HIV

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 2021, 81% 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 the end of 2021, 15 countries and territories were validated for eliminating mother-to-child HIV.

38.4 million people are living with HIV worldwide

Globally, an estimated 38.4 million [33.9–43.8 million] people were living with HIV in 2021, and 1.7 million [1.3–2.1 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 [1.1–2.0 million] people were newly infected with HIV in 2021. Up to 40.1 million [33.6–48.6 million] people have died from HIV-related causes so far, including 650 000 [510 000–860 000] people in 2021.

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.

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.

An estimated 1.7 million children are living with HIV

According to 2021 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 160 000 children [110 000–230 000] became newly infected with HIV in 2021 globally.

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 15% of people with HIV or 5.9 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.

At the end of 2021, 28.7 million people were receiving ART worldwide

Of these, 26.6 million lived in low- and middle-income countries. Since 2016, WHO has recommended that all people living with HIV be provided with lifelong ART, including children, adolescents, adults and pregnant and breastfeeding women, regardless of clinical status or CD4 cell count. 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 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;

HIV is the greatest risk factor for developing active TB disease

In 2020, an estimated 8% of the 9.9 million people who developed TB worldwide were HIV-positive. In the same year approximately 214 000 deaths from tuberculosis occurred among people living with HIV. The WHO African Region accounted for 80% of the estimated number of HIV-related TB deaths.

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.