Epidemiology
Since the start of the epidemic, approximately 88 million people have lived with HIV and 42 million people have died of AIDS-related illness. New cases peaked in 1995 (3.3 million) and have gradually decreased since then. Mortality peaked in 2004 with 2.1 million deaths.[10] Approximately 80% of new cases are from people who do not know they have HIV or who are not fully engaged in regular HIV care.[11]
Global
39.9 million people were living with HIV in 2023.[10]
Of these, 97% were adults, 53% were women and girls, 77% were accessing antiretroviral therapy (ART), and 86% knew their status.
1.3 million new HIV diagnoses in 2023.[10]
Fewer people acquired HIV in 2023 than at any point since the late 1980s. About 39% fewer people acquired HIV in 2023 compared to 2010, with the steepest reduction occurring in sub-Saharan Africa.
More new diagnoses occurred outside of sub-Saharan Africa than in sub-Saharan Africa for the first time in the history of the epidemic. Eastern Europe and central Asia, Latin America, and the Middle East and North Africa experienced rising numbers of new diagnoses.
630,000 people died from AIDS-related illness in 2023.[10]
Deaths have decreased by 69% since their peak in 2004.
Median HIV prevalence in adults (aged 15-49 years) was 0.8% in 2023, but it was higher in certain populations:[10]
Transgender people (9.2%)
Gay men and other men who have sex with men (7.7%)
People who inject drugs (5%)
Commercial sex workers (3%)
Women and girls aged 15-24 years in eastern and southern Africa (2.3%)
People in prisons (1.3%)
UK
In the UK, new HIV diagnoses increased in England by 51% from 3975 cases in 2022 to 6008 cases in 2023. Most of the increase is attributable to people previously diagnosed abroad, and does not reflect a rise in transmission in England. The number of new diagnoses first made in England increased by 15% from 2451 in 2022 to 2810 in 2023. The increase in diagnoses was steepest among heterosexual men and women, increasing by more than 30% since 2022. A total of 100,063 people were accessing HIV care in England in 2023.[12]
Europe
In the World Health Organization (WHO) European Region (data reported from 49 countries), there were 110,486 new HIV diagnoses in 2022 (12.4 new diagnoses per 100,000 population), a slight increase from 2021.[13]
US
In the US, there were 31,800 new HIV diagnoses in 2022. The number of cases has decreased by 12% overall since 2018. The majority of new diagnoses were in males (81%), and in the 25-34 age group. About 67% of all new diagnoses were among men who have sex with men, 22% were among people who reported heterosexual contact, and 7% were among people who inject drugs. Black/African American people and Hispanic/Latino people accounted for 37% and 33% of new diagnoses, respectively.[14]
Estimated annual HIV incidence increased from 20,000 cases in 1981 to a peak of 130,400 cases in 1984 and 1985. Incidence was relatively stable between 1991 and 2007 with approximately 50,000 to 58,000 cases annually, and then decreased in recent years.[15]
Survey data underscore the disproportionate impact of the AIDS epidemic on women, especially in sub-Saharan Africa where women and girls (all ages) are at higher risk of HIV, and accounted for approximately 62% of all new diagnoses in 2023, despite comprising only approximately 10% of the population. Globally, 44% of all new HIV diagnoses occurred among women and girls, and 53% of all people living with HIV were women and girls.[10]
Overall, globally, the HIV incidence rate is believed to have peaked in the 1990s and to have stabilised subsequently, notwithstanding increasing incidence in a number of countries. Changes in incidence along with rising AIDS mortality have caused global HIV prevalence to level off. However, the numbers of people living with HIV have continued to rise, due to population growth and, more recently, the life-prolonging effects of ART. In sub-Saharan Africa, the region with the largest burden of the AIDS epidemic, data also indicate that the HIV incidence rate has peaked and is starting to plateau in most countries. However, the epidemics in this region are highly diverse and especially severe in southern Africa, where some of the epidemics are still expanding. Due to its transition from fatal illness to a lifelong chronic disease, the population of people living with HIV is ageing, placing increased demands on health services, and increasing the complexity of management (e.g., polypharmacy, management of comorbidities).
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