Globally, new infections and
AIDS-related deaths continue to decline, but less steeply than before. At the
same time, the number of people on HIV treatment continues to rise and appears
on track to meet the 2020 target. According to UNAIDS global estimates, in
2018:

  • 37.9 people worldwide were living with HIV;
  • 23.3 million (62%) had access to antiretroviral
    therapy;
  • 1.7 million newly acquired HIV;
  • 770,000 died from AIDS-related illnesses.

This represents a 16% drop in new infections since
2010, with most of the progress seen in Eastern and Southern Africa. But incidence
has increased in some regions including Eastern Europe and Central Asia (up
29%), the Middle East and North Africa (up 10%) and Latin America (up 7%).

The report shows that members
of key populations and their sexual partners now account for more than half
(54%) of the 1.7 million people who newly acquired HIV in 2018. These groups
include men who have sex with men, transgender people, sex workers, people who
inject drugs and and prisoners. In Eastern Europe and Central Asia and in the
Middle East and North Africa, these populations are thought to account for 95%
of new infections. Here too, the distribution of who bears the brunt of the
epidemic varies widely by region.

Despite the availability of
antiretrovirals that can prevent mother-to-child HIV transmission, just 82% of
pregnant women have access to them, resulting in 160,000 new infections among
children – well short of the target of less than 40,000.

Regarding HIV prevention, the report says that only
around 300,000 people worldwide – including 130,000 in the US – are using
pre-exposure prophylaxis (PrEP), although this is at best a rough estimate.
Similarly, although people who inject drugs account for a high proportion of
new HIV infections in some regions, many lack access to adequate harm reduction
services.

Although it is harder to gauge progress in this
area, the report notes that stigma, discrimination, criminalisation, harassment
and violence remain problems for many people living with HIV.

In the face of this continued need, the gap between
needs and available resources is widening, according to the report. Global funding
for the HIV/AIDS response declined for the first time, by nearly US$1 billion,
as international donors provided less and domestic investment did not keep up. Nonetheless,
in 2018, more than half of all funding in low- and middle-income countries came
from domestic sources. In 2018, US$19 billion was available for the response, falling
US$7.2 billion short of the estimated US$26.2 billion needed by 2020.