What is the global prevalence of HIV infection?

Updated: Jul 27, 2020
  • Author: Shelley A Gilroy, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), [81] worldwide in 2018, approximately 37.9 million people were infected with HIV. UNAIDS estimates that approximately 1.7 million people were newly infected with HIV and that 770,000 people died of AIDS in 2018, both statistics showing a decline over time.

The vast majority of infections remain in sub-Saharan Africa, where 5.2% of the population is believed to be infected. Between 2004 and 2006, the prevalence of HIV infection in central and eastern Asia and Eastern Europe increased by 21%. During this period, the number of new HIV infections in persons aged 15 to 64 years rose by 70% in Eastern Europe and central Asia.

The infection rates in many developed countries remain stable, and some developing countries have achieved significant gains in controlling and even reversing the effects of the HIV epidemic. However, this is partially due to deaths in HIV-infected people, together with simultaneous prevention of new infections. India, for example, has used a national prevention campaign focusing on high-risk populations that may have prevented 100,000 new HIV infections over the 5 years it has been implemented, with increasing results seen in areas with higher levels of investment. [82] These figures together show that global HIV infection is in a state of flux.

Men who have sex with men (MSM) are still 28 times more likely than heterosexuals to contract HIV infection despite sharp declines of infection among such populations in Western countries. The institution of pre-exposure prophylaxis (PrEP) in Western Europe, North America, and Australia has dramatically decreased transmission rates among gay men in those areas. [83]

The mortality rate in some countries has greatly increased. In South Africa (a country that, despite having a relatively late-onset HIV epidemic, has developed one of the highest prevalence rates), the all-cause HIV-associated mortality rate increased by 79% between 1997 and 2004. In women aged 25-34 years, mortality rates increased by 500% during this period.

Swaziland has the highest overall prevalence of HIV infection (>26% of all adults based on 2007 figures).

The Ministry of Health in Zambia predicts that, without therapy and assuming current levels of prevalence, young adults have a 50% lifetime risk of dying from AIDS.

In developing nations, co-infection with HIV and tuberculosis is very common. The immunosuppressed state induced by HIV infection contributes not only to a higher rate of tuberculosis reactivation but also to an increased disease severity, as with many other opportunistic infections.

Further details of the global epidemic can be found in the UNAIDS Global HIV & AIDS statistics — 2019 fact sheet.


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