IN DANGER: 4,000 new HIV cases a day - where will we be in 2025?

‘In Danger’, the new report from UNAIDS was presented yesterday, July 27th 2022, ahead of the launch of the International AIDS Conference (AIDS 2022) in Montreal, Canada. The report contains new data that indicates a slowdown in the progress towards combating HIV, depletion of resources and the frightening consequences that brings.

In addition to participating in the ‘In Danger’ press conference, Life4me+ journalists were given the opportunity to speak to UNAIDS’ Strategic Information Advisor, Lev Zohrabyan, about the ongoing situation in Eastern Europe and Central Asia (EECA) - one of the regions where the number of new HIV cases has continued to increase year on year.

Overview of global data

Process in HIV prevention and treatment is slowing down around the world, and in some regions where we have previously seen a decrease in new HIV diagnoses - increases have begun. Against the backdrop of the global COVID-19 pandemic the amount of resources allocated to the HIV response has decreased significantly.

As a result, 1.5 million new infections have been registered over the past year, which is three times higher than the previously set targets. Additionally, the number of people living with HIV who started treatment was at a 10 year low in 2021.

In 2021, a new infection occurred every two minutes among young women and girls. 

There is a disproportionate number of new infections amongst young women and girls. The reasons are numerous, but are thought to include: 

• Lack of HIV prevention and treatment services
• Gender-based violence
• Gender-based discrimination
• Limited access to resources and education
• Depriving women and girls of control over their sexual life and reproductive health.

In 2021, the number of people living with HIV was 38.4 million, of which 54% were women and girls.

The total number of AIDS related deaths in 2021 was 650,000. One death every minute.

Despite the availability of effective HIV treatment and prevention, the number of deaths remains at a frighteningly high level. Key populations have suffered the worse during the crisis. 

For example, in El Salvador, the HIV prevalence rate among men who have sex with men has almost doubled, and amongst transgender people it has gone up eight times.

Racial inequality also has a big part to play. In the United States and United Kingdom, the number of new cases is higher in people of colour. Moreover, in Australia, Canada and the United States, the HIV infection rate in indigenous communities is higher than non-indigenous people. 

10 million people living with HIV do not have access to antiretroviral therapy. Only 52% of children living with HIV are receiving vital medication. 

Eastern Europe and Central Asia

Despite the alarming data contained within the UNAIDS ‘In Danger’ report, in an interview with UNAIDS’ Strategic Information Advisor Lev Zohrabyan, there were some positive changes that were worth highlighting in the EECA region.

These include, the development of a HIV diagnosis and treatment database that covers various countries in the region. The development process is being accompanied by the introduction of new, modern, methodologies and technologies. A new community monitoring system is also being developed, aiming to improve the quality of preventative measures and services. 

“For example, new digital platforms are being created in Moldova, as well as a number of other countries, that allow you to clearly monitor the situation in compliance with human rights”, said Zohrabyan.

These platforms will allow monitoring of, not only the quantity, but the quality of services being provided - in real time. In other words, the region is actively working to promote non-discriminatory services for people living with, or at risk of HIV, along with monitoring the legislative framework.

“It should be noted that communities in Ukraine have shown their viability and commitment to providing services to those in need, despite difficult conditions, devastation and failure in established systems” added Zohrabyan.

The situation, when it comes to prevention of vertical transmission (sometimes called mother-to-child transmission), is also looking good. The lack of published data is because numbers remain so low. 

Why, along with the feminisation of the HIV epidemic, are prevention and treatment programmes still often aimed mainly at men?

The most important factor the affects the spread of HIV to women and girls is unequal access to services and uneven distribution of resources. 

It is necessary that the scientific community, national governments and the civil sector recognise that fact and quickly pivot to provide prevention and care programmes in the right direction.

Evidence suggests that the number of new HIV cases among women is higher than among men. This should be the basis for changing stereotypes that have stubbornly remained since the beginning of the HIV epidemic - when most cases were detected amongst men who have sex with men, and injecting drug users. According to UNAIDS experts, the key to solving this situation is prompt and appropriate responses to up-to-date data.

In terms of net figures, how many times will it be necessary to increase funding for HIV programmes in the region to achieve the 2030 goals?

“This is a very difficult question that I cannot answer. The trajectory of the epidemic is currently going in the wrong direction” Lev Zohrabyan admitted.

At the same time, Zohrabyan explained that some countries are very close to achieving the 2030 goals, whilst int he EECA region the trend of the epidemic has continued to consistently rise. 

Given the geopolitical situation, it is almost impossible how much more funding is necessary to bolster healthcare and grants for non-governmental organisations critical to solving the epidemic.

“Instead of consolidating efforts against challenges such as coronavirus, monkeypox and other natural threats, people are separated and huge amounts of money is spent on taking lives and sowing grief (war). In these conditions no healthcare system can cope with the HIV epidemic. That requires peace, stability, and stable financing” Zohrabyan added in conclusion. 

You can read the UNAIDS ‘In Danger’ report here: https://indanger.unaids.org