HIV/AIDS in the World

  • In 2020, 37.7 million people were living with HIV, and 1.5 million people became newly infected with HIV. 
  • The global HIV response was already falling behind when the COVID-19 pandemic began—COVID-related impacts further derailed progress worldwide toward achieving the United Nations’ Fast-Track Targets. 
  • In some regions of the world, new HIV infections are increasing. Since 2010, there has been a 43% increase in annual new infections in Eastern Europe and Central Asia and a 21% increase in Asia and the Pacific.
  • Annual deaths from AIDS-related causes have declined by 43% since 2010, from 1.2 million in 2010 to 680,000 in 2020. 
  • At the end of December 2020, 27.5 million people living with HIV were accessing antiretroviral therapy, up from 17.2 million in 2015 and 7.7 million in 2010.
  • Of all people living with HIV in 2020, 84% knew their status, 73% were accessing treatment, and 66% were virally suppressed.
  • Since the beginning of the pandemic, 79.3 million people have become infected with HIV and 36.3 million have died of AIDS-related illnesses.

HIV in Key Populations

  • Approximately 65% of new HIV infections globally in 2020 were among key populations (men who have sex with men, people who inject drugs, sex workers, and transgender people) and their sexual partners.
  • In Eastern Europe and Central Asia and the Middle East and North Africa, key populations and their sexual partners accounted for at least 95% of new HIV infections.
  • Compared to the general population, the risk of acquiring HIV is 25 times higher among men who have sex with men, 35 times higher among people who inject drugs, 26 times higher for sex workers, and 34 times higher for transgender women.

HIV in Children

  • In 2020, there were 1.7 million children below the age of 15 living with HIV.
  • New HIV infections among children under the age of 15 decreased from 320,000 in 2010 to 150,000 in 2020. The global target of reducing new HIV infections among children to fewer than 20,000 by 2020 was not met.
  • About 920,000 children aged 0–14 years were accessing treatment in 2020, more than twice as many as in 2010 but far short of the target.
  • There were 99,000 AIDS-related deaths among children below the age of 15 in 2020.
  • In 2020, while 74% of adults aged 15 and older living with HIV had access to treatment, just 54% of children had access.
  • In 2020, an estimated 19.3 million women were living with HIV, constituting more than half of all adults aged 15 and over living with HIV.
  • About 50% of the estimated 1.5 million new HIV infections in adults globally were among women in 2020.
  • More than one in three women globally have experienced physical and/or sexual violence by an intimate partner or sexual violence by a non-partner. In some regions, women who have experienced violence are 50% more likely to acquire HIV than women who have not experienced such violence in their lives. 
  • In 2020, around 85% of pregnant women living with HIV received antiretroviral medicines to prevent the transmission of HIV to their children.

The Regional Picture

Asia and the Pacific
In 2020, an estimated 240,000 people in Asia and the Pacific became newly infected with HIV, bringing the total number of people living with HIV in the region to 5.8 million. AIDS-related illnesses claimed 130,000 lives. Progress has been uneven, with strong gains in some locations but a worsening of the epidemic in others. Annual new HIV infections and AIDS-related deaths are rising rapidly in countries such as Bangladesh, Pakistan, and the Philippines—which has seen about a 200% increase in annual new HIV infections since 2010. More than 94% of new infections in the region are among key populations and their sexual partners. Young people aged 15-24 account for more than 25% of new infections.

Eastern and Southern Africa
Since 2010, Eastern and Southern Africa has seen a 43% decline in new HIV infections and a 50% decrease in AIDS-related deaths. However, progress is fragile, and it varies considerably within the region. Retention in care for people living with HIV is an increasing challenge. In 2020, there were 20.6 million people living with HIV in East and Southern Africa—more than half of all people living with HIV in the world—and an estimated 670,000 new infections. Women and girls account for an estimated 58% of new infections in the region. In 2020, about 310,000 people died of AIDS-related illnesses. 

Western and Central Africa
In 2020, there were 4.7 million people living with HIV in Western and Central Africa. Women and girls accounted for 65% of adults 15 years of age and older living with HIV, reflecting continued gender disparities in the region. In 2020, the region saw an estimated 200,000 new HIV infections and 150,000 AIDS-related deaths. Only 44% of pregnant women living with HIV are receiving antiretroviral therapy—and in 2020, the region accounted for more than one in three new infections among children globally, reflecting continued barriers to maternal and newborn health services. 

Middle East and North Africa
The Middle East and North Africa is one of only two regions globally where new HIV infections are still on the rise. However, AIDS-related deaths have declined by 17% since 2010. In 2020, about 61% of the estimated 230,000 people living with HIV in the region knew their status, and only 43% of people living with HIV were receiving antiretroviral therapy—the lowest treatment coverage of any region in the world. In the Middle East and North Africa region the epidemic is highly concentrated among key populations and their sexual partners. In 2020, people who inject drugs accounted for 25% of new infections and men who have sex with men another 20%.

Eastern Europe and Central Asia
Eastern Europe and Central Asia has the fastest growing HIV epidemic in the world. Between 2010 and 2020, the annual number of new HIV infections increased 43%—most occurring in the Russian Federation and Ukraine. Key populations are disproportionately affected and lack access to HIV services. There continue to be high rates of new HIV infections among people who inject drugs, who now represent 43% of people living with HIV in the region. In 2020, an estimated 140,000 people in Eastern Europe and Central Asia became newly infected, bringing the number of people living with HIV in the region to 1.6 million. AIDS-related illnesses claimed 35,000 lives.

Western and Central Europe and North America
The Western and Central Europe and North America region has achieved the 90–90–90 targets. However, overall success obscures challenges. For example, in Western and Central Europe undocumented migrants lack access to critical treatment and prevention services. And, in North America, Black and Latino people are disproportionately impacted by HIV. In 2020, key populations and their sexual partners accounted for 96% of HIV infections. There were 2.2 million people living with HIV and an estimated 67,000 new HIV infections. AIDS-related illnesses claimed 13,000 lives.

Latin America
In 2020, there were 100,000 new HIV infections in Latin America, of which 92% were among key populations and their sexual partners. There were 2.1 million people living with HIV and 31,000 AIDS-related deaths—a decrease of 21% since 2010. Inconsistent access to health services and lack of government investment in health care systems continue to slow the regional response. Stigma and discrimination continue to impede progress in Latin America, where nearly one in five people living with HIV do not know their status, and 35% are not accessing antiretroviral therapy.

The Caribbean
The Caribbean has made steady progress in access to testing and treatment for people living with HIV, although the region fell short of the 2020 testing targets. From 2010 to 2020, AIDS-related deaths have decreased by about half. In 2020 82% of people living with HIV knew their status and 82% of those who knew their status were receiving treatment. Key populations and their sexual partners account for 68% of new infections. There were 330,000 people living with HIV in the region in 2020, and 13,000 new infections. 

Sources:
UNAIDS. Fact Sheet—Global AIDS Update 2021. Published July 2021. Accessed September 2021.
UNAIDS. Confronting Inequalities: Lessons for pandemic responses from 40 years of AIDS. Published July 2021. Accessed September 2021.
UNAIDS. Start Free, Stay Free, AIDS Free. Published July 2021. Accessed September 2021.
UNAIDS. AIDSinfo. Updated July 2021. Accessed September 2021.

(Last updated September 2021)