Number of people living with HIV on antiretroviral therapy reaches 17 million
but many challenges remain, study states
Islamabad
In just the last two years, the number of people living with HIV on antiretroviral therapy has increased by about a third, reaching 17.0 million people, which is 2 million more than the 15 million by 2015 target set by the United Nations General Assembly in 2011. Moreover, ever since the first global treatment target was set in 2003, annual AIDS-related deaths have decreased by 43 per cent, states the Global AIDS Update 2016 released globally by UNAIDS on July 1.
While celebrating the gains as reflected in latest data covering 160 countries, and reflecting on what can be achieved in the coming years through a fast-track approach, UNAIDS is also wary of the huge challenges that still lie ahead.
“The world has committed to ending the AIDS epidemic by 2030. How to reach this bold target within the Sustainable Development Goals is the central question facing the United Nations General Assembly High-Level Meeting on Ending AIDS, to be held from June 8-10,” the report flags, while recommending a substantial increase in investment over the next five years to accelerate scale-up and establish the momentum required to overcome within 15 years, one of the greatest public health challenges in this generation.
According to the report, there were 2.1 million new HIV infections worldwide in 2015, adding up to a total of 36.7 million people living with HIV.
“The scale-up of antiretroviral therapy is on a fast-track trajectory that has surpassed expectations,” the report maintains. Global coverage of antiretroviral therapy, according to the report, reached 46 per cent at the end of 2015. Treatment coverage in the Asia and Pacific region more than doubled, from 19 per cent in 2010 to 41 per cent in 2015. In eastern Europe and central Asia, coverage increased by just a few percentage points in recent years to 21 per cent -- about one in five people living with HIV in the region.
The gains in treatment are largely responsible for a 26 per cent decline in AIDS-related deaths globally since 2010, from an estimated 1.5 million in 2010 to 1.1 million in 2015, the report states. The reduction in deaths since 2010 has been greater among adult women (33 per cent decrease) compared with adult men (15 per cent decrease), reflecting higher treatment coverage among women than men, 52 per cent and 41 per cent, respectively.
The gender gap for treatment among adults highlights the impact of gender norms that delay initiation of treatment among men, reduce treatment adherence, blunt the preventive effects of treatment, and lead to men accounting for 58 per cent of adult AIDS-related deaths.
UNAIDS believes that the fast-track approach to HIV treatment is working, and that the continuing momentum reinforces the determination to achieve the 90–90–90 treatment target by 2020, whereby 90 per cent of people living with HIV know their HIV status, 90 per cent of people who know their HIV-positive status are accessing treatment, and 90 per cent of people on treatment have suppressed viral loads.
Declines in new HIV infections among adults have slowed alarmingly in recent years, with the estimated annual number of new infections among adults remaining nearly static at about 1.9 million in 2015.
Adolescent girls and young women aged 15-24 years are at particularly high risk of HIV infection, accounting for 20 per cent of new HIV infections among adults globally in 2015, despite accounting for just 11 per cent of the adult population.
Key populations at increased risk of HIV infection include sex workers, people who inject drugs, transgender people, prisoners and gay men and other men who have sex with men. UNAIDS data show that the distribution of new HIV infections among key populations varies by region. People who inject drugs accounted for 51 per cent of HIV infections in eastern Europe and central Asia and 13% of new HIV infections in Asia and the Pacific in 2014. Gay men and other men who have sex with men accounted for 30 per cent of new HIV infections in Latin America, 49 per cent of new infections in western and central Europe and North America and 18 per cent of new infections in Asia and the Pacific. This underscores the need to ensure that key populations are fully included in AIDS responses and services are made available to them. Data show that when services are made available within an environment free of stigma and discrimination, new HIV infections have declined significantly.
Data from population-based surveys suggest that discriminatory attitudes towards people living with HIV have declined slowly, but progress has been uneven across countries and between women and men. In approximately half of countries with available data between 2009 and 2014, over 50 per cent of women and men aged 15-49 years reported they would not buy vegetables from a shopkeeper living with HIV.
UNAIDS believes that exceptional results can be achieved when there is broad leadership and consistent financial commitment. The job is still only half done, however, as approximately 54 per cent of people living with HIV are in need of treatment, many of whom do not know their HIV status, the report concludes.