number-of-people-living-with-hiv", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Number of new infections each year", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/new-cases-of-hiv-infection", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Prevalence by gender", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "text": [ { "text": "Is HIV/AIDS more common in men or women?", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex{ref}Greig, A., Peacock, D., Jewkes, R., & Msimang, S. (2008). Gender and AIDS: time to act.\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "AIDS (London, England)", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ",\u00a0", "spanType": "span-simple-text" }, { "children": [ { "text": "22", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(Suppl 2), S35. Available ", "spanType": "span-simple-text" }, { "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356155/", "children": [ { "text": "online", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref}.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-women-among-the-population-living-with-hiv", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Prevalence in children", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "text": [ { "text": "Share of children infected with HIV", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/share-of-children-under-five-years-old-with-hiv", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Children living with HIV", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/children-living-with-hiv", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "New HIV infections of children", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The map shows the total number of children newly infected with HIV yearly. Globally\u00a0\u2014 with similar trends at national levels\u00a0\u2014 the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/number-of-children-newly-infected-with-hiv", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Orphaned children from AIDS", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/number-of-children-orphaned-from-aids", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Tuberculosis among people living with HIV", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "type": "text", "value": [ { "text": "Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/tb-patients-tested-positive-for-hiv", "type": "chart", "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/tb-patients-living-with-hiv-receiving-art", "type": "chart", "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/tb-related-deaths-hiv", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "What can be done to prevent HIV/AIDS?", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Anti-retroviral treatment (ART)", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "text", "value": [ { "text": "A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "Millions of lives are saved by ART", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths \u2013 1.2 million \u2013 were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/hivaids-deaths-and-averted-due-to-art", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "People who use ART are living longer", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.{ref}We should note, though, that the life expectancy for people living with HIV infection without ART can vary depending on the age when a person got infected with HIV, a person's immune status (e.g., CD4 count), and socioeconomic factors.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Babiker, A., Darby, S., De Angelis, D., Kwart, D., Porter, K., Beral, V., ... & Prins, M. (2000). ", "spanType": "span-simple-text" }, { "url": "https://www.sciencedirect.com/science/article/pii/S0140673600020614#tbl1", "children": [ { "text": "Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action.", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": " Concerted Action on SeroConversion to AIDS and Death in Europe. ", "spanType": "span-simple-text" }, { "children": [ { "text": "Lancet", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "355", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(9210).", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Wandel, S., Egger, M., Rangsin, R., Nelson, K. E., Costello, C., Lewden, C., ... & Minga, A. (2008). ", "spanType": "span-simple-text" }, { "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418/", "children": [ { "text": "Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". ", "spanType": "span-simple-text" }, { "children": [ { "text": "Sexually transmitted infections", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "84", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(Suppl_1), i31-i36.{/ref} ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years \u2014 well into their 60s.{ref}This number is based on a study that used European and North American countries. Few studies have systematically assessed the life expectancy of people living with HIV/AIDS in middle and low-income countries, but it is predicted to be significantly lower between 60-74% of the life expectancy of the general population (see Wandeler et ", "spanType": "span-simple-text" }, { "children": [ { "text": "al. ", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "reference).\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Multiple factors account for this difference, including a higher prevalence of other diseases, such as co-infections with hepatitis or tuberculosis, and a higher prevalence of opportunistic diseases. 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The average life expectancy in Europe is 78.6 years.{/ref}\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.{ref}Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). 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", "spanType": "span-simple-text" }, { "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529404/", "children": [ { "text": "Modelling the impact of antiretroviral therapy on the epidemic of HIV.", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "children": [ { "text": "Current HIV research", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "9", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(6), 367-382.{/ref} ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases.\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "In 2011, the journal ", "spanType": "span-simple-text" }, { "children": [ { "text": "Science", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its \u201cBreakthrough of the Year\u201d.{ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Science announcement: ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Cohen, J. 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", "spanType": "span-simple-text" }, { "children": [ { "text": "JAIDS Journal of Acquired Immune Deficiency Syndromes", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "40", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(1), 96-101.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "A study in San Francisco showing after ART became available, viral loads dropped to 40% and HIV infection rates fell by 60%.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "\u00a0Das, M., Chu, P. L., Santos, G. M., Scheer, S., Vittinghoff, E., McFarland, W., & Colfax, G. N. (2010). 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(2004). ", "spanType": "span-simple-text" }, { "url": "https://academic.oup.com/jid/article-abstract/190/5/879/868453", "children": [ { "text": "Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "children": [ { "text": "Journal of Infectious Diseases", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "190", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(5), 879-885.{/ref} A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.{ref}\u00a0Hogg, R. S., Heath, K., Lima, V. D., Nosyk, B., Kanters, S., Wood, E., ... & Montaner, J. S. (2012). ", "spanType": "span-simple-text" }, { "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047260", "children": [ { "text": "Disparities in the burden of HIV/AIDS in Canada", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ". 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In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.{ref}The 79% figure is based on ", "spanType": "span-simple-text" }, { "url": "https://www.unaids.org/en/resources/fact-sheet", "children": [ { "text": "2019 UNAIDS estimates", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The frequency of undiagnosed HIV/AIDS can be measured using observational studies. Measures of the expected rate of HIV infection, the actual number of people diagnosed with HIV, and delay in diagnosis are taken into account to predict the true expected prevalence of HIV in a population and the proportion of undiagnosed cases (see Singh et ", "spanType": "span-simple-text" }, { "children": [ { "text": "al.", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": " reference).\u00a0", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The initial HIV infection is often followed by flu-like symptoms, which subside in a few weeks. The infected patient can then live without symptoms for months or years while their immune system may be slowly deteriorating. Hence, people infected with HIV may not even know they need to be tested due to the lack of symptoms. 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In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.{ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "WHO eligibility criteria are based on CD4 counts, which go down as the illness progresses. A healthy person\u2019s CD4 counts are >500/mm3. WHO recommends ART for anyone with HIV diagnosis and CD4 count >350 cells and \u2264500/mm3, regardless of clinical symptoms. All children, people with TB, HBV, and pregnant women diagnosed with HIV regardless of their CD4 status, should get ART.\u00a0", "spanType": "span-simple-text" }, { "url": "https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/", "children": [ { "text": "https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/", "spanType": "span-simple-text" } ], "spanType": "span-link" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). 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", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "children": [ { "text": "AIDS (London, England)", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": ", ", "spanType": "span-simple-text" }, { "children": [ { "text": "22", "spanType": "span-simple-text" } ], "spanType": "span-italic" }, { "text": "(Suppl 2), S67.{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/antiretroviral-therapy-coverage-among-people-living-with-hiv", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Prevention of mother-to-child transmission (PMTCT)", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.{ref}World Health Organization (WHO)", "spanType": "span-simple-text" }, { "url": "https://www.who.int/hiv/topics/mtct/about/en/", "children": [ { "text": "\u00a0'Mother-to-child transmission of HIV'\u00a0", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": "[accessed November 2019]{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection. ", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The visualization shows the number of child infections averted from ART coverage in mothers.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/new-hiv-infections-averted-due-to-pmtct", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/number-of-new-hiv-child-infections-vs-number-of-infections-averted-due-to-pmtct", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Coverage of ART in pregnant women", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy \u2013 a vital intervention to prevent the transmission from mother to child.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/art-coverage-for-pregnant-women", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Safe sex", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "text": [ { "text": "Unsafe sex is a leading risk factor for death in Sub-Saharan Africa", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor?country=~Sub-Saharan+Africa+%28WB%29", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Share of people practicing safe sex", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The majority of HIV infections are transmitted through sexual activity.", "spanType": "span-simple-text" }, { "spanType": "span-newline" }, { "spanType": "span-newline" }, { "text": "Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of 'high-risk sex', which is that with a non-marital, non-cohabiting sexual partner.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/condom-use-at-last-high-risk-sex", "type": "chart", "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/condom-use-during-last-high-risk-sex", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Education on HIV/AIDS", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/young-people-with-knowledge-on-hiv-prevention", "type": "chart", "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/knowledge-hiv-prevention-in-males-vs-females", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Funding to support efforts against HIV/AIDS", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "text", "value": [ { "text": "You can explore the breakdown of funding resources by source for each country ", "spanType": "span-simple-text" }, { "url": "https://ourworldindata.org/grapher/hivaids-funding-by-source", "children": [ { "text": "here", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/hiv-expenditure", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Future funding needs to meet HIV targets", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/resource-needs-to-meet-hiv-targets", "type": "chart", "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Data quality and definition", "spanType": "span-simple-text" } ], "type": "heading", "level": 1, "parseErrors": [] }, { "type": "horizontal-rule", "parseErrors": [] }, { "text": [ { "text": "Terminology and definitions", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "text", "value": [ { "text": "The following terminology and definitions are sourced from the UNAIDS organization.{ref}UNAIDS (2015). Terminology guidelines. Available ", "spanType": "span-simple-text" }, { "url": "http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf", "children": [ { "text": "online", "spanType": "span-simple-text" } ], "spanType": "span-link" }, { "text": ".{/ref}", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "HIV", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": Human Immunodeficiency Virus.\u00a0HIV is a virus that weakens the immune system, ultimately leading to AIDS.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "AIDS", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ":\u00a0acquired immunodeficiency syndrome.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term \"highly active\" antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. \"Highly active\" is not needed as a qualification, and the term is no longer commonly used.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use.\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "ARV-based prevention", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention).\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Epidemic", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic.\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "HIV-negative (seronegative)", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative.\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "HIV-positive (seropositive)", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies.\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Incidence", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15\u201349 years and 0\u201314 years.\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Mother-to-child transmission (MTCT)", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4).", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "PMTCT is often mistakenly referring to only prong 3\u2014 the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT).\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Prevalence", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15\u201349 years.\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "children": [ { "text": "Tuberculosis (TB)", "spanType": "span-simple-text" } ], "spanType": "span-bold" }, { "text": ": \"Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "type": "text", "value": [ { "text": "The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria.\"", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "Comparisons of UNAIDS and IHME estimates", "spanType": "span-simple-text" } ], "type": "heading", "level": 2, "parseErrors": [] }, { "type": "text", "value": [ { "text": "Several sources publish estimates on HIV and AIDS - two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources' relationship/consistency in prevalence estimates.", "spanType": "span-simple-text" } ], "parseErrors": [] }, { "text": [ { "text": "Prevalence of HIV", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/prevalence-of-hiv-unaids-vs-ihme-estimates", "type": "chart", "parseErrors": [] }, { "text": [ { "text": "Incidence/new cases of HIV", "spanType": "span-simple-text" } ], "type": "heading", "level": 3, "parseErrors": [] }, { "url": "https://ourworldindata.org/grapher/new-cases-of-hiv-unaids-vs-ihme", "type": "chart", "parseErrors": [] }, { "top": [], "type": "all-charts", "heading": "Interactive charts on hiv / aids", "parseErrors": [] } ], "type": "linear-topic-page", "title": "HIV / AIDS", "authors": [ "Max Roser", "Hannah Ritchie" ], "excerpt": "A global epidemic and the leading cause of death in some countries.", "dateline": "April 3, 2018", "subtitle": "A global epidemic and the leading cause of death in some countries.", "sticky-nav": [], "sidebar-toc": true, "featured-image": "Screen-Shot-2021-02-05-at-10.05.57.png" }, "createdAt": "2019-11-05T15:24:59.000Z", "published": false, "updatedAt": "2023-08-31T15:57:37.000Z", "revisionId": null, "publishedAt": "2018-04-03T22:07:27.000Z", "relatedCharts": [ { "slug": "incidence-of-hiv-the-share-of-new-infections-among-the-previously-uninfected-population-ages-15-49", "title": "Annual incidence rate of HIV", "variantName": null, "keyChartLevel": 2 }, { "slug": "number-of-children-newly-infected-with-hiv", "title": "Annual number of children newly infected with HIV", "variantName": null, "keyChartLevel": 2 }, { "slug": "annual-number-of-deaths-by-cause", "title": "Causes of death", "variantName": "IHME", "keyChartLevel": 2 }, { "slug": "causes-of-death-in-50-69-year-olds", "title": "Causes of death in 50- to 69-year-olds", "variantName": null, "keyChartLevel": 2 }, { "slug": 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"slug": "tb-patients-tested-positive-for-hiv", "title": "Tuberculosis patients tested positive for HIV", "variantName": null, "keyChartLevel": 2 }, { "slug": "share-of-women-among-the-population-living-with-hiv", "title": "What share of the population living with HIV are women?", "variantName": null, "keyChartLevel": 2 } ], "publicationContext": "listed" }	{ "errors": [ { "name": "unhandled html tag found", "details": "Encountered the unhandled tag hr" }, { "name": "unexpected wp component tag", "details": "Found unhandled wp:comment tag separator" } ], "numBlocks": 191, "numErrors": 2, "wpTagCounts": { "html": 32, "list": 1, "heading": 42, "paragraph": 100, "separator": 1, "owid/summary": 1 }, "htmlTagCounts": { "p": 100, "h2": 7, "h3": 10, "h4": 25, "hr": 1, "ul": 1, "div": 1, "figure": 16, "iframe": 31 } }	2018-04-03 22:07:27	2024-02-16 14:22:39		[ "Max Roser", "Hannah Ritchie" ]	A global epidemic and the leading cause of death in some countries.	2019-11-05 15:24:59	2023-08-31 15:57:37	https://ourworldindata.org/wp-content/uploads/2021/02/Screen-Shot-2021-02-05-at-10.05.57.png	{}	This article was first published in November 2014; last revised in August 2023. Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in a heightened risk of life-threatening infection and [cancers](https://owid.cloud/cancer). In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from mother to child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur by sharing injection equipment such as needles. [See all interactive charts on hiv / aids ↓](#all-charts) --- # HIV/AIDS is one of the world's most fatal infectious disease --- ### Almost 1 million people die from HIV/AIDS each year; in some countries, it's the leading cause of death HIV/AIDS is one of the world's most fatal infectious diseases – particularly across Sub-Saharan Africa, where the disease has had a massive impact on health outcomes and life expectancy in recent decades. The _Global Burden of Disease_ is a major global study on the causes of death and disease published in the medical journal _The Lancet_.{ref}The latest study can be found at the website of the Lancet here: [TheLancet.com/GBD](https://www.thelancet.com/gbd) The 2017 study was published in the following publication: "Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., ... & Abdollahpour, I. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. _The Lancet_, 392(10159), 1736-1788", and is online [here](http://www.healthdata.org/research-article/global-regional-and-national-age-sex-specific-mortality-282-causes-death-195).{/ref} These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the "change country" toggle. According to the _Global Burden of Disease_ study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from [malaria](https://owid.cloud/malaria). It's _one of_ the largest killers globally, but for some countries – particularly across Sub-Saharan Africa, it's the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique – which you can do on the interactive chart – we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of [cancer](https://owid.cloud/cancer) deaths. <Chart url="https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause"/> --- # The global distribution of deaths from HIV/AIDS --- ### In some countries, HIV/AIDS is the cause of a quarter of all deaths Globally, around 1.5% of deaths are caused by HIV/AIDS. This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher. In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths. But the share is very high across some countries – focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana. <Chart url="https://ourworldindata.org/grapher/share-deaths-aids"/> ### Death rates are high across Sub-Saharan Africa The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region. In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 – often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000. Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. <Chart url="https://ourworldindata.org/grapher/hiv-death-rates"/> ### Death rates are highest for younger adults and children under five years old Which population groups are most at risk from HIV/AIDS? In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds – typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect. But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected. <Chart url="https://ourworldindata.org/grapher/hiv-death-rates-by-age"/> --- # Is the world making progress in its fight against HIV/AIDS? --- ### How have cases and deaths changed over time? The 1990s saw a substantial increase in people infected with HIV and dying of AIDS. In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it's now below 2 million, the lowest number of new infections since 1990. As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS. The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever. <Chart url="https://ourworldindata.org/grapher/deaths-and-new-cases-of-hiv"/> ### Global deaths from HIV/AIDS halved within a decade The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade. In the visualization, we see the global number of deaths from HIV/AIDS in recent decades – this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year. Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then. You can explore this change for any country or region using the "change country" toggle on the interactive chart. <Chart url="https://ourworldindata.org/grapher/deaths-from-hiv-by-age"/> ### HIV/AIDS once accounted for a large share of deaths in some countries, but rates are now falling Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic. Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher. In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe. Over the past decade, this share has fallen as antiretroviral treatment has become more widely available. <Chart url="https://ourworldindata.org/grapher/share-deaths-aids?tab=chart&country=ZAF+ZWE+NAM+OWID_WRL+Sub-Saharan%20Africa+MOZ+ZMB"/> ### HIV/AIDS has had a significant impact on life expectancy across Sub-Saharan Africa The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in [life expectancy](https://owid.cloud/life-expectancy). In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll. We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s — as progress has been made in tackling HIV — we see that life expectancy has been rising again. In some countries, life expectancy is now higher than before the epidemic began. <Chart url="https://ourworldindata.org/grapher/life-expectancy?country=BWA+NAM+ZAF+SWZ+TZA+ZMB"/> --- # The prevalence of HIV/AIDS --- ## Prevalence in the total population ### Share of the population with HIV You can explore the total number of people living with HIV/AIDS worldwide [here](https://ourworldindata.org/grapher/number-of-people-living-with-hiv). <Chart url="https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme"/> ### Number of new infections each year <Chart url="https://ourworldindata.org/grapher/new-cases-of-hiv-infection"/> ## Prevalence by gender ### Is HIV/AIDS more common in men or women? There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV. As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex{ref}Greig, A., Peacock, D., Jewkes, R., & Msimang, S. (2008). Gender and AIDS: time to act. _AIDS (London, England)_, _22_(Suppl 2), S35. Available [online](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356155/).