HIV / AIDS

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Max Roser (2017) - "HIV / AIDS". Published online at OurWorldInData.org. Retrieved from: 'https://ourworldindata.org/hiv-aids' [Online Resource]

 

I. Empirical View

The 1990s saw a substantial increase in the number of people infected with HIV and dying of AIDS. In 1997, almost 3.5 million people were diagnosed with HIV per year. After 1997, the number of new diagnoses began to decline and in 2015 it was reduced to 2.1 million per year.

The number of AIDS-related deaths increased throughout the 1990s and reached a peak in 2004, 2005 when in both years 2 million people died. Since then the annual number of deaths from AIDS declined as well and a decade later it was almost halved when 1.1 million people died in 2015.

The chart also shows the continuing increase in the number of people living with HIV. The rate of increase has slowed down compared to the 1990s but the absolute number reached a peak in 2015 when 36.7 million people were living with HIV globally.

Global number of AIDS-related deaths, new HIV Infections, and People living with HIV (1990-2015)1

small_hiv-aids

I.1 People with HIV/AIDS

In the map below you can see how adult HIV prevalence has changed by clicking the play button on the bottom left. As seen above, prevalence increased until the mid 2000s, when it began to decrease. Southern Africa remains the world region with the highest prevalence.

I.2 New Infections

Number of new infections per year

HIV incidence

0.05% of the world population are currently (2015 data) newly infected with HIV every year. This incidence of HIV was halved from 0.1% in the mid 1990s.

The distribution of these new cases is not even across different regions. While in Asian and Latin American countries the incidence is well below 0.1% there are some countries with much higher incidence. In South Africa 1.44% of the previously uninfected population was infected with HIV in 2015.

Fortunately, the number of new cases in Sub-Sarharan Africa and other world regions has now been steadily decreasing each year.

I.3 Deaths from AIDS

HIV/AIDS deaths by age group

The visualisation below shows the annual number of deaths from HIV/AIDS, differentiated by age group. Note that this data can be viewed for any country in the interactive chart features below.

Globally we see a clear rise-peak-decline trend in HIV-related deaths. In 1990, the total number of deaths is estimated to be approximately 290,000; this increased to peak in 2005/06 at approximately 1.9 million. Since then, the total number of deaths has almost halved, falling to around 1 million in 2016.

Across this period, 15-49 year olds have maintained the highest (and a consistent) share of around 74-75 percent of global deaths from HIV/AIDS.

HIV/AIDS death rates

The chart below shows HIV/AIDS age-standardized death rates (measured as the number of deaths per 100,000 people) across the world over this period.

HIV/AIDS death rates by age

The visualisation below shows the breakdown of death rates from HIV/AIDS (measured as the number of deaths per 100,000 individuals) by age category.

I.4 HIV and children

Children living with HIV

New HIV infections of children

I.5 HIV and gender

Differences of HIV prevalence between men and women


II. Correlates, Determinants, & Consequences

II.1 Antiretroviral Medicine

Below, we can see how the increased use of antiretroviral therapy (ART) corresponds with the decrease in AIDS-related deaths. As ART use increased, AIDS-related deaths began to slow and decrease.

AIDS related deaths and number of people receiving anti-retroviral therapy (ART) – The Economist2

AIDS related deaths and number of people receiving anti-retroviral therapy (ART) – The Economist

The following graphs show what a profound effect ART has on the number of AIDS-related deaths. In most regions, the number of people who died while using ART peaked in the mid-2000s and then began to decline, while the number of people who died without ART has continued to increase or remain fairly steady. The Middle East and North Africa region is a notable exception to this trend, where ART has made a difference in the number of deaths, but not a profound one.

Estimated number of AIDS-related deaths, with and without antiretroviral therapy, in low- and middle-income countries, and by region, 1995-2012 – UNAIDS (2013)3

Estimated number of AIDS-related deaths, with and without antiretroviral therapy, in low- and middle-income countries, and by region, 1995-2012 – UNAIDS (2013)

The chart below shows the number of people receiving ART in different global regions. The number of people on ART has increased since 2002, and a large portion of that global increase is due to the increase in Sub-Saharan Africa.

Number of people receiving antiretroviral therapy in low- and middle-income countries, by region, 2002-2011 – UNAIDS (2012)4

Number of people receiving antiretroviral therapy in low- and middle-income countries, by region, 2002-2011 – UNAIDS (2012)

II.2 Resources Available to Spend on AIDS

The following chart shows international and domestic spending on ART in various low and middle income countries. Previously, we have seen that AIDs deaths are still steadily increasing in the Middle East and North Africa, which may partially be due to the lack of domestic resources placed on ART therapy in this region.

International and domestic public spending on antiretroviral therapy in low- and middle-income countries, by region, various years up to 2013 – UNAIDS (2013)5

International and domestic public spending on antiretroviral therapy in low- and middle-income countries, by region, various years up to 2013 – UNAIDS (2013)

The source of funding for HIV/AIDS treatment varies across world region. Many countries in Sub-Saharan Africa care for HIV/AIDS patients primarily via funding from international assistance, while most countries in Latin America primarily use domestic funds.

Share of care and treatment expenditure originating from international assistance, low- and middle-income countries, 2007-2011 – UNAIDS (2012)6

Share of care and treatment expenditure originating from international assistance, low- and middle-income countries, 2007-2011 – UNAIDS (2012)

II.3 Education and HIV/AIDS

Education about HIV/AIDS is an incredibly important factor to prevent the disease's spread. Unfortunately often knowledge about HIV/AIDS much lower for students of low socioeconomic status than students with high status.

