How Have Deaths From Hiv/aids Changed Over Time
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 early 2000s 2004 to 2005 global deaths reached their peak at almost 2 million per year.
Driven mostly by the development and availability of antiretroviral therapy , global deaths have halved since then. In 2017, just under one million died from the disease.
You can explore this change for any country or region using the change country toggle on the interactive chart.
HIV/AIDS once accounted for more than 1-in-3 deaths in some countries, but rates are now falling
Global progress on HIV/AIDS has been driven by large improvements in countries which were most affected by the HIV epidemic.
Today the share of deaths remains high: more than 1-in-4 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. In Zimbabwe, it accounted for more than half of annual deaths in the late 1990s.
We see that over the past decade this share has fallen as antiretoviral treatment has become more widely available.
Children living with HIV
New HIV infections of children
Who Is Most At Risk
Tuberculosis mostly affects adults in their most productive years. However, all age groups are at risk. Over 95% of cases and deaths are in developing countries.
People who are infected with HIV are 18 times more likely to develop active TB . The risk of active TB is also greater in persons suffering from other conditions that impair the immune system. People with undernutrition are 3 times more at risk. Globally in 2019, there were 2.2 million new TB cases in 2018 that were attributable to undernutrition.
Alcohol use disorder and tobacco smoking increase the risk of TB disease by a factor of 3.3 and 1.6, respectively. In 2019, 0.72 million new TB cases worldwide were attributable to alcohol use disorder and 0.70 million were attributable to smoking.
New Hiv Diagnoses Among Gay And Bisexual Men In The Us And Dependent Areas By Race/ethnicity 2019
* Black refers to people having origins in any of the Black racial groups of Africa. African American is a term often used for people of African descent with ancestry in North America. Hispanic/Latino people can be of any race.
From 2015 to 2019, HIV diagnoses decreased 9% among gay and bisexual men overall. But trends varied for different groups of gay and bisexual men.
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Orphans And Vulnerable Children
In Eswatini, 11,000 children were living with HIV in 2018, of whom 76% were on antiretroviral treatment. New infections among children and AIDS-related deaths have reduced greatly to fewer than 1,000 each year.20 However, the HIV epidemic continues to have a significant effect on children in other ways. Around 45,000 0 to 17 year-olds have been orphaned due to AIDS-related illnesses.21
Around 38% of Eswatinis population are aged under 15 and only 5% are aged 60 or over.22 With such high HIV prevalence and AIDS-related deaths amongst the most productive working age ranges, care of orphans and vulnerable children often falls upon older generations such as grandparents. This also exacerbates existing poverty for families.
Men Who Have Sex With Men
Estimates suggest that HIV prevalence among men who have sex with men in Eswatini is 12.6%, although data is extremely limited.27 Same-sex sexual relations are illegal, which helps to fuel the stigmatisation of this population group.
Despite being highly vulnerable to HIV, men who have sex with men often remain hidden and do not access prevention, treatment or care services. For example, a study involving around 400 men who have sex with men and 100 transgender women in Eswatini found participants who reported that healthcare workers knew their sexual orientation were more likely to receive poor treatment, be gossiped about and avoid seeking healthcare. Similarly, participants whose family members were aware of their sexuality were more likely to be excluded from other family members and be subject to gossip. 28
Historically, the government has done little to address this groups needs.29 Few HIV programmes specifically target men who have sex with men.30 As a result, only 27% of men who have sex with men were reached with targeted HIV prevention programmes in 2013, the most recent data available.31 Around 57% of men who have sex with men are estimated to use condoms.32
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Hiv Among People Who Acquire Hiv Through Heterosexual Sex
How many people living with HIV in Canada acquired HIV through heterosexual sex?
According to national HIV estimates, 20,750 people living with HIV in Canada acquired HIV through heterosexual sex in 2018. This represents 33.4% of all people with HIV in Canada.
In 2016, the Public Health Agency of Canada separated heterosexual transmission into two categories those born in an HIV-endemic country and those born in a non HIV-endemic country . According to the Public Health Agency of Canada This separation is no longer considered appropriate, for reasons of increasing data incompleteness. The Public Health Agency of Canada is working with communities and with provinces and territories to find ways to better reflect the HIV situation in these communities.
The 2016 estimates that separate heterosexual transmission into these two categories can be found in the Summary: Estimates of HIV incidence, prevalence and Canadas progress on meeting the 90-90-90 HIV targets, 2016.
How many new HIV infections are acquired through heterosexual sex in Canada each year?
According to national HIV estimates, 761 new HIV infections in Canada were acquired through heterosexual sex in Canada in 2018. This represents 34.0% of all new HIV infections.
The 2016 estimates that separate heterosexual transmission into these two categories can be found in the Summary: Estimates of HIV incidence, prevalence and Canadas progress on meeting the 90-90-90 HIV targets, 2016.
Increased Uptake Of Prep
Andrew Grulich, head of the HIV epidemiology and prevention program at the Kirby Institute, said the introduction of PrEP in Australia had “turned the HIV epidemic in gay and bisexual men around”.