{/ref}. <Chart url="https://ourworldindata.org/grapher/share-of-women-among-the-population-living-with-hiv"/> ## Prevalence in children ### Share of children infected with HIV <Chart url="https://ourworldindata.org/grapher/share-of-children-under-five-years-old-with-hiv"/> ### Children living with HIV In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million. <Chart url="https://ourworldindata.org/grapher/children-living-with-hiv"/> ### New HIV infections of children The map shows the total number of children newly infected with HIV yearly. Globally — with similar trends at national levels — the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually. <Chart url="https://ourworldindata.org/grapher/number-of-children-newly-infected-with-hiv"/> ### Orphaned children from AIDS Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths. <Chart url="https://ourworldindata.org/grapher/number-of-children-orphaned-from-aids"/> --- # Tuberculosis among people living with HIV --- Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa. The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV. <Chart url="https://ourworldindata.org/grapher/tb-patients-tested-positive-for-hiv"/> <Chart url="https://ourworldindata.org/grapher/tb-patients-living-with-hiv-receiving-art"/> <Chart url="https://ourworldindata.org/grapher/tb-related-deaths-hiv"/> --- # What can be done to prevent HIV/AIDS? --- ## Anti-retroviral treatment (ART) A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives. ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections. ### Millions of lives are saved by ART Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives. The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART. Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths – 1.2 million – were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS. <Chart url="https://ourworldindata.org/grapher/hivaids-deaths-and-averted-due-to-art"/> ### People who use ART are living longer ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.{ref}We should note, though, that the life expectancy for people living with HIV infection without ART can vary depending on the age when a person got infected with HIV, a person's immune status (e.g., CD4 count), and socioeconomic factors. Babiker, A., Darby, S., De Angelis, D., Kwart, D., Porter, K., Beral, V., ... & Prins, M. (2000). [Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action.](https://www.sciencedirect.com/science/article/pii/S0140673600020614#tbl1) Concerted Action on SeroConversion to AIDS and Death in Europe. _Lancet_, _355_(9210). Wandel, S., Egger, M., Rangsin, R., Nelson, K. E., Costello, C., Lewden, C., ... & Minga, A. (2008). [Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418/). _Sexually transmitted infections_, _84_(Suppl_1), i31-i36.{/ref} According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years — well into their 60s.{ref}This number is based on a study that used European and North American countries. Few studies have systematically assessed the life expectancy of people living with HIV/AIDS in middle and low-income countries, but it is predicted to be significantly lower between 60-74% of the life expectancy of the general population (see Wandeler et _al. _reference). Multiple factors account for this difference, including a higher prevalence of other diseases, such as co-infections with hepatitis or tuberculosis, and a higher prevalence of opportunistic diseases. In addition, people tend to adhere to ART regimens less strictly because of poorer care for AIDS patients, less access to medical clinics, and social stigma. Wandeler, G., Johnson, L. F., & Egger, M. (2016). [Trends in life expectancy of HIV-positive adults on ART across the globe: comparisons with general population](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055447/). _Current Opinion in HIV and AIDS_, _11_(5), 492. Currently, no equivalent estimate for life expectancy is available for low and middle-income countries. However, we do know that with decreasing rates of HIV mortality in low and middle-income countries, the life expectancy of the general population has increased. Haris et al. discuss this, and you can read more about life expectancy and HIV [here](https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa). Harris, T. G., Rabkin, M., & El-Sadr, W. M. (2018). Achieving the fourth 90: healthy aging for people living with HIV. _AIDS (London, England)_, _32_(12), 1563. Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). [Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.](https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures)_The Lancet HIV_, _4_(8), e349-e356.{/ref} While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the [life expectancy](https://ourworldindata.org/life-expectancy) of the general population, we are getting closer to this goal.{ref}Global average [life expectancy](https://ourworldindata.org/grapher/life-expectancy?tab=chart&time=1543..latest&country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL) in 2019 was 72.6 years. The average life expectancy in Europe is 78.6 years.{/ref} The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.{ref}Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). [Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.](https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures)_The Lancet HIV_, _4_(8), e349-e356.{/ref} This increase goes beyond the general increase in life expectancy in that period and reflects the improvements in ART — fewer side effects, more people following the prescribed treatment, and more support for the people in need of ART. ### ART prevents new HIV infections There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.{ref} G Williams, B., Lima, V., & Gouws, E. (2011). [Modelling the impact of antiretroviral therapy on the epidemic of HIV.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529404/)_Current HIV research_, _9_(6), 367-382.{/ref} ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases. In 2011, the journal _Science_ named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its “Breakthrough of the Year”.{ref} Science announcement: Cohen, J. (2011). [HIV treatment as prevention](https://science.sciencemag.org/content/334/6063/1628). Study that was awarded: Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., ... & Godbole, S. V. (2011).[ Prevention of HIV-1 infection with early antiretroviral therapy.](https://www.nejm.org/doi/full/10.1056/Nejmoa1105243)_New England journal of medicine_, _365_(6), 493-505.{/ref} Many other studies have now shown similar findings, with a range of reduction in transmission attributable to ART depending on location and groups studied.{ref}PARTNER study showed chances of transmission between gay couples with successfull virus suppression by ART are “effectively zero”. Rodger, A. J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Degen, O., ... & Raben, D. (2019). [Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30418-0/fulltext)_The Lancet_. Transmission rates in Madrid fell by 86% after ART became available Castilla, J., Del Romero, J., Hernando, V., Marincovich, B., García, S., & Rodríguez, C. (2005). [Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV](https://journals.lww.com/jaids/Fulltext/2005/09010/Prevalence_of_Unsafe_Sexual_Behavior_Among.16.aspx?casa_token=4RZtew6owdYAAAAA:YrqHOyO0wmGz7hSrlm0r6loCZUtsZd1wVRVQvR2U0_XPeUnJpSC9ykITGg0bsGmB1IjAinXZbUd9hslCBo-DtYCk). _JAIDS Journal of Acquired Immune Deficiency Syndromes_, _40_(1), 96-101. A study in San Francisco showing after ART became available, viral loads dropped to 40% and HIV infection rates fell by 60%. Das, M., Chu, P. L., Santos, G. M., Scheer, S., Vittinghoff, E., McFarland, W., & Colfax, G. N. (2010). [Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0011068). _PloS one_, _5_(6), e11068. After ART became freely available in Taiwan transmission rates fell by 50%. Fang, C. T., Hsu, H. M., Twu, S. J., Chen, M. Y., Chang, Y. Y., Hwang, J. S., ... & Division of AIDS and STD, Center for Disease Control, Department of Health, Executive Yuan. (2004). [Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.](https://academic.oup.com/jid/article-abstract/190/5/879/868453)_Journal of Infectious Diseases_, _190_(5), 879-885.{/ref} A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.{ref} Hogg, R. S., Heath, K., Lima, V. D., Nosyk, B., Kanters, S., Wood, E., ... & Montaner, J. S. (2012). [Disparities in the burden of HIV/AIDS in Canada](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047260). _PLoS One_, _7_(11), e47260.{/ref} ### We need to increase ART coverage The number of people who receive ART has increased significantly in recent years, especially in African countries where the prevalence of HIV/AIDS is the highest. But many millions of people who could benefit from the life-saving treatment currently don’t. To increase ART coverage, we must first improve access to testing for HIV status. In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.{ref}The 79% figure is based on [2019 UNAIDS estimates](https://www.unaids.org/en/resources/fact-sheet). The frequency of undiagnosed HIV/AIDS can be measured using observational studies. Measures of the expected rate of HIV infection, the actual number of people diagnosed with HIV, and delay in diagnosis are taken into account to predict the true expected prevalence of HIV in a population and the proportion of undiagnosed cases (see Singh et _al._ reference). The initial HIV infection is often followed by flu-like symptoms, which subside in a few weeks. The infected patient can then live without symptoms for months or years while their immune system may be slowly deteriorating. Hence, people infected with HIV may not even know they need to be tested due to the lack of symptoms. Models used to predict HIV incidence rate often use an expected 5-year lag between infection and diagnosis. Singh, S., Song, R., Johnson, A. S., McCray, E., & Hall, H. I. (2018). [HIV incidence, prevalence, and undiagnosed infections in US men who have sex with men.](https://annals.org/aim/fullarticle/2675979/hiv-incidence-prevalence-undiagnosed-infections-u-s-men-who-have)_Annals of internal medicine_, _168_(10), 685-694.{/ref} And awareness is also not enough. In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.{ref} WHO eligibility criteria are based on CD4 counts, which go down as the illness progresses. A healthy person’s CD4 counts are >500/mm3. WHO recommends ART for anyone with HIV diagnosis and CD4 count >350 cells and ≤500/mm3, regardless of clinical symptoms. All children, people with TB, HBV, and pregnant women diagnosed with HIV regardless of their CD4 status, should get ART. [https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/](https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/) Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). [Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub‐Saharan Africa: a systematic review.](https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383)_Journal of the International AIDS Society_, _15_(2), 17383.{/ref} Of those who should start ART, only 66% did.{ref}For some countries, eligibility for ART treatment is determined by the so-called CD4+ counts, which go down as the illness progresses. Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). [Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub‐Saharan Africa: a systematic review.](https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383)_Journal of the International AIDS Society_, _15_(2), 17383.{/ref} Stigmatization of people who have HIV/AIDS also leads to a decrease in engagement with care, treatment, and prevention services.{ref}Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates, T. J. (2008). [Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. ](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/)_AIDS (London, England)_, _22_(Suppl 2), S67.{/ref} <Chart url="https://ourworldindata.org/grapher/antiretroviral-therapy-coverage-among-people-living-with-hiv"/> ## Prevention of mother-to-child transmission (PMTCT) Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV. The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.{ref}World Health Organization (WHO)[ 'Mother-to-child transmission of HIV' ](https://www.who.int/hiv/topics/mtct/about/en/)[accessed November 2019]{/ref} PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection. The visualization shows the number of child infections averted from ART coverage in mothers. You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world [here](https://ourworldindata.org/grapher/new-hiv-infections-averted-due-to-pmtct). <Chart url="https://ourworldindata.org/grapher/number-of-new-hiv-child-infections-vs-number-of-infections-averted-due-to-pmtct"/> ### Coverage of ART in pregnant women This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy – a vital intervention to prevent the transmission from mother to child. <Chart url="https://ourworldindata.org/grapher/art-coverage-for-pregnant-women"/> ## Safe sex ### Unsafe sex is a leading risk factor for death in Sub-Saharan Africa <Chart url="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor?country=~Sub-Saharan+Africa+%28WB%29"/> ### Share of people practicing safe sex The majority of HIV infections are transmitted through sexual activity. Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of 'high-risk sex', which is that with a non-marital, non-cohabiting sexual partner. <Chart url="https://ourworldindata.org/grapher/condom-use-at-last-high-risk-sex"/> <Chart url="https://ourworldindata.org/grapher/condom-use-during-last-high-risk-sex"/> ## Education on HIV/AIDS <Chart url="https://ourworldindata.org/grapher/young-people-with-knowledge-on-hiv-prevention"/> <Chart url="https://ourworldindata.org/grapher/knowledge-hiv-prevention-in-males-vs-females"/> ## Funding to support efforts against HIV/AIDS You can explore the breakdown of funding resources by source for each country [here](https://ourworldindata.org/grapher/hivaids-funding-by-source). <Chart url="https://ourworldindata.org/grapher/hiv-expenditure"/> ### Future funding needs to meet HIV targets <Chart url="https://ourworldindata.org/grapher/resource-needs-to-meet-hiv-targets"/> --- # Data quality and definition --- ## Terminology and definitions The following terminology and definitions are sourced from the UNAIDS organization.{ref}UNAIDS (2015). Terminology guidelines. Available [online](http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf).{/ref} HIV: Human Immunodeficiency Virus. HIV is a virus that weakens the immune system, ultimately leading to AIDS. AIDS: acquired immunodeficiency syndrome. Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment: "Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations. More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term "highly active" antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. "Highly active" is not needed as a qualification, and the term is no longer commonly used. ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use." ARV-based prevention: "ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention)." Epidemic: "An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic." HIV-negative (seronegative): "A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative." HIV-positive (seropositive): "A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies." Incidence: "HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15–49 years and 0–14 years." Mother-to-child transmission (MTCT): "MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4). PMTCT is often mistakenly referring to only prong 3— the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT)." Prevalence: "Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15–49 years." Tuberculosis (TB): "Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se. The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria." ## Comparisons of UNAIDS and IHME estimates Several sources publish estimates on HIV and AIDS - two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources' relationship/consistency in prevalence estimates. ### Prevalence of HIV <Chart url="https://ourworldindata.org/grapher/prevalence-of-hiv-unaids-vs-ihme-estimates"/> ### Incidence/new cases of HIV <Chart url="https://ourworldindata.org/grapher/new-cases-of-hiv-unaids-vs-ihme"/> <AllCharts heading="Interactive charts on hiv / aids"/>	{ "id": 3083, "date": "2018-04-03T23:07:27", "guid": { "rendered": "http://ourworldindata.org/?page_id=3083" }, "link": "https://owid.cloud/hiv-aids", "meta": { "owid_publication_context_meta_field": [], "owid_key_performance_indicators_meta_field": { "raw": "860,000 people die from HIV/AIDS each year.\n\n77% are younger than 50 years old.", "rendered": "<p><strong>860,000</strong> people die from HIV/AIDS each year.</p>\n<p>77% are younger than 50 years old.</p>\n" } }, "slug": "hiv-aids", "tags": [], "type": "page", "title": { "rendered": "HIV / AIDS" }, "_links": { "self": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages/3083" } ], "about": [ { "href": "https://owid.cloud/wp-json/wp/v2/types/page" } ], "author": [ { "href": "https://owid.cloud/wp-json/wp/v2/users/2", "embeddable": true } ], "curies": [ { "href": "https://api.w.org/{rel}", "name": "wp", "templated": true } ], "replies": [ { "href": "https://owid.cloud/wp-json/wp/v2/comments?post=3083", "embeddable": true } ], "wp:term": [ { "href": "https://owid.cloud/wp-json/wp/v2/categories?post=3083", "taxonomy": "category", "embeddable": true }, { "href": "https://owid.cloud/wp-json/wp/v2/tags?post=3083", "taxonomy": "post_tag", "embeddable": true } ], "collection": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages" } ], "wp:attachment": [ { "href": "https://owid.cloud/wp-json/wp/v2/media?parent=3083" } ], "version-history": [ { "href": "https://owid.cloud/wp-json/wp/v2/pages/3083/revisions", "count": 30 } ], "wp:featuredmedia": [ { "href": "https://owid.cloud/wp-json/wp/v2/media/39993", "embeddable": true } ], "predecessor-version": [ { "id": 58108, "href": "https://owid.cloud/wp-json/wp/v2/pages/3083/revisions/58108" } ] }, "author": 2, "parent": 0, "status": "publish", "content": { "rendered": "\n<div class=\"blog-info\">This article was first published in November 2014; last revised in August 2023.</div>\n\n\n\n<p>Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in a heightened risk of life-threatening infection and <a href=\"https://owid.cloud/cancer\">cancers</a>.</p>\n\n\n\n<p>In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from mother to child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur by sharing injection equipment such as needles.</p>\n\n\n\t<div class=\"wp-block-owid-summary\">\n\t\t<h2>Summary</h2>\n\t\t\n\n<ul><li><a href=\"#almost-1-million-people-die-from-hiv-aids-each-year-in-some-countries-it-s-the-leading-cause-of-death\">Almost one million die from HIV/AIDS each year \u2013 in some countries it’s the leading cause of death.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#in-some-countries-hiv-aids-is-the-cause-of-more-than-1-in-4-deaths\">In some countries, HIV/AIDS is the cause of one quarter of deaths.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#death-rates-are-high-across-sub-saharan-africa\">Death rates are highest across Sub-Saharan Africa.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#death-rates-are-highest-for-younger-adults-and-children-under-five-years-old\">Death rates are highest for younger adults, and for children (when HIV is transmitted from a mother).</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#global-deaths-from-hiv-aids-halved-within-a-decade\">The world is making progress: over the past decade the number of global deaths has halved.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa\">The HIV epidemic had a major impact on life expectancy across Sub-Saharan Africa, and life expectancy is only now back to pre-epidemic levels.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#anti-retroviral-treatment-art\">Antiretroviral treatment (ART) has been key to preventing deaths from AIDS. It is estimated that it now averts 1.2 million deaths per year \u2013 without it, global deaths would be more than twice as high.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#funding-to-support-efforts-against-hiv-aids\">Funding for HIV treatment and prevention needs to increase if the world is to meet its 2030 targets.</a></li></ul>\n\n\n\t</div>\n\n\n<h2>HIV/AIDS is one of the world’s most fatal infectious disease</h2>\n\n\n\n<h4>Almost 1 million people die from HIV/AIDS each year; in some countries, it’s the leading cause of death</h4>\n\n\n\n<p>HIV/AIDS is one of the world’s most fatal infectious diseases \u2013 particularly across Sub-Saharan Africa, where the disease has had a massive impact on health outcomes and life expectancy in recent decades.</p>\n\n\n\n<p>The <em>Global Burden of Disease</em> is a major global study on the causes of death and disease published in the medical journal <em>The Lancet</em>.{ref}The latest study can be found at the website of the Lancet here: <a href=\"https://www.thelancet.com/gbd\">TheLancet.com/GBD</a></p>\n\n\n\n<p>The 2017 study was published in the following publication: “Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., … & Abdollahpour, I. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. <em>The Lancet</em>, 392(10159), 1736-1788″, and is online <a href=\"http://www.healthdata.org/research-article/global-regional-and-national-age-sex-specific-mortality-282-causes-death-195\">here</a>.{/ref} These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the “change country” toggle.</p>\n\n\n\n<p>According to the <em>Global Burden of Disease</em> study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from <a href=\"https://owid.cloud/malaria\">malaria</a>.</p>\n\n\n\n<p>It’s <em>one of</em> the largest killers globally, but for some countries \u2013 particularly across Sub-Saharan Africa, it’s the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique \u2013 which you can do on the interactive chart \u2013 we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of <a href=\"https://owid.cloud/cancer\">cancer</a> deaths.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>The global distribution of deaths from HIV/AIDS</h2>\n\n\n\n<h4>In some countries, HIV/AIDS is the cause of a quarter of all deaths</h4>\n\n\n\n<p>Globally, around 1.5% of deaths are caused by HIV/AIDS.</p>\n\n\n\n<p>This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher.<br> <br>In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.</p>\n\n\n\n<p>But the share is very high across some countries \u2013 focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-deaths-aids\"></iframe></figure>\n\n\n\n<h4>Death rates are high across Sub-Saharan Africa</h4>\n\n\n\n<p>The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.</p>\n\n\n\n<p>In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 \u2013 often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000.</p>\n\n\n\n<p>Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. </p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/hiv-death-rates\"></iframe></figure>\n\n\n\n<h4>Death rates are highest for younger adults and children under five years old</h4>\n\n\n\n<p>Which population groups are most at risk from HIV/AIDS?<br><br>In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds \u2013 typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect.</p>\n\n\n\n<p>But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected. </p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/hiv-death-rates-by-age\"></iframe></figure>\n\n\n\n<h2>Is the world making progress in its fight against HIV/AIDS?</h2>\n\n\n\n<h4>How have cases and deaths changed over time?</h4>\n\n\n\n<p>The 1990s saw a substantial increase in people infected with HIV and dying of AIDS. </p>\n\n\n\n<p>In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it’s now below 2 million, the lowest number of new infections since 1990.</p>\n\n\n\n<p>As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS.</p>\n\n\n\n<p>The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/deaths-and-new-cases-of-hiv\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>Global deaths from HIV/AIDS halved within a decade</h4>\n\n\n\n<p>The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade.</p>\n\n\n\n<p>In the visualization, we see the global number of deaths from HIV/AIDS in recent decades \u2013 this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year. </p>\n\n\n\n<p>Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then.</p>\n\n\n\n<p>You can explore this change for any country or region using the “change country” toggle on the interactive chart.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/deaths-from-hiv-by-age\"></iframe></figure>\n\n\n\n<h4>HIV/AIDS once accounted for a large share of deaths in some countries, but rates are now falling</h4>\n\n\n\n<p>Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic.</p>\n\n\n\n<p>Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher.<br><br>In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe.