Infection with HIV (human immunodeficiency virus) can lead to AIDS (acquired immunodeficiency syndrome). AIDS results in a gradual and persistent decline and failure of the immune system, resulting in a heightened risk of life-threatening infection and cancers.
In the majority of cases, HIV is a sexually-transmitted infection. However, HIV can also be transmitted from mother to child, during pregnancy or childbirth, or through breastfeeding. Non-sexual transmission can also occur by sharing injection equipment such as needles.
Summary
- Almost one million die from HIV/AIDS each year – in some countries it’s the leading cause of death.
- In some countries, HIV/AIDS is the cause of one quarter of deaths.
- Death rates are highest across Sub-Saharan Africa.
- Death rates are highest for younger adults, and for children (when HIV is transmitted from a mother).
- The world is making progress: over the past decade the number of global deaths has halved.
- The HIV epidemic had a major impact on life expectancy across Sub-Saharan Africa, and life expectancy is only now back to pre-epidemic levels.
- Antiretroviral treatment (ART) has been key to preventing deaths from AIDS. It is estimated that it now averts 1.2 million deaths per year – without it, global deaths would be more than twice as high.
- Funding for HIV treatment and prevention needs to increase if the world is to meet its 2030 targets.
Interactive charts on HIV / AIDS
Almost 1 million people die from HIV/AIDS each year; in some countries, it’s the leading cause of death
HIV/AIDS is one of the world’s most fatal infectious diseases – particularly across Sub-Saharan Africa, where the disease has had a massive impact on health outcomes and life expectancy in recent decades.
The Global Burden of Disease is a major global study on the causes of death and disease published in the medical journal The Lancet.1 These estimates of the annual number of deaths by cause are shown here. This chart is shown for the global total, but can be explored for any country or region using the “change country” toggle.
According to the Global Burden of Disease study, nearly a million people die yearly from HIV/AIDS. To put this into context: this is just over 50% higher than the number of deaths from malaria.
It’s one of the largest killers globally, but for some countries – particularly across Sub-Saharan Africa, it’s the leading cause of death. If we look at the breakdown for South Africa, Botswana, or Mozambique – which you can do on the interactive chart – we see that HIV/AIDS tops the list. For countries in Southern Sub-Saharan Africa, deaths from HIV/AIDS are more than 50% higher than deaths from heart disease and more than twice that of cancer deaths.
Globally, around 1.5% of deaths are caused by HIV/AIDS.
This share is high but masks the wide variations in the toll of HIV/AIDS worldwide. In some countries, this share was much higher.
In the interactive map, we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions, the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.
But the share is very high across some countries – focused primarily in Southern Sub-Saharan Africa. Among the countries most affected are Lesotho, Eswatini, Equatorial Guinea, South Africa, and Botswana.
The significant health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.
In the interactive map, we see the distribution of death rates worldwide. Most countries have a rate of less than 10 deaths per 100,000 – often much lower, below 5 per 100,000. Across Europe, the death rate is less than one per 100,000.
Across Sub-Saharan Africa, the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000.
Which population groups are most at risk from HIV/AIDS?
In the chart, we show death rates by age group. Here we see that the most at-risk group is 15 to 49-year-olds – typically younger adults. Since HIV is primarily a sexually-transmitted infection, where unsafe sex is a primary risk factor, this is what we would expect.
But we also see that death rates are higher for children under five. HIV can be transmitted from mother to child if the mother is infected.
The 1990s saw a substantial increase in people infected with HIV and dying of AIDS.
In the second half of that decade, over 3 million people were infected with HIV yearly. Since then, the number of new infections began to decline, and it’s now below 2 million, the lowest number of new infections since 1990.
As for mortality, AIDS-related deaths increased throughout the 1990s and peaked in the mid-2000s, with nearly 2 million annual deaths. Since then, the annual number of deaths from AIDS has declined and since halved. 2016 was the first year since the peak in which fewer than 1 million people died from AIDS.
The chart also shows the continuing increase in the number of people living with HIV. The growth rate has slowed compared to the 1990s, but the absolute number is at the highest ever.
The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade.
