The Status Of The Hiv/aids Epidemic In Sub
Senior Fellow, Futures Group International
Despite the fact that sub-Saharan Africa contains only about 11 percent of the Earths population, the region is the worlds epicenter of HIV/AIDS. The numbers are daunting. Adult HIV prevalence is 1.2 percent worldwide , but it is 9.0 percent in sub-Saharan Africa. UNAIDS estimates that at the end of 2001, there were 40 million people living with HIV/AIDS, 28.5 million of them from sub-Saharan African. Five million adults and children became newly infected with HIV in 2001, 3.5 million of them from sub-Saharan Africa. Three million people died from AIDS-related causes in 2001, and 2.2 million of these deaths were among sub-Saharan Africans.2
AIDS is now the leading cause of death in sub-Saharan Africa. Life expectancy at birth has plummeted in many African countries, wiping out the gains made since independence. The combination of high birth rates and high AIDS mortality among adults, including many parents, has meant that more than 90 percent of children who have been orphaned as a consequence of the HIV/AIDS epidemic are in this region.2
According to UNAIDS, all the worst affected countries are contiguous to one another in the lower part of the continent. These include South Africa, Lesotho, Swaziland, Botswana, Namibia, Zambia, and Zimbabwe. Botswana, Lesotho, Swaziland, and Zimbabwe have prevalence rates above 30 percent.4
|Total Adults and Children|
Hiv And Aids In Eswatini
- Despite its small population size, Eswatini has the highest HIV prevalence in the world and has been greatly affected by the epidemic.
- Although the epidemic is generalised, certain groups are particularly affected, especially those who are socially marginalised and criminalised. For example, the country has the highest HIV prevalence among sex workers in the world .
- Over the last decade, Eswatini has made great efforts to turn around its epidemic with improved access to HIV testing services and the provision of free antiretroviral treatment to those who need it.
- Eswatini has a dual epidemic of TB and HIV and has responded with successful dual test and treatment programmes.
- High levels of HIV stigma and discrimination in Eswatini remain major barriers to people accessing HIV prevention services.
Explore this page to find out more about populations most affected by HIV, testing and counselling, , antiretroviral treatment availability, , tuberculosis and HIV, barriers to prevention, and the future of HIV in eSwatini.
Eswatini, a small, landlocked country in southern Africa, has the highest HIV prevalence in the world, with 27.3% of adults living with HIV. In 2018, 7,800 adults were newly infected with HIV and 2,800 people died of an AIDS-related illness.1
Although Strides Have Been Made In The Hiv Response Children Are Still Affected By The Epidemic
Of the estimated 38.0 million people living with HIV worldwide in 2020, 2.78 million were children aged 0-19. Each day in 2020, approximately 850 children became infected with HIV and approximately 330 children died from AIDS related causes, mostly because of inadequate access to HIV prevention, care and treatment services.
As of 2020, roughly 15.4 million children under the age of 18 had lost one or both parents to AIDS-related causes. Millions more have been affected by the epidemic, through a heightened risk of poverty, homelessness, school dropout, discrimination and loss of opportunities, as well as COVID-19. These hardships include prolonged illness and death. Of the estimated 680,000 people who died of AIDS-related illnesses in 2020, 120,000 of them were children under 20 years of age.
In 2020, around 160,000 children aged 0-9 were newly infected with HIV, bringing the total number of children aged 0-9 living with HIV to 1.03 million . Nearly 90 per cent of these children live in sub-Saharan Africa. One bright spot on the global horizon is the rapid decline of approximately 52 per cent in new HIV infections among children aged 0-9 since 2010 due to stepped-up efforts to prevent mother-to-child transmission of HIV. However, the number of new HIV infections among adolescents has declined at a slower rate of about 38 per cent.
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Regional Network Of People Living With Hiv Launched In The Middle East And North Africa
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19 APRIL 2021
The HIV epidemic in the Middle East and North Africa is still growingan estimated 20 000 new HIV infections in 2019 marked a 25% increase over the 16 000 new infections in 2010. The region is far from controlling its HIV epidemic and HIV treatment coverage is low, with only 38% of people living with HIV accessing HIV treatment in 2019, resulting in 8000 people dying from AIDS-related illnesses in the region.
Community-based organizations can play important roles in the regions HIV response, but they are constrained in many countries by limited civic space and resources. In response, community leaders living with HIV have come together to launch the first regional network of people living with HIV, MENA Plus, to strengthen the community HIV response in the region.
It is time people living with HIV have a network where they make their own decisions and get our rights without stigma and discrimination, said Amina Ibrahim , a member of MENA Plus from Egypt.