</p>\n\n\n\n<p>Over the past decade, this share has fallen as antiretroviral treatment has become more widely available.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-deaths-aids?tab=chart&country=ZAF+ZWE+NAM+OWID_WRL+Sub-Saharan%20Africa+MOZ+ZMB\"></iframe></figure>\n\n\n\n<h4>HIV/AIDS has had a significant impact on life expectancy across Sub-Saharan Africa</h4>\n\n\n\n<p>The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in <a href=\"https://owid.cloud/life-expectancy\">life expectancy</a>. In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll. </p>\n\n\n\n<p>We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s \u2014 as progress has been made in tackling HIV \u2014 we see that life expectancy has been rising again.</p>\n\n\n\n<p>In some countries, life expectancy is now higher than before the epidemic began.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/life-expectancy?country=BWA+NAM+ZAF+SWZ+TZA+ZMB\"></iframe></figure>\n\n\n\n<h2>The prevalence of HIV/AIDS</h2>\n\n\n\n<h3>Prevalence in the total population</h3>\n\n\n\n<h4>Share of the population with HIV</h4>\n\n\n\n<p>You can explore the total number of people living with HIV/AIDS worldwide <a href=\"https://ourworldindata.org/grapher/number-of-people-living-with-hiv\">here</a>.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>Number of new infections each year</h4>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/new-cases-of-hiv-infection\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h3>Prevalence by gender</h3>\n\n\n\n<h4>Is HIV/AIDS more common in men or women?</h4>\n\n\n\n<p>There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV.</p>\n\n\n\n<p>As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex{ref}Greig, A., Peacock, D., Jewkes, R., & Msimang, S. (2008). Gender and AIDS: time to act. <em>AIDS (London, England)</em>, <em>22</em>(Suppl 2), S35. Available <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356155/\">online</a>.{/ref}.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-of-women-among-the-population-living-with-hiv\"></iframe></figure>\n\n\n\n<h3>Prevalence in children</h3>\n\n\n\n<h4>Share of children infected with HIV</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-of-children-under-five-years-old-with-hiv\"></iframe></figure>\n\n\n\n<h4>Children living with HIV</h4>\n\n\n\n<p>In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/children-living-with-hiv\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h4>New HIV infections of children</h4>\n\n\n\n<p>The map shows the total number of children newly infected with HIV yearly. Globally\u00a0\u2014 with similar trends at national levels\u00a0\u2014 the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/number-of-children-newly-infected-with-hiv\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h4>Orphaned children from AIDS</h4>\n\n\n\n<p>Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/number-of-children-orphaned-from-aids\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h2>Tuberculosis among people living with HIV</h2>\n\n\n\n<p>Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.</p>\n\n\n\n<p>The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/tb-patients-tested-positive-for-hiv\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/tb-patients-living-with-hiv-receiving-art\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/tb-related-deaths-hiv\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h2>What can be done to prevent HIV/AIDS?</h2>\n\n\n\n<h3>Anti-retroviral treatment (ART)</h3>\n\n\n\n<p>A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives. </p>\n\n\n\n<p>ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections. </p>\n\n\n\n<h4>Millions of lives are saved by ART</h4>\n\n\n\n<p>Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives.</p>\n\n\n\n<p>The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART. </p>\n\n\n\n<p>Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths \u2013 1.2 million \u2013 were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS.\u00a0</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/hivaids-deaths-and-averted-due-to-art\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>People who use ART are living longer</h4>\n\n\n\n<p>ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.{ref}We should note, though, that the life expectancy for people living with HIV infection without ART can vary depending on the age when a person got infected with HIV, a person’s immune status (e.g., CD4 count), and socioeconomic factors. </p>\n\n\n\n<p>Babiker, A., Darby, S., De Angelis, D., Kwart, D., Porter, K., Beral, V., … & Prins, M. (2000). <a href=\"https://www.sciencedirect.com/science/article/pii/S0140673600020614#tbl1\">Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action.</a> Concerted Action on SeroConversion to AIDS and Death in Europe. <em>Lancet</em>, <em>355</em>(9210).</p>\n\n\n\n<p>Wandel, S., Egger, M., Rangsin, R., Nelson, K. E., Costello, C., Lewden, C., … & Minga, A. (2008). <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418/\">Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies</a>. <em>Sexually transmitted infections</em>, <em>84</em>(Suppl_1), i31-i36.{/ref} </p>\n\n\n\n<p>According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years \u2014 well into their 60s.{ref}This number is based on a study that used European and North American countries. Few studies have systematically assessed the life expectancy of people living with HIV/AIDS in middle and low-income countries, but it is predicted to be significantly lower between 60-74% of the life expectancy of the general population (see Wandeler et <em>al. </em>reference).\u00a0</p>\n\n\n\n<p>Multiple factors account for this difference, including a higher prevalence of other diseases, such as co-infections with hepatitis or tuberculosis, and a higher prevalence of opportunistic diseases. In addition, people tend to adhere to ART regimens less strictly because of poorer care for AIDS patients, less access to medical clinics, and social stigma. </p>\n\n\n\n<p>Wandeler, G., Johnson, L. F., & Egger, M. (2016). <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055447/\">Trends in life expectancy of HIV-positive adults on ART across the globe: comparisons with general population</a>. <em>Current Opinion in HIV and AIDS</em>, <em>11</em>(5), 492.</p>\n\n\n\n<p>Currently, no equivalent estimate for life expectancy is available for low and middle-income countries. However, we do know that with decreasing rates of HIV mortality in low and middle-income countries, the life expectancy of the general population has increased. Haris et al. discuss this, and you can read more about life expectancy and HIV <a href=\"https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa\">here</a>.</p>\n\n\n\n<p>Harris, T. G., Rabkin, M., & El-Sadr, W. M. (2018). Achieving the fourth 90: healthy aging for people living with HIV. <em>AIDS (London, England)</em>, <em>32</em>(12), 1563.</p>\n\n\n\n<p>Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., … & Cavassini, M. (2017). <a href=\"https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures\">Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.</a> <em>The Lancet HIV</em>, <em>4</em>(8), e349-e356.{/ref}</p>\n\n\n\n<p>While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the <a href=\"https://ourworldindata.org/life-expectancy\">life expectancy</a> of the general population, we are getting closer to this goal.{ref}Global average <a rel=\"noreferrer noopener\" href=\"https://ourworldindata.org/grapher/life-expectancy?tab=chart&time=1543..latest&country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL\" data-type=\"URL\" data-id=\"https://ourworldindata.org/grapher/life-expectancy?tab=chart&time=1543..latest&country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL\" target=\"_blank\">life expectancy</a> in 2019 was 72.6 years. The average life expectancy in Europe is 78.6 years.{/ref} </p>\n\n\n\n<p>The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.{ref}Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., … & Cavassini, M. (2017). <a href=\"https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures\">Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.</a><em>The Lancet HIV</em>, <em>4</em>(8), e349-e356.{/ref} This increase goes beyond the general increase in life expectancy in that period and reflects the improvements in ART \u2014 fewer side effects, more people following the prescribed treatment, and more support for the people in need of ART.</p>\n\n\n\n<h4>ART prevents new HIV infections</h4>\n\n\n\n<p>There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.{ref} G Williams, B., Lima, V., & Gouws, E. (2011). <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529404/\">Modelling the impact of antiretroviral therapy on the epidemic of HIV.</a> <em>Current HIV research</em>, <em>9</em>(6), 367-382.{/ref} ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases. </p>\n\n\n\n<p>In 2011, the journal <em>Science</em> named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its \u201cBreakthrough of the Year\u201d.{ref}</p>\n\n\n\n<p>Science announcement: </p>\n\n\n\n<p>Cohen, J. (2011). <a href=\"https://science.sciencemag.org/content/334/6063/1628\">HIV treatment as prevention</a>.<br></p>\n\n\n\n<p>Study that was awarded: </p>\n\n\n\n<p>Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., … & Godbole, S. V. (2011).<a href=\"https://www.nejm.org/doi/full/10.1056/Nejmoa1105243\"> Prevention of HIV-1 infection with early antiretroviral therapy.</a><em>New England journal of medicine</em>, <em>365</em>(6), 493-505.{/ref} Many other studies have now shown similar findings, with a range of reduction in transmission attributable to ART depending on location and groups studied.{ref}PARTNER study showed chances of transmission between gay couples with successfull virus suppression by ART are \u201ceffectively zero\u201d. </p>\n\n\n\n<p>Rodger, A. J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Degen, O., … & Raben, D. (2019). <a href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30418-0/fulltext\">Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.</a> <em>The Lancet</em>.</p>\n\n\n\n<p>Transmission rates in Madrid fell by 86% after ART became available</p>\n\n\n\n<p>Castilla, J., Del Romero, J., Hernando, V., Marincovich, B., Garc\u00eda, S., & Rodr\u00edguez, C. (2005). <a href=\"https://journals.lww.com/jaids/Fulltext/2005/09010/Prevalence_of_Unsafe_Sexual_Behavior_Among.16.aspx?casa_token=4RZtew6owdYAAAAA:YrqHOyO0wmGz7hSrlm0r6loCZUtsZd1wVRVQvR2U0_XPeUnJpSC9ykITGg0bsGmB1IjAinXZbUd9hslCBo-DtYCk\">Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV</a>. <em>JAIDS Journal of Acquired Immune Deficiency Syndromes</em>, <em>40</em>(1), 96-101.</p>\n\n\n\n<p>A study in San Francisco showing after ART became available, viral loads dropped to 40% and HIV infection rates fell by 60%.</p>\n\n\n\n<p> Das, M., Chu, P. L., Santos, G. M., Scheer, S., Vittinghoff, E., McFarland, W., & Colfax, G. N. (2010). <a href=\"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0011068\">Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco</a>. <em>PloS one</em>, <em>5</em>(6), e11068.</p>\n\n\n\n<p>After ART became freely available in Taiwan transmission rates fell by 50%. Fang, C. T., Hsu, H. M., Twu, S. J., Chen, M. Y., Chang, Y. Y., Hwang, J. S., … & Division of AIDS and STD, Center for Disease Control, Department of Health, Executive Yuan. (2004). <a href=\"https://academic.oup.com/jid/article-abstract/190/5/879/868453\">Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.</a><em>Journal of Infectious Diseases</em>, <em>190</em>(5), 879-885.{/ref} A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.{ref} Hogg, R. S., Heath, K., Lima, V. D., Nosyk, B., Kanters, S., Wood, E., … & Montaner, J. S. (2012). <a href=\"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047260\">Disparities in the burden of HIV/AIDS in Canada</a>. <em>PLoS One</em>, <em>7</em>(11), e47260.{/ref}</p>\n\n\n\n<h4>We need to increase ART coverage</h4>\n\n\n\n<p>The number of people who receive ART has increased significantly in recent years, especially in African countries where the prevalence of HIV/AIDS is the highest.</p>\n\n\n\n<p>But many millions of people who could benefit from the life-saving treatment currently don\u2019t.\u00a0</p>\n\n\n\n<p>To increase ART coverage, we must first improve access to testing for HIV status. In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.{ref}The 79% figure is based on <a href=\"https://www.unaids.org/en/resources/fact-sheet\">2019 UNAIDS estimates</a>.</p>\n\n\n\n<p>The frequency of undiagnosed HIV/AIDS can be measured using observational studies. Measures of the expected rate of HIV infection, the actual number of people diagnosed with HIV, and delay in diagnosis are taken into account to predict the true expected prevalence of HIV in a population and the proportion of undiagnosed cases (see Singh et <em>al.</em> reference). </p>\n\n\n\n<p>The initial HIV infection is often followed by flu-like symptoms, which subside in a few weeks. The infected patient can then live without symptoms for months or years while their immune system may be slowly deteriorating. Hence, people infected with HIV may not even know they need to be tested due to the lack of symptoms. Models used to predict HIV incidence rate often use an expected 5-year lag between infection and diagnosis. </p>\n\n\n\n<p>Singh, S., Song, R., Johnson, A. S., McCray, E., & Hall, H. I. (2018). <a href=\"https://annals.org/aim/fullarticle/2675979/hiv-incidence-prevalence-undiagnosed-infections-u-s-men-who-have\">HIV incidence, prevalence, and undiagnosed infections in US men who have sex with men.</a> <em>Annals of internal medicine</em>, <em>168</em>(10), 685-694.{/ref} And awareness is also not enough. In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.{ref}</p>\n\n\n\n<p>WHO eligibility criteria are based on CD4 counts, which go down as the illness progresses. A healthy person\u2019s CD4 counts are >500/mm3. WHO recommends ART for anyone with HIV diagnosis and CD4 count >350 cells and \u2264500/mm3, regardless of clinical symptoms. All children, people with TB, HBV, and pregnant women diagnosed with HIV regardless of their CD4 status, should get ART. <a href=\"https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/\">https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/</a></p>\n\n\n\n<p>Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). <a href=\"https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383\">Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub\u2010Saharan Africa: a systematic review.</a> <em>Journal of the International AIDS Society</em>, <em>15</em>(2), 17383.{/ref} Of those who should start ART, only 66% did.{ref}For some countries, eligibility for ART treatment is determined by the so-called CD4+ counts, which go down as the illness progresses.\u00a0</p>\n\n\n\n<p> Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). <a href=\"https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383\">Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub\u2010Saharan Africa: a systematic review.</a> <em>Journal of the International AIDS Society</em>, <em>15</em>(2), 17383.{/ref} </p>\n\n\n\n<p>Stigmatization of people who have HIV/AIDS also leads to a decrease in engagement with care, treatment, and prevention services.{ref}Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates, T. J. (2008). <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/\">Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. </a><em>AIDS (London, England)</em>, <em>22</em>(Suppl 2), S67.{/ref}</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/antiretroviral-therapy-coverage-among-people-living-with-hiv\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h3>Prevention of mother-to-child transmission (PMTCT)</h3>\n\n\n\n<p>Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV. </p>\n\n\n\n<p>The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.{ref}World Health Organization (WHO)<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https://www.who.int/hiv/topics/mtct/about/en/\" target=\"_blank\"> ‘Mother-to-child transmission of HIV’ </a>[accessed November 2019]{/ref}</p>\n\n\n\n<p>PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection. </p>\n\n\n\n<p>The visualization shows the number of child infections averted from ART coverage in mothers.</p>\n\n\n\n<p>You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world <a href=\"https://ourworldindata.org/grapher/new-hiv-infections-averted-due-to-pmtct\">here</a>.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/number-of-new-hiv-child-infections-vs-number-of-infections-averted-due-to-pmtct\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>Coverage of ART in pregnant women</h4>\n\n\n\n<p>This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy \u2013 a vital intervention to prevent the transmission from mother to child.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/art-coverage-for-pregnant-women\"></iframe></figure>\n\n\n\n<h3>Safe sex</h3>\n\n\n\n<h4>Unsafe sex is a leading risk factor for death in Sub-Saharan Africa</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor?country=~Sub-Saharan+Africa+%28WB%29\" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe></figure>\n\n\n\n<h4>Share of people practicing safe sex</h4>\n\n\n\n<p>The majority of HIV infections are transmitted through sexual activity.<br> <br>Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of ‘high-risk sex’, which is that with a non-marital, non-cohabiting sexual partner.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/condom-use-at-last-high-risk-sex\"></iframe></figure>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/condom-use-during-last-high-risk-sex\"></iframe></figure>\n\n\n\n<h3>Education on HIV/AIDS</h3>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/young-people-with-knowledge-on-hiv-prevention\"></iframe></figure>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/knowledge-hiv-prevention-in-males-vs-females\"></iframe></figure>\n\n\n\n<h3>Funding to support efforts against HIV/AIDS</h3>\n\n\n\n<p>You can explore the breakdown of funding resources by source for each country <a href=\"https://ourworldindata.org/grapher/hivaids-funding-by-source\">here</a>.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/hiv-expenditure\"></iframe></figure>\n\n\n\n<h4>Future funding needs to meet HIV targets</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/resource-needs-to-meet-hiv-targets\"></iframe></figure>\n\n\n\n<hr class=\"wp-block-separator\"/>\n\n\n\n<h2>Data quality and definition</h2>\n\n\n\n<h3>Terminology and definitions</h3>\n\n\n\n<p>The following terminology and definitions are sourced from the UNAIDS organization.{ref}UNAIDS (2015). Terminology guidelines. Available <a href=\"http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf\">online</a>.{/ref}</p>\n\n\n\n<p><strong>HIV</strong>: Human Immunodeficiency Virus. HIV is a virus that weakens the immune system, ultimately leading to AIDS.</p>\n\n\n\n<p><strong>AIDS</strong>: acquired immunodeficiency syndrome.</p>\n\n\n\n<p><strong>Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment</strong>: “Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations.</p>\n\n\n\n<p>More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term “highly active” antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. “Highly active” is not needed as a qualification, and the term is no longer commonly used.</p>\n\n\n\n<p>ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use.”</p>\n\n\n\n<p><strong>ARV-based prevention</strong>: “ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention).”</p>\n\n\n\n<p><strong>Epidemic</strong>: “An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic.”</p>\n\n\n\n<p><strong>HIV-negative (seronegative)</strong>: “A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative.”</p>\n\n\n\n<p><strong>HIV-positive (seropositive)</strong>: “A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies.”</p>\n\n\n\n<p><strong>Incidence</strong>: “HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15\u201349 years and 0\u201314 years.”</p>\n\n\n\n<p><strong>Mother-to-child transmission (MTCT)</strong>: “MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4).</p>\n\n\n\n<p>PMTCT is often mistakenly referring to only prong 3\u2014 the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT).”</p>\n\n\n\n<p><strong>Prevalence</strong>: “Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15\u201349 years.”</p>\n\n\n\n<p><strong>Tuberculosis (TB)</strong>: “Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se.</p>\n\n\n\n<p>The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria.”</p>\n\n\n\n<h3>Comparisons of UNAIDS and IHME estimates</h3>\n\n\n\n<p>Several sources publish estimates on HIV and AIDS – two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources’ relationship/consistency in prevalence estimates.</p>\n\n\n\n<h4>Prevalence of HIV</h4>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/prevalence-of-hiv-unaids-vs-ihme-estimates\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h4>Incidence/new cases of HIV</h4>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/new-cases-of-hiv-unaids-vs-ihme\" width=\"300\" height=\"150\"></iframe>\n", "protected": false }, "excerpt": { "rendered": "A global epidemic and the leading cause of death in some countries.", "protected": false }, "date_gmt": "2018-04-03T22:07:27", "modified": "2023-08-31T16:57:37", "template": "", "categories": [ 44, 46, 171 ], "menu_order": 174, "ping_status": "closed", "authors_name": [ "Max Roser", "Hannah Ritchie" ], "modified_gmt": "2023-08-31T15:57:37", "comment_status": "open", "featured_media": 39993, "featured_media_paths": { "thumbnail": "/app/uploads/2021/02/Screen-Shot-2021-02-05-at-10.05.57-150x81.png", "medium_large": "/app/uploads/2021/02/Screen-Shot-2021-02-05-at-10.05.57-768x412.png" } }

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HIV / AIDS

