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 * HIV and AIDS


HIV AND AIDS

22 July 2024
العربية
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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 should have a diagnosis, 95% of
   whom should be taking lifesaving antiretroviral treatment, and 95% of people
   living with HIV on treatment should achieve a suppressed viral load for the
   benefit of the person’s health and for reducing onward HIV transmission. In
   2023, these percentages 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

Human immunodeficiency virus (HIV) is a virus that attacks the body’s immune
system. Acquired immunodeficiency syndrome (AIDS) occurs at the most advanced
stage of infection.

HIV targets the body’s white blood cells, weakening the immune system. This
makes it easier to get sick with diseases like tuberculosis, infections and some
cancers.

HIV is spread from the body fluids of an infected person, including blood,
breast milk, semen and vaginal fluids. It is not spread by kisses, hugs or
sharing food. It can also spread from a mother to her baby.

HIV can be prevented and treated with antiretroviral therapy (ART). Untreated
HIV can progress to AIDS, often after many years.

WHO now defines Advanced HIV Disease (AHD) as CD4 cell count less than 200
cells/mm3 or WHO stage 3 or 4 in adults and adolescents. All children younger
than 5 years of age living with HIV are considered to have advanced HIV disease.


SIGNS AND SYMPTOMS

The symptoms of HIV vary depending on the stage of infection.

HIV spreads more easily in the first few months after a person is infected, but
many are unaware of their status until the later stages. In the first few weeks
after being infected people may not experience symptoms. Others may have an
influenza-like illness including:

 * fever
 * headache
 * rash
 * sore throat.

The infection progressively weakens the immune system. This can cause other
signs and symptoms:

 * swollen lymph nodes
 * weight loss
 * fever
 * diarrhoea
 * cough.

Without treatment, people living with HIV infection can also develop severe
illnesses:

 * tuberculosis (TB)
 * cryptococcal meningitis
 * severe bacterial infections
 * cancers such as lymphomas and Kaposi's sarcoma.

HIV causes other infections to get worse, such as hepatitis C, hepatitis B and
mpox.


TRANSMISSION

HIV can be transmitted via the exchange of body fluids from people living with
HIV, including blood, breast milk, semen, and vaginal secretions. HIV can also
be transmitted to a child during pregnancy and delivery.  People cannot become
infected with HIV through ordinary day-to-day contact such as kissing, hugging,
shaking hands, or sharing personal objects, food or water.

People living with HIV who are taking ART and have an undetectable viral load
will not transmit HIV to their sexual partners. Early access to ART and support
to remain on treatment is therefore critical not only to improve the health of
people living with HIV but also to prevent HIV transmission.


RISK FACTORS

Behaviours and conditions that put people at greater risk of contracting HIV
include:

 * having anal or vaginal sex without a condom;
 * having another sexually transmitted infection (STI) such as syphilis, herpes,
   chlamydia, gonorrhoea and bacterial vaginosis;
 * harmful use of alcohol or drugs in the context of sexual behaviour;
 * sharing contaminated needles, syringes and other injecting equipment, or drug
   solutions when injecting drugs;
 * receiving unsafe injections, blood transfusions, or tissue transplantation;
   and
   
 * medical procedures that involve unsterile cutting or piercing; or accidental
   needle stick injuries, including among health workers.


DIAGNOSIS

HIV can be diagnosed through rapid diagnostic tests that provide same-day
results. This greatly facilitates early diagnosis and linkage with treatment and
prevention. People can also use HIV self-tests to test themselves. However, no
single test can provide a full HIV positive diagnosis; confirmatory testing is
required, conducted by a qualified and trained health worker or community
worker. HIV infection can be detected with great accuracy using WHO prequalified
tests within a nationally approved testing strategy and algorithm.

Most widely used HIV diagnostic tests detect antibodies produced by a person as
part of their immune response to fight HIV. In most cases, people develop
antibodies to HIV within 28 days of infection. During this time, people are in
the so-called “window period” when they have low levels of antibodies which
cannot be detected by many rapid tests, but they may still transmit HIV to
others. People who have had a recent high-risk exposure and test negative can
have a further test after 28 days.