With a vision of a society where people living with HIV live with respect and dignity, enjoy their full rights and have equal opportunities, MENA Plus aims to enhance the leadership, representation and effective engagement of people living with HIV across the Middle East and North Africa.
The network will advocate for HIV treatment and prevention services in the region, the sustainability of HIV funding and ending vertical transmission of HIV and new HIV infections among children.
Ologies For Estimating The Number Of People Living With Hiv
There are several methods used to estimate the number of people living with HIV in a given jurisdiction . One article reviewing the data sources, methodology, and comparability of HIV care continuums found that cascades that reported undiagnosed HIV-infection used different sets of data and employed methods that were not comparable .
The Working Group on Estimation of HIV Prevalence in Europe describes three main approaches for estimating the number of undiagnosed individuals living with HIV: methods that are based on calculating cumulative incidence of HIV, methods based on CD4 cell count, and methods based on prevalence surveys . The first approach is described in more detail as this is the approach PHAC used to estimate figures for Canada in 2016 . Note that there does not appear to be a gold standard for calculating estimates of the undiagnosed proportion each method has benefits and drawbacks , and various assumptions are made to arrive at each estimate .
Methods based on cumulative incidence of HIV
The Ottawa/Sydney method is a mathematical modelling technique that utilizes national HIV/AIDS surveillance data to produce estimates . These kinds of models simulate real-life circumstances by using equations to predict future trends . PHAC used statistical modelling to estimate HIV incidence, prevalence, and the 90-90-90 measures for Canada for 2016 .
Methods based on CD4 cell count
Methods based on prevalence surveys
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Hiv In The United States
Currently, in the United States, over 1.1 million Americans are living with HIV. After years of stagnation in the annual infection rate, which hovered at around 50,000 new infections per year, the rate has begun to steadily drop in recent years due to newer preventive strategies like PrEP and HIV treatment as prevention, the latter of which can reduce the risk of HIV transmission to zero.
According to data from the Centers for Disease Control and Prevention , 37,968 new HIV infections were reported in the 2019 surveillancea drop of nearly 8% since 2010.
Despite these gains, around 15,800 people with HIV died in the United States in 2019, and as many as 14% of those infected remain unaware of their status. Of those who have been diagnosed, only 63% are linked to medical care, and only 51% are unable to achieve an undetectable viral load needed to ensure a normal to near-normal life expectancy.
HIV stigma and a lack of access to medical care, particularly among the poor and communities of color, are among the driving factors for these failures.
County And Municipal Hiv/aids Statistics 2018
Prevalence Rate by County of Persons Living with HIV/AIDSReported as of December 31, 2018
Select a county to view its statistical summary report.
Note: Top number indicates number of persons reported currently living with HIV/AIDS as of 12/31/2017, based on most recent data on patient residence available in HARS. Not Included in this number are cases of Perinatal HIV Exposure that are not confirmed HIV Positive. Bottom number in parentheses indicates prevalence rate of persons living with HIV/AIDS per 100,000 population .
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Hiv/aids Disparities Amongst The Incarcerated Population
As of the end of 2018, the black imprisonment rate was about twice that of Hispanics and more than five times the imprisonment rate amongst whites. Moreover, black males are more likely to be imprisoned with 2,272 inmates per 100,000 black men, in comparison to 1,018 inmates per 100,000 Hispanic men and 392 inmates per 100,000 white men. Incarcerated individuals have a much higher risk of having HIV than non-incarcerated individuals. The estimated global HIV prevalence for prisoners is 3%, whereas the estimated global HIV prevalence for adults in general is 0.7%. Additionally, women in prison have a higher HIV prevalence than men. Incarcerated individuals also have a high risk of transmission as well due to high-risk activity . Needle sharing is much more prevalent in prisons because possession of needles in prison is oftentimes a criminal offense, causing clean needles to be scarce. Only about 30% of countries worldwide offer condoms for incarcerated individuals, but for the countries that do offer condoms, coverage and access is not reported. Moreover, these individuals have a harder time accessing critical HIV resources such as ART. Even if ART is offered, those with HIV may still lack the ability to get specialized care and specific ART regimens.
Revised Un Estimates Show Over 33 Million People Worldwide Living With Hiv
A new report released today by two United Nations agencies puts the number of people living with HIV at about 33.2 million, down from last years estimate of 39.5 million, attributing the decrease to more accurate data collection and analysis.
The new data show global HIV prevalence, or the percentage of people living with HIV, has levelled off and that the number of new infections has also fallen, thanks in part to global HIV programmes. In addition to the 33.2 million people estimated to be living with HIV in 2007, 2.5 million people have become newly infected and 2.1 million people have died of AIDS.
The findings were presented by the Joint UN Programme on HIV/AIDS and the World Health Organization in their report, 2007 AIDS Epidemic Update.