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<div class="blog-info">This article was first published in November 2014; last revised in August 2023.</div>   <p>Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in a heightened risk of life-threatening infection and <a href="https://owid.cloud/cancer">cancers</a>.</p>   <p>In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from mother to child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur by sharing injection equipment such as needles.</p>    <ul><li><a href="#almost-1-million-people-die-from-hiv-aids-each-year-in-some-countries-it-s-the-leading-cause-of-death">Almost one million die from HIV/AIDS each year – in some countries it's the leading cause of death.</a></li><li><a href="https://ourworldindata.org/hiv-aids#in-some-countries-hiv-aids-is-the-cause-of-more-than-1-in-4-deaths">In some countries, HIV/AIDS is the cause of one quarter of deaths.</a></li><li><a href="https://ourworldindata.org/hiv-aids#death-rates-are-high-across-sub-saharan-africa">Death rates are highest across Sub-Saharan Africa.</a></li><li><a href="https://ourworldindata.org/hiv-aids#death-rates-are-highest-for-younger-adults-and-children-under-five-years-old">Death rates are highest for younger adults, and for children (when HIV is transmitted from a mother).</a></li><li><a href="https://ourworldindata.org/hiv-aids#global-deaths-from-hiv-aids-halved-within-a-decade">The world is making progress: over the past decade the number of global deaths has halved.</a></li><li><a href="https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa">The HIV epidemic had a major impact on life expectancy across Sub-Saharan Africa, and life expectancy is only now back to pre-epidemic levels.</a></li><li><a href="https://ourworldindata.org/hiv-aids#anti-retroviral-treatment-art">Antiretroviral treatment (ART) has been key to preventing deaths from AIDS. It is estimated that it now averts 1.2 million deaths per year – without it, global deaths would be more than twice as high.</a></li><li><a href="https://ourworldindata.org/hiv-aids#funding-to-support-efforts-against-hiv-aids">Funding for HIV treatment and prevention needs to increase if the world is to meet its 2030 targets.</a></li></ul>    <h2>HIV/AIDS is one of the world's most fatal infectious disease</h2>   <h4>Almost 1 million people die from HIV/AIDS each year; in some countries, it's the leading cause of death</h4>   <p>HIV/AIDS is one of the world's most fatal infectious diseases – particularly across Sub-Saharan Africa, where the disease has had a massive impact on health outcomes and life expectancy in recent decades.</p>   <p>The <em>Global Burden of Disease</em> is a major global study on the causes of death and disease published in the medical journal <em>The Lancet</em>.{ref}The latest study can be found at the website of the Lancet here: <a href="https://www.thelancet.com/gbd">TheLancet.com/GBD</a></p>   <p>The 2017 study was published in the following publication: "Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., ... & Abdollahpour, I. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. <em>The Lancet</em>, 392(10159), 1736-1788", and is online <a href="http://www.healthdata.org/research-article/global-regional-and-national-age-sex-specific-mortality-282-causes-death-195">here</a>.{/ref} These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the "change country" toggle.</p>   <p>According to the <em>Global Burden of Disease</em> study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from <a href="https://owid.cloud/malaria">malaria</a>.</p>   <p>It's <em>one of</em> the largest killers globally, but for some countries – particularly across Sub-Saharan Africa, it's the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique – which you can do on the interactive chart – we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of <a href="https://owid.cloud/cancer">cancer</a> deaths.</p>   <iframe src="https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h2>The global distribution of deaths from HIV/AIDS</h2>   <h4>In some countries, HIV/AIDS is the cause of a quarter of all deaths</h4>   <p>Globally, around 1.5% of deaths are caused by HIV/AIDS.</p>   <p>This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher.<br> <br>In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.</p>   <p>But the share is very high across some countries – focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana.</p>   <figure><iframe src="https://ourworldindata.org/grapher/share-deaths-aids"></iframe></figure>   <h4>Death rates are high across Sub-Saharan Africa</h4>   <p>The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.</p>   <p>In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 – often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000.</p>   <p>Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. </p>   <figure><iframe src="https://ourworldindata.org/grapher/hiv-death-rates"></iframe></figure>   <h4>Death rates are highest for younger adults and children under five years old</h4>   <p>Which population groups are most at risk from HIV/AIDS?<br><br>In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds – typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect.</p>   <p>But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected. </p>   <figure><iframe src="https://ourworldindata.org/grapher/hiv-death-rates-by-age"></iframe></figure>   <h2>Is the world making progress in its fight against HIV/AIDS?</h2>   <h4>How have cases and deaths changed over time?</h4>    <p>The 1990s saw a substantial increase in people infected with HIV and dying of AIDS. </p>   <p>In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it's now below 2 million, the lowest number of new infections since 1990.</p>   <p>As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS.</p>   <p>The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever.</p>   <iframe src="https://ourworldindata.org/grapher/deaths-and-new-cases-of-hiv" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h4>Global deaths from HIV/AIDS halved within a decade</h4>   <p>The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade.</p>   <p>In the visualization, we see the global number of deaths from HIV/AIDS in recent decades – this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year. </p>   <p>Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then.</p>   <p>You can explore this change for any country or region using the "change country" toggle on the interactive chart.</p>   <figure><iframe src="https://ourworldindata.org/grapher/deaths-from-hiv-by-age"></iframe></figure>   <h4>HIV/AIDS once accounted for a large share of deaths in some countries, but rates are now falling</h4>   <p>Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic.</p>   <p>Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher.<br><br>In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe.</p>   <p>Over the past decade, this share has fallen as antiretroviral treatment has become more widely available.</p>   <figure><iframe src="https://ourworldindata.org/grapher/share-deaths-aids?tab=chart&country=ZAF+ZWE+NAM+OWID_WRL+Sub-Saharan%20Africa+MOZ+ZMB"></iframe></figure>   <h4>HIV/AIDS has had a significant impact on life expectancy across Sub-Saharan Africa</h4>   <p>The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in <a href="https://owid.cloud/life-expectancy">life expectancy</a>. In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll. </p>   <p>We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s — as progress has been made in tackling HIV — we see that life expectancy has been rising again.</p>   <p>In some countries, life expectancy is now higher than before the epidemic began.</p>   <figure><iframe src="https://ourworldindata.org/grapher/life-expectancy?country=BWA+NAM+ZAF+SWZ+TZA+ZMB"></iframe></figure>   <h2>The prevalence of HIV/AIDS</h2>   <h3>Prevalence in the total population</h3>   <h4>Share of the population with HIV</h4>   <p>You can explore the total number of people living with HIV/AIDS worldwide <a href="https://ourworldindata.org/grapher/number-of-people-living-with-hiv">here</a>.</p>   <iframe src="https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h4>Number of new infections each year</h4>   <iframe src="https://ourworldindata.org/grapher/new-cases-of-hiv-infection" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h3>Prevalence by gender</h3>   <h4>Is HIV/AIDS more common in men or women?</h4>   <p>There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV.</p>   <p>As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex{ref}Greig, A., Peacock, D., Jewkes, R., & Msimang, S. (2008). Gender and AIDS: time to act. <em>AIDS (London, England)</em>, <em>22</em>(Suppl 2), S35. Available <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356155/">online</a>.{/ref}.</p>   <figure><iframe src="https://ourworldindata.org/grapher/share-of-women-among-the-population-living-with-hiv"></iframe></figure>   <h3>Prevalence in children</h3>   <h4>Share of children infected with HIV</h4>   <figure><iframe src="https://ourworldindata.org/grapher/share-of-children-under-five-years-old-with-hiv"></iframe></figure>   <h4>Children living with HIV</h4>    <p>In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/children-living-with-hiv" width="300" height="150"></iframe>   <h4>New HIV infections of children</h4>    <p>The map shows the total number of children newly infected with HIV yearly. Globally — with similar trends at national levels — the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/number-of-children-newly-infected-with-hiv" width="300" height="150"></iframe>   <h4>Orphaned children from AIDS</h4>    <p>Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/number-of-children-orphaned-from-aids" width="300" height="150"></iframe>   <h2>Tuberculosis among people living with HIV</h2>    <p>Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.</p>   <p>The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV.</p>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/tb-patients-tested-positive-for-hiv" width="300" height="150"></iframe>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/tb-patients-living-with-hiv-receiving-art" width="300" height="150"></iframe>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/tb-related-deaths-hiv" width="300" height="150"></iframe>   <h2>What can be done to prevent HIV/AIDS?</h2>   <h3>Anti-retroviral treatment (ART)</h3>   <p>A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives. </p>   <p>ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections. </p>    <h4>Millions of lives are saved by ART</h4>   <p>Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives.</p>   <p>The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART. </p>   <p>Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths – 1.2 million – were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS. </p>   <iframe src="https://ourworldindata.org/grapher/hivaids-deaths-and-averted-due-to-art" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h4>People who use ART are living longer</h4>   <p>ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.{ref}We should note, though, that the life expectancy for people living with HIV infection without ART can vary depending on the age when a person got infected with HIV, a person's immune status (e.g., CD4 count), and socioeconomic factors. </p>   <p>Babiker, A., Darby, S., De Angelis, D., Kwart, D., Porter, K., Beral, V., ... & Prins, M. (2000). <a href="https://www.sciencedirect.com/science/article/pii/S0140673600020614#tbl1">Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action.</a> Concerted Action on SeroConversion to AIDS and Death in Europe. <em>Lancet</em>, <em>355</em>(9210).</p>   <p>Wandel, S., Egger, M., Rangsin, R., Nelson, K. E., Costello, C., Lewden, C., ... & Minga, A. (2008). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418/">Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies</a>. <em>Sexually transmitted infections</em>, <em>84</em>(Suppl_1), i31-i36.{/ref} </p>   <p>According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years — well into their 60s.{ref}This number is based on a study that used European and North American countries. Few studies have systematically assessed the life expectancy of people living with HIV/AIDS in middle and low-income countries, but it is predicted to be significantly lower between 60-74% of the life expectancy of the general population (see Wandeler et <em>al. </em>reference). </p>   <p>Multiple factors account for this difference, including a higher prevalence of other diseases, such as co-infections with hepatitis or tuberculosis, and a higher prevalence of opportunistic diseases. In addition, people tend to adhere to ART regimens less strictly because of poorer care for AIDS patients, less access to medical clinics, and social stigma. </p>   <p>Wandeler, G., Johnson, L. F., & Egger, M. (2016). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055447/">Trends in life expectancy of HIV-positive adults on ART across the globe: comparisons with general population</a>. <em>Current Opinion in HIV and AIDS</em>, <em>11</em>(5), 492.</p>   <p>Currently, no equivalent estimate for life expectancy is available for low and middle-income countries. However, we do know that with decreasing rates of HIV mortality in low and middle-income countries, the life expectancy of the general population has increased. Haris et al. discuss this, and you can read more about life expectancy and HIV <a href="https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa">here</a>.</p>   <p>Harris, T. G., Rabkin, M., & El-Sadr, W. M. (2018). Achieving the fourth 90: healthy aging for people living with HIV. <em>AIDS (London, England)</em>, <em>32</em>(12), 1563.</p>   <p>Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). <a href="https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures">Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.</a> <em>The Lancet HIV</em>, <em>4</em>(8), e349-e356.{/ref}</p>   <p>While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the <a href="https://ourworldindata.org/life-expectancy">life expectancy</a> of the general population, we are getting closer to this goal.{ref}Global average <a rel="noreferrer noopener" href="https://ourworldindata.org/grapher/life-expectancy?tab=chart&time=1543..latest&country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL" data-type="URL" data-id="https://ourworldindata.org/grapher/life-expectancy?tab=chart&time=1543..latest&country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL" target="_blank">life expectancy</a> in 2019 was 72.6 years. The average life expectancy in Europe is 78.6 years.{/ref} </p>   <p>The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.{ref}Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). <a href="https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures">Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.</a><em>The Lancet HIV</em>, <em>4</em>(8), e349-e356.{/ref} This increase goes beyond the general increase in life expectancy in that period and reflects the improvements in ART — fewer side effects, more people following the prescribed treatment, and more support for the people in need of ART.</p>   <h4>ART prevents new HIV infections</h4>   <p>There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.{ref} G Williams, B., Lima, V., & Gouws, E. (2011). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529404/">Modelling the impact of antiretroviral therapy on the epidemic of HIV.</a> <em>Current HIV research</em>, <em>9</em>(6), 367-382.{/ref} ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases. </p>   <p>In 2011, the journal <em>Science</em> named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its “Breakthrough of the Year”.{ref}</p>   <p>Science announcement: </p>   <p>Cohen, J. (2011). <a href="https://science.sciencemag.org/content/334/6063/1628">HIV treatment as prevention</a>.<br></p>   <p>Study that was awarded: </p>   <p>Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., ... & Godbole, S. V. (2011).<a href="https://www.nejm.org/doi/full/10.1056/Nejmoa1105243"> Prevention of HIV-1 infection with early antiretroviral therapy.</a><em>New England journal of medicine</em>, <em>365</em>(6), 493-505.{/ref} Many other studies have now shown similar findings, with a range of reduction in transmission attributable to ART depending on location and groups studied.{ref}PARTNER study showed chances of transmission between gay couples with successfull virus suppression by ART are “effectively zero”. </p>   <p>Rodger, A. J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Degen, O., ... & Raben, D. (2019). <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30418-0/fulltext">Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.</a> <em>The Lancet</em>.</p>   <p>Transmission rates in Madrid fell by 86% after ART became available</p>   <p>Castilla, J., Del Romero, J., Hernando, V., Marincovich, B., García, S., & Rodríguez, C. (2005). <a href="https://journals.lww.com/jaids/Fulltext/2005/09010/Prevalence_of_Unsafe_Sexual_Behavior_Among.16.aspx?casa_token=4RZtew6owdYAAAAA:YrqHOyO0wmGz7hSrlm0r6loCZUtsZd1wVRVQvR2U0_XPeUnJpSC9ykITGg0bsGmB1IjAinXZbUd9hslCBo-DtYCk">Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV</a>. <em>JAIDS Journal of Acquired Immune Deficiency Syndromes</em>, <em>40</em>(1), 96-101.</p>   <p>A study in San Francisco showing after ART became available, viral loads dropped to 40% and HIV infection rates fell by 60%.</p>   <p> Das, M., Chu, P. L., Santos, G. M., Scheer, S., Vittinghoff, E., McFarland, W., & Colfax, G. N. (2010). <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0011068">Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco</a>. <em>PloS one</em>, <em>5</em>(6), e11068.</p>   <p>After ART became freely available in Taiwan transmission rates fell by 50%. Fang, C. T., Hsu, H. M., Twu, S. J., Chen, M. Y., Chang, Y. Y., Hwang, J. S., ... & Division of AIDS and STD, Center for Disease Control, Department of Health, Executive Yuan. (2004). <a href="https://academic.oup.com/jid/article-abstract/190/5/879/868453">Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.</a><em>Journal of Infectious Diseases</em>, <em>190</em>(5), 879-885.{/ref} A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.{ref} Hogg, R. S., Heath, K., Lima, V. D., Nosyk, B., Kanters, S., Wood, E., ... & Montaner, J. S. (2012). <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047260">Disparities in the burden of HIV/AIDS in Canada</a>. <em>PLoS One</em>, <em>7</em>(11), e47260.{/ref}</p>   <h4>We need to increase ART coverage</h4>   <p>The number of people who receive ART has increased significantly in recent years, especially in African countries where the prevalence of HIV/AIDS is the highest.</p>   <p>But many millions of people who could benefit from the life-saving treatment currently don’t. </p>   <p>To increase ART coverage, we must first improve access to testing for HIV status. In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.{ref}The 79% figure is based on <a href="https://www.unaids.org/en/resources/fact-sheet">2019 UNAIDS estimates</a>.</p>   <p>The frequency of undiagnosed HIV/AIDS can be measured using observational studies. Measures of the expected rate of HIV infection, the actual number of people diagnosed with HIV, and delay in diagnosis are taken into account to predict the true expected prevalence of HIV in a population and the proportion of undiagnosed cases (see Singh et <em>al.</em> reference). </p>   <p>The initial HIV infection is often followed by flu-like symptoms, which subside in a few weeks. The infected patient can then live without symptoms for months or years while their immune system may be slowly deteriorating. Hence, people infected with HIV may not even know they need to be tested due to the lack of symptoms. Models used to predict HIV incidence rate often use an expected 5-year lag between infection and diagnosis. </p>   <p>Singh, S., Song, R., Johnson, A. S., McCray, E., & Hall, H. I. (2018). <a href="https://annals.org/aim/fullarticle/2675979/hiv-incidence-prevalence-undiagnosed-infections-u-s-men-who-have">HIV incidence, prevalence, and undiagnosed infections in US men who have sex with men.</a> <em>Annals of internal medicine</em>, <em>168</em>(10), 685-694.{/ref} And awareness is also not enough. In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.{ref}</p>   <p>WHO eligibility criteria are based on CD4 counts, which go down as the illness progresses. A healthy person’s CD4 counts are >500/mm3. WHO recommends ART for anyone with HIV diagnosis and CD4 count >350 cells and ≤500/mm3, regardless of clinical symptoms. All children, people with TB, HBV, and pregnant women diagnosed with HIV regardless of their CD4 status, should get ART. <a href="https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/">https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/</a></p>   <p>Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). <a href="https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383">Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub‐Saharan Africa: a systematic review.</a> <em>Journal of the International AIDS Society</em>, <em>15</em>(2), 17383.{/ref} Of those who should start ART, only 66% did.{ref}For some countries, eligibility for ART treatment is determined by the so-called CD4+ counts, which go down as the illness progresses. </p>   <p> Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). <a href="https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383">Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub‐Saharan Africa: a systematic review.</a> <em>Journal of the International AIDS Society</em>, <em>15</em>(2), 17383.{/ref} </p>   <p>Stigmatization of people who have HIV/AIDS also leads to a decrease in engagement with care, treatment, and prevention services.{ref}Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates, T. J. (2008). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/">Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. </a><em>AIDS (London, England)</em>, <em>22</em>(Suppl 2), S67.{/ref}</p>   <iframe src="https://ourworldindata.org/grapher/antiretroviral-therapy-coverage-among-people-living-with-hiv" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h3>Prevention of mother-to-child transmission (PMTCT)</h3>    <p>Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV. </p>   <p>The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.{ref}World Health Organization (WHO)<a rel="noreferrer noopener" aria-label=" (opens in a new tab)" href="https://www.who.int/hiv/topics/mtct/about/en/" target="_blank"> 'Mother-to-child transmission of HIV' </a>[accessed November 2019]{/ref}</p>   <p>PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection. </p>   <p>The visualization shows the number of child infections averted from ART coverage in mothers.</p>   <p>You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world <a href="https://ourworldindata.org/grapher/new-hiv-infections-averted-due-to-pmtct">here</a>.</p>   <iframe src="https://ourworldindata.org/grapher/number-of-new-hiv-child-infections-vs-number-of-infections-averted-due-to-pmtct" style="width: 100%; height: 600px; border: 0px none;"></iframe>   <h4>Coverage of ART in pregnant women</h4>   <p>This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy – a vital intervention to prevent the transmission from mother to child.</p>   <figure><iframe src="https://ourworldindata.org/grapher/art-coverage-for-pregnant-women"></iframe></figure>   <h3>Safe sex</h3>   <h4>Unsafe sex is a leading risk factor for death in Sub-Saharan Africa</h4>   <figure><iframe src="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor?country=~Sub-Saharan+Africa+%28WB%29" loading="lazy" style="width: 100%; height: 600px; border: 0px none;"></iframe></figure>   <h4>Share of people practicing safe sex</h4>   <p>The majority of HIV infections are transmitted through sexual activity.<br> <br>Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of 'high-risk sex', which is that with a non-marital, non-cohabiting sexual partner.</p>   <figure><iframe src="https://ourworldindata.org/grapher/condom-use-at-last-high-risk-sex"></iframe></figure>   <figure><iframe src="https://ourworldindata.org/grapher/condom-use-during-last-high-risk-sex"></iframe></figure>   <h3>Education on HIV/AIDS</h3>   <figure><iframe src="https://ourworldindata.org/grapher/young-people-with-knowledge-on-hiv-prevention"></iframe></figure>   <figure><iframe src="https://ourworldindata.org/grapher/knowledge-hiv-prevention-in-males-vs-females"></iframe></figure>   <h3>Funding to support efforts against HIV/AIDS</h3>   <p>You can explore the breakdown of funding resources by source for each country <a href="https://ourworldindata.org/grapher/hivaids-funding-by-source">here</a>.</p>   <figure><iframe src="https://ourworldindata.org/grapher/hiv-expenditure"></iframe></figure>   <h4>Future funding needs to meet HIV targets</h4>   <figure><iframe src="https://ourworldindata.org/grapher/resource-needs-to-meet-hiv-targets"></iframe></figure>   <hr class="wp-block-separator"/>   <h2>Data quality and definition</h2>   <h3>Terminology and definitions</h3>   <p>The following terminology and definitions are sourced from the UNAIDS organization.{ref}UNAIDS (2015). Terminology guidelines. Available <a href="http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf">online</a>.{/ref}</p>   <p><strong>HIV</strong>: Human Immunodeficiency Virus. HIV is a virus that weakens the immune system, ultimately leading to AIDS.</p>   <p><strong>AIDS</strong>: acquired immunodeficiency syndrome.</p>   <p><strong>Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment</strong>: "Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations.</p>   <p>More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term "highly active" antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. "Highly active" is not needed as a qualification, and the term is no longer commonly used.</p>   <p>ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use."</p>   <p><strong>ARV-based prevention</strong>: "ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention)."</p>   <p><strong>Epidemic</strong>: "An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic."</p>   <p><strong>HIV-negative (seronegative)</strong>: "A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative."</p>   <p><strong>HIV-positive (seropositive)</strong>: "A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies."</p>   <p><strong>Incidence</strong>: "HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15–49 years and 0–14 years."</p>   <p><strong>Mother-to-child transmission (MTCT)</strong>: "MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4).</p>   <p>PMTCT is often mistakenly referring to only prong 3— the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT)."</p>   <p><strong>Prevalence</strong>: "Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15–49 years."</p>   <p><strong>Tuberculosis (TB)</strong>: "Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se.</p>   <p>The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria."</p>   <h3>Comparisons of UNAIDS and IHME estimates</h3>   <p>Several sources publish estimates on HIV and AIDS - two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources' relationship/consistency in prevalence estimates.</p>   <h4>Prevalence of HIV</h4>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/prevalence-of-hiv-unaids-vs-ihme-estimates" width="300" height="150"></iframe>   <h4>Incidence/new cases of HIV</h4>   <iframe style="width: 100%; height: 600px; border: 0px none;" src="https://ourworldindata.org/grapher/new-cases-of-hiv-unaids-vs-ihme" width="300" height="150"></iframe>

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                        "text": "Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in a heightened risk of life-threatening infection and ",
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                        "text": "In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from mother to child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur by sharing injection equipment such as needles.",
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                        "text": "Almost one million die from HIV/AIDS each year \u2013 in some countries it's the leading cause of death."
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                        "text": "Death rates are highest for younger adults, and for children (when HIV is transmitted from a mother)."
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                        "text": "The world is making progress: over the past decade the number of global deaths has halved."
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                        "text": "Antiretroviral treatment (ART) has been key to preventing deaths from AIDS. It is estimated that it now averts 1.2 million deaths per year \u2013 without it, global deaths would be more than twice as high."
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                        "text": "Funding for HIV treatment and prevention needs to increase if the world is to meet its 2030 targets."
