Facts and figures

Detailed information on the HIV epidemic

Present situation and trends

Electron microscope image of an immune cell infected with HI viruses. The viruses are highlighted by a fluorescent dye.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) publishes regular, up-to-date reports and statistics on the spread of the virus and the disease. Robust figures are already available for 2018: some 37.9 million people were living with the human immunodeficiency virus (HIV) around the globe, including 1.7 million children under the age of 15.

Around 1.7 million people (including 160,000 children) were newly infected with HIV in 2018 (compared to 2.9 million in 1997).

Some 770,000 people died of acquired immune deficiency syndrome (AIDS) in 2018. The annual mortality rate has dropped by 55 per cent since 2005 (2005: 1.7 million AIDS-related deaths; 2010: 1.2 million).

These figures show that considerable successes have been scored when it comes to containing AIDS. However, they also show that the HIV epidemic still represents one of humanity’s biggest disasters and that the threat of the HI virus spreading further has not yet been averted.

The drop in annual new HIV infections and AIDS-related deaths is due to several factors: successful preventive measures, improvements in the supply of antiretroviral medicines, and better care and support for those living with HIV. Nevertheless, every day almost 4,700 people contract HIV and more than 2,000 people die of AIDS.

Regional differences

The situation in sub-Saharan Africa is particularly serious. In 2018, some 25.6 million people were HIV positive in that region. Almost 90 per cent of children who became infected with HIV in 2018 live in sub-Saharan Africa. In some countries in Africa, more than 10 per cent of those aged between 15 and 49 are HIV positive; in Botswana, Lesotho, Eswatini (Swaziland) and South Africa that figure is more than 20 per cent.

The trend in Central Asia and Eastern Europe is particular worrying: according to UNAIDS figures, the rate of new HIV infections rose by 29 per cent in these regions between 2010 and 2018. The number of infections has, however, changed relatively little in industrialised countries in recent years.

Women at particular risk

A young woman doing an apprenticeship at the SOS vocational school in Kigali, Rwanda.

The HI virus spreads across national borders and continents. During the early stages of the AIDS epidemic, the disease was chiefly regarded as one which affected homosexual men. Today, a little over half of all HIV-positive adults around the world are female – in eastern and southern Africa around 60 per cent of those infected with HIV are women. Young women are at particularly high risk of being infected there. In 2018 the rate of new HIV infections for women in the 15 to 24 age group was 55 per cent higher than for men in that age group.

The reason why women are a high-risk group is in part biological: women having unprotected sexual intercourse are at a significantly higher risk of infection than men. Further, there are social, economic and cultural reasons why women are at greater risk. Being exposed to violence or economic dependency, for example, means women are unable themselves to choose who they have sex with and how to protect themselves against infections.

The epidemic hits women particularly hard, because it is they who bear the brunt of care work and looking after AIDS orphans. Women and girls living with HIV often face considerable discrimination, too.

The gender roles which are firmly entrenched in society also have an important role to play in regard to boys’ and men’s HIV risk – because they are linked to high-risk behaviours such as alcohol consumption or multiple sexual partners. Sexual minorities such as homosexual men are often forced onto the fringes of society or are criminalised.

All these factors reduce the effectiveness of measures taken to stop the further spread of HIV and improve the care which AIDS patients receive. That is why German development cooperation places special emphasis on changing gender roles in the context of its HIV and AIDS programmes.

Young people and children

Since it is especially young people between the ages of 15 and 24 who become infected with HIV, they are the most important target group for HIV prevention measures. Sex education teaches them how to lead sex lives which are self-determined, partnership-based, safe and free of violence.

Infant in Rwanda

The prevention of mother-to-child transmission is thus another important task. Where pregnant women are systematically treated with antiretroviral drugs, the risk of mother-to-child transmission can be reduced to as low as two per cent. HIV-positive children still lack access to appropriate medicines. Their situation has not improved as significantly as that of adults in recent years.

And even where children are not themselves infected, many of them are hit hard by the consequences of the epidemic. Millions have already lost their mother, father or both parents to AIDS. Because they have to care for relatives or earn money to support their sick parents, many children are unable to go to school.

Impact of HIV and AIDS

In the period after 1990 average life expectancy in some African countries regressed to a level last recorded in the 1960s on account of the HIV epidemic. In South Africa, for instance, average life expectancy in 1992 was 63 years, but then dropped to 53 in 2004. In 2017 it had risen again to 63 years.

Because HIV and AIDS hit the younger and middle-aged generations hardest, these sections of the population are getting smaller in the worst affected countries. The fact that the most economically active generation of 20- to 40-year-olds is now smaller leads to serious economic and development problems. In the long term this can exacerbate poverty. In a country like Botswana, where one fifth of 15- to 49-year-olds are HIV positive, very many families may lack a breadwinner in the foreseeable future if those affected are not given access to adequate antiretroviral treatment.

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