HIV/AIDS

Key facts

• HIV remains a major global public health issue, having claimed an estimated 42.3 million lives to date.  Transmission is ongoing in all countries globally. 
• There were an estimated 39.9 million people living with HIV at the end of 2023, 65% of whom are in the WHO African Region.
• In 2023, an estimated 630,000 people died from HIV-related causes and an estimated 1.3 million people acquired HIV. 
• There is no cure for HIV infection. However, with access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives. 
• WHO, the Global Fund and UNAIDS all have global HIV strategies that are aligned with the SDG target 3.3 of ending the HIV epidemic by 2030.
• By 2025, 95% of all people living with HIV aids should have a diagnosis, 95% of whom should be taking lifesaving antiretroviral treatments, and 95% of people living with HIV health and for reducing onwards HIV transmission. In 2023, these percentage were 86%, 89%, and 93% respectively. 
• In 2023, of all people living with HIV, 86% knew their status, 77% were receiving antiretroviral therapy and 72% had suppressed viral loads. 

Overview 

HIV ( Human Immunodeficiency Virus) is a virus that attacks the body's immune system, specifically the CD4 cells (T cells), which are crucial for immune defense.  If left untreated, HIV reduces the number of these cells, making the person more vulnerable to infections and certain cancers. 

AIDS (Acquired Immunodeficiency Syndrome) is the final stage of HIV infection, where the immune system is severely damaged and the individual becomes susceptible to opportunistic infections and certain concerns. Not everyone with HIV will develop Aids, especially with effective treatment. 

Transmission 

HIV is primarily transmitted through: 

• Unprotected sexual contact ( vaginal, anal, and oral sex).
• Sharing needles or syringes with someone who has HIV.
• From mother to child during childbirth or breastfeeding. 
• Blood transfusions or organ transplants ( rare in countries with rigorous screening).

Symptoms 

Early Stage (Acute HIV Infection ):

•  Flu-like symptoms ( fever, chills, rash, night sweats, muscle aches, sore throats, swollen lymph nodes, mouth ulcers).
• Symptoms may appear 2-4 weeks after exposure and can last for days to several weeks.

Chronic HIV infection (Clinical Latency) 

• HIV remains active but reproduces at very levels. 
• May not show symptoms or only mild ones.
• Without treatment, this stage can last a decade or longer. 

Progression to AIDS 

• Rapid weight loss 
• Recurring fever or profuse night sweats. 
• Extreme and unexplained tiredness. 
• Prolonged swelling of the lymph glands. 
• Diarrhea that lasts for more than a week. 
• Sores of the mouth, anus, or genitals.
• Pneumonia. 
• Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids. 
• Memory loss, depression, and other neurologic disorders. 

Diagnosis 

• HIV Antibody Tests: Detect antibodies the body makes in response to HIV. It may take 3 - 12 weeks for these to be detectable. 
• Antigen/ Antibody Tests: Detect both HIV antigens ( a part of the virus) and antibodies. This can detect HIV earlier than antibody tests alone. 
• Nucleic Acid Tests (NATs): Detect the virus itself and can be used early after exposure. 

Treatment 

Antiretroviral therapy (ART):

• A combination of HIV medicines (called an HIV treatment regimen) taken every day.
• ART helps control the virus, allowing individuals to live longer, healthier lives and reducing the risk of transmission. 
• Undetectable = Untransmutable (U=U): If the viral load is undetectable, HIV cannot be transmitted through sex.

Prevention 

• Safe Sax Practices: Use condoms and reduce the number of sexual partners 
• Pre-Exposure Prophylaxis (PEP): taking HIV medicines within 72 hours of potential to prevent infection. 
• Avoid Sharing Needles: Use clean needles and syringes. 
• Mother-to-Child Transmission Prevention: Pregnant women with HIV should take ART to reduce the risk of transmission to the baby. 

Global Impact 

• Approximately 38 million people were living with HIV globally in 2021.
• Sub-Saharan Africa remains the most affected region, accounting for nearly two-thirds of the global total of new HIV infections. 
• Significant progress has been made with global efforts in increasing access to ART, reducing new infections, and improving the quality of life for those living with HIV.

Social and economic impacts 

• Stigma and discrimination remain major barriers to effective HIV prevention and treatment. 
• Economic impacts include loss of income and increased healthcare costs for individuals and communities. 
• Education and awareness programs are crucial in combating stigma and preventing the spread of HIV. 

Research and Future Directions 

• Vaccine development is ongoing but has not yet produced an effective HIV vaccine. 
• Research into new treatment options, including long-acting injectable and potential cures, continues to advance. 
• Efforts to improve access to treatment and care, particularly in low-income countries, are essential for controlling the epidemic.