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                        "text": ".{ref}The latest study can be found at the website of the Lancet here: ",
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                        "text": "The 2017 study was published in the following publication: \"Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., ... & Abdollahpour, I. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. ",
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                        "text": ".{/ref} These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the \"change country\" toggle.",
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                        "text": " study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from ",
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                        "text": " the largest killers globally, but for some countries \u2013 particularly across Sub-Saharan Africa, it's the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique \u2013 which you can do on the interactive chart \u2013 we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of ",
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                        "text": "The global distribution of deaths from HIV/AIDS",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 1,
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "In some countries, HIV/AIDS is the cause of a quarter of all deaths",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Globally, around 1.5% of deaths are caused by HIV/AIDS.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher.",
                        "spanType": "span-simple-text"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "But the share is very high across some countries \u2013 focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/share-deaths-aids",
                "type": "chart",
                "parseErrors": []
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            {
                "text": [
                    {
                        "text": "Death rates are high across Sub-Saharan Africa",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 \u2013 often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000.",
                        "spanType": "span-simple-text"
                    }
                ],
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            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. ",
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                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/hiv-death-rates",
                "type": "chart",
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            {
                "text": [
                    {
                        "text": "Death rates are highest for younger adults and children under five years old",
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                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Which population groups are most at risk from HIV/AIDS?",
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                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds \u2013 typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect.",
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                ],
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            {
                "type": "text",
                "value": [
                    {
                        "text": "But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected. ",
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                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/hiv-death-rates-by-age",
                "type": "chart",
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Is the world making progress in its fight against HIV/AIDS?",
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                    }
                ],
                "type": "heading",
                "level": 1,
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "How have cases and deaths changed over time?",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "The 1990s saw a substantial increase in people infected with HIV and dying of AIDS. ",
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                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it's now below 2 million, the lowest number of new infections since 1990.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS.",
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                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/deaths-and-new-cases-of-hiv",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Global deaths from HIV/AIDS halved within a decade",
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                    }
                ],
                "type": "heading",
                "level": 3,
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            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "In the visualization, we see the global number of deaths from HIV/AIDS in recent decades \u2013 this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year. ",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then.",
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                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "You can explore this change for any country or region using the \"change country\" toggle on the interactive chart.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/deaths-from-hiv-by-age",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "HIV/AIDS once accounted for a large share of deaths in some countries, but rates are now falling",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
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            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic.",
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                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher.",
                        "spanType": "span-simple-text"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "spanType": "span-newline"
                    },
                    {
                        "text": "In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe.",
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                    }
                ],
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            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Over the past decade, this share has fallen as antiretroviral treatment has become more widely available.",
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                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/share-deaths-aids?tab=chart&country=ZAF+ZWE+NAM+OWID_WRL+Sub-Saharan%20Africa+MOZ+ZMB",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "HIV/AIDS has had a significant impact on life expectancy across Sub-Saharan Africa",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://owid.cloud/life-expectancy",
                        "children": [
                            {
                                "text": "life expectancy",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ". In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll. ",
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                    }
                ],
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            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s \u2014 as progress has been made in tackling HIV \u2014 we see that life expectancy has been rising again.",
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                ],
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            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "In some countries, life expectancy is now higher than before the epidemic began.",
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                    }
                ],
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            },
            {
                "url": "https://ourworldindata.org/grapher/life-expectancy?country=BWA+NAM+ZAF+SWZ+TZA+ZMB",
                "type": "chart",
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "The prevalence of HIV/AIDS",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 1,
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Prevalence in the total population",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 2,
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Share of the population with HIV",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "You can explore the total number of people living with HIV/AIDS worldwide ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/number-of-people-living-with-hiv",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Number of new infections each year",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/new-cases-of-hiv-infection",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Prevalence by gender",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 2,
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Is HIV/AIDS more common in men or women?",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex{ref}Greig, A., Peacock, D., Jewkes, R., & Msimang, S. (2008). Gender and AIDS: time to act.\u00a0",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "AIDS (London, England)",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
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                    {
                        "text": ",\u00a0",
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                        "children": [
                            {
                                "text": "22",
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                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": "(Suppl 2), S35. Available ",
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                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356155/",
                        "children": [
                            {
                                "text": "online",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".{/ref}.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/share-of-women-among-the-population-living-with-hiv",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Prevalence in children",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 2,
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Share of children infected with HIV",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/share-of-children-under-five-years-old-with-hiv",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Children living with HIV",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/children-living-with-hiv",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "New HIV infections of children",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "The map shows the total number of children newly infected with HIV yearly. Globally\u00a0\u2014 with similar trends at national levels\u00a0\u2014 the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/number-of-children-newly-infected-with-hiv",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Orphaned children from AIDS",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/number-of-children-orphaned-from-aids",
                "type": "chart",
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Tuberculosis among people living with HIV",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 1,
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/tb-patients-tested-positive-for-hiv",
                "type": "chart",
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/tb-patients-living-with-hiv-receiving-art",
                "type": "chart",
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/tb-related-deaths-hiv",
                "type": "chart",
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "What can be done to prevent HIV/AIDS?",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 1,
                "parseErrors": []
            },
            {
                "type": "horizontal-rule",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Anti-retroviral treatment (ART)",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 2,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives.\u00a0",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections.\u00a0",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "Millions of lives are saved by ART",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives.",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART.\u00a0",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths \u2013 1.2 million \u2013 were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS.\u00a0",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/hivaids-deaths-and-averted-due-to-art",
                "type": "chart",
                "parseErrors": []
            },
            {
                "text": [
                    {
                        "text": "People who use ART are living longer",
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                        "text": "ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.{ref}We should note, though, that the life expectancy for people living with HIV infection without ART can vary depending on the age when a person got infected with HIV, a person's immune status (e.g., CD4 count), and socioeconomic factors.\u00a0",
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                        "text": "Babiker, A., Darby, S., De Angelis, D., Kwart, D., Porter, K., Beral, V., ... & Prins, M. (2000). ",
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                    },
                    {
                        "url": "https://www.sciencedirect.com/science/article/pii/S0140673600020614#tbl1",
                        "children": [
                            {
                                "text": "Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": " Concerted Action on SeroConversion to AIDS and Death in Europe. ",
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                        "children": [
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                                "text": "Lancet",
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                        "text": ", ",
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                        "children": [
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                                "text": "355",
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                        "text": "(9210).",
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                        "text": "Wandel, S., Egger, M., Rangsin, R., Nelson, K. E., Costello, C., Lewden, C., ... & Minga, A. (2008). ",
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                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418/",
                        "children": [
                            {
                                "text": "Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies",
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                        "text": ". ",
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                        "children": [
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                                "text": "Sexually transmitted infections",
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                        "text": ", ",
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                                "text": "84",
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                        "text": "(Suppl_1), i31-i36.{/ref} ",
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                        "text": "According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years \u2014 well into their 60s.{ref}This number is based on a study that used European and North American countries. Few studies have systematically assessed the life expectancy of people living with HIV/AIDS in middle and low-income countries, but it is predicted to be significantly lower between 60-74% of the life expectancy of the general population (see Wandeler et ",
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                        "children": [
                            {
                                "text": "al. ",
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                        "text": "reference).\u00a0",
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                        "text": "Multiple factors account for this difference, including a higher prevalence of other diseases, such as co-infections with hepatitis or tuberculosis, and a higher prevalence of opportunistic diseases. In addition, people tend to adhere to ART regimens less strictly because of poorer care for AIDS patients, less access to medical clinics, and social stigma.\u00a0",
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                        "text": "Wandeler, G., Johnson, L. F., & Egger, M. (2016). ",
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                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055447/",
                        "children": [
                            {
                                "text": "Trends in life expectancy of HIV-positive adults on ART across the globe: comparisons with general population",
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                        "text": ". ",
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                                "text": "Current Opinion in HIV and AIDS",
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                        "text": ", ",
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                                "text": "11",
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                        "text": "(5), 492.",
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                        "text": "Currently, no equivalent estimate for life expectancy is available for low and middle-income countries. However, we do know that with decreasing rates of HIV mortality in low and middle-income countries, the life expectancy of the general population has increased. Haris et al. discuss this, and you can read more about life expectancy and HIV ",
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                        "url": "https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa",
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                                "text": "here",
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                        "text": "Harris, T. G., Rabkin, M., & El-Sadr, W. M. (2018). Achieving the fourth 90: healthy aging for people living with HIV. ",
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                        "children": [
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                                "text": "AIDS (London, England)",
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                        "text": "Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). ",
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                        "url": "https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures",
                        "children": [
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                                "text": "Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.",
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                                "text": "The Lancet HIV",
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                        "text": "(8), e349-e356.{/ref}",
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                        "text": "While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the ",
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                        "text": " of the general population, we are getting closer to this goal.{ref}Global average ",
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                        "text": " in 2019 was 72.6 years. The average life expectancy in Europe is 78.6 years.{/ref}\u00a0",
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                        "text": "The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.{ref}Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). ",
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                        "text": "(8), e349-e356.{/ref} This increase goes beyond the general increase in life expectancy in that period and reflects the improvements in ART \u2014 fewer side effects, more people following the prescribed treatment, and more support for the people in need of ART.",
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                        "text": "There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.{ref}\u00a0G Williams, B., Lima, V., & Gouws, E. (2011). ",
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                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529404/",
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                                "text": "Modelling the impact of antiretroviral therapy on the epidemic of HIV.",
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                        "text": "(6), 367-382.{/ref} ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases.\u00a0",
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                        "text": " named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its \u201cBreakthrough of the Year\u201d.{ref}",
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                        "text": "Cohen, J. (2011). ",
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                        "text": "Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., ... & Godbole, S. V. (2011).",
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                                "text": " Prevention of HIV-1 infection with early antiretroviral therapy.",
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                        "text": "(6), 493-505.{/ref} Many other studies have now shown similar findings, with a range of reduction in transmission attributable to ART depending on location and groups studied.{ref}PARTNER study showed chances of transmission between gay couples with successfull virus suppression by ART are \u201ceffectively zero\u201d.\u00a0",
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                        "text": "Rodger, A. J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Degen, O., ... & Raben, D. (2019). ",
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                                "text": "Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.",
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                        "text": "Transmission rates in Madrid fell by 86% after ART became available",
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                        "text": "Castilla, J., Del Romero, J., Hernando, V., Marincovich, B., Garc\u00eda, S., & Rodr\u00edguez, C. (2005). ",
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                        "text": ". ",
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                                "text": "JAIDS Journal of Acquired Immune Deficiency Syndromes",
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                        "text": ", ",
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                        "text": "A study in San Francisco showing after ART became available, viral loads dropped to 40% and HIV infection rates fell by 60%.",
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                        "text": "\u00a0Das, M., Chu, P. L., Santos, G. M., Scheer, S., Vittinghoff, E., McFarland, W., & Colfax, G. N. (2010). ",
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                        "url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0011068",
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                                "text": "Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco",
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                        "text": ". ",
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                        "text": ", ",
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                        "text": "After ART became freely available in Taiwan transmission rates fell by 50%.\u00a0Fang, C. T., Hsu, H. M., Twu, S. J., Chen, M. Y., Chang, Y. Y., Hwang, J. S., ... & Division of AIDS and STD, Center for Disease Control, Department of Health, Executive Yuan. (2004). ",
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                                "text": "Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.",
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                                "text": "Journal of Infectious Diseases",
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                        "text": ", ",
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                        "text": "(5), 879-885.{/ref} A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.{ref}\u00a0Hogg, R. S., Heath, K., Lima, V. D., Nosyk, B., Kanters, S., Wood, E., ... & Montaner, J. S. (2012). ",
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                                "text": "Disparities in the burden of HIV/AIDS in Canada",
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                        "text": "(11), e47260.{/ref}",
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                "level": 3,
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                "value": [
