Epidemiology of HIV/AIDS
The global pandemic of HIV/AIDS (human immunodeficiency virus infection and acquired immunodeficiency syndrome) began in 1981, and is an ongoing worldwide public health issue.[4][5][6] According to the World Health Organization (WHO), by 2023, HIV/AIDS had killed approximately 40.4 million people, and approximately 39 million people were infected with HIV globally.[4] Of these, 29.8 million people (75%) are receiving antiretroviral treatment.[4] There were about 630,000 deaths from HIV/AIDS in 2022.[4] The 2015 Global Burden of Disease Study estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year.[7] Incidence of HIV has continued to fall, decreasing by 23% from 2010 to 2020, with progress dominated by decreases in Eastern Africa and Southern Africa.[8] As of 2020, there are approximately 1.5 million new infections of HIV per year globally.[9]
According to the World Health Organization (WHO), the prevalence of HIV in the Africa Region was estimated at 1.1 million people as of 2018.[10] The African Region accounts for two thirds of the incidence of HIV around the world.[10] Sub-Saharan Africa is the region most affected by HIV. In 2018, an estimated 61% of new HIV infections occurred in this region,[11] and as of 2020, more than two thirds of those living with HIV are living in Africa.[4] HIV rates have been decreasing in the region: From 2010 to 2020, new infections in eastern and southern Africa fell by 38%.[8] Still, South Africa has the largest population of people with HIV of any country in the world, at 8.45 million,[12] 13.9%[13] of the population as of 2022. As of 2022, it is estimated that the adult HIV prevalence rate is 6.2%, a 1.2% increase from data reported in the 2011 UNAIDS World Aids Day Report.[14][15]
In western Europe and North America, most people with HIV are able to access treatment and live long and healthy lives.[16] As of 2020, 88% of people living with HIV in this region know their HIV status, and 67% have suppressed viral loads.[16] In 2019, approximately 1.2 million people in the United States had HIV; 13% did not realize that they were infected.[17] In Canada as of 2016, there were about 63,110 cases of HIV.[18][19] In 2020, 106,890 people were living with HIV in the UK and 614 died (99 of these from COVID-19 comorbidity).[20] In Australia, as of 2020, there were about 29,090 cases.[21]
Throughout the world, HIV disproportionately affects certain key populations (sex workers and their clients, men who have sex with men, people who inject drugs, and transgender people) and their sexual partners. These groups account for 65% of global HIV infections, and 93% of new infections outside of sub-Saharan Africa.[9] In Western Europe and North America, men who have sex with men account for almost two thirds of new HIV infections.[16]
In Sub-Saharan Africa, 63% of new infections are women, with young women (aged 15 to 24 years) twice as likely as men of the same age to be living with HIV.[9]
HIV originated in nonhuman primates in Central Africa and jumped to humans several times in the late 19th or early 20th century.[22][23][24] One reconstruction of its genetic history suggests that HIV-1 group M, the strain most responsible for the global epidemic, may have originated in Kinshasa, the capital of the Democratic Republic of the Congo, around 1920.[25][26] AIDS was first recognized in 1981, and in 1983 the HIV virus was discovered and identified as the cause of AIDS.[27][28][29]
In June 2001, the United Nations held a Special General Assembly to intensify international action to fight the HIV/AIDS pandemic as a global health issue, and to mobilize the resources needed towards this aim, labelling the situation a "global crisis".[103]
Regarding the social effects of the HIV/AIDS pandemic, some sociologists suggest that AIDS has caused a "profound re-medicalisation of sexuality".[104][105]
There has been extensive research done with HIV since 2001 in the United States, The National Institutes of Health (NIH) which is an agency funded by the U.S. department of Health and Human Services (HHS) has substantially improved the health, treatment, and lives of many individuals across the nation. The human immunodeficiency virus (HIV) is generally the precursor to AIDS. To this day there is no cure for this virus; However, treatment, education programs, proper medical care, and support have been made available.
NIH, is coordinated by the Office of AIDS Research (OAR) and this research carried out by nearly all the NIH Institutes and Centers, in both at NIH and at NIH-funded institutions worldwide. The NIH HIV/AIDS Research Program, represents the world's largest public investment in AIDS research.[106] Other agencies like the National Institute of Allergy and Infectious Diseases have also made substantial efforts to provide the latest and newest research and treatment available.
The NIH found that in certain areas of the world, the correlation in risky behaviors and the acquisition of HIV/AIDS is causational. Consistent drug usage and related risk behaviors, such as the exchange of sex for drugs or money, are linked to an increased risk of HIV acquisition in marginalized areas. NIAID and other NIH institutes work to develop and optimize harm reduction interventions that decrease the risk of drug use-associated and sexual transmission of HIV among injecting and non-injecting drug users.[107] Most organizations work collectively around the globe to understand, diagnose, treat, and battle the spread of this notorious disease, through the use of intervention and preventive programs the risk of acquiring HIV and the development of AIDS has dramatically dropped by 40% since its peak of cases back in 1998.[108]
Despite the advancements in scientific research and treatment, to this day there's no available cure for HIV/AIDS. Yet major efforts to contain the disease and improve the lives of many individuals through modernized anti-viral therapy have resulted in positive and promising results that may one day lead to a cure. The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is one of the largest U.S. Government's response to the global HIV/AIDS epidemic and represents the largest commitment by any nation to address a single disease in history. PEPFAR provided HIV testing services for 79.6 million people in Fiscal Year 2019 and, as of September 30, 2019, supported lifesaving anti-retroviral therapy for nearly 15.7 million men, women, and children.[33] As of the end of 2019, 25.4 million people with HIV (67%) were accessing antiretroviral therapy (ART) globally. That means 12.6 million people are still waiting. HIV treatment access is key to the global effort to end AIDS as a public health threat.[33] Individuals who not only are aware of their condition but also are prescribed ART, are encouraged to remain consistent with their daily-dosage treatment so they can reduce the spread, viral load, and live happy and healthy lives.
Because HIV is more prevalent in urban areas of the United States, individuals living in rural areas generally don't participate or receive HIV diagnosis. The CDC found huge disparities in HIV cases between Northern and Southern regions of the Nation. At a rate of 15.9 the Southern regions account for a large number of reports of HIV; subsequently, regions like the North and Midwest account for general rates between 9 and 7.2 making it significantly lower in case prevalence.[109] The development of an HIV vaccine has made little progress in the last forty years, but thanks to the development of mRNA technology used to quickly create COVID-19 vaccines for the SARS-CoV2 virus, creation of an HIV vaccine seems much more promising. The greatest challenge in applying the strategies of the COVID-19 vaccine is that HIV has a much greater number of variants that its vaccine needs to address.[110]
According to the CDC, populations affected and with most reported cases of HIV are generally found in gay, bisexual, and other men who reported male-to-male sexual contact. In 2018, gay and bisexual men accounted for 69% of the 37,968 new HIV diagnoses and 86% of diagnoses among males. HIV doesn't only affect individuals in this category, heterosexuals tend to be affected by HIV as well. In 2018, heterosexuals accounted for 24% of the 37,968 new HIV diagnoses in the United States.
UNAIDS also suggested that the individuals who may also be at risk of acquiring this disease are generally: