Of 35 million people living with HIV, 19 million do not know it. While new infections dropped by 13 percent in last three years, more than three quarters of new infections took place in just 15 countries, and 48 percent of new infections in sub-Saharan Africa took place in just three countries.
If the gap between those with access to HIV testing, treatment, care, and prevention and those without were closed with an accelerated effort to “include the whole human family,” the epidemic could end by 2030, according to a UNAIDS report.
On the eve of the 20th International AIDS Conference, the just released UNAIDS GAP Report provides updated data on the global HIV pandemic. It also adds details to the outcomes of dramatic progress in both quality and quantity of treatment and prevention efforts, and to the outcomes of stagnation and setbacks in addressing human rights obstacles standing between many and the resources they need. The report, of more than 400 pages, presents regional data and analyses, followed by examinations of challenges facing specific populations affected most by HIV, including people who are infected, young women and adolescent girls, and children as well as populations marginalized by laws, bias and discrimination.
While data on HIV behind bars remains inadequate, the report includes a five page section on challenges to essential HIV services in prisons where estimates put the HIV prevalence at from two to 10 times higher than that of the general population. Indeed, in some settings, according to the report, HIV prevalence may be up to 50 times higher than that of the general population. And yet, the report notes, denial of treatment is common, while access to condoms, lubricants, sterile needles and syringes, opioid substitutes, and voluntary testing for HIV remain scarce. The report also notes that 30 million people worldwide spend time in prisons or other confined settings each year, and that virtually all will return to their communities.
The report also is the first UNAIDS comprehensive report to contain an examination of some of the challenges to people living with disabilities to accessing HIV services, including a low perception of risk. It highlights a survey among people with disabilities in South Africa that found more a than 16 percent prevalence of the virus.
In addition the report highlights HIV service shortfalls and hurdles facing:
- Transgender women, whom, it estimates, are as much as 94 percent more likely to get HIV than other adults,
- Men who have sex with men, who are criminalized in at least 76 countries around the world,
- People displaced by conflicts or disasters for whom HIV services are not prioritized in humanitarian relief responses,
- People who sell sex among whom HIV prevalence can be from 12 to 50 times that of the general population but for whom only a third of countries reported supporting with risk reduction programs,
- People who inject drugs, for whom, in most countries, HIV service levels fall below the lowest levels set as essential by international agencies.
For all of that, ending the epidemic is possible, the report says, if efforts founded on evidence-based measures, including harm reduction programs and medical circumcision, reached the majority of those who need them, including people who sell sex, their clients, gay men and other men who have sex with men, transgender people and people who inject drugs. The report includes recommendations on how to do that, as well as a global plan with targets for individual countries.