                    {
                        "text": "The number of people who receive ART has increased significantly in recent years, especially in African countries where the prevalence of HIV/AIDS is the highest.",
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                ],
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                "type": "text",
                "value": [
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                        "text": "But many millions of people who could benefit from the life-saving treatment currently don\u2019t.\u00a0",
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                "value": [
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                        "text": "To increase ART coverage, we must first improve access to testing for HIV status. In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.{ref}The 79% figure is based on ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.unaids.org/en/resources/fact-sheet",
                        "children": [
                            {
                                "text": "2019 UNAIDS estimates",
                                "spanType": "span-simple-text"
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                        "spanType": "span-link"
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                    {
                        "text": ".",
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                "value": [
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                        "text": "The frequency of undiagnosed HIV/AIDS can be measured using observational studies. Measures of the expected rate of HIV infection, the actual number of people diagnosed with HIV, and delay in diagnosis are taken into account to predict the true expected prevalence of HIV in a population and the proportion of undiagnosed cases (see Singh et ",
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                    },
                    {
                        "children": [
                            {
                                "text": "al.",
                                "spanType": "span-simple-text"
                            }
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                        "spanType": "span-italic"
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                    {
                        "text": " reference).\u00a0",
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                "type": "text",
                "value": [
                    {
                        "text": "The initial HIV infection is often followed by flu-like symptoms, which subside in a few weeks. The infected patient can then live without symptoms for months or years while their immune system may be slowly deteriorating. Hence, people infected with HIV may not even know they need to be tested due to the lack of symptoms. Models used to predict HIV incidence rate often use an expected 5-year lag between infection and diagnosis.\u00a0",
                        "spanType": "span-simple-text"
                    }
                ],
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            {
                "type": "text",
                "value": [
                    {
                        "text": "Singh, S., Song, R., Johnson, A. S., McCray, E., & Hall, H. I. (2018). ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://annals.org/aim/fullarticle/2675979/hiv-incidence-prevalence-undiagnosed-infections-u-s-men-who-have",
                        "children": [
                            {
                                "text": "HIV incidence, prevalence, and undiagnosed infections in US men who have sex with men.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "children": [
                            {
                                "text": "Annals of internal medicine",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
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                        "children": [
                            {
                                "text": "168",
                                "spanType": "span-simple-text"
                            }
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                    {
                        "text": "(10), 685-694.{/ref} And awareness is also not enough. In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.{ref}",
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                    }
                ],
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                        "text": "WHO eligibility criteria are based on CD4 counts, which go down as the illness progresses. A healthy person\u2019s CD4 counts are >500/mm3. WHO recommends ART for anyone with HIV diagnosis and CD4 count >350 cells and \u2264500/mm3, regardless of clinical symptoms. All children, people with TB, HBV, and pregnant women diagnosed with HIV regardless of their CD4 status, should get ART.\u00a0",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/",
                        "children": [
                            {
                                "text": "https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    }
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            },
            {
                "type": "text",
                "value": [
                    {
                        "text": "Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383",
                        "children": [
                            {
                                "text": "Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub\u2010Saharan Africa: a systematic review.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "children": [
                            {
                                "text": "Journal of the International AIDS Society",
                                "spanType": "span-simple-text"
                            }
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                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
                        "spanType": "span-simple-text"
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                        "children": [
                            {
                                "text": "15",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": "(2), 17383.{/ref} Of those who should start ART, only 66% did.{ref}For some countries, eligibility for ART treatment is determined by the so-called CD4+ counts, which go down as the illness progresses.\u00a0",
                        "spanType": "span-simple-text"
                    }
                ],
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                "type": "text",
                "value": [
                    {
                        "text": "\u00a0Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383",
                        "children": [
                            {
                                "text": "Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub\u2010Saharan Africa: a systematic review.",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "children": [
                            {
                                "text": "Journal of the International AIDS Society",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "15",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": "(2), 17383.{/ref} ",
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                    }
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                "type": "text",
                "value": [
                    {
                        "text": "Stigmatization of people who have HIV/AIDS also leads to a decrease in engagement with care, treatment, and prevention services.{ref}Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates, T. J. (2008). ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/",
                        "children": [
                            {
                                "text": "Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. ",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "children": [
                            {
                                "text": "AIDS (London, England)",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": ", ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "children": [
                            {
                                "text": "22",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-italic"
                    },
                    {
                        "text": "(Suppl 2), S67.{/ref}",
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                    }
                ],
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            {
                "url": "https://ourworldindata.org/grapher/antiretroviral-therapy-coverage-among-people-living-with-hiv",
                "type": "chart",
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            {
                "text": [
                    {
                        "text": "Prevention of mother-to-child transmission (PMTCT)",
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                    }
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                "type": "heading",
                "level": 2,
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                "value": [
                    {
                        "text": "Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV. ",
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                    }
                ],
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            {
                "type": "text",
                "value": [
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                        "text": "The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.{ref}World Health Organization (WHO)",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://www.who.int/hiv/topics/mtct/about/en/",
                        "children": [
                            {
                                "text": "\u00a0'Mother-to-child transmission of HIV'\u00a0",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": "[accessed November 2019]{/ref}",
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                "value": [
                    {
                        "text": "PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection. ",
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                    }
                ],
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            {
                "type": "text",
                "value": [
                    {
                        "text": "The visualization shows the number of child infections averted from ART coverage in mothers.",
                        "spanType": "span-simple-text"
                    }
                ],
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            {
                "type": "text",
                "value": [
                    {
                        "text": "You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world ",
                        "spanType": "span-simple-text"
                    },
                    {
                        "url": "https://ourworldindata.org/grapher/new-hiv-infections-averted-due-to-pmtct",
                        "children": [
                            {
                                "text": "here",
                                "spanType": "span-simple-text"
                            }
                        ],
                        "spanType": "span-link"
                    },
                    {
                        "text": ".",
                        "spanType": "span-simple-text"
                    }
                ],
                "parseErrors": []
            },
            {
                "url": "https://ourworldindata.org/grapher/number-of-new-hiv-child-infections-vs-number-of-infections-averted-due-to-pmtct",
                "type": "chart",
                "parseErrors": []
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            {
                "text": [
                    {
                        "text": "Coverage of ART in pregnant women",
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                ],
                "type": "heading",
                "level": 3,
                "parseErrors": []
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            {
                "type": "text",
                "value": [
                    {
                        "text": "This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy \u2013 a vital intervention to prevent the transmission from mother to child.",
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                    }
                ],
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            },
            {
                "url": "https://ourworldindata.org/grapher/art-coverage-for-pregnant-women",
                "type": "chart",
                "parseErrors": []
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            {
                "text": [
                    {
                        "text": "Safe sex",
                        "spanType": "span-simple-text"
                    }
                ],
                "type": "heading",
                "level": 2,
                "parseErrors": []
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            {
                "text": [
                    {
                        "text": "Unsafe sex is a leading risk factor for death in Sub-Saharan Africa",
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                "type": "heading",
                "level": 3,
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                "url": "https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor?country=~Sub-Saharan+Africa+%28WB%29",
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            {
                "text": [
                    {
                        "text": "Share of people practicing safe sex",
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                "level": 3,
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                "value": [
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                        "text": "The majority of HIV infections are transmitted through sexual activity.",
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                    {
                        "spanType": "span-newline"
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                        "spanType": "span-newline"
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                    {
                        "text": "Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of 'high-risk sex', which is that with a non-marital, non-cohabiting sexual partner.",
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                "url": "https://ourworldindata.org/grapher/condom-use-at-last-high-risk-sex",
                "type": "chart",
                "parseErrors": []
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                "url": "https://ourworldindata.org/grapher/condom-use-during-last-high-risk-sex",
                "type": "chart",
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                "text": [
                    {
                        "text": "Education on HIV/AIDS",
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                "type": "heading",
                "level": 2,
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            {
                "url": "https://ourworldindata.org/grapher/young-people-with-knowledge-on-hiv-prevention",
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                "url": "https://ourworldindata.org/grapher/knowledge-hiv-prevention-in-males-vs-females",
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            {
                "text": [
                    {
                        "text": "Funding to support efforts against HIV/AIDS",
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                    }
                ],
                "type": "heading",
                "level": 2,
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                        "text": "You can explore the breakdown of funding resources by source for each country ",
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                    },
                    {
                        "url": "https://ourworldindata.org/grapher/hivaids-funding-by-source",
                        "children": [
                            {
                                "text": "here",
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                    },
                    {
                        "text": ".",
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                "url": "https://ourworldindata.org/grapher/hiv-expenditure",
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                "text": [
                    {
                        "text": "Future funding needs to meet HIV targets",
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                "level": 3,
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                "url": "https://ourworldindata.org/grapher/resource-needs-to-meet-hiv-targets",
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            {
                "type": "horizontal-rule",
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                "text": [
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                        "text": "Data quality and definition",
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                "text": [
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                        "text": "Terminology and definitions",
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                        "text": "The following terminology and definitions are sourced from the UNAIDS organization.{ref}UNAIDS (2015). Terminology guidelines. Available ",
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                        "url": "http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf",
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                                "text": "online",
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                    {
                        "text": ".{/ref}",
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                        "children": [
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                                "text": "HIV",
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                    {
                        "text": ": Human Immunodeficiency Virus.\u00a0HIV is a virus that weakens the immune system, ultimately leading to AIDS.",
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                                "text": "AIDS",
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                    {
                        "text": ":\u00a0acquired immunodeficiency syndrome.",
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                        "children": [
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                                "text": "Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment",
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                        "spanType": "span-bold"
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                        "text": ": \"Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations.",
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                        "text": "More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term \"highly active\" antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. \"Highly active\" is not needed as a qualification, and the term is no longer commonly used.",
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                        "text": "ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use.\"",
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                                "text": "ARV-based prevention",
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                        "text": ": \"ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention).\"",
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                                "text": "Epidemic",
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                    },
                    {
                        "text": ": \"An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic.\"",
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                        "children": [
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                                "text": "HIV-negative (seronegative)",
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                        "spanType": "span-bold"
                    },
                    {
                        "text": ": \"A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative.\"",
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                        "children": [
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                                "text": "HIV-positive (seropositive)",
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                        "spanType": "span-bold"
                    },
                    {
                        "text": ": \"A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies.\"",
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                        "children": [
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                                "text": "Incidence",
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                    {
                        "text": ": \"HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15\u201349 years and 0\u201314 years.\"",
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                        "children": [
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                                "text": "Mother-to-child transmission (MTCT)",
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                    },
                    {
                        "text": ": \"MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4).",
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                        "text": "PMTCT is often mistakenly referring to only prong 3\u2014 the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT).\"",
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                        "text": ": \"Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15\u201349 years.\"",
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                        "text": ": \"Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se.",
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                        "text": "The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria.\"",
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                        "text": "Several sources publish estimates on HIV and AIDS - two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources' relationship/consistency in prevalence estimates.",
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        "title": "HIV / AIDS",
        "authors": [
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        "excerpt": "A global epidemic and the leading cause of death in some countries.",
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2018-04-03 22:07:27

2024-02-16 14:22:39

[
    "Max Roser",
    "Hannah Ritchie"
]

A global epidemic and the leading cause of death in some countries.

2019-11-05 15:24:59

2023-08-31 15:57:37

https://ourworldindata.org/wp-content/uploads/2021/02/Screen-Shot-2021-02-05-at-10.05.57.png

{}

