HIV

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 clinical stage of HIV infection, defined by the occurrence of any of more than 20 opportunistic infections or related cancers associated with the disease.

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 and has an undetectable viral load, there is zero risk of sexual transmission to the HIV-negative partner. Expanding coverage of HIV treatment contributes to HIV prevention efforts.

There are several ways to prevent HIV transmission

Key ways to prevent HIV transmission:

• practice safer sexual behaviours such as using male and female condoms;
• 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(s) or to your infant (if you are pregnant or breastfeeding). People with HIV who are taking antiretroviral therapy and have an undetectable viral load have zero risk of transmitting HIV sexually;
• get tested and treated for sexually transmitted infections,  including HIV, to prevent transmission to sexual partners;
• avoid injecting drugs, or if you do, always use sterile needles and syringes. This will prevent you from acquiring HIV and other blood-borne infections;
• 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;
• use pre-exposure prophylaxis prior to engaging in higher risk behaviour;
• request post-exposure prophylaxis if there is the risk that you have been exposed to HIV infection through sex, injecting drug use or if you are a health care workers who has had a potential high risk HIV exposure, such as a needle stick injury.

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 tissues;
• the sharing of contaminated injecting equipment and solutions (needles, syringes) or tattooing equipment;
• through the use of contaminated surgical equipments and other sharp instruments;

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 2022, 82% of all pregnant women living with HIV – 1.2 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 2022, 16 countries and territories were validated for eliminating mother-to-child transmission of HIV.

39.0  million people are living with HIV worldwide

Globally, an estimated 39.0 million [33.1–45.7 million] people were living with HIV in 2022, and 1.5 million [1.2–2.1 million] of these were children. The vast majority of people living with HIV are in low- and middle-income countries. An estimated 1.3 million [1.0–1.7 million] people acquired HIV in 2022. Up to 40.4 million [32.9–51.3 million] people have died from HIV-related causes so far, including 630 000 [480 000–880 000] people in 2022.

An estimated 1.5 million children are living with HIV

According to 2022 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 130 000 children [90 000–210 000] acquired HIV in 2022 globally.

HIV testing with linkage to treatment or appropriate prevention is essential to reach the goal of ending AIDS by 2030

Access to HIV testing should be improved to make sure everyone with HIV is diagnosed and linked to treatment or appropriate and effective prevention choices. There are still gaps in HIV testing coverage, as an estimated 14% of people with HIV or 5.5 million people remain undiagnosed. WHO recommends HIV-self-testing, partner and social network testing as additional effective approaches to increase HIV testing access.

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 is the greatest risk factor for developing active TB disease

In 2021, an estimated 6.7% of the 10.6 million people who developed TB worldwide were living with HIV. In the same year approximately 187 000 deaths from tuberculosis occurred among people living with HIV. The WHO African Region accounted for 73% of the estimated number of HIV-related TB deaths.