GENEVA, 16 July 2014—A new report by UNAIDS shows that 19 million of
the 35 million people living with HIV globally do not know their
HIV-positive status.

“Whether you live or die should not depend on access to an HIV test,”
said Michel Sidibé, Executive Director of UNAIDS. “Smarter scale-up is
needed to close the gap between people who know their HIV status and
people who don’t, people who can get services and people who can’t and
people who are protected and people who are punished.”

The UNAIDS Gap report shows that as people find out their HIV-positive
status they will seek life-saving treatment. In sub-Saharan Africa,
almost 90% of people who tested positive for HIV went on to access
antiretroviral therapy (ART). Research shows that in sub-Saharan
Africa, 76% of people on ART have achieved viral suppression, whereby
they are unlikely to transmit the virus to their sexual partners. New
data analysis demonstrates that for every 10% increase in treatment
coverage there is a 1% decline in the percentage of new infections
among people living with HIV.

The report highlights that efforts to increase access to ART are
working. In 2013, an additional 2.3 million people gained access to
the life-saving medicines. This brings the global number of people
accessing ART to nearly 13 million by the end of 2013. Based on past
scale-up, UNAIDS projects that as of July 2014 as many as 13 950 296
people were accessing ART.

“If we accelerate all HIV scale-up by 2020, we will be on track to end
the epidemic by 2030,” said Mr Sidibé. “If not, we risk significantly
increasing the time it would take—adding a decade, if not more.”

By ending the epidemic by 2030, the world would avert 18 million new
HIV infections and 11.2 million AIDS-related deaths between 2013 and
2030.

Ending the AIDS epidemic

The report reveals that just 15 countries* account for more than 75%
of the 2.1 million new HIV infections that occurred in 2013. In every
region of the world the report finds that there are three or four
countries that bear the burden of the epidemic. In sub-Saharan Africa,
just three countries—Nigeria, South Africa and Uganda—account for 48%
of all new HIV infections.

However, the report also shows that entire countries are being left
behind—for example, six nations—Central African Republic, Democratic
Republic of the Congo, Indonesia, Nigeria, Russian Federation and
South Sudan—are facing the triple threat of high HIV burden, low
treatment coverage and no or little decline in new HIV infections.

In the first report of its kind, the UNAIDS Gap report emphasizes the
importance of location and population through an in-depth regional
analysis of HIV epidemics and through analysis of 12 populations at
higher risk of HIV. It analyses the reasons for the widening gap
between people gaining access to HIV prevention, treatment, care and
support, and people being left behind. It shows how focusing on
populations that are underserved and at higher risk of HIV will be key
to ending the AIDS epidemic.

HIV prevalence is estimated to be 28 times higher among people who
inject drugs, 12 times higher among sex workers and up to 49 times
higher among transgender women than among the rest of the adult
population. In sub-Saharan Africa, adolescent girls and young women
account for one in four new HIV infections. The report looks at why
certain populations are not accessing HIV services and outlines the
urgent need to address their specific needs.

“There will be no ending AIDS without putting people first, without
ensuring that people living with and affected by the epidemic are part
of a new movement,” said Mr Sidibé. “Without a people-centred
approach, we will not go far in the post-2015 era.”

The report shows that it is both essential and possible to go deeper
than a country-wide approach. Because countries and regions have
multiple and varying epidemics, the report outlines that having
country targets and sound policies in place creates space to address
complex micro-epidemics with tailored, bite-sized solutions that will
help reach people faster with better HIV services. It notes that
cities and communities will play an increasingly major role in
effective scale-up.

However, the report also shows that a lack of data on people most
affected by HIV, coupled with widespread stigma and discrimination,
punitive legal environments, barriers to civil society engagement and
lack of investment in tailored programmes are holding back results. It
confirms that countries that ignore discrimination and condone
inequalities will not reach their full potential, and face serious
public health and financial consequences of inaction. The report
emphasizes the need for equal access to quality HIV services as both a
human rights and public health imperative.
Hope and gaps
UNAIDS is reporting the lowest levels of new HIV infections this
century, at 2.1 million [1.9 million–2.4 million]. In the last three
years alone new HIV infections have fallen by 13%.

It is estimated that 35 million people were living with HIV in the
world at the end of 2013. AIDS-related deaths are at their lowest
since the peak in 2005, having declined by 35%. Tuberculosis continues
to be the leading cause of death among people living with HIV.

New HIV infections among children have fallen by 58% since 2001 and
dropped below 200 000 for the first time in the 21 most affected
countries in Africa.

The highest number of people living with HIV was in sub-Saharan
Africa—24.7 million [23.5 million–26.1 million] people. Asia and the
Pacific had the next largest population of people living with HIV, at
an estimated 4.8 million [4.1 million–5.5 million] people.

The percentage of people living with HIV who were receiving treatment
was found to be highest in western Europe and North America, at 51%
[39–60%], and in Latin America, at 45% [33–51%]. However, coverage was
lowest in the Middle East and North Africa, at just 11% [8–16%].

New HIV infections declined most in the Caribbean—by 40% since 2005;
however, new HIV infections have risen by 8% in western Europe and
North America, by 7% in the Middle East and North Africa and by 5% in
eastern Europe and central Asia since 2005.

AIDS-related deaths were seen to be rising steeply in the Middle East
and North Africa, by 66%. The only other region where AIDS-related
deaths are increasing is eastern Europe and central Asia, where
AIDS-related deaths rose by 5% between 2005 and 2013.

The report outlines that to close the gap between people who are
reached with HIV services and people who are not will require research
and innovation combined with protective laws that promote freedom and
equality for all people. It will also require increased commitment
from the global community and countries most affected to the
remarkable returns on investment that have been witnessed over the
last 10 years to continue so that the end of the AIDS epidemic can be
achieved by 2030.
In 2013, an estimated:
            35 million [33.2 million–37.2 million] people globally
were living with HIV
            2.1 million [19 million–2.4 million] people became newly
infected with HIV
            1.5 million [14 million–1.7 million] people died from
AIDS-related illnesses
UNAIDS is providing video footage (broll and video news release) for
broadcasters, as well as excerpts from the report launch press
conference.

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