This article was first published in November 2014; last revised in August 2023. Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in a heightened risk of life-threatening infection and [cancers](https://owid.cloud/cancer). In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from mother to child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur by sharing injection equipment such as needles. **[See all interactive charts on hiv / aids ↓](#all-charts)** --- # HIV/AIDS is one of the world's most fatal infectious disease --- ### Almost 1 million people die from HIV/AIDS each year; in some countries, it's the leading cause of death HIV/AIDS is one of the world's most fatal infectious diseases – particularly across Sub-Saharan Africa, where the disease has had a massive impact on health outcomes and life expectancy in recent decades. The _Global Burden of Disease_ is a major global study on the causes of death and disease published in the medical journal _The Lancet_.{ref}The latest study can be found at the website of the Lancet here: [TheLancet.com/GBD](https://www.thelancet.com/gbd) The 2017 study was published in the following publication: "Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., ... & Abdollahpour, I. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. _The Lancet_, 392(10159), 1736-1788", and is online [here](http://www.healthdata.org/research-article/global-regional-and-national-age-sex-specific-mortality-282-causes-death-195).{/ref} These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the "change country" toggle. According to the _Global Burden of Disease_ study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from [malaria](https://owid.cloud/malaria). It's _one of_ the largest killers globally, but for some countries – particularly across Sub-Saharan Africa, it's the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique – which you can do on the interactive chart – we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of [cancer](https://owid.cloud/cancer) deaths. <Chart url="https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause"/> --- # The global distribution of deaths from HIV/AIDS --- ### In some countries, HIV/AIDS is the cause of a quarter of all deaths Globally, around 1.5% of deaths are caused by HIV/AIDS. This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher. In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths. But the share is very high across some countries – focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana. <Chart url="https://ourworldindata.org/grapher/share-deaths-aids"/> ### Death rates are high across Sub-Saharan Africa The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region. In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 – often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000. Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. <Chart url="https://ourworldindata.org/grapher/hiv-death-rates"/> ### Death rates are highest for younger adults and children under five years old Which population groups are most at risk from HIV/AIDS? In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds – typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect. But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected. <Chart url="https://ourworldindata.org/grapher/hiv-death-rates-by-age"/> --- # Is the world making progress in its fight against HIV/AIDS? --- ### How have cases and deaths changed over time? The 1990s saw a substantial increase in people infected with HIV and dying of AIDS. In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it's now below 2 million, the lowest number of new infections since 1990. As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS. The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever. <Chart url="https://ourworldindata.org/grapher/deaths-and-new-cases-of-hiv"/> ### Global deaths from HIV/AIDS halved within a decade The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade. In the visualization, we see the global number of deaths from HIV/AIDS in recent decades – this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year. Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then. You can explore this change for any country or region using the "change country" toggle on the interactive chart. <Chart url="https://ourworldindata.org/grapher/deaths-from-hiv-by-age"/> ### HIV/AIDS once accounted for a large share of deaths in some countries, but rates are now falling Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic. Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher. In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe. Over the past decade, this share has fallen as antiretroviral treatment has become more widely available. <Chart url="https://ourworldindata.org/grapher/share-deaths-aids?tab=chart&country=ZAF+ZWE+NAM+OWID_WRL+Sub-Saharan%20Africa+MOZ+ZMB"/> ### HIV/AIDS has had a significant impact on life expectancy across Sub-Saharan Africa The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in [life expectancy](https://owid.cloud/life-expectancy). In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll. We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s — as progress has been made in tackling HIV — we see that life expectancy has been rising again. In some countries, life expectancy is now higher than before the epidemic began. <Chart url="https://ourworldindata.org/grapher/life-expectancy?country=BWA+NAM+ZAF+SWZ+TZA+ZMB"/> --- # The prevalence of HIV/AIDS --- ## Prevalence in the total population ### Share of the population with HIV You can explore the total number of people living with HIV/AIDS worldwide [here](https://ourworldindata.org/grapher/number-of-people-living-with-hiv). <Chart url="https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme"/> ### Number of new infections each year <Chart url="https://ourworldindata.org/grapher/new-cases-of-hiv-infection"/> ## Prevalence by gender ### Is HIV/AIDS more common in men or women? There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV. As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex{ref}Greig, A., Peacock, D., Jewkes, R., & Msimang, S. (2008). Gender and AIDS: time to act. _AIDS (London, England)_, _22_(Suppl 2), S35. Available [online](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356155/).{/ref}. <Chart url="https://ourworldindata.org/grapher/share-of-women-among-the-population-living-with-hiv"/> ## Prevalence in children ### Share of children infected with HIV <Chart url="https://ourworldindata.org/grapher/share-of-children-under-five-years-old-with-hiv"/> ### Children living with HIV In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million. <Chart url="https://ourworldindata.org/grapher/children-living-with-hiv"/> ### New HIV infections of children The map shows the total number of children newly infected with HIV yearly. Globally — with similar trends at national levels — the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually. <Chart url="https://ourworldindata.org/grapher/number-of-children-newly-infected-with-hiv"/> ### Orphaned children from AIDS Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths. <Chart url="https://ourworldindata.org/grapher/number-of-children-orphaned-from-aids"/> --- # Tuberculosis among people living with HIV --- Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa. The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV. <Chart url="https://ourworldindata.org/grapher/tb-patients-tested-positive-for-hiv"/> <Chart url="https://ourworldindata.org/grapher/tb-patients-living-with-hiv-receiving-art"/> <Chart url="https://ourworldindata.org/grapher/tb-related-deaths-hiv"/> --- # What can be done to prevent HIV/AIDS? --- ## Anti-retroviral treatment (ART) A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives. ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections. ### Millions of lives are saved by ART Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives. The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART. Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths – 1.2 million – were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS. <Chart url="https://ourworldindata.org/grapher/hivaids-deaths-and-averted-due-to-art"/> ### People who use ART are living longer ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.{ref}We should note, though, that the life expectancy for people living with HIV infection without ART can vary depending on the age when a person got infected with HIV, a person's immune status (e.g., CD4 count), and socioeconomic factors. Babiker, A., Darby, S., De Angelis, D., Kwart, D., Porter, K., Beral, V., ... & Prins, M. (2000). [Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action.](https://www.sciencedirect.com/science/article/pii/S0140673600020614#tbl1) Concerted Action on SeroConversion to AIDS and Death in Europe. _Lancet_, _355_(9210). Wandel, S., Egger, M., Rangsin, R., Nelson, K. E., Costello, C., Lewden, C., ... & Minga, A. (2008). [Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418/). _Sexually transmitted infections_, _84_(Suppl_1), i31-i36.{/ref} According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years — well into their 60s.{ref}This number is based on a study that used European and North American countries. Few studies have systematically assessed the life expectancy of people living with HIV/AIDS in middle and low-income countries, but it is predicted to be significantly lower between 60-74% of the life expectancy of the general population (see Wandeler et _al. _reference). Multiple factors account for this difference, including a higher prevalence of other diseases, such as co-infections with hepatitis or tuberculosis, and a higher prevalence of opportunistic diseases. In addition, people tend to adhere to ART regimens less strictly because of poorer care for AIDS patients, less access to medical clinics, and social stigma. Wandeler, G., Johnson, L. F., & Egger, M. (2016). [Trends in life expectancy of HIV-positive adults on ART across the globe: comparisons with general population](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055447/). _Current Opinion in HIV and AIDS_, _11_(5), 492. Currently, no equivalent estimate for life expectancy is available for low and middle-income countries. However, we do know that with decreasing rates of HIV mortality in low and middle-income countries, the life expectancy of the general population has increased. Haris et al. discuss this, and you can read more about life expectancy and HIV [here](https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa). Harris, T. G., Rabkin, M., & El-Sadr, W. M. (2018). Achieving the fourth 90: healthy aging for people living with HIV. _AIDS (London, England)_, _32_(12), 1563. Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). [Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.](https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures)_The Lancet HIV_, _4_(8), e349-e356.{/ref} While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the [life expectancy](https://ourworldindata.org/life-expectancy) of the general population, we are getting closer to this goal.{ref}Global average [life expectancy](https://ourworldindata.org/grapher/life-expectancy?tab=chart&time=1543..latest&country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL) in 2019 was 72.6 years. The average life expectancy in Europe is 78.6 years.{/ref} The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.{ref}Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., ... & Cavassini, M. (2017). [Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.](https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures)_The Lancet HIV_, _4_(8), e349-e356.{/ref} This increase goes beyond the general increase in life expectancy in that period and reflects the improvements in ART — fewer side effects, more people following the prescribed treatment, and more support for the people in need of ART. ### ART prevents new HIV infections There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.{ref} G Williams, B., Lima, V., & Gouws, E. (2011). [Modelling the impact of antiretroviral therapy on the epidemic of HIV.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529404/)_Current HIV research_, _9_(6), 367-382.{/ref} ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases. In 2011, the journal _Science_ named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its “Breakthrough of the Year”.{ref} Science announcement: Cohen, J. (2011). [HIV treatment as prevention](https://science.sciencemag.org/content/334/6063/1628). Study that was awarded: Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., ... & Godbole, S. V. (2011).[ Prevention of HIV-1 infection with early antiretroviral therapy.](https://www.nejm.org/doi/full/10.1056/Nejmoa1105243)_New England journal of medicine_, _365_(6), 493-505.{/ref} Many other studies have now shown similar findings, with a range of reduction in transmission attributable to ART depending on location and groups studied.{ref}PARTNER study showed chances of transmission between gay couples with successfull virus suppression by ART are “effectively zero”. Rodger, A. J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Degen, O., ... & Raben, D. (2019). [Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30418-0/fulltext)_The Lancet_. Transmission rates in Madrid fell by 86% after ART became available Castilla, J., Del Romero, J., Hernando, V., Marincovich, B., García, S., & Rodríguez, C. (2005). [Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV](https://journals.lww.com/jaids/Fulltext/2005/09010/Prevalence_of_Unsafe_Sexual_Behavior_Among.16.aspx?casa_token=4RZtew6owdYAAAAA:YrqHOyO0wmGz7hSrlm0r6loCZUtsZd1wVRVQvR2U0_XPeUnJpSC9ykITGg0bsGmB1IjAinXZbUd9hslCBo-DtYCk). _JAIDS Journal of Acquired Immune Deficiency Syndromes_, _40_(1), 96-101. A study in San Francisco showing after ART became available, viral loads dropped to 40% and HIV infection rates fell by 60%. Das, M., Chu, P. L., Santos, G. M., Scheer, S., Vittinghoff, E., McFarland, W., & Colfax, G. N. (2010). [Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0011068). _PloS one_, _5_(6), e11068. After ART became freely available in Taiwan transmission rates fell by 50%. Fang, C. T., Hsu, H. M., Twu, S. J., Chen, M. Y., Chang, Y. Y., Hwang, J. S., ... & Division of AIDS and STD, Center for Disease Control, Department of Health, Executive Yuan. (2004). [Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.](https://academic.oup.com/jid/article-abstract/190/5/879/868453)_Journal of Infectious Diseases_, _190_(5), 879-885.{/ref} A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.{ref} Hogg, R. S., Heath, K., Lima, V. D., Nosyk, B., Kanters, S., Wood, E., ... & Montaner, J. S. (2012). [Disparities in the burden of HIV/AIDS in Canada](https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047260). _PLoS One_, _7_(11), e47260.{/ref} ### We need to increase ART coverage The number of people who receive ART has increased significantly in recent years, especially in African countries where the prevalence of HIV/AIDS is the highest. But many millions of people who could benefit from the life-saving treatment currently don’t. To increase ART coverage, we must first improve access to testing for HIV status. In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.{ref}The 79% figure is based on [2019 UNAIDS estimates](https://www.unaids.org/en/resources/fact-sheet). The frequency of undiagnosed HIV/AIDS can be measured using observational studies. Measures of the expected rate of HIV infection, the actual number of people diagnosed with HIV, and delay in diagnosis are taken into account to predict the true expected prevalence of HIV in a population and the proportion of undiagnosed cases (see Singh et _al._ reference). The initial HIV infection is often followed by flu-like symptoms, which subside in a few weeks. The infected patient can then live without symptoms for months or years while their immune system may be slowly deteriorating. Hence, people infected with HIV may not even know they need to be tested due to the lack of symptoms. Models used to predict HIV incidence rate often use an expected 5-year lag between infection and diagnosis. Singh, S., Song, R., Johnson, A. S., McCray, E., & Hall, H. I. (2018). [HIV incidence, prevalence, and undiagnosed infections in US men who have sex with men.](https://annals.org/aim/fullarticle/2675979/hiv-incidence-prevalence-undiagnosed-infections-u-s-men-who-have)_Annals of internal medicine_, _168_(10), 685-694.{/ref} And awareness is also not enough. In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.{ref} WHO eligibility criteria are based on CD4 counts, which go down as the illness progresses. A healthy person’s CD4 counts are >500/mm3. WHO recommends ART for anyone with HIV diagnosis and CD4 count >350 cells and ≤500/mm3, regardless of clinical symptoms. All children, people with TB, HBV, and pregnant women diagnosed with HIV regardless of their CD4 status, should get ART. [https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/](https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/) Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). [Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub‐Saharan Africa: a systematic review.](https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383)_Journal of the International AIDS Society_, _15_(2), 17383.{/ref} Of those who should start ART, only 66% did.{ref}For some countries, eligibility for ART treatment is determined by the so-called CD4+ counts, which go down as the illness progresses. Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., & Lawn, S. D. (2012). [Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub‐Saharan Africa: a systematic review.](https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383)_Journal of the International AIDS Society_, _15_(2), 17383.{/ref} Stigmatization of people who have HIV/AIDS also leads to a decrease in engagement with care, treatment, and prevention services.{ref}Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., & Coates, T. J. (2008). [Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. ](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/)_AIDS (London, England)_, _22_(Suppl 2), S67.{/ref} <Chart url="https://ourworldindata.org/grapher/antiretroviral-therapy-coverage-among-people-living-with-hiv"/> ## Prevention of mother-to-child transmission (PMTCT) Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV. The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.{ref}World Health Organization (WHO)[ 'Mother-to-child transmission of HIV' ](https://www.who.int/hiv/topics/mtct/about/en/)[accessed November 2019]{/ref} PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection. The visualization shows the number of child infections averted from ART coverage in mothers. You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world [here](https://ourworldindata.org/grapher/new-hiv-infections-averted-due-to-pmtct). <Chart url="https://ourworldindata.org/grapher/number-of-new-hiv-child-infections-vs-number-of-infections-averted-due-to-pmtct"/> ### Coverage of ART in pregnant women This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy – a vital intervention to prevent the transmission from mother to child. <Chart url="https://ourworldindata.org/grapher/art-coverage-for-pregnant-women"/> ## Safe sex ### Unsafe sex is a leading risk factor for death in Sub-Saharan Africa <Chart url="https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor?country=~Sub-Saharan+Africa+%28WB%29"/> ### Share of people practicing safe sex The majority of HIV infections are transmitted through sexual activity. Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of 'high-risk sex', which is that with a non-marital, non-cohabiting sexual partner. <Chart url="https://ourworldindata.org/grapher/condom-use-at-last-high-risk-sex"/> <Chart url="https://ourworldindata.org/grapher/condom-use-during-last-high-risk-sex"/> ## Education on HIV/AIDS <Chart url="https://ourworldindata.org/grapher/young-people-with-knowledge-on-hiv-prevention"/> <Chart url="https://ourworldindata.org/grapher/knowledge-hiv-prevention-in-males-vs-females"/> ## Funding to support efforts against HIV/AIDS You can explore the breakdown of funding resources by source for each country [here](https://ourworldindata.org/grapher/hivaids-funding-by-source). <Chart url="https://ourworldindata.org/grapher/hiv-expenditure"/> ### Future funding needs to meet HIV targets <Chart url="https://ourworldindata.org/grapher/resource-needs-to-meet-hiv-targets"/> --- # Data quality and definition --- ## Terminology and definitions The following terminology and definitions are sourced from the UNAIDS organization.{ref}UNAIDS (2015). Terminology guidelines. Available [online](http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf).{/ref} **HIV**: Human Immunodeficiency Virus. HIV is a virus that weakens the immune system, ultimately leading to AIDS. **AIDS**: acquired immunodeficiency syndrome. **Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment**: "Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations. More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term "highly active" antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. "Highly active" is not needed as a qualification, and the term is no longer commonly used. ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use." **ARV-based prevention**: "ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention)." **Epidemic**: "An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic." **HIV-negative (seronegative)**: "A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative." **HIV-positive (seropositive)**: "A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies." **Incidence**: "HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15–49 years and 0–14 years." **Mother-to-child transmission (MTCT)**: "MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4). PMTCT is often mistakenly referring to only prong 3— the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT)." **Prevalence**: "Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15–49 years." **Tuberculosis (TB)**: "Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se. The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria." ## Comparisons of UNAIDS and IHME estimates Several sources publish estimates on HIV and AIDS - two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources' relationship/consistency in prevalence estimates. ### Prevalence of HIV <Chart url="https://ourworldindata.org/grapher/prevalence-of-hiv-unaids-vs-ihme-estimates"/> ### Incidence/new cases of HIV <Chart url="https://ourworldindata.org/grapher/new-cases-of-hiv-unaids-vs-ihme"/> <AllCharts heading="Interactive charts on hiv / aids"/>

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        "rendered": "\n<div class=\"blog-info\">This article was first published in November 2014; last revised in August 2023.</div>\n\n\n\n<p>Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in a heightened risk of life-threatening infection and <a href=\"https://owid.cloud/cancer\">cancers</a>.</p>\n\n\n\n<p>In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from mother to child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur by sharing injection equipment such as needles.</p>\n\n\n\t<div class=\"wp-block-owid-summary\">\n\t\t<h2>Summary</h2>\n\t\t\n\n<ul><li><a href=\"#almost-1-million-people-die-from-hiv-aids-each-year-in-some-countries-it-s-the-leading-cause-of-death\">Almost one million die from HIV/AIDS each year \u2013 in some countries it&#8217;s the leading cause of death.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#in-some-countries-hiv-aids-is-the-cause-of-more-than-1-in-4-deaths\">In some countries, HIV/AIDS is the cause of one quarter of deaths.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#death-rates-are-high-across-sub-saharan-africa\">Death rates are highest across Sub-Saharan Africa.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#death-rates-are-highest-for-younger-adults-and-children-under-five-years-old\">Death rates are highest for younger adults, and for children (when HIV is transmitted from a mother).</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#global-deaths-from-hiv-aids-halved-within-a-decade\">The world is making progress: over the past decade the number of global deaths has halved.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa\">The HIV epidemic had a major impact on life expectancy across Sub-Saharan Africa, and life expectancy is only now back to pre-epidemic levels.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#anti-retroviral-treatment-art\">Antiretroviral treatment (ART) has been key to preventing deaths from AIDS. It is estimated that it now averts 1.2 million deaths per year \u2013 without it, global deaths would be more than twice as high.</a></li><li><a href=\"https://ourworldindata.org/hiv-aids#funding-to-support-efforts-against-hiv-aids\">Funding for HIV treatment and prevention needs to increase if the world is to meet its 2030 targets.</a></li></ul>\n\n\n\t</div>\n\n\n<h2>HIV/AIDS is one of the world&#8217;s most fatal infectious disease</h2>\n\n\n\n<h4>Almost 1 million people die from HIV/AIDS each year; in some countries, it&#8217;s the leading cause of death</h4>\n\n\n\n<p>HIV/AIDS is one of the world&#8217;s most fatal infectious diseases \u2013 particularly across Sub-Saharan Africa, where the disease has had a massive impact on health outcomes and life expectancy in recent decades.</p>\n\n\n\n<p>The <em>Global Burden of Disease</em> is a major global study on the causes of death and disease published in the medical journal <em>The Lancet</em>.{ref}The latest study can be found at the website of the Lancet here: <a href=\"https://www.thelancet.com/gbd\">TheLancet.com/GBD</a></p>\n\n\n\n<p>The 2017 study was published in the following publication: &#8220;Roth, G. A., Abate, D., Abate, K. H., Abay, S. M., Abbafati, C., Abbasi, N., &#8230; &amp; Abdollahpour, I. (2018). Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. <em>The Lancet</em>, 392(10159), 1736-1788&#8243;, and is online <a href=\"http://www.healthdata.org/research-article/global-regional-and-national-age-sex-specific-mortality-282-causes-death-195\">here</a>.{/ref} These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the &#8220;change country&#8221; toggle.</p>\n\n\n\n<p>According to the <em>Global Burden of Disease</em> study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from <a href=\"https://owid.cloud/malaria\">malaria</a>.</p>\n\n\n\n<p>It&#8217;s <em>one of</em> the largest killers globally, but for some countries \u2013 particularly across Sub-Saharan Africa, it&#8217;s the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique \u2013 which you can do on the interactive chart \u2013 we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of <a href=\"https://owid.cloud/cancer\">cancer</a> deaths.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/annual-number-of-deaths-by-cause\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h2>The global distribution of deaths from HIV/AIDS</h2>\n\n\n\n<h4>In some countries, HIV/AIDS is the cause of a quarter of all deaths</h4>\n\n\n\n<p>Globally, around 1.5% of deaths are caused by HIV/AIDS.</p>\n\n\n\n<p>This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher.<br> <br>In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.