Global HIV Statistics: Complete Geographical Breakdown – Verywell Health

Since the start of the HIV (human immunodeficiency virus) epidemic back in 1981, an estimated 75.7 million people have been diagnosed with HIV worldwide, and 32.7 million people have died of AIDS-related illnesses.

Progress in global prevention of HIV remains far too slow. Despite advances in HIV research, HIV continues to be a major public health issue around the world.

HIV disproportionately impacts low- and middle-income countries. Of the 4,500 people who contract HIV every day in the world, 59% live in sub-Saharan Africa.

Global health organizations like the United Nations (UN) and the World Health Organization (WHO) have spoken of goals to decrease the impact of HIV around the world. One goal is to achieve three zeros by 2030: zero new HIV cases, zero AIDS-related deaths, and zero discrimination.

The factors that drive the HIV epidemic are becoming increasingly understood. This has refined the worldwide HIV response, allowing officials to identify gaps and develop strategies to reach people who are being left behind.

This article will look at the state of HIV/AIDS around the world.

A Global Take on HIV

Worldwide Rates and Yearly Shifts 

HIV diagnoses and mortality rates have continually decreased over the past decade. This is due to continuing public health efforts in HIV prevention, early recognition, and treatment. However, progress has been unequal among and within countries. Also, the pace of decline has varied widely by age, sex, and religion. 

The disease burden (the impact of a health problem on a population, as measured by financial cost, mortality, and morbidity) of HIV remains entirely too high given the advances made in HIV screening and treatment.

Recent data have shown that there were about 1.7 million new HIV diagnoses in 2019, nearly 5,000 new diagnoses per day. This highlights the need for continued and sustained efforts.

In 2020, 37.7 million people globally were living with HIV, down from 39 million in 2019. HIV is now slightly more common in women than men—53% of all people living with HIV worldwide are women and girls.

Black women, both cis and trans, are disproportionately affected by HIV and account for about 60% of all new infections among women. Black women also carry the largest burden of HIV globally.

But the most troubling statistic is the number of preventable deaths caused by HIV/AIDS. In 2020, 680,000 people died from AIDS-related illnesses—a number far too high given the prevention and treatment options that exist. 

Even more, HIV awareness, testing, and prompt diagnoses continue to lag, especially in low socioeconomic areas of the world. Only 84% of all people living with HIV knew their HIV status in 2020. This means that 16% or 6.1 million people did not know that they were living with HIV.

Where We Are Now

The latest data from countries around the world show both progress and challenges. On one hand, the disease burden of HIV is decreasing. More people are getting diagnosed and treated than ever before, and HIV has turned from an acutely fatal condition to a chronic one that many people are now able to live long, fulfilling lives with.

Still, far too many countries have not acted sufficiently to reach the milestones that were set by the UN and other global health organizations.

The COVID-19 pandemic further derailed prevention efforts: Lockdowns caused service disruptions of prevention programs and economic uncertainty deepened many of the systemic inequalities (such as poverty and limited access to medical care) that drive the HIV epidemic.

As a result, the goal of reducing new HIV infections to fewer than 500,000, reducing AIDS-related deaths to fewer than 500,000, and eliminating HIV-related stigma and discrimination by 2020 was not met. These realities have the potential of derailing the world’s goal of achieving the three zeros by 2030.

HIV Facts: Continents 

The continent of Africa has been hit hardest by the HIV epidemic. Of the 33 million people diagnosed with HIV around the world, approximately 65% are in sub-Saharan African countries and 15% are in South Asia and Southeast Asia. The remaining 20% are spread over the rest of the world.