These improved data present us with a clearer picture of the AIDS epidemic, one that reveals both challenges and opportunities, said UNAIDS Executive Director Dr. Peter Piot.
Unquestionably, we are beginning to see a return on investment new HIV infections and mortality are declining and the prevalence of HIV levelling. But with more than 6,800 new infections and over 5,700 deaths each day due to AIDS we must expand our efforts in order to significantly reduce the impact of AIDS worldwide.
The findings also show that AIDS is among the leading causes of death globally and remains the primary cause of death in Africa.
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Misconceptions About Hiv In The United States
Today, there continues to be significant misconceptions about HIV within the United States. Furthermore, misconceptions about the transmission of HIV promotes fear amongst many members of society, and this often translates into biased and discriminatory actions against PLHIV.
A 2009 study conducted by the Kaiser Family Foundation found that many Americans still lack basic knowledge about HIV. According to the survey, a third of Americans erroneously believe that HIV could be transmitted through sharing a drink or touching a toilet used by an HIV-positive individual. Furthermore, the study reported that 42 percent of Americans would be uncomfortable with having an HIV-positive roommate, 23 percent would be uncomfortable with an HIV-positive coworker, 50 percent would be uncomfortable with an HIV-positive person preparing their food, and 35 percent would be uncomfortable with their child having an HIV-positive teacher. Many of the respondents who were able to correctly answer questions about HIV transmission still reported similar biased views against HIV-positive individuals in fact, 85 percent of these respondents reported that they would feel uncomfortable working with an HIV-positive coworker.
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
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How Many New Hiv Infections Are There In Canada Each Year
According to national HIV estimates, there were 2,242 new HIV infections in Canada in 2018. This means that for every 100,000 Canadians, six people became HIV positive in 2018 .
There was a small increase in the number of new HIV infections in 2018 compared with 2016, when there were an estimated 1,960 new HIV infections.
Tuberculosis And Hiv Co
Eswatini has a dual epidemic of tuberculosis and HIV, with 65% of all people who have TB also living with HIV. 90 Men are more likely to be affected due to their lack of access to HIV and TB testing and treatment.91 In 2016, 79% of people co-infected with HIV and TB were found to have drug resistant TB strains.92
TB preventive therapy should be offered to all people initiating HIV treatment, but not all those eligible in Eswatini receive the service. WHO reports that only 10% of people newly diagnosed with HIV were put on appropriate TB therapy in 2018 , and only 3.7% of those newly enrolled on preventative therapy were expected to complete it.93
Eswatini is in the process of strengthening and integrating its TB/HIV services. These services have been decentralised and are now offered in a one-stop-shop where people can seek screening for TB and HIV testing, as well as being able to pick up their treatment for both at the same time.
As of 2017, around 80% of people with TB were on treatment. This is below the coverage required to control the countrys TB epidemic, with people who are HIV-positive particularly in need of better access to TB treatment. However these efforts are significantly reducing TB transmission. In 2010, around 11,050 people developed active TB in Eswatini in 2018 this figure had fallen to 2,845. Still, more needs to be done to ensure all people with TB are diagnosed and put on treatment in order to reduce transmission further.94
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Hiv/aids And Other Public Health Threats
Inequities resulting from discrimination and stigma towards PLHIV can impact susceptibility to other public health threats. Discrimination in the housing, medical, and employment sectors towards PLHIV has helped to drive the COVID-19 public health threat in marginalized populations.
The effects of COVID-19 on people with HIV is still being studied. It is thought individuals of older age or with serious underlying medical conditions may be at greater risk for severe illness from COVID-19. This includes people with HIV who have comorbidities, a low CD4 cell count, or are not currently on effective HIV treatment. The Coronavirus Under Research Exclusion database collects information on outcome of COVID-19 in people living with HIV.
The populations prioritized for the COVID-19 vaccine are recommended by the Center for Disease Control and Prevention , but each state determines its own distribution schedule. Explicit prioritizations for people living with HIV or key populations impacted by HIV/AIDS have not been made.
Estimated Number Of People Living With Hiv
hereIndicator Metadata Registry ListSince the beginning of the epidemic, 76 million people have been infected with the HIV virus and about 33 million people have died of HIV. Globally, 38.0 million people were living with HIV at the end of 2019. An estimated 0.7% of adults aged 1549 years worldwide are living with HIV, although the burden of the epidemic continues to vary considerably between countries and regions. The WHO African region remains most severely affected, with nearly 1 in every 25 adults living with HIV and accounting for more than two-thirds of the people living with HIV worldwide.herehere
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New Hiv Diagnoses 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.
The most affected subpopulation is Black/African American gay and bisexual men.