Following a positive diagnosis, people should be retested before they are
enrolled in treatment and care to rule out any potential testing or reporting
error. While testing for adolescents and adults has been made simple and
efficient, this is not the case for babies born to HIV-positive mothers. For
children less than 18 months of age, rapid antibody testing is not sufficient to
identify HIV infection – virological testing must be provided as early as birth
or at 6 weeks of age. New technologies are now available to perform this test at
the point of care and enable same-day results, which will accelerate appropriate
linkage with treatment and care.


PREVENTION

HIV is a preventable disease.  Reduce the risk of HIV infection by:

 * using a male or female condom during sex
 * being tested for HIV and sexually transmitted infections
 * having a voluntary medical male circumcision
 * using harm reduction services for people who inject and use drugs.

Doctors may suggest medicines and medical devices to help prevent HIV infection,
including:

 * antiretroviral drugs (ARVs), including oral Pre-Exposure Prophylaxis (PrEP)
   and long acting products
 * dapivirine vaginal rings
 * injectable long acting cabotegravir.

ARVs can also be used to prevent mothers from passing HIV to their children.

People taking antiretroviral therapy (ART) and who have no evidence of virus in
the blood will not pass HIV to their sexual partners. Access to testing and ART
is an important part of preventing HIV.


ANTIRETROVIRAL DRUGS GIVEN TO PEOPLE WITHOUT HIV CAN PREVENT INFECTION

When given before possible exposures to HIV it is called pre-exposure
prophylaxis (PrEP) and when given after an exposure it is called post-exposure
prophylaxis (PEP).  People can use PrEP or PEP when the risk of contracting HIV
is high; people should seek advice from a clinician when thinking about using
PrEP or PEP.


TREATMENT

There is no cure for HIV infection. It is treated with antiretroviral drugs,
which stop the virus from replicating in the body.

Current antiretroviral therapy (ART) does not cure HIV infection but allows a
person’s immune system to get stronger. This helps them to fight other
infections.

Currently, ART must be taken every day for the rest of a person’s life.

ART lowers the amount of the virus in a person’s body. This stops symptoms and
allows people to live full and healthy lives. People living with HIV who are
taking ART and who have no evidence of virus in the blood will not spread the
virus to their sexual partners.

Pregnant women with HIV should have access to, and take, ART as soon as
possible. This protects the health of the mother and will help prevent HIV
transmission to the fetus before birth, or through breast milk.

Advanced HIV disease remains a persistent problem in the HIV response. WHO is
supporting countries to implement the advanced HIV disease package of care to
reduce illness and death. Newer HIV medicines and short course treatments for
opportunistic infections like cryptococcal meningitis are being developed that
may change the way people take ART and prevention medicines, including access to
injectable formulations, in the future.

More information on HIV treatments


WHO RESPONSE

Global health sector strategies on HIV, viral hepatitis, and sexually
transmitted infections for the period 2022–2030 (GHSSs) guide strategic
responses to achieve the goals of ending AIDS, viral hepatitis B and C, and
sexually transmitted infections by 2030.

WHO’s Global HIV, Hepatitis and STIs Programmes recommend shared and
disease-specific country actions supported by WHO and partners. They consider
the epidemiological, technological, and contextual shifts of previous years,
foster learning, and create opportunities to leverage innovation and new
knowledge.

WHO’s programmes call to reach the people most affected and most at risk for
each disease, and to address inequities.  Under a framework of universal health
coverage and primary health care, WHO’s programmes contribute to achieving the
goals of the 2030 Agenda for Sustainable Development.

 

Related

 * Global HIV, Hepatitis and STIs Programmes
   
 * Global Health Sector Strategies on, respectively, HIV, viral hepatitis and
   sexually transmitted infections for the period 2022–2030 (GHSS)
 * GHSS report on progress and gaps 2024
 * HIV country profiles
 * HIV statistics, globally and by WHO region, 2024

 






 

News

WHO approves packaging and shipping of a prequalified HIV rapid test at African
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Over 1 in 5 adults worldwide has a genital herpes infection – WHO 11 December
2024

Facts in pictures

HIV 22 July 2024


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