Geographic Breakdown

The areas of the world that are hit hardest by HIV include:

• Eastern and Southern Africa: With roughly 20.7 million people living with HIV here, this region contains more than half (54%) of all HIV cases worldwide. Additionally, two-thirds of children living with HIV (67%) are found in this region.
• Western and Central Africa: There are 4.9 million people living with HIV here, although the number of new cases has declined by 25% from 2010 to 2019.
• Asia and the Pacific: This region has 5.8 million people living with HIV, but new case rates are declining, falling by 12% since 2010.
• Western and Central Europe and North America: An estimated 2.2 million people are living with HIV. Of note, 67% of this group have achieved viral suppression and since 2010, the number of AIDS-related deaths decreased by 40%
• Latin America: An estimated 2.1 million people are living with HIV in Latin America. Alarmingly, HIV cases have increased by 21% since 2019. On the plus side, the number of AIDS-related deaths fell by 8% in the region overall.
• Eastern Europe and Central Asia: An estimated 1.7 million people are living with HIV in this region. Both new HIV diagnoses and AIDS-related deaths increased in the region by 72% and 24% between 2010 and 2019, respectively. HIV transmission via injection drug use is of particular concern in this region. 
• The Caribbean: An estimated 330,000 people are living with HIV in the Caribbean. The number of people living with HIV who are receiving treatment has more than doubled since 2010, but just 50% of people have achieved viral suppression, which is below the global average of 59%.
• Middle East and North Africa: New cases rose by 25% from 2010 to 2019, to an estimated 240,000 people living with HIV. Treatment rates in this region are the lowest worldwide, with only 38% of those with HIV receiving medical care.

Population Breakdown  

In 2020, sex workers and their clients, gay men and other men who have sex with men, people who inject drugs, and those who identify as transgender, and their sexual partners account for 65% of HIV cases around the world. Studies show the criminalization of sex work and drugs, transphobia, homophobia, and HIV stigma contribute to the spiked rates.

The risk of acquiring HIV is:

• 35 times higher among people who inject drugs
• 34 times higher for transgender women (with Black and Latinx trans women being most likely to test HIV positive in their lifetime)
• 26 times higher for sex workers
• 25 times higher among gay men and other men who have sex with men (with Black and Latinx gay men being more likely to test HIV positive in their lifetime)

It is important to note HIV rates among the trans community at large remain poorly understood due to historical exclusion from HIV research. Few HIV studies are inclusive of trans men, transmasculine people, and non-binary people even though they test positive at higher rates than the general population

Global Disparities and HIV Risk Factors 

Though HIV is often associated with men who have sex with other men, the majority of HIV cases around the world are transmitted between cisgender men and women.

Differences in the socioeconomic determinants of health, such as poverty, contribute greatly to global disparities. This underscores the importance of designing policies that address financial and other barriers and securing treatment access for the poor and marginalized while supporting essential health services.

Along with the socioeconomic issues that put people at higher risk of contracting HIV, the following behaviors can put individuals at greater risk of contracting HIV:

• Having condomless anal or vaginal sex
• Having another sexually transmitted infection (STI) such as syphilis, herpes, chlamydia, gonorrhea, and bacterial vaginosis
• Sharing contaminated needles, syringes, and other injecting equipment and drug solutions when injecting drugs
• Receiving unsafe injections, blood transfusions and tissue transplantation, and medical procedures that involve unsterile cutting or piercing

As such, the following groups have been disproportionately impacted by the HIV epidemic: 

• Men who have sex with men
• People who inject drugs
• Sex workers
• Transgender people
• Incarcerated people

Global HIV disparities emerge from a complex combination of factors such as structural racism and poverty, small sexual networks, and inequalities in access to medical care.

Too often, the focus of research and outreach is based on lessening risky sexual practices and drug use alone. But it is clear that differences in living conditions among vulnerable populations are also a major contributor to these disparities.

Interventions aimed at groups disproportionately impacted have helped, but interventions targeting social inequalities continue to lag. 

Impact of the COVID-19 Pandemic

HIV weakens the immune system, which may leave people living with HIV more susceptible to severe illness if they develop COVID-19. Because of this, public health officials recommend all people with HIV get vaccinated against COVID-19. Vaccines jump-start the immune system and protect people from developing severe illness that can result in hospitalization or death.

Antiviral HIV medications help strengthen the immune system of people living with HIV, so it’s important for those with HIV to take their meds regularly. This reduces the risk of COVID-19 complications and may improve how well the COVID-19 vaccine works. 

People who take medications that weaken their immune system and those who do not take their antiviral medications regularly may not be sufficiently protected from COVID-19, even if they are fully vaccinated.