In the visualization, we see the global number of deaths from HIV/AIDS in recent decades – this is shown by age group. In the mid-2000s, global deaths peaked at almost 2 million per year.
Driven mainly by the development and availability of antiretroviral therapy (ART), global deaths have more than halved since then.
You can explore this change for any country or region using the “change country” toggle on the interactive chart.
Global progress on HIV/AIDS has been driven by significant improvements in countries most affected by the HIV epidemic.
Today the share of deaths remains high: more than 1 in 5 deaths in some countries are caused by HIV/AIDS. But in the past, this share was even higher.
In the visualization, we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries and even more than half of annual deaths in the late 1990s in Zimbabwe.
Over the past decade, this share has fallen as antiretroviral treatment has become more widely available.
The health and mortality burden of HIV/AIDS across Sub-Saharan Africa has been considerable. We see this impact on health reflected in trends in life expectancy. In the visualization, we show changes in life expectancy across select countries in Sub-Saharan Africa for which HIV/AIDS has had the most significant toll.
We see a dramatic drop in life expectancy starting around 1990, coinciding with the rise of HIV. In Botswana, life expectancy fell by a decade; in Eswatini, it fell by two decades. Since the early 2000s — as progress has been made in tackling HIV — we see that life expectancy has been rising again.
In some countries, life expectancy is now higher than before the epidemic began.
Prevalence in the total population
You can explore the total number of people living with HIV/AIDS worldwide here.
Prevalence by gender
There are differences in the prevalence of HIV and death rates from AIDS between men and women. The chart shows the share of women in populations living with HIV.
As we see, HIV prevalence tends to be higher in women across Sub-Saharan Africa, although higher in males across most other regions. The trend in AIDS-related deaths shows the opposite: more men tend to die from AIDS every year than women. The reasons for differences in prevalence and death rates are complex; however, across Sub-Saharan Africa, women tend to be infected with HIV earlier than men and survive longer (explaining both the higher prevalence and lower annual AIDS deaths in women). Several gender inequality and social norm issues result in a higher prevalence of HIV in females across many countries; women are at greater risk when they have a limited role in sexual decision-making and protection, role rates of sexual education, and higher rates of transactional sex2.
Prevalence in children
In children with HIV, transmission has typically occurred from the mother (mother-to-child-transmission; MTCT) either during pregnancy or childbirth or through breastfeeding. This map shows the total number of children aged 14 and under living with HIV. Globally the number of children living with HIV peaked in 2005 at approximately 2.6 million.
The map shows the total number of children newly infected with HIV yearly. Globally — with similar trends at national levels — the number of new infections in children peaked around the early 2000s (with over 500,000 new infections per year globally), followed by a rapid decline over the last decade. Around 150,000 children are now newly infected with HIV annually.
Some children have lost either one or both parents to AIDS. This does not necessarily imply that children orphaned by AIDS have HIV themselves (although, in some cases, HIV has been transmitted from mother to child). The chart shows the number of children (aged 17 and under) orphaned from AIDS deaths.
Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis remains high among people living with HIV. However, the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.
The charts here show the number of tuberculosis (TB) patients who tested positive for HIV, the number receiving antiretroviral therapy (ART), and the number of TB-related deaths among those living with HIV.
Anti-retroviral treatment (ART)
A couple of decades ago, the chances of surviving more than ten years with HIV were slim. Today, thanks to antiretroviral therapy (ART), people with HIV/AIDS can expect to live long lives.
ART is a long-term medical treatment for HIV/AIDS. It works by suppressing the virus from multiplying in the body. This keeps the infection under control and helps to prevent the disease from progressing. ART is essential in progressing against HIV/AIDS because it saves lives, allows people with HIV to live longer, and prevents new HIV infections.
Since the first version of ART was introduced in the late 1980s, the treatment has saved millions of lives.
The chart here shows the annual number of deaths from HIV/AIDS and the number of deaths averted due to ART.
Globally, 850,000 people died from HIV/AIDS in 2016, but even more deaths – 1.2 million – were averted due to ART. Without ART, more than twice as many people would have died from HIV/AIDS.
ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART, very few infected people survive beyond ten years.3
According to a 2016 study, a person in a high-income country who started ART in their twenties can now expect to live for another 46 years — well into their 60s.4
While the life expectancy of people living with HIV/AIDS in high-income countries has still not reached the life expectancy of the general population, we are getting closer to this goal.5
The combination of antiretroviral drugs which make-up ART has progressively improved. Recent research shows that a person who started ART in the late 1990s would be expected to live ten years less than one who started ART in 2008.6 This increase goes beyond the general increase in life expectancy in that period and reflects the improvements in ART — fewer side effects, more people following the prescribed treatment, and more support for the people in need of ART.
There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.7 ART reduces the number of viral particles in an HIV-positive individual; therefore, the likelihood of passing the virus to another person decreases.
In 2011, the journal Science named a study that found that ART reduced the risk of HIV transmission between couples by 96% as its “Breakthrough of the Year”.8 Many other studies have now shown similar findings, with a range of reduction in transmission attributable to ART depending on location and groups studied.9 A study from British Columbia, for example, showed that with every 10% increase in ART coverage there was an 8% decrease in new diagnoses of HIV.10
The number of people who receive ART has increased significantly in recent years, especially in African countries where the prevalence of HIV/AIDS is the highest.
But many millions of people who could benefit from the life-saving treatment currently don’t.
To increase ART coverage, we must first improve access to testing for HIV status. In 2018, 79% of people living with HIV knew their status. This means 1-in-5 people living with HIV were unaware.11 And awareness is also not enough. In Sub-Saharan Africa, among people who are HIV positive, only 57% went on to complete the required pre-treatment assessments.12 Of those who should start ART, only 66% did.13
Stigmatization of people who have HIV/AIDS also leads to a decrease in engagement with care, treatment, and prevention services.14
Prevention of mother-to-child transmission (PMTCT)
Given that most AIDS cases in children are due to the virus transmission from mother to child during pregnancy, stopping the mother-to-child transmission is critical to preventing children from getting newly infected with HIV.
The chances of HIV positive mother transmitting the virus to a child are between 15% and 45%. Effective prevention of mother-to-child transmission (PMTCT) services can reduce the chances of virus transmission to newborns down to 5%.15
PMTCT services include preventative measures such as antiviral therapy for mothers and newborns, correct breastfeeding practices, and early child testing for HIV infection.
The visualization shows the number of child infections averted from ART coverage in mothers.
You can explore the number of new HIV infections prevented by PMTCT as a result of antiretroviral therapy across the world here.
This map shows the share of pregnant women infected with HIV who receive antiretroviral therapy – a vital intervention to prevent the transmission from mother to child.
Safe sex
The majority of HIV infections are transmitted through sexual activity.
Sexual transmission can be prevented through condom use (both in heterosexual and homosexual relationships). In the charts here, we see the prevalence of condom use, particularly in cases of ‘high-risk sex’, which is that with a non-marital, non-cohabiting sexual partner.
Education on HIV/AIDS
Funding to support efforts against HIV/AIDS
You can explore the breakdown of funding resources by source for each country here.
Terminology and definitions
The following terminology and definitions are sourced from the UNAIDS organization.16
HIV: Human Immunodeficiency Virus. HIV is a virus that weakens the immune system, ultimately leading to AIDS.
AIDS: acquired immunodeficiency syndrome.
Antiretroviral medicines/ Antiretrovirals (ARVs)/ Antiretroviral therapy (ART)/ HIV treatment: “Antiretroviral therapy is highly active in suppressing viral replication, reducing the amount of the virus in the blood to undetectable levels and slowing the progress of HIV disease. The usual antiretroviral therapy regimen combines three or more different medicines, such as two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor, two nucleoside analog reverse transcriptase inhibitors, and a non-nucleoside reverse transcriptase inhibitor (NNRTI), or other combinations.
More recently, entry and integrase inhibitors have joined the range of treatment options. Suboptimal regimens are monotherapy and dual therapy. The term “highly active” antiretroviral therapy was commonly used after demonstrating excellent virological and clinical response to combinations of three (or more) antiretroviral medicines. “Highly active” is not needed as a qualification, and the term is no longer commonly used.