PrEP, a pill taken daily to prevent the transmission of HIV between men during sex, was added to the Pharmaceutical Benefits Scheme in April 2018. Since then, data shows an additional 18,530 individuals have begun taking the preventative treatment.
“We’re really quite pleased with how many gay and bisexual men have embraced PrEP as a way to protect themselves from HIV,” Professor Grulich said.
“However, for declines to continue at this impressive rate, PrEP coverage needs to be significantly higher.”
In Australia, approximately 41 per cent of gay men at high risk of HIV were taking PrEP in 2017.
Modelling suggests at least 75 per cent would need to take PrEP in order to achieve the elimination of HIV transmission in this high-risk group.
Professor Grulich said gay and bisexual men from culturally and linguistically diverse backgrounds should be the target of future PrEP rollouts, as well as gay men living in outer suburban, regional and rural parts of Australia.
“But it isn’t just PrEP,” he said, “it requires continued focus on testing, treatment, and condom promotion, which will help us continue the decline of HIV.”
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Structural And Resource Barriers
Although Eswatini is politically stable and uncrowded, and has good farming land, high HIV prevalence, unemployment and food insecurity mean many residents experience hardship and poverty.111
Eswatini is a lower-middle income country, however these factors, coupled with a weak business climate and low foreign investment, mean the country operates more as a low-income country.112
As a result many residents migrate, particularly to South Africa. This makes the delivery of ongoing healthcare services a challenge and complicates the way in which the countrys HIV epidemic is monitored.113
It also contributes to the lack of skilled healthcare workers in Eswatini, with staffing levels unable to meet demand in a significant number of health facilities. There is also an urgent need to expand the number of community-based peer and outreach workers who can specifically meet the needs of key populations.114
Antiretroviral Treatment Availability In South Africa
South Africa has the largest ART programme in the world. In 2018, UNAIDS reported that 4.8 million people were receiving treatment in South Africa. This equates to 62% of people living with HIV in the country.107
South Africas ART services have undergone dramatic expansion in recent years, in keeping with the World Health Organizations changing guidelines. In 2016, South Africa implemented the test and treat strategy, making everyone with a positive diagnosis eligible for treatment regardless of how advanced HIV is in their body. This has seen the number of people eligible for treatment more than double in recent years: from 3.39 million in 2015 to 7.7 million people in 2018.108
Initially many were concerned that the dramatic scale-up of ART would overstretch clinics and services and reduce the quality of care. However, evidence suggests the increase in ART provision has had no significant effect on patient outcomes, either in terms of either AIDS-related deaths or illnesses.109
Studies have, however, highlighted other issues around treatment provision. They found that men were more likely to start ART at an older age and later stage of infection and had almost double the mortality rate than that of women. In 2018, 65% of women living with HIV were accessing treatment, compared to 56% of HIV positive men.110 This again highlights the need to engage men in testing services and ensure that they are linked to treatment.111
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What About Hiv Around The World
HIV disease continues to be a serious health issue for parts of the world. Worldwide, there were about 2.1 million new cases of HIV in 2015. About 36.7 million people are living with HIV around the world, and as of June 2016, 17 million people living with HIV were receiving medicines to treat HIV, called antiretroviral therapy . An estimated 1.1 million people died from AIDS-related illnesses in 2015. Sub-Saharan Africa, which bears the heaviest burden of HIV/AIDS worldwide, accounts for 65% of all new HIV infections. Other regions significantly affected by HIV/AIDS include Asia and the Pacific, Latin America and the Caribbean, and Eastern Europe and Central Asia.
CDC’s Global AIDS websiteexplains what CDC is doing in the global fight against HIV.
Global Commitments And The Who Response
On 26 September 2018, the United Nations held its first- ever high-level meeting on TB, elevating discussion about the status of the TB epidemic and how to end it to the level of heads of state and government. It followed the first global ministerial conference on TB hosted by WHO and the Russian government in November 2017. The outcome was a political declaration agreed by all UN Member States, in which existing commitments to the SDGs and WHOs End TB Strategy were reaffirmed, and new ones added.
SDG Target 3.3 includes ending the TB epidemic by 2030. The End TB Strategy defines milestones and targets for reductions in TB cases and deaths. The targets for 2030 are a 90% reduction in the number of TB deaths and an 80% reduction in the TB incidence rate compared with levels in 2015. The milestones for 2020 are a 35% reduction in the number of TB deaths and a 20% reduction in the TB incidence rate. The strategy also includes a 2020 milestone that no TB patients and their households face catastrophic costs as a result of TB disease.
The political declaration of the UN high-level meeting included four new global targets:
- treat 40 million people for TB disease in the 5-year period 20182022
- reach at least 30 million people with TB preventive treatment for a latent TB infection in the 5-year period 20182022
- mobilize at least US$ 13 billion annually for universal access to TB diagnosis, treatment and care by 2022
- mobilize at least US$ 2 billion annually for TB research.