It is, therefore, very important for this group to take all the necessary precautions recommended for unvaccinated people, including wearing a well-fitted mask, handwashing, and practicing social distancing until advised otherwise by a healthcare provider.

Despite being at higher risk of severe illness, people living with HIV have not been prioritized during the vaccine distribution. People living with HIV have had less vaccine access than other vulnerable populations. COVID-19 lockdowns and other restrictions also disrupted HIV testing. This led to steep drops in diagnoses and referrals for HIV treatment in many countries.

The initial COVID-19 response has been eerily similar to the initial response to HIV. The initial response to both HIV and COVID-19 underestimated the risk to the general population and focused instead on the specific populations in which infections first emerged.

As time went on, it became clear that both viruses disproportionately impact vulnerable populations such as low socioeconomic status groups that are largely made up of members of Black and Latinx communities.

As such, the impact of both HIV and COVID-19 on Black and Latinx communities in the United States is similar to their impact on racial and ethnic minorities around the world.

Ensuring Equal Access to Treatment 

A number of challenges contribute to the global HIV disparities and unequal access to testing and treatment, including:

• Poverty
• Lack of access to healthcare
• Higher rates of some STIs
• Smaller sexual networks
• Lack of awareness of HIV status
• Little or no education about HIV prevention
• Cultural stigma

The number of people who need antiretroviral therapy (ART) is much greater than the resources that are available to help them in many countries. Therefore, additional investments are needed to properly identify and prioritize those who need critical lifesaving treatment.

Public health organizations around the world are encouraged to establish policies that clearly and objectively identify and prioritize groups disproportionately impacted when making healthcare decisions. Policies should ensure access for women and the most vulnerable, poor, and marginalized populations.

Recent advances in treatment technologies mean that ART can be provided successfully in settings in which basic health services are weak. However, decision-makers in each country need to carefully design policies that address financial and other barriers and give access to the poor and marginalized while supporting essential health services.

These efforts on the community, national, and federal levels must be coordinated so that the cost of care is offset for underserved populations.  

International HIV/AIDs Organizations 

Despite global efforts to turn back the tide of HIV, the world is behind in making the inroads needed to end the epidemic. Working together and coordinating efforts can help to advance HIV research and offer outreach and education to prevent the further spread of HIV.

The following international HIV/AIDS organizations are leading the charge on global prevention, early diagnosis, and prompt treatment in hopes of eliminating HIV:

U.S. Outreach

The United States has been a major contributor to funding the global HIV response. The country has spent billions of dollars in global outreach since the start of the HIV epidemic, despite having its own significant issues to address.

The Linkages across the Continuum of HIV Services for Key Populations Affected by HIV project, also known as LINKAGES, is one initiative that works with governments, leaders, and healthcare providers to expand their ability to plan and deliver services that reduce HIV transmission among key populations and their sex partners, and to extend the lives of those already living with HIV.

The United States has also created policies, such as the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2003, that have expanded access to lifesaving ART drugs, prevented millions of new HIV cases, and provided compassionate care to millions of people affected by HIV/AIDS around the world.

This legislation launched the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which has invested $85 billion dollars in global preventative efforts. Since PEPFAR was established in 2003, this initiative has saved over 20 million lives, supported antiretroviral treatment for 18.2 million people, and provided critical care for 6.7 million orphans and vulnerable children.

Summary

In recent decades, major global efforts have been mounted to address the HIV epidemic, with significant progress having been made despite many challenges and obstacles. Still, a sustained and unified approach is needed to increase access to HIV testing and treatment, especially in low-resources areas and communities, to reach the UN and WHO goals of eliminating HIV by 2030.

A Word From Verywell 

The goal of ending the HIV/AID epidemic has been set by the United Nations and confirmed by the World Health Organization and the U.S. government. While the goal of a cure remains, the interim goal is reaching “95-95-95” (or, 95% of people living with HIV knowing their HIV status; 95% of people who know their HIV positive status on antiretroviral treatment; and 95% of people on treatment with suppressed viral loads) by 2025.

This goal is in sight if coordinated and sustained global health efforts continue. Placing a greater emphasis on societal aspects and social services to address the inequalities of HIV is central to meeting these goals.

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