Percentage of grade 6 pupils who achieved minimal level of HIV and AIDS knowledge by socio-economic status, 2007 – UNESCO (2012)7

Percentage of grade 6 pupils who achieved minimal level of HIV and AIDS knowledge by socio-economic status, 2007 – UNESCO (2012)

The more education pregnant women have received, the more likely they are to seek HIV testing during their antenatal care visits.

Percentage of pregnant women who, when it was offered during an antenatal care visit, sought HIV testing and received their results, by education, selected sub-Saharan African countries, 2004-2007 – UNESCO (2011)8

Percentage of pregnant women who, when it was offered during an antenatal care visit, sought HIV testing and received their results, by education, selected sub-Saharan African countries, 2004-2007 – UNESCO (2011)

 

Increases in education lead to safer behaviors. In both Kenya and the Dominican Republic, higher education level is correlated with higher condom usage. Even having only part of a primary education leads to a massive increase in the percentage of people who know that condoms prevent the spread of HIV.

Education and condom usage in Kenya and the Dominican Republic – World Development Report (2007)9

Knowing that condoms prevent HIV increases with education, but so does the gap between knowledge and behavior.
Education and condom usage in Kenya and the Dominican Republic – World Development Report (2007)

II.4 Mother to Child Infection

Mother to child transmission of HIV is one of the leading causes of HIV spread. Fortunately, in all Sub-Saharan African regions, mother-to-child transmission has decreased. For Eastern and Southern Africa, the decrease has been dramatic, while Western and Central Africa have see periods of increased transmission, though the percentage is still lower than it was in 2003.

Trends in mother-to-child transmission rates by subregion in sub-Saharan Africa, 2000-2011 – UNAIDS (2012)10
Trends in mother-to-child transmission rates by subregion in sub-Saharan Africa, 2000-2011 – UNAIDS (2012)

The following chart shows that while globally life expectancy has been increasing since the 1960s, several countries in Sub-Saharan Africa saw a major decrease in life expectancy with the onset of the AIDS crisis around 1990. Life expectancy has started to increase again since the early 2000s, but for the countries shown, it still has not reached a level as high as it was before the AIDS crisis.

Decline and recovery of life expectancy in Africa, 1960-2010 – Wikipedia11Decline and recovery of life expectancy in Africa, 1960-2010 – Wikipedia

II.5 Deaths Due to Tuberculosis among People Living with HIV

Death due to tuberculosis still remains high among people living with HIV, however the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.

Estimated number of TB-related deaths among people living with HIV, 2004-2011 – UNAIDS (2012)12
Estimated number of TB-related deaths among people living with HIV, 2004–2011 – UNAIDS (2012)


III. Data Quality & Definition

According to the Wikipedia page on HIV/AIDS, human immunodeficiency virus (HIV) is a virus that leads to acquired immune deficiency syndrome (AIDS), a condition that progressively compromises the immune system. It is transmitted through "unprotected sexual intercourse, contaminated blood transfusions, hypodermic needles, and from mother to child during pregnancy, delivery or breastfeeding."13

The following table gives estimates for the number of people living with HIV, the number of new infections, the number of deaths, the number accessing treatment, and the financial resources behind HIV.

HIV estimates with uncertainty bounds, 1990-2012 – UNAIDS14
HIV estimates with uncertainty bounds, 1990-2012 – UNAIDS

Since the mid-2000s, an increasing number of countries have demonstrated their focus on HIV/AIDS by reporting the HIV/AIDS rate in their respective nations. In 2012, there were only 7 countries that did not report, while in 2004 89 countries did not report.

Reporting rates (UN Member States reporting/total number of UN Member) by region, 2004 - 2012 – UNAIDS (2012)15
Reporting rates (UN Member States reporting/total number of UN Member) by region, 2004 - 2012 – UNAIDS (2012)

Unfortunately, in many countries, the percentage of people who know their HIV status is very low

Knowledge of HIV status among men and women living with HIV, selected countries, 2010-2011 – UNAIDS (2013)16
Knowledge of HIV status among men and women living with HIV, selected countries, 2010-2011 – UNAIDS (2013)

IV. Data Sources

 

Joint United Nations Program on HIV and AIDS (UNAIDS)
  • Data: Data on size of epidemic and response
  • Geographical coverage: Global
  • Time span: 1990-2014
  • Available at: Online here
  • There are also tools to analyze the data online, and there is background information on the data and the disease.
World Health Organization
  • Data: Data on size of epidemic and response
  • Geographical coverage: WHO member nations
  • Time span: Since c. 2001
  • Available at: The WHO publishes data here.
Institute of Health Metrics and Evaluation (IHME), Global Burden of Disease (GBD)
  • Data: Death rates & absolute number of deaths from HIV/AIDS
  • Geographical coverage:Global, across all regions and countries
  • Time span:Available from 1990 onwards
  • Available at: Online here
Gapminder
  • Data: HIV/AIDS prevalence and mortality
  • Geographical coverage: Global
  • Time span: Mostly 1990-2011, but some data goes back as far as 1980
  • Available at: Here are data on the share of adults with AIDS.
  • Gapminder also published an extensive documentation of their data, which is online here.
USAID Demographic and Health Surveys
  • Data: Survey data
  • Geographical coverage: Global
  • Time span: Since the 1980s for some countries
  • Available at: Online here
United States Census Bureau in partnership with USAID
  • Data: Data on prevalence and incidence
  • Geographical coverage: Global
  • Time span: Since 1980s for some countries
  • Available at: Online here