Who is most at risk from HIV today?

So now that we understand the origins of HIV, what has happened since then? Every disease outbreak affects certain groups more than others, so which demographics are most at risk? Annie Howard is from the National AIDS Trust...

Annie - At the end of 2021, which is the most recent year that we have accurate data for, the World Health Organization reported that there were 1.5 million new cases of HIV globally, which would equate to over 4,000 per day, which is far too many, considering that we now have effective treatment and prevention mechanisms to manage an epidemic.

Chris - How many people around the world right now then do we think are currently living with this infection?

Annie - So we estimate it to be around 35 million. Again, that was in 2021, so probably more now. But what I will say is that while that is a high number and actually is the highest number that it's ever been, this is kind of attributed to two different things. So of course, in part, that will be attributable to new HIV cases, which we want to stop as the ultimate goal, and 2030 is the global goal to stop new transmissions, and new cases have reduced by roughly half since the peak of the epidemic in 1996. But the other part of that large number is that a large number of people living with HIV are now doing so thanks to these effective treatments that we have, which allow them to live full and healthy lives as anyone else would. So this is really important to reduce the viral load of HIV within the individual. And in the field we use the term ‘U=U’, so undetectable equals untransmissable. So the more individuals we have on effective treatment, the less transmissions that we're going to see, and then we'll really reduce that number. So the fact that there are less people getting really sick and dying from HIV means that more people are living with it. So that large number isn't actually all really bad.

Chris - Where are most of these cases?

Annie - It's really variable across the world. So the African region continues to be the most severely affected. So that region accounts for around two thirds of the global cases. Different countries need different interventions to really target those different needs. And obviously, low and middle income countries are experiencing different social environments. So the needs there would be quite different to say what we see in the UK.

Chris - Indeed. Who do you think are the most vulnerable communities that we need to keep our eye on in terms of preventing increases and making sure we meet those goals of stopping transmission by 2030?

Annie - So a lot of the work we do at the National AIDS Trust in partnership with the European Center for Disease Control focuses on the European region. So I can mostly speak to that. And the groups in this region are mostly men who have sex with men, which is probably the group that people most align with this disease. But also people who inject drugs, sex workers, migrants, prisoners, and heterosexual women are all groups that we need to be really focusing on.