</p>\n\n\n\n<p>But the share is very high across some countries \u2013 focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-deaths-aids\"></iframe></figure>\n\n\n\n<h4>Death rates are high across Sub-Saharan Africa</h4>\n\n\n\n<p>The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.</p>\n\n\n\n<p>In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 \u2013 often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000.</p>\n\n\n\n<p>Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. </p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/hiv-death-rates\"></iframe></figure>\n\n\n\n<h4>Death rates are highest for younger adults and children under five years old</h4>\n\n\n\n<p>Which population groups are most at risk from HIV/AIDS?<br><br>In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds \u2013 typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect.</p>\n\n\n\n<p>But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected. </p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/hiv-death-rates-by-age\"></iframe></figure>\n\n\n\n<h2>Is the world making progress in its fight against HIV/AIDS?</h2>\n\n\n\n<h4>How have cases and deaths changed over time?</h4>\n\n\n\n<p>The 1990s saw a substantial increase in people infected with HIV and dying of AIDS. </p>\n\n\n\n<p>In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it&#8217;s now below 2 million, the lowest number of new infections since 1990.</p>\n\n\n\n<p>As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS.</p>\n\n\n\n<p>The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/deaths-and-new-cases-of-hiv\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>Global deaths from HIV/AIDS halved within a decade</h4>\n\n\n\n<p>The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade.</p>\n\n\n\n<p>In the visualization, we see the global number of deaths from HIV/AIDS in recent decades \u2013 this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year. </p>\n\n\n\n<p>Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then.</p>\n\n\n\n<p>You can explore this change for any country or region using the &#8220;change country&#8221; toggle on the interactive chart.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/deaths-from-hiv-by-age\"></iframe></figure>\n\n\n\n<h4>HIV/AIDS once accounted for a large share of deaths in some countries, but rates are now falling</h4>\n\n\n\n<p>Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic.</p>\n\n\n\n<p>Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher.<br><br>In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe.</p>\n\n\n\n<p>Over the past decade, this share has fallen as antiretroviral treatment has become more widely available.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-deaths-aids?tab=chart&amp;country=ZAF+ZWE+NAM+OWID_WRL+Sub-Saharan%20Africa+MOZ+ZMB\"></iframe></figure>\n\n\n\n<h4>HIV/AIDS has had a significant impact on life expectancy across Sub-Saharan Africa</h4>\n\n\n\n<p>The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in <a href=\"https://owid.cloud/life-expectancy\">life expectancy</a>. In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll. </p>\n\n\n\n<p>We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s \u2014 as progress has been made in tackling HIV \u2014 we see that life expectancy has been rising again.</p>\n\n\n\n<p>In some countries, life expectancy is now higher than before the epidemic began.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/life-expectancy?country=BWA+NAM+ZAF+SWZ+TZA+ZMB\"></iframe></figure>\n\n\n\n<h2>The prevalence of HIV/AIDS</h2>\n\n\n\n<h3>Prevalence in the total population</h3>\n\n\n\n<h4>Share of the population with HIV</h4>\n\n\n\n<p>You can explore the total number of people living with HIV/AIDS worldwide <a href=\"https://ourworldindata.org/grapher/number-of-people-living-with-hiv\">here</a>.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/share-of-population-infected-with-hiv-ihme\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>Number of new infections each year</h4>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/new-cases-of-hiv-infection\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h3>Prevalence by gender</h3>\n\n\n\n<h4>Is HIV/AIDS more common in men or women?</h4>\n\n\n\n<p>There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV.</p>\n\n\n\n<p>As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex{ref}Greig, A., Peacock, D., Jewkes, R., &amp; Msimang, S. (2008). Gender and AIDS: time to act.&nbsp;<em>AIDS (London, England)</em>,&nbsp;<em>22</em>(Suppl 2), S35. Available <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356155/\">online</a>.{/ref}.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-of-women-among-the-population-living-with-hiv\"></iframe></figure>\n\n\n\n<h3>Prevalence in children</h3>\n\n\n\n<h4>Share of children infected with HIV</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/share-of-children-under-five-years-old-with-hiv\"></iframe></figure>\n\n\n\n<h4>Children living with HIV</h4>\n\n\n\n<p>In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/children-living-with-hiv\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h4>New HIV infections of children</h4>\n\n\n\n<p>The map shows the total number of children newly infected with HIV yearly. Globally\u00a0\u2014 with similar trends at national levels\u00a0\u2014 the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/number-of-children-newly-infected-with-hiv\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h4>Orphaned children from AIDS</h4>\n\n\n\n<p>Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/number-of-children-orphaned-from-aids\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h2>Tuberculosis among people living with HIV</h2>\n\n\n\n<p>Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.</p>\n\n\n\n<p>The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV.</p>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/tb-patients-tested-positive-for-hiv\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/tb-patients-living-with-hiv-receiving-art\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/tb-related-deaths-hiv\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h2>What can be done to prevent HIV/AIDS?</h2>\n\n\n\n<h3>Anti-retroviral treatment (ART)</h3>\n\n\n\n<p>A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives.&nbsp;</p>\n\n\n\n<p>ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections.&nbsp;</p>\n\n\n\n<h4>Millions of lives are saved by ART</h4>\n\n\n\n<p>Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives.</p>\n\n\n\n<p>The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART.&nbsp;</p>\n\n\n\n<p>Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths \u2013 1.2 million \u2013 were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS.\u00a0</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/hivaids-deaths-and-averted-due-to-art\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>People who use ART are living longer</h4>\n\n\n\n<p>ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.{ref}We should note, though, that the life expectancy for people living with HIV infection without ART can vary depending on the age when a person got infected with HIV, a person&#8217;s immune status (e.g., CD4 count), and socioeconomic factors.&nbsp;</p>\n\n\n\n<p>Babiker, A., Darby, S., De Angelis, D., Kwart, D., Porter, K., Beral, V., &#8230; &amp; Prins, M. (2000). <a href=\"https://www.sciencedirect.com/science/article/pii/S0140673600020614#tbl1\">Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action.</a> Concerted Action on SeroConversion to AIDS and Death in Europe. <em>Lancet</em>, <em>355</em>(9210).</p>\n\n\n\n<p>Wandel, S., Egger, M., Rangsin, R., Nelson, K. E., Costello, C., Lewden, C., &#8230; &amp; Minga, A. (2008). <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569418/\">Duration from seroconversion to eligibility for antiretroviral therapy and from ART eligibility to death in adult HIV-infected patients from low and middle-income countries: collaborative analysis of prospective studies</a>. <em>Sexually transmitted infections</em>, <em>84</em>(Suppl_1), i31-i36.{/ref} </p>\n\n\n\n<p>According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years \u2014 well into their 60s.{ref}This number is based on a study that used European and North American countries. Few studies have systematically assessed the life expectancy of people living with HIV/AIDS in middle and low-income countries, but it is predicted to be significantly lower between 60-74% of the life expectancy of the general population (see Wandeler et <em>al. </em>reference).\u00a0</p>\n\n\n\n<p>Multiple factors account for this difference, including a higher prevalence of other diseases, such as co-infections with hepatitis or tuberculosis, and a higher prevalence of opportunistic diseases. In addition, people tend to adhere to ART regimens less strictly because of poorer care for AIDS patients, less access to medical clinics, and social stigma.&nbsp;</p>\n\n\n\n<p>Wandeler, G., Johnson, L. F., &amp; Egger, M. (2016). <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055447/\">Trends in life expectancy of HIV-positive adults on ART across the globe: comparisons with general population</a>. <em>Current Opinion in HIV and AIDS</em>, <em>11</em>(5), 492.</p>\n\n\n\n<p>Currently, no equivalent estimate for life expectancy is available for low and middle-income countries. However, we do know that with decreasing rates of HIV mortality in low and middle-income countries, the life expectancy of the general population has increased. Haris et al. discuss this, and you can read more about life expectancy and HIV <a href=\"https://ourworldindata.org/hiv-aids#hiv-aids-has-had-a-major-impact-on-life-expectancy-across-sub-saharan-africa\">here</a>.</p>\n\n\n\n<p>Harris, T. G., Rabkin, M., &amp; El-Sadr, W. M. (2018). Achieving the fourth 90: healthy aging for people living with HIV. <em>AIDS (London, England)</em>, <em>32</em>(12), 1563.</p>\n\n\n\n<p>Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., &#8230; &amp; Cavassini, M. (2017). <a href=\"https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures\">Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.</a> <em>The Lancet HIV</em>, <em>4</em>(8), e349-e356.{/ref}</p>\n\n\n\n<p>While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the <a href=\"https://ourworldindata.org/life-expectancy\">life expectancy</a> of the general population, we are getting closer to this goal.{ref}Global average <a rel=\"noreferrer noopener\" href=\"https://ourworldindata.org/grapher/life-expectancy?tab=chart&amp;time=1543..latest&amp;country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL\" data-type=\"URL\" data-id=\"https://ourworldindata.org/grapher/life-expectancy?tab=chart&amp;time=1543..latest&amp;country=Africa~Americas~Asia~Europe~Oceania~OWID_WRL\" target=\"_blank\">life expectancy</a> in 2019 was 72.6 years. The average life expectancy in Europe is 78.6 years.{/ref}&nbsp;</p>\n\n\n\n<p>The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.{ref}Trickey, A., May, M. T., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., &#8230; &amp; Cavassini, M. (2017). <a href=\"https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30066-8/fulltext#figures\">Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.</a><em>The Lancet HIV</em>, <em>4</em>(8), e349-e356.{/ref} This increase goes beyond the general increase in life expectancy in that period and reflects the improvements in ART \u2014 fewer side effects, more people following the prescribed treatment, and more support for the people in need of ART.</p>\n\n\n\n<h4>ART prevents new HIV infections</h4>\n\n\n\n<p>There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.{ref}&nbsp;G Williams, B., Lima, V., &amp; Gouws, E. (2011). <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529404/\">Modelling the impact of antiretroviral therapy on the epidemic of HIV.</a> <em>Current HIV research</em>, <em>9</em>(6), 367-382.{/ref} ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases.&nbsp;</p>\n\n\n\n<p>In 2011, the journal <em>Science</em> named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its \u201cBreakthrough of the Year\u201d.{ref}</p>\n\n\n\n<p>Science announcement: </p>\n\n\n\n<p>Cohen, J. (2011). <a href=\"https://science.sciencemag.org/content/334/6063/1628\">HIV treatment as prevention</a>.<br></p>\n\n\n\n<p>Study that was awarded: </p>\n\n\n\n<p>Cohen, M. S., Chen, Y. Q., McCauley, M., Gamble, T., Hosseinipour, M. C., Kumarasamy, N., &#8230; &amp; Godbole, S. V. (2011).<a href=\"https://www.nejm.org/doi/full/10.1056/Nejmoa1105243\"> Prevention of HIV-1 infection with early antiretroviral therapy.</a><em>New England journal of medicine</em>, <em>365</em>(6), 493-505.{/ref} Many other studies have now shown similar findings, with a range of reduction in transmission attributable to ART depending on location and groups studied.{ref}PARTNER study showed chances of transmission between gay couples with successfull virus suppression by ART are \u201ceffectively zero\u201d.&nbsp;</p>\n\n\n\n<p>Rodger, A. J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Degen, O., &#8230; &amp; Raben, D. (2019). <a href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30418-0/fulltext\">Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study.</a> <em>The Lancet</em>.</p>\n\n\n\n<p>Transmission rates in Madrid fell by 86% after ART became available</p>\n\n\n\n<p>Castilla, J., Del Romero, J., Hernando, V., Marincovich, B., Garc\u00eda, S., &amp; Rodr\u00edguez, C. (2005). <a href=\"https://journals.lww.com/jaids/Fulltext/2005/09010/Prevalence_of_Unsafe_Sexual_Behavior_Among.16.aspx?casa_token=4RZtew6owdYAAAAA:YrqHOyO0wmGz7hSrlm0r6loCZUtsZd1wVRVQvR2U0_XPeUnJpSC9ykITGg0bsGmB1IjAinXZbUd9hslCBo-DtYCk\">Effectiveness of highly active antiretroviral therapy in reducing heterosexual transmission of HIV</a>. <em>JAIDS Journal of Acquired Immune Deficiency Syndromes</em>, <em>40</em>(1), 96-101.</p>\n\n\n\n<p>A study in San Francisco showing after ART became available, viral loads dropped to 40% and HIV infection rates fell by 60%.</p>\n\n\n\n<p>&nbsp;Das, M., Chu, P. L., Santos, G. M., Scheer, S., Vittinghoff, E., McFarland, W., &amp; Colfax, G. N. (2010). <a href=\"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0011068\">Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco</a>. <em>PloS one</em>, <em>5</em>(6), e11068.</p>\n\n\n\n<p>After ART became freely available in Taiwan transmission rates fell by 50%.&nbsp;Fang, C. T., Hsu, H. M., Twu, S. J., Chen, M. Y., Chang, Y. Y., Hwang, J. S., &#8230; &amp; Division of AIDS and STD, Center for Disease Control, Department of Health, Executive Yuan. (2004). <a href=\"https://academic.oup.com/jid/article-abstract/190/5/879/868453\">Decreased HIV transmission after a policy of providing free access to highly active antiretroviral therapy in Taiwan.</a><em>Journal of Infectious Diseases</em>, <em>190</em>(5), 879-885.{/ref} A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.{ref}&nbsp;Hogg, R. S., Heath, K., Lima, V. D., Nosyk, B., Kanters, S., Wood, E., &#8230; &amp; Montaner, J. S. (2012). <a href=\"https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0047260\">Disparities in the burden of HIV/AIDS in Canada</a>. <em>PLoS One</em>, <em>7</em>(11), e47260.{/ref}</p>\n\n\n\n<h4>We need to increase ART coverage</h4>\n\n\n\n<p>The number of people who receive ART has increased significantly in recent years, especially in African countries where the prevalence of HIV/AIDS is the highest.</p>\n\n\n\n<p>But many millions of people who could benefit from the life-saving treatment currently don\u2019t.\u00a0</p>\n\n\n\n<p>To increase ART coverage, we must first improve access to testing for HIV status. In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.{ref}The 79% figure is based on <a href=\"https://www.unaids.org/en/resources/fact-sheet\">2019 UNAIDS estimates</a>.</p>\n\n\n\n<p>The frequency of undiagnosed HIV/AIDS can be measured using observational studies. Measures of the expected rate of HIV infection, the actual number of people diagnosed with HIV, and delay in diagnosis are taken into account to predict the true expected prevalence of HIV in a population and the proportion of undiagnosed cases (see Singh et <em>al.</em> reference).&nbsp;</p>\n\n\n\n<p>The initial HIV infection is often followed by flu-like symptoms, which subside in a few weeks. The infected patient can then live without symptoms for months or years while their immune system may be slowly deteriorating. Hence, people infected with HIV may not even know they need to be tested due to the lack of symptoms. Models used to predict HIV incidence rate often use an expected 5-year lag between infection and diagnosis.&nbsp;</p>\n\n\n\n<p>Singh, S., Song, R., Johnson, A. S., McCray, E., &amp; Hall, H. I. (2018). <a href=\"https://annals.org/aim/fullarticle/2675979/hiv-incidence-prevalence-undiagnosed-infections-u-s-men-who-have\">HIV incidence, prevalence, and undiagnosed infections in US men who have sex with men.</a> <em>Annals of internal medicine</em>, <em>168</em>(10), 685-694.{/ref} And awareness is also not enough. In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.{ref}</p>\n\n\n\n<p>WHO eligibility criteria are based on CD4 counts, which go down as the illness progresses. A healthy person\u2019s CD4 counts are &gt;500/mm3. WHO recommends ART for anyone with HIV diagnosis and CD4 count &gt;350 cells and \u2264500/mm3, regardless of clinical symptoms. All children, people with TB, HBV, and pregnant women diagnosed with HIV regardless of their CD4 status, should get ART.&nbsp;<a href=\"https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/\">https://www.who.int/hiv/pub/guidelines/arv2013/art/statartadolescents/en/</a></p>\n\n\n\n<p>Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., &amp; Lawn, S. D. (2012). <a href=\"https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383\">Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub\u2010Saharan Africa: a systematic review.</a> <em>Journal of the International AIDS Society</em>, <em>15</em>(2), 17383.{/ref} Of those who should start ART, only 66% did.{ref}For some countries, eligibility for ART treatment is determined by the so-called CD4+ counts, which go down as the illness progresses.\u00a0</p>\n\n\n\n<p>&nbsp;Kranzer, K., Govindasamy, D., Ford, N., Johnston, V., &amp; Lawn, S. D. (2012). <a href=\"https://onlinelibrary.wiley.com/doi/full/10.7448/IAS.15.2.17383\">Quantifying and addressing losses along the continuum of care for people living with HIV infection in sub\u2010Saharan Africa: a systematic review.</a> <em>Journal of the International AIDS Society</em>, <em>15</em>(2), 17383.{/ref} </p>\n\n\n\n<p>Stigmatization of people who have HIV/AIDS also leads to a decrease in engagement with care, treatment, and prevention services.{ref}Mahajan, A. P., Sayles, J. N., Patel, V. A., Remien, R. H., Ortiz, D., Szekeres, G., &amp; Coates, T. J. (2008). <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835402/\">Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. </a><em>AIDS (London, England)</em>, <em>22</em>(Suppl 2), S67.{/ref}</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/antiretroviral-therapy-coverage-among-people-living-with-hiv\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h3>Prevention of mother-to-child transmission (PMTCT)</h3>\n\n\n\n<p>Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV. </p>\n\n\n\n<p>The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.{ref}World Health Organization (WHO)<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https://www.who.int/hiv/topics/mtct/about/en/\" target=\"_blank\">&nbsp;&#8216;Mother-to-child transmission of HIV&#8217;&nbsp;</a>[accessed November 2019]{/ref}</p>\n\n\n\n<p>PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection. </p>\n\n\n\n<p>The visualization shows the number of child infections averted from ART coverage in mothers.</p>\n\n\n\n<p>You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world <a href=\"https://ourworldindata.org/grapher/new-hiv-infections-averted-due-to-pmtct\">here</a>.</p>\n\n\n\n<iframe src=\"https://ourworldindata.org/grapher/number-of-new-hiv-child-infections-vs-number-of-infections-averted-due-to-pmtct\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe>\n\n\n\n<h4>Coverage of ART in pregnant women</h4>\n\n\n\n<p>This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy \u2013 a vital intervention to prevent the transmission from mother to child.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/art-coverage-for-pregnant-women\"></iframe></figure>\n\n\n\n<h3>Safe sex</h3>\n\n\n\n<h4>Unsafe sex is a leading risk factor for death in Sub-Saharan Africa</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/number-of-deaths-by-risk-factor?country=~Sub-Saharan+Africa+%28WB%29\" loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\"></iframe></figure>\n\n\n\n<h4>Share of people practicing safe sex</h4>\n\n\n\n<p>The majority of HIV infections are transmitted through sexual activity.<br> <br>Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of &#8216;high-risk sex&#8217;, which is that with a non-marital, non-cohabiting sexual partner.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/condom-use-at-last-high-risk-sex\"></iframe></figure>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/condom-use-during-last-high-risk-sex\"></iframe></figure>\n\n\n\n<h3>Education on HIV/AIDS</h3>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/young-people-with-knowledge-on-hiv-prevention\"></iframe></figure>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/knowledge-hiv-prevention-in-males-vs-females\"></iframe></figure>\n\n\n\n<h3>Funding to support efforts against HIV/AIDS</h3>\n\n\n\n<p>You can explore the breakdown of funding resources by source for each country <a href=\"https://ourworldindata.org/grapher/hivaids-funding-by-source\">here</a>.</p>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/hiv-expenditure\"></iframe></figure>\n\n\n\n<h4>Future funding needs to meet HIV targets</h4>\n\n\n\n<figure><iframe src=\"https://ourworldindata.org/grapher/resource-needs-to-meet-hiv-targets\"></iframe></figure>\n\n\n\n<hr class=\"wp-block-separator\"/>\n\n\n\n<h2>Data quality and definition</h2>\n\n\n\n<h3>Terminology and definitions</h3>\n\n\n\n<p>The following terminology and definitions are sourced from the UNAIDS organization.{ref}UNAIDS (2015). Terminology guidelines. Available <a href=\"http://www.unaids.org/sites/default/files/media_asset/2015_terminology_guidelines_en.pdf\">online</a>.{/ref}</p>\n\n\n\n<p><strong>HIV</strong>: Human Immunodeficiency Virus.&nbsp;HIV is a virus that weakens the immune system, ultimately leading to AIDS.</p>\n\n\n\n<p><strong>AIDS</strong>:&nbsp;acquired immunodeficiency syndrome.</p>\n\n\n\n<p><strong>Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment</strong>: &#8220;Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations.</p>\n\n\n\n<p>More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term &#8220;highly active&#8221; antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. &#8220;Highly active&#8221; is not needed as a qualification, and the term is no longer commonly used.</p>\n\n\n\n<p>ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use.&#8221;</p>\n\n\n\n<p><strong>ARV-based prevention</strong>: &#8220;ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention).&#8221;</p>\n\n\n\n<p><strong>Epidemic</strong>: &#8220;An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic.&#8221;</p>\n\n\n\n<p><strong>HIV-negative (seronegative)</strong>: &#8220;A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative.&#8221;</p>\n\n\n\n<p><strong>HIV-positive (seropositive)</strong>: &#8220;A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies.&#8221;</p>\n\n\n\n<p><strong>Incidence</strong>: &#8220;HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15\u201349 years and 0\u201314 years.&#8221;</p>\n\n\n\n<p><strong>Mother-to-child transmission (MTCT)</strong>: &#8220;MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4).</p>\n\n\n\n<p>PMTCT is often mistakenly referring to only prong 3\u2014 the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT).&#8221;</p>\n\n\n\n<p><strong>Prevalence</strong>: &#8220;Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15\u201349 years.&#8221;</p>\n\n\n\n<p><strong>Tuberculosis (TB)</strong>: &#8220;Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se.</p>\n\n\n\n<p>The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria.&#8221;</p>\n\n\n\n<h3>Comparisons of UNAIDS and IHME estimates</h3>\n\n\n\n<p>Several sources publish estimates on HIV and AIDS &#8211; two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources&#8217; relationship/consistency in prevalence estimates.</p>\n\n\n\n<h4>Prevalence of HIV</h4>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/prevalence-of-hiv-unaids-vs-ihme-estimates\" width=\"300\" height=\"150\"></iframe>\n\n\n\n<h4>Incidence/new cases of HIV</h4>\n\n\n\n<iframe loading=\"lazy\" style=\"width: 100%; height: 600px; border: 0px none;\" src=\"https://ourworldindata.org/grapher/new-cases-of-hiv-unaids-vs-ihme\" width=\"300\" height=\"150\"></iframe>\n",
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        "rendered": "A global epidemic and the leading cause of death in some countries.",
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    "date_gmt": "2018-04-03T22:07:27",
    "modified": "2023-08-31T16:57:37",
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    "authors_name": [
        "Max Roser",
        "Hannah Ritchie"
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