Documents
UNAIDS Scientific Expert Panel 2013...
Scientific evidence and evidence-based action are essential to advance the Joint United Nations Programme on HIV/AIDS (UNAIDS) vision of zero HIV infections, zero discrimination and zero AIDS-related deaths. In light of the rapid pace at which new scientific information is becoming available, the diversity of fields where research evidence is growing rapidly and their potential importance for current policies, UNAIDS is ensuring it has adequate capacity to assess and assimilate the latest scientific developments to inform UNAIDS policies and advance the global AIDS response.
Fast-track cities: Ending the AIDS...
Working together, cities can take local actions for global impact. Leveraging our reach, infrastructure and human capacity, cities will build a more equitable, inclusive, prosperous and sustainable future for all of our residents—regardless of gender, age, social and economic status or sexual orientation.
The Cities Report
Urban areas are also home to millions of people who have fallen through the cracks of social, political and economic life. People who lack access to education, health services and prevention measures face significantly higher health risks. Under these social conditions, many diseases including HIV spread more quickly. Additionally, poor sanitation and crowding foster the spread of tuberculosis, which is the leading cause of death among people living with HIV. Cities need to address their significant disparities in access to basic services, social justice and economic opportunities. Using a Fast-Track AIDS response, cities can improve social equality for people affected by HIV and those living with the disease, while also addressing related public health challenges in new and innovative ways to prevent disease. Methodology Additional resources
Methodology— understanding the HIV...
UNAIDS’ 2013 modelled estimates that the HIV prevalence in the urban areas of countries in sub-Saharan Africa is twice the national HIV prevalence elsewhere in the countries were multiplied by the population sizes of cities to identify a preliminary list of 300 cities in which the largest number of people living with HIV were likely to reside. For each of the 300 top-ranked cities, a comprehensive review of all available data sources was conducted to refine the modelled estimates and to produce a final estimate of the total number of people living with HIV in each city for the top-ranked 200 cities.
Women living with HIV speak out...
Violence against women and girls is an unacceptable violation of basic human rights. It also is so widespread that ending it must be a global public health priority. An estimated one in three women is beaten, coerced into sex or otherwise abused by an intimate partner during her lifetime. Intimate partner violence has been shown to increase the risk of HIV infection by around 50%, and violence (and the fear of violence) deters women and girls from seeking services for HIV prevention, treatment, care and support.
Fast-Track - Ending the AIDS...
The world is embarking on a Fast-Track strategy to end the AIDS epidemic by 2030. To reach this visionary goal after three decades of the most serious epidemic in living memory, countries will need to use the powerful tools available, hold one another accountable for results and make sure that no one is left behind. Additional resources.
2014 progress report on the Global...
This report reflects the results of data for the calendar year 2013. For the first time since the 1990s, the number of new HIV infections among children in the 21 Global Plan priority countries1 in sub-Saharan Africa dropped to under 200 000 [170 000–230 000]. This represents a 43% decline in the number of new HIV infections among children in these 21 countries since 2009, providing reasons for optimism as the Global Plan pushes towards its 2015 goals of 90% reduction. However, there are also reasons for concern. Between 2012 and 2013 the pace of progress in reducing new HIV infections among children across the priority countries slowed substantially. While a number of countries made impressive gains, others stagnated or lost ground.
HIV and Ebola update
It is essential that all people, including people living with HIV, are able to access health services and ongoing treatment. If people living with HIV who are on ART stop abruptly because they cannot access new supplies they could rapidly become unwell, drug resistance may build and the chances of onward transmission of the virus would increase.
Gender matters: overcoming gender-...
After more than 30 years of the HIV epidemic—and an unprecedented medical and social response—discrimination, violence, harmful gender norms and related stigma continue to pose challenges to an effective HIV response. The findings of these assessments indicate that gender-related barriers pose significant obstacles to the uptake of services that prevent new HIV infections among children and keep mothers alive—obstacles that require urgent attention. Without dedicated attempts to overcome these gender-related barriers, current efforts will meet with limited success, and the needs and rights of both women and children will remain compromised.
Highlights from the high-level side...
A high-level panel welcomes a new Fast-Track strategy and emphasizes a fragile five-year window for rapid and massive acceleration of HIV treatment and prevention services.
Fast track: Ending the AIDS...
Fast-tracking the AIDS response and setting ambitious targets are critical to ending the AIDS epidemic. This requires transforming the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths into concrete milestones and endpoints.
The Gap Report
How do we close the gap between the people moving forward and the people being left behind? This was the question we set out to answer in the UNAIDS Gap report. Similar to the Global report, the goal of the Gap report is to provide the best possible data, but, in addition, to give information and analysis on the people being left behind.
People living with HIV
Since the start of the AIDS epidemic, more than 78 million people have been infected with HIV and 39 million have died. Acquiring HIV no longer means certain death. A person on HIV treatment in a high-income setting now has nearly the same life expectancy as a person who does not have the virus. However, only two out of five people living with HIV have access to antiretroviral therapy. Among people who do have access, great inequities exist. People living with HIV are being left behind because they are not benefitting from health care, employment, education or social protection. This is often due to stigma, discrimination, prohibitive laws and policies or a lack of services.
Adolescent girls and young women
Worldwide, there are approximately 880 million adolescent girls and young women aged 15–24 years. Despite making up 12% of the world’s population, this population is often left without a voice or control of their own bodies. Gender-based violence and limited access to health care and education, coupled with systems and policies that do not address the needs of young people, are obstacles that block adolescent girls and young women from being able to protect themselves against HIV, particularly as they transition into adulthood.
Prisoners
Every year, 30 million people spend time in prisons or closed settings and 10 million are incarcerated at any given point in time. Virtually all will return to their communities, many within a few months to a year. Health in prisons and other closed settings is thus closely connected to the health of the wider society. Prisons are often overcrowded due to inappropriate, ineffective and excessive criminal laws. People who are already more likely to be exposed to HIV, including people who use drugs, sex workers, and gay men and other men who have sex with men, are overrepresented in prisons and other closed settings. Overcrowding increases vulnerability to infections such as HIV, tuberculosis and hepatitis. Prisoners are also at risk of violence and disruption in HIV prevention and treatment services, including access to harm reduction measures.
Migrants
There are approximately 231.5 million international migrants. Combined with some 740 million internal migrants, this means that there are about 1 billion people on the move at any given time. Migration can place people in situations of heightened vulnerability to HIV, and has been identified in certain regions as an independent risk factor for HIV (3–5). In a majority of countries, undocumented migrants face complex obstacles, such as a lack of access to health-care services or social protection. Social exclusion also leaves migrants highly vulnerable to HIV.
People who inject drugs
It is estimated that worldwide there are nearly 12.7 million people who inject drugs. Approximately 1.7 million, or 13%, are also living with HIV. Injecting drug use is found in nearly every country. Typically, when heroin injection reaches a new community, there is an exponential increase in HIV transmission. People who inject drugs continue to face punitive legal environments, a variety of human rights abuses and have poor access to services; these and other factors combine to exacerbate their risks of acquiring HIV.
Sex workers
Evidence shows that HIV prevalence among sex workers is 12 times greater than among the general population. Even in very high prevalence countries, HIV prevalence among sex workers is much higher than among the general population. An analysis of 16 countries in sub-Saharan Africa in 2012 showed a pooled prevalence of more than 37% among sex workers. Stigma and discrimination, violence and punitive legal and social environments are key determinants of this increased HIV vulnerability. Punitive environments have been shown to limit the availability, access and uptake of HIV prevention, treatment, care and support for sex workers and their clients.
Gay men and other men who have sex...
Globally, gay men and other men who have sex with men are 19 times more likely to be living with HIV than the general population. The incidence of HIV among gay men and other men who have sex with men is rising in several parts of the world. Structural factors, such as stigma, discrimination and violence based on sexual orientation and gender identity and the criminalization of same-sex sexual practices, contribute to hindering the availability, access and uptake of HIV prevention, testing and treatment services among gay men and other men who have sex with men.
Transgender people
Many transgender people experience social exclusion and marginalization because of the way in which they express their gender identity. A transgender person does not identify with the gender assigned at birth. Estimates from countries indicate that the transgender population could be between 0.1% and 1.1% of reproductive age adults.
Children and pregnant women living...
HIV is the leading cause of death among women of reproductive age. In 2013, 54% of pregnant women in low- and middle-income countries did not receive an HIV test, a key step to accessing HIV prevention, treatment and care. Without treatment, about one third of children living with HIV die by their first birthday and half die by their second. For children, the health benefits of HIV treatment are magnified. Beginning antiretroviral therapy before the twelfth week of life reduces HIV-related mortality in children living with HIV by 75%.
Displaced persons
The forcible displacement of people through conflict or disaster is associated with increased food insecurity, the destruction of livelihoods and resulting poverty. Emergencies can disrupt care and treatment for people already living with HIV, and the negative impact of HIV on their health and livelihoods can increase the severity of the disasters they experience. HIV in emergency situations is often addressed as a generic set of issues. However, available evidence suggests that different types of emergencies have different impacts on people living with HIV, which require tailored humanitarian responses and the integration of HIV-related concerns.
People with disabilities
There are more than one billion people living with a physical, sensory, intellectual or mental health disability in the world—four out of five live in low- and middle-income countries. People with disabilities experience negative attitudes that can result in violence, sexual abuse, stigma and discrimination, which can lead to low self-esteem and social isolation. Vulnerability, combined with a poor understanding and appreciation of their sexual and reproductive health needs, places people with disabilities at higher risk of HIV infection.
People aged 50 years and older
The ageing of the world’s population is one of the most significant demographic trends of this era, and there are a growing number of people aged 50 and older living with HIV in the world today. With the size of this demographic growing, there will be an increased need for long-term access to HIV and other health services. This group includes men, women and transgender people. A large proportion of people aged 50 and older are sexually active. Like younger people, people aged 50 and older also need HIV services, although their needs are often overlooked, neglected or ignored.
Methodology – Understanding the...
Modelled HIV estimates are created by country teams using UNAIDS-supported software. The country teams are comprised primarily of epidemiologists, demographers, monitoring and evaluation specialists and technical partners. Country-submitted files are reviewed at UNAIDS, and selected HIV service data contained in the files are reviewed and validated in partnership with WHO and UNICEF. UNAIDS review aims to ensure comparability of results across regions, countries and over time.
A short technical update on self-...
HIV self-testing is a process whereby a person who wants to know his or her HIV status collects a specimen, performs a test and interprets the test result in private. HIV self-testing does not provide a definitive diagnosis; instead, it is a screening test for the presence of HIV-1/2 antibodies or the HIV-1 p24 antigen. Any positive HIV result must be confirmed by a health worker in accordance with national testing algorithms.
Advocacy strategy toolkit
A practical toolkit for young people who are passionate about advancing HIV and sexual and reproductive health and rights through national advocacy in the post-2015 agenda.
Issues brief: local epidemics
This brief discusses important new opportunities to reverse the HIV epidemic in specific locations and among key populations at higher risk of HIV exposure. More and more countries are collecting and analysing data that enable these locations to be identified and addressed. Data collection is expanding, and new methods are being used to identify where localized epidemics may be emerging, where specific populations are the most affected by HIV and where vital HIV services are deficient or absent. These data are being combined in innovative ways, including with geographical information, to produce a more detailed and vivid understanding of the HIV epidemic, down to the district and subdistrict levels. This makes it possible to focus HIV programmes more precisely and effectively and to offer or adapt services to reach greater numbers of people in need.
Considerations and guidance for...
The existence of national health identifiers (NHIDs) ensures that each patient has one unique identity within the health system. This facilitates the development of longitudinal medical records and allows users of services to be tracked across health-care sectors.
For young activists and youth...
This tool has been developed in collaboration between the PACT—a global alliance of 25 youth organizations working on HIV—UNAIDS and the Global Fund Secretariat. It aims to increase young people’s effective and meaningful participation in the Global Fund, with a specific emphasis on opportunities to participate at the national level.
For Country Coordinating Mechanism...
This tool offers guidance for how to involve young people in all Global Fund processes, including the development or review of national strategic plans (and/or investment cases), the management of the ongoing country dialogue, the creation of the concept note, the composition of Country Coordinating Mechanisms, and the implementation of Global Fund supported programs. We welcome your feedback and are available to answer any questions you have about implementing this tool. You can contact us at PACT-GlobalFund@gmail.com.
A focus on women: a key strategy to...
This issue brief is intended to inform and support partners in ensuring that the implementation of the Global Plan in their respective countries considers the best interests and rights of women. These partners include the relevant government ministries, health-care providers, policy-makers, development partners, donors and all NGOs that are involved in perinatal care. This brief is also intended for women living with HIV. It was prepared in consultation with women living with HIV, because they are central actors in the HIV response and should be engaged in a meaningful way in the implementation of the Global Plan.
The Bravest Boy I Know
This book features two delightful eight-year olds living in Africa: a girl called Kayla and a boy called Kendi. Kendi is living with HIV, but seems as happy as any other child. The story focuses on their carefree life at school, at home and in the countryside. The book also discusses Kendi’s feelings about being unwell sometimes, and about his mum’s support when he takes medicine. Kendi is full of dreams and imagination, and has worked out how to deal with the challenges that come with living with HIV. And Kayla adores him, describing him as the “Bravest boy I know”.
UNAIDS gender assessment tool:...
The Gender assessment tool for national HIV responses is intended to assist countries assess their HIV epidemic, context and response from a gender perspective, helping them to make their HIV responses gender transformative and (as such) more effective. The Tool is specifically designed to support the development or review of national strategic plans (NSP) and to inform submissions to both country investment cases and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM).
Eliminating forced, coercive and...
Like any other contraceptive method, sterilization should only be provided with the full, free and informed consent of the individual. However, in some countries, people belonging to certain population groups, including people living with HIV, persons with disabilities, indigenous peoples and ethnic minorities, and transgender and intersex persons, continue to be sterilized without their full, free and informed consent. This statement aims to contribute to the elimination of forced, coercive and otherwise involuntary sterilization. It reaffirms that sterilization as a method of contraception and family planning should be available, accessible, acceptable, of good quality, and free from discrimination, coercion and violence, and that laws, regulations, policies and practices should ensure that the provision of procedures resulting in sterilization is based on the full, free and informed decision-making of the person concerned.
Harm reduction works
Abundant evidence shows that harm reduction programmes can significantly reduce HIV transmission among people who inject drugs. Several countries are demonstrating the benefits of actively scaling up quality programmes that are based on human rights and public health needs.
Unite with women - Unite against...
The AIDS response is producing exciting results and we can already foresee a time when the AIDS epidemic could end. Yet, the promises of science, politics and economic development will not be realized if we do not unite with women against violence as an integral part of the HIV response. Violence is a key risk factor for HIV among women, including sex workers, transgender women and other women from key populations. Global and regional estimates of violence against women and the related health consequences show that it is a significant public health concern as well as a violation of women’s rights. Yet, there is much that can be done to address the impact that violence against women has on the HIV epidemic. Based on global and regional estimates for violence against women, the World Health Organization (WHO) has identified no fewer than 16 programmatic opportunities to address violence against women in the context of HIV.Building on that work, this advocacy brief provides key messages to inspire actions that respond to the needs and rights of women. As this brief makes plain, the widespread prevalence of violence against women means there is no time to lose and everything to gain.
#zerodiscrimination - Join the...
Zero Discrimination Day is the opportunity to celebrate everyone’s right to live a full and productive life with dignity—no matter what they look like, where they come from or whom they love. By joining hearts and voices, individuals, communities and societies can transform the world every day and everywhere. Zero Discrimination Day is a moment to highlight how everyone can become informed and promote tolerance, compassion and peace.
Be in the know
Around the world 5.4 million adolescents and young people between the ages of 10 and 24 are living with HIV. Globally, the proportion of young people getting tested for HIV is very low.
UNAIDS meeting report: Reducing...
In an effort to re-energize and re-shape global HIV prevention towards reaching the 2015 target and the ultimate goal of eliminating sexual transmission by 2030, UNAIDS convened a meeting of key stakeholders including National AIDS Programme managers from 14 key countries on 10-11 April, 2014 in Geneva, Switzerland.