For the first time, more than half of the 36.7 million people with HIV have access to treatment. That means most people with HIV are taking the antiretroviral medicines needed to suppress the virus. The report cited 53 percent, compared to roughly 27 percent in 2012.
The news is a reminder of how the HIV/AIDS epidemic is ever-changing. There are promising trends. And there are setbacks as well.
Fewer people are dying in traditional epidemic hot spots.
In 2010, there were roughly 760,000 AIDS-related deaths in eastern and southern Africa. In 2016, the number had dropped almost by half, to 420,000. The improvement is due to no one single cause. Governments have increased domestic funding for testing and treating HIV, self-tests have made diagnosis easier, and government campaigns have worked with traditional leaders to mobilize communities to get tested for HIV and to start antiretroviral treatment if they test positive. The daily regimen of pills can prevent the virus from worsening and prevent transmission to others.
Improvements in countries like South Africa, which has the largest number of people with HIV in the world, is what’s driving these results. The South African government has invested significantly in its AIDS response; the country spent more than $1.5 billion in 2014. To help people with HIV learn their status, South Africa rolled out self-testing and has supported community-based health groups to get people to get treatment and stay in it.
People with HIV are growing older — and that means new challenges.
HIV has long been a young person’s disease. In 1990, for example, UNAIDS estimates say that of the 130,000 people with HIV in South Africa, only 1,700 were age 50 or older.
Improvements in treatment allow more people with HIV to live longer. And fewer young people are contracting HIV, in part because they’re becoming sexually active later and using condoms more in areas like Sub-Saharan Africa.
So the population of people living with the virus is aging. The year 2012 was the first time people age 50 or older accounted for 10 percent of the adult population living with HIV in low and middle-income countries, according to UNAIDS. In high-income countries, this group accounts for 30 percent of the population.
Older people are more susceptible to diseases, for example TB. More testing need to be done for infection in these groups.