ARV refers to antiretroviral medicines. It should only be used when referring to the medicines, not their use.”
ARV-based prevention: “ARV-based prevention includes the oral or topical use of antiretroviral medicines to prevent the acquisition of HIV in HIV-negative persons (such as the use of pre-exposure prophylaxis or post-exposure prophylaxis) or to reduce the transmission of HIV from people living with HIV (treatment as prevention).”
Epidemic: “An epidemic refers to a disease condition affecting (or tending to affect) a disproportionately large number of individuals within a population, community, or region simultaneously. The population may be all of the inhabitants of a given geographic area, the population of a school or similar institution, or everyone of a certain age or sex (such as the children or women of a region). An epidemic may be restricted to one locale (an outbreak), be more general (an epidemic) or be global (a pandemic). Common diseases that occur at a constant but relatively high rate in the population are said to be endemic.”
HIV-negative (seronegative): “A person who is HIV-negative (also known as seronegative) shows no evidence of HIV in a blood test (e.g., there is an absence of antibodies against HIV). The test result of a person who has acquired HIV but is in the window period between HIV exposure and detection of antibodies also will be negative.”
HIV-positive (seropositive): “A person who is HIV-positive (or seropositive) has had antibodies against HIV detected in a blood test or gingival exudate test (commonly known as a saliva test). Results may occasionally be false-positive, especially in infants up to 18 months carrying maternal antibodies.”
Incidence: “HIV incidence is expressed as the number of new HIV infections over the number of people susceptible to infection in a specified time period. Cumulative incidence may be expressed as the number of new cases arising in a given period in a specified population. UNAIDS reports the estimated number of incident cases that occurred in the past year among people aged 15–49 years and 0–14 years.”
Mother-to-child transmission (MTCT): “MTCT is the abbreviation for mother-to-child transmission. PMTCT, the abbreviation for prevention of mother-to-child transmission, refers to a four-prong strategy for stopping new HIV infections among children and keeping their mothers alive and families healthy. The four prongs are: helping reproductive-age women avoid HIV (prong 1); reducing unmet need for family planning (prong 2); providing antiretroviral medicine prophylaxis to prevent HIV transmission during pregnancy, labour and delivery, and breastfeeding (prong 3); and providing care, treatment and support for mothers and their families (prong 4).
PMTCT is often mistakenly referring to only prong 3— the provision of antiretroviral medicine prophylaxis. Some countries prefer to use the terms parent-to-child transmission or vertical transmission as more inclusive terms to avoid stigmatizing pregnant women, to acknowledge the role of the father/male sexual partner in transmitting HIV to the woman, and to encourage male involvement in HIV prevention. Still other countries and organizations use the term elimination of mother-to-child transmission (eMTCT).”
Prevalence: “Usually given as a percentage, HIV prevalence quantifies the proportion of individuals in a population who are living with HIV at a specific point in time. HIV prevalence also can refer to the number of people living with HIV. UNAIDS normally reports HIV prevalence among people aged 15–49 years.”
Tuberculosis (TB): “Tuberculosis (TB) is the leading HIV-associated opportunistic infection in low- and middle-income countries, and it is a leading cause of death globally among people living with HIV. The term HIV-associated tuberculosis or HIV-associated TB should be used, rather than the shorthand HIV/TB, to distinguish such instances from tuberculosis per se.
The main strategies to reduce the burden of HIV in TB patients are HIV testing (for people whose HIV status is unknown) and the provision of antiretroviral therapy and cotrimoxazole preventive therapy (CPT) (for people living with HIV). The main activities to reduce TB among people living with HIV are regular screening for TB among people in HIV care and the provision of isoniazid preventive therapy (IPT) and ART to HIV-positive people without active TB who meet eligibility criteria.”
Comparisons of UNAIDS and IHME estimates
Several sources publish estimates on HIV and AIDS – two of the most established (presented in this entry) are UNAIDS and the Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease. The charts below show these two sources’ relationship/consistency in prevalence estimates.
