World AIDS Day is celebrated on 1 December each year. This year marks the 30th anniversary of World AIDS Day. The theme this year is ‘Know your status’.

Background Information:

Immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off.

The most advanced stage of HIV infection is Acquired Immunodeficiency Syndrome (AIDS), which can take from 2 to 15 years to develop depending on the individual. AIDS is defined by the development of certain cancers, infections, or other severe clinical manifestations.

HIV can be transmitted via the exchange of a variety of body fluids from infected individuals, such as blood, breast milk, semen and vaginal secretions.

Individuals cannot become infected through ordinary day-to-day contact such as kissing, hugging, shaking hands, or sharing personal objects, food or water.

Behaviours and conditions that put individuals at greater risk of contracting HIV include:

• having unprotected anal or vaginal sex;
• having another sexually transmitted infection such as syphilis, herpes, chlamydia, gonorrhoea, and bacterial vaginosis;
• sharing contaminated needles, syringes and other injecting equipment and drug solutions when injecting drugs;
• receiving unsafe injections, blood transfusions, tissue transplantation, medical procedures that involve unsterile cutting or piercing; and
• experiencing accidental needle stick injuries, including among health workers.

Serological tests, such as Rapid Diagnostic Tests (RDTs) or enzyme immunoassays (EIAs), detect the presence or absence of antibodies to HIV-1/2 and/or HIV p24 antigen. No single HIV test can provide an HIV-positive diagnosis. HIV infection can be detected with great accuracy, using WHO prequalified tests within a validated approach.

It is important to note that serological tests detect antibodies produced by an individual as part of their immune system to fight off foreign pathogens, rather than direct detection of HIV itself.

Individuals can reduce the risk of HIV infection by limiting exposure to risk factors. Key approaches for HIV prevention, which are often used in combination, are:

• Male and female condom use
• Voluntary Male Medical Circumcision (VMMC)
• Testing and counselling for HIV and STIs
• Testing and counselling, linkages to tuberculosis care
• Antiretroviral drug use for prevention
• Harm reduction for people who inject and use drugs
• Elimination of mother-to-child transmission of HIV (EMTCT) 

Key Messages:

HIV continues to be a major global public health issue, having claimed more than 35 million lives so far. In 2017, 940 000 people died from HIV-related causes globally.

There were approximately 36.9 million people living with HIV at the end of 2017 with 1.8 million people becoming newly infected in 2017 globally.

59% of adults and 52% of children living with HIV were receiving lifelong antiretroviral therapy (ART) in 2017.

Global ART coverage for pregnant and breastfeeding women living with HIV is high at 80%.

The WHO African Region is the most affected region, with 25.7 million people living with HIV in 2017. The African region also accounts for over two thirds of the global total of new HIV infections.

Key populations are groups who are at increased risk of HIV irrespective of epidemic type or local context. They include:

• men who have sex with men,
• people who inject drugs,
• people in prisons and other closed settings,
• sex workers and their clients, and
• transgender people.

Key populations often have legal and social issues related to their behaviours that increase vulnerability to HIV and reduce access to testing and treatment programmes.

In 2017, an estimated 47% of new infections occurred among key populations and their partners.

There is no cure for HIV infection. However, effective antiretroviral (ARV) drugs can control the virus and help prevent transmission so that people with HIV, and those at substantial risk, can enjoy healthy, long and productive lives.

It is estimated that currently only 75% of people with HIV know their status. In 2017, 21.7 million people living with HIV were receiving antiretroviral therapy (ART) globally.

The objectives of the World AIDS Day campaign this year are:

1. urge people to know their HIV infection status through testing, and to access HIV prevention, treatment and care services; and
2. urge policy-makers to promote a “health for all” agenda for HIV and related health services, such as tuberculosis (TB), hepatitis and noncommunicable diseases.

Out of every 4 people with HIV infection, 1 does not know that they have HIV.

1 million people die from HIV each year because they

• don’t know they have HIV
• are not on treatment
• start treatment very late

Two-thirds of new HIV infections outside sub-Saharan Africa occur among 

• sex workers
• men who have sex with men
• transgenders
• people who inject drugs
• prisoners
• the sexual partners of the above

Every 60 seconds, a girl aged 15-24 years in sub-Saharan Africa gets infected with HIV.

Useful Links:

Link to the World AIDS Day campaign website:

http://www.who.int/who-campaigns/world-aids-day/world-aids-day-2018

Link to WHO fact sheet on HIV/AIDS (updated July 2018):

http://www.who.int/news-room/fact-sheets/detail/hiv-aids

Link to WHO video on HIV self-testing: