HIV/AIDS

Fact sheet N360

November 2012
Key facts
HIV continues to be a major global public health issue, having claime more than 2!
million lives over the past three ecaes"
#here $ere appro%imatel& 3' (31"')3!"*+ million people living $ith HIV in 2011"
,ub-,aharan ./rica is the most a//ecte region, $ith nearl& 1 in ever& 20 aults living
$ith HIV" ,i%t& nine per cent o/ all people living $ith HIV are living in this region"
HIV in/ection is usuall& iagnose through bloo tests etecting the presence or absence
o/ HIV antiboies"
#here is no cure /or HIV in/ection" Ho$ever, e//ective treatment $ith antiretroviral rugs
can control the virus so that people $ith HIV can enjo& health& an prouctive lives"
In 2011, more than 0 million people living $ith HIV $ere receiving antiretroviral therap&
1.2#3 in lo$- an mile-income countries" .nother 4 million people nee to be
enrolle in treatment to meet the target o/ proviing .2# to 1! million people b& 201!"
#he Human Immunodeficiency Virus (HIV) targets the immune s&stem an $ea5ens people6s
surveillance an e/ense s&stems against in/ections an some t&pes o/ cancer" .s the virus
estro&s an impairs the /unction o/ immune cells, in/ecte iniviuals grauall& become
immunoe/icient" Immune /unction is t&picall& measure b& 78' cell count" Immunoe/icienc&
results in increase susceptibilit& to a $ie range o/ in/ections an iseases that people $ith
health& immune s&stems can /ight o//" #he most avance stage o/ HIV in/ection is Acquired
Immunodeficiency Syndrome (AIDS), $hich can ta5e /rom 2 to 1! &ears to evelop epening
on the iniviual" .I8, is e/ine b& the evelopment o/ certain cancers, in/ections, or other
severe clinical mani/estations"
Signs and symptoms
#he s&mptoms o/ HIV var& epening on the stage o/ in/ection" #hough people living $ith HIV
ten to be most in/ectious in the /irst /e$ months, man& are una$are o/ their status until later
stages" #he /irst /e$ $ee5s a/ter initial in/ection, iniviuals ma& e%perience no s&mptoms or an
in/luen9a-li5e illness incluing /ever, heaache, rash or sore throat"
.s the in/ection progressivel& $ea5ens the person6s immune s&stem, the iniviual can evelop
other signs an s&mptoms such as s$ollen l&mph noes, $eight loss, /ever, iarrhoea an cough"
:ithout treatment, the& coul also evelop severe illnesses such as tuberculosis, cr&ptococcal
meningitis, an cancers such as l&mphomas an ;aposi6s sarcoma, among others"
Transmission
HIV can be transmitte via the e%change o/ a variet& o/ bo& /luis /rom in/ecte iniviuals,
such as bloo, breast mil5, semen an vaginal secretions" Iniviuals cannot become in/ecte
through orinar& a&-to-a& contact such as 5issing, hugging, sha5ing hans, or sharing personal
objects, /oo or $ater"
Risk factors
<ehaviours an conitions that put iniviuals at greater ris5 o/ contracting HIV inclue=
having unprotecte anal or vaginal se%>
having another se%uall& transmitte in/ection such as s&philis, herpes, chlam&ia,
gonorrhoea, an bacterial vaginosis>
sharing contaminate neeles, s&ringes an other injecting e?uipment an rug solutions
$hen injecting rugs>
receiving unsa/e injections, bloo trans/usions, meical proceures that involve unsterile
cutting or piercing> an
e%periencing acciental neele stic5 injuries, incluing among health $or5ers"
Diagnosis
.n HIV test reveals in/ection status b& etecting the presence or absence o/ antiboies to HIV in
the bloo" .ntiboies are prouce b& an iniviual@s immune s&stem to /ight o// /oreign
pathogens" Aost people have a B$ino$ perioB o/ usuall& 3 to 6 $ee5s uring $hich antiboies
to HIV are still being prouce an are not &et etectable" #his earl& perio o/ in/ection
represents the time o/ greatest in/ectivit&, but transmission can occur uring all stages o/ the
in/ection" I/ someone has ha a recent possible HIV e%posure, retesting shoul be one a/ter 6
$ee5s to con/irm test results, $hich enables su//icient time to pass /or antibo& prouction in
in/ecte iniviuals"
Testing and counseing
HIV testing shoul be voluntar& an the right to ecline testing shoul be recogni9e" Aanator&
or coerce testing b& a health-care provier, authorit& or /rom a partner or /amil& member is not
acceptable as it unermines goo public health practice an in/ringes on human rights"
.ll testing an counselling services must inclue the /ive 7@s recommene b& :HC= in/orme
7onsent, 7on/ientialit&, 7ounselling, 7orrect test results an lin5age to 7are, treatment an
other services"
!re"ention
Iniviuals can reuce the ris5 o/ HIV in/ection b& limiting e%posure to ris5 /actors" ;e&
approaches /or HIV prevention, $hich are o/ten use in combination, inclue=
#$ %ae and femae condom use
7orrect an consistent use o/ male an /emale conoms uring vaginal or anal penetration can
protect against the sprea o/ se%uall& transmitte in/ections, incluing HIV" Dvience sho$s that
male late% conoms have an 0!E or greater protective e//ect against the se%ual transmission o/
HIV an other se%uall& transmitte in/ections 1,#Is3"
&$ Testing and counseing for HIV and STIs
#esting /or HIV an other ,#Is is strongl& avise /or all people e%pose to an& o/ the ris5
/actors so that the& can learn o/ their o$n in/ection status an access necessar& prevention an
treatment services $ithout ela&" :HC also recommens o//ering testing /or partners or couples"
'$ Vountary medica mae circumcision
Aeical male circumcision, $hen sa/el& provie b& $ell-traine health pro/essionals, reuces
the ris5 o/ heterose%uall& ac?uire HIV in/ection in men b& appro%imatel& 60E" #his is a 5e&
intervention in generali9e epiemic settings $ith high HIV prevalence an lo$ male
circumcision rates"
($ ARV )ased pre"ention
($# ART as pre"ention
. recent trial has con/irme i/ an HIV-positive person aheres to an e//ective antiretroviral
therap& regimen, the ris5 o/ transmitting the virus to their unin/ecte se%ual partner can be
reuce b& *6E" For couples in $hich one partner is HIV-positive an the other HIV-negative,
:HC recommens o//ering .2# /or the HIV-positive partner regarless o/ herFhis 78' count"
($& !re*e+posure prop,ya+is (!r-!) for HIV*negati"e partner
#rials among seroiscorant couples have emonstrate that antiretroviral rugs ta5en b& the
HIV-negative partner can be e//ective in preventing HIV ac?uisition /rom the HIV-positive
partner" #his is 5no$n as pre-e%posure proph&la%is 1GrDG3"
:HC is recommening that countries implement emonstration projects on GrDG /or
seroiscorant couples an men an transgener $omen $ho have se% $ith men be/ore an&
ecision is mae about possible $ier use o/ GrDG"
($' !ost*e+posure prop,ya+is for HIV (!-!)