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Hiv Among Indigenous People
How many Indigenous people are living with HIV in Canada ?
According to national HIV estimates, 6,180 Indigenous people were living with HIV in Canada in 2018. This represents 10.0% of all people with HIV in Canada.
How many new infections are there in Indigenous people in Canada each year?
According to national HIV estimates, 314 new HIV infections in Canada were in Indigenous people in 2018. This represents 14.0% of all new infections. In comparison, Indigenous people made up only 4.9% of the total Canadian population in 2016, making Indigenous people over-represented in new HIV infections in Canada.
How is Canada doing at reaching the global targets of 90-90-90 for Indigenous people who inject drugs?
According to a surveillance study conducted with Indigenous people who inject drugs in Canada between 2017 and 2019:
- 78.2% of Indigenous PWID with HIV were aware of their status in 20172019
- 83.7% of Indigenous PWID diagnosed with HIV were on treatment in 20172019
- 64.4% of Indigenous PWID on HIV treatment reported an undetectable viral load in 20172019
The Future Of Hiv In Eswatini
In recent years Eswatini has made great progress in tackling HIV, particularly around the areas of treatment, PMTCT and reducing HIV incidence overall.
However, the high HIV prevalence among the general population means the government will need to tackle many of the social and cultural problems that hamper the response. These include poverty, gender inequality and risky cultural practices that contribute to a high risk of HIV infection.120
Effective prevention initiatives and a greater focus on improving access to HIV testing facilities are also urgently needed, especially for men, young people and criminalised populations. The epidemic among key affected populations, particularly female sex workers and men who have sex with men, also needs to be addressed.
ART coverage shows adolescent boys and girls and men are lagging behind. Without increased testing and treatment enrolment among these groups, HIV incidence will not decline as quickly as anticipated.121 In addition, the decline in the proportion of pregnant women who are HIV-positive accessing ART must be reversed, or important gains is this area risk being lost.
The government needs to work harder to collect data and understand the complex needs of population groups most affected by HIV in order to develop adequate HIV programming. The dual epidemic of TB and HIV also remains a cause for concern.
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Representativeness And Limitations Of Data
HIV infection surveillance data represents confidential reports of HIV infection and AIDS diagnoses, though not all persons with an HIV infection. The distinction here is that HIV diagnosis data represent the earliest date of diagnosis reported to the ODH HIV/AIDS Surveillance Program. The earliest date reported may not be the earliest date an individual became aware of their HIV infection. Individuals may have previously tested anonymously or were diagnosed out-of-state prior to being confidentially tested and reported to Ohio. HIV infection surveillance data may underestimate the level of recently infected persons because some infected persons do not know they are infected as they have not sought testing or have sought testing but did not respond to learn their test results. Reporting of behavioral risk information may not be complete as some persons diagnosed with an HIV infection may be reluctant to disclose their sexual and drug use history.
The Future Of Hiv In South Africa
South Africa has made great strides in tackling its HIV epidemic in recent years and now has the biggest HIV treatment programme in the world. Moreover, these efforts are now largely funded from South Africa’s own resources.
HIV prevention initiatives are having a particularly significant impact on mother-to-child transmission rates, which are falling dramatically. New HIV infections overall have fallen by half in the last decade, however there are still too many. For certain population groups, such as transgender women, a lack of data is hampering HIV prevention efforts. In addition, the criminalisation of at-risk groups such as sex workers, and widespread gender inequity particularly gender-based violence continues to fuel transmission.
While the short term financing of South Africa’s HIV epidemic is secure, in the longer term, the government needs to explore other strategies in order to sustain and expand its progress.
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What Statistics Are Available In Canada To Inform Programming
There are two main types of numbers available, HIV estimates and HIV surveillance data .
HIV estimates are developed by the Public Health Agency of Canada through statistical modelling, using a variety of data sources. There are two main types of estimates:
- Prevalence estimates tell us how many people are living with HIV at a given point in time. They include estimates for the number of people who are undiagnosed and take into account the number of people with HIV who have died.
- Incidence estimates tell us how many people got HIV in a given year, including those who had not yet been diagnosed.
HIV surveillance data are published by the Public Health Agency of Canada and tell us how many people were diagnosed with HIV in a given year. This information does not tell us when they got HIV, just when the diagnosis was made. People may have had HIV for many years before diagnosis.
Tuberculosis Among People Living With Hiv
Tuberculosis 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 still 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.
In the charts here we see the number of tuberculosis patients who tested positive for HIV the number receiving antiretroviral therapy and the number of TB-related deaths among those living with HIV.
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.3
Today, a person living in a high-income country who started ART in their twenties can expect to live for another 46 years that is well into their 60s.4
While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the life expectancy of the general population, we are getting closer to this goal.5
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.7 ART reduces the number of viral particles present in an HIV-positive individual and therefore, the likelihood of passing the virus to another person decreases.
We need to increase ART coverage
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