HIV/AIDS

HIV (human immunodeficiency virus) infects cells of the immune system

Infection results in the progressive deterioration of the immune system, breaking down the body's ability to fend off some infections and other diseases. AIDS (Acquired immune deficiency syndrome) refers to the most advanced stages of HIV infection, defined by the occurrence of any of more than 20 opportunistic infections or related cancers.

HIV can be transmitted in several ways

HIV can be transmitted through:

• the transmission between a mother and her baby during pregnancy, childbirth and breastfeeding.

• unprotected sexual intercourse (vaginal or anal) or oral sex with an infected person;

• transfusions of contaminated blood or blood products or transplantation of contaminated tissue;

• the sharing of contaminated injecting equipment and solutions (needles, syringes) or tattooing equipment;

• through the use of contaminated surgical equipment and other sharp instruments;

37.7 million people are living with HIV worldwide

Globally, an estimated 37.7 million [30.2–45.1 million] people were living with HIV in 2020, and 1.7 million [1.2–2.2 million] of these were children. The vast majority of people living with HIV are in low- and middle-income countries. An estimated 1.5 million [1.0–2.0 million] people were newly infected with HIV in 2020. Almost 36.3 million [27.2-47.8 million] people have died from HIV-related causes so far, including 680 000 [480 000–1 million] in 2020.

There are several ways to prevent HIV transmission

Key ways to prevent HIV transmission:

• practice safe sexual behaviours such as using condoms;
• get tested and treated for sexually transmitted infections, including HIV to prevent onward transmission;
• avoid injecting drugs, or if you do, always use sterile needles and syringes;
• ensure that any blood or blood products that you might need are tested for HIV;
• access voluntary medical male circumcision if you live in one of the 15 African countries where this intervention is promoted;
• if you have HIV start antiretroviral therapy as soon as possible for your own health and to prevent HIV transmission to your sexual or drug using partner or to your infant (if you are pregnant or breastfeeding);
• use pre-exposure prophylaxis prior to engaging in high risk behaviour; demand post-exposure prophylaxis if there is the risk that you have been exposed to HIV infection in both occupational and non-occupational settings.

Combination antiretroviral therapy (ART) prevents HIV from multiplying in the body

If the reproduction of HIV stops, then the body's immune cells are able to live longer and provide the body with protection from infections. Effective ART results in a reduction in viral load, the amount of virus in the body, greatly reducing the risk of transmitting the virus to sexual partners. If the HIV positive partner in a couple is on effective ART, the likelihood of sexual transmission to the HIV-negative partner can be reduced by as much as 96%. Expanding coverage of HIV treatment contributes to HIV prevention efforts.

As of end-2020, 27.5 million people were receiving ART worldwide

Of these, almost 25.5 million lived in low- and middle-income countries. Since 2016, WHO has recommended provision of lifelong ART to all children, adolescents and adults living with HIV, including all pregnant and breastfeeding women, regardless of CD4 cell count as soon as possible after diagnosis. WHO has also expanded earlier recommendations to offer pre-exposure prophylaxis of HIV (PrEP) to selected people at substantial risk of acquiring HIV. Alternative first-line treatment regimens are also recommended. Since the release of the 2016 version, WHO has provided updates in several areas of this guideline – Antiretroviral options for first- and second-line treatment, infant diagnosis, post-exposure prophylaxis, advanced HIV disease and management of cryptococcal infections and delivering HIV services. In 2021, WHO released the "Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach”. These consolidated guidelines bring together existing and new clinical and programmatic recommendations across different ages, populations and settings, bringing together all relevant WHO guidance on HIV produced since 2016. It serves as an update to the previous edition of the consolidated guidelines on HIV.

HIV testing can help to ensure treatment for people in need

Access to HIV testing and medicines should be dramatically accelerated in order to reach the goal of ending AIDS by 2030. HIV testing reach is still limited, as an estimated 16% of people with HIV or 6.1 million people remain undiagnosed and don't know their infection status. WHO is recommending innovative HIV-self-testing and partner notification approaches to increase HIV testing services among undiagnosed people.

An estimated 1.7 million children are living with HIV

According to 2020 figures most of these children live in sub-Saharan Africa and were infected through transmission from their HIV-positive mothers during pregnancy, childbirth or breastfeeding. Around 150 000 children [100 000–240 000] became newly infected with HIV in 2020 globally.

Elimination of mother-to-child-transmission is becoming a reality

Access to preventive interventions remains limited in many low- and middle-income countries. But progress has been made in some areas such as prevention of mother-to-child transmission of HIV and keeping mothers alive. In 2020, 85% of all pregnant women living with HIV – 1.1 million women – received antiretrovirals worldwide. In 2015, Cuba was the first country declared by WHO as having eliminated mother-to-child transmission of HIV and syphilis. By end 2020, 14 countries and territories were validated for eliminating mother-to-child transmission of HIV.

HIV is the greatest risk factor for developing active TB disease

In 2019, an estimated 8.2% of the 10 million people who developed TB worldwide were HIV-positive. In the same year approximately 208 000 deaths from tuberculosis occurred among people living with HIV. The WHO African Region accounted for 81% of the estimated number of HIV-related TB deaths.