Gost-e%posure proph&la%is 1GDG3 is the use o/ .2V rugs $ithin 42 hours o/ e%posure to HIV in
orer to prevent in/ection" GDG is o/ten recommene /or health-care $or5ers /ollo$ing neele
stic5 injuries in the $or5place" GDG inclues counselling, /irst ai care, HIV testing, an
epening on ris5 level, aministering o/ a 20-a& course o/ antiretroviral rugs $ith /ollo$-up
care"
.$ Harm reduction for in/ecting drug users
Geople $ho inject rugs can ta5e precautions against becoming in/ecte $ith HIV b& using
sterile injecting e?uipment, incluing neeles an s&ringes, /or each injection" . comprehensive
pac5age o/ interventions /or HIV prevention an treatment inclues=
neele an s&ringe programmes>
opioi substitution therap& /or people epenent on opiois an other evience base
rug epenence treatment>
HIV testing an counselling>
HIV treatment an care>
access to conoms> an
management o/ ,#Is, tuberculosis an viral hepatitis"
0$ -imination of mot,er*to*c,id transmission of HIV (e%T1T)
#he transmission o/ HIV /rom an HIV-positive mother to her chil uring pregnanc&, labour,
eliver& or breast/eeing is calle vertical or mother-to-chil transmission 1A#7#3" In the
absence o/ an& interventions HIV transmission rates are bet$een 1!-'!E" A#7# can be nearl&
/ull& prevente i/ both the mother an the chil are provie $ith antiretroviral rugs throughout
the stages $hen in/ection coul occur"
:HC recommens a range o/ options /or prevention o/ A#7# 1GA#7#3, $hich inclues
proviing .2Vs to mothers an in/ants uring pregnanc&, labour an the post-natal perio, or
o//ering li/e-long treatment to HIV-positive pregnant $omen regarless o/ their 78' count" Ne$
guielines /or GA#7# $ill be issue in 2013"
In 2011, !4E o/ the estimate 1"! million pregnant $omen living $ith HIV in lo$- an mile-
income countries receive e//ective antiretroviral rugs to avoi transmission to their chilren,
up /rom '0E in 2010"
Treatment
HIV can be suppresse b& combination antiretroviral therap& 1.2#3 consisting o/ three or more
antiretroviral 1.2V3 rugs" .2# oes not cure HIV in/ection but controls viral replication
$ithin a person6s bo& an allo$s an iniviual6s immune s&stem to strengthen an regain the
capacit& to /ight o// in/ections" :ith .2#, people living $ith HIV can live health& an
prouctive lives"
Aore than 0 million people living $ith HIV in lo$- an mile-income countries $ere receiving
.2# at the en o/ 2011" C/ this, about !62 000 $ere chilren" #his is a 20-/ol increase in the
number o/ people receiving .2# in eveloping countries bet$een 2003 an 2011, an a 20E
increase in just one &ear 1/rom 6"6 million in 2010 to more than 0 million in 20113"
<& the en o/ 2011, !'E o/ the people eligible /or treatment $ere receiving .2#" 7overage is
highest in Hatin .merica 140E3 an the 7aribbean 164E3, /ollo$e b& sub-,aharan ./rica
1!6E3, .sia 1''E3, Dastern Durope an 7entral .sia 123E3 an lo$est in the Aile-Dast an
North ./rica 113E3"
2H3 response
,ince the beginning o/ the epiemic, :HC has been leaing the global health sector response to
HIV" .s a cosponsor o/ the Ioint Jnite Nations Grogramme on .I8, 1JN.I8,3, :HC leas
on the priorit& areas o/ HIV treatment an care, an HIVFtuberculosis co-in/ection, an jointl&
coorinates $ith JNI7DF the $or5 on the elimination o/ mother-to-chil transmission o/ HIV"
In 2011, :HC Aember ,tates aopte a ne$ Global health sector strategy on HIV/AIDS for
2011-2015. #he strateg& outlines /our strategic irections to guie actions b& :HC an
countries /or /ive &ears=
Cptimi9e HIV prevention, iagnosis, treatment an care outcomes"
Heverage broaer health outcomes through HIV responses"
<uil strong an sustainable health s&stems"
.ress ine?ualities an avance human rights"
:HC6s core activities on HIV also inclue=
s&nthesi9ing the evience on the e//ectiveness, /easibilit& an sa/et& o/ HIV interventions
an approaches, an guiing the HIV research agena>
articulating polic& options /or national HIV programmes>
improving the availabilit& an ?ualit& o/ HIV-relate meicines an iagnostics tools>
setting norms an stanars /or scaling up HIV prevention, iagnosis, treatment, care an
support services>
proviing technical support to countries to buil national capacit& to plan, implement,
monitor an evaluate e//ective HIV responses>
monitoring an reporting on progress in the health-sector response to$ars achieving
universal access to HIV services, incluing coverage an impact o/ HIV services> an
leaing global e//orts an /acilitating cohesion an collaboration among partners to
achieve the HIV-relate Aillennium 8evelopment Koals an the targets set out in the
Klobal health sector strateg& on HIVF.I8,, 2011-201!"