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Four weeks before the African Cup of Nations football tournament kicked off it was down to the wire. José Fardon, a Côte d’Ivoire web designer and digital developer, had his whole team frantically working on a special edition of an interactive health and HIV game app, called "A l'Assaut du Sida", ‘Tackling AIDS’ (AADS) to coincide with the tournament.

The UNAIDS team had secured funds for the latest rendition of the online game and had rallied UNICEF and the Global Fund to chip in.

“We had launched various versions of the game in the past, but this required a different look and feel to gel with the sporting event,” said Mr Fardon, founder of SYL.

They also needed a final approval from the National AIDS Programme (PNLS).

"Out of the many initiatives put forward ahead of the CAN, the online app really appealed to us because we knew it would not only reach the target audience, it would also make an impact,” said Eboi Ehui, PNLS Coordinating Director. “This is a generation that has never seen the ravages of AIDS so they have felt like it isn’t a problem but it is.”

The success was beyond anyone’s expectations.

The 20,000 tournament volunteers recruited by the Ministry of Youth not only played the online game themselves but they fanned out around the stadiums promoting the game by sharing the QR code with the hundreds of thousands of supporters. And with various prize giveaways during the tournament and afterwards, more and more people downloaded the app to play. Since mid-January 2024, AADS has reached nearly 200,000 adolescents and young people with the latest version reaching a lot of young boys and men (cumulatively, the three versions have reached almost 300 000 people.)

“When I think back, this idea germinated in 2016 as a tool for schools then was launched at the Francophonie Games a year later but now, we really brought it to the general public,” Mr Fardon said. “I am so proud we never gave up.”

His determination impressed more than one person.

In eight years, he convinced UNAIDS staff, the country’s Ministry of Health in close collaboration with PNLS, the Ministry of Education, the Ministry of Youth and countless partners on the ground.

UNAIDS Country Director Henk Van Renterghem, like his predecessors before him, saw the value and potential of using digital technology to reach adolescents and young people. “General knowledge about HIV and overall comprehensive sexual education has decreased and young people are struggling with so many choices that this easy to download game is without a doubt relevant,” he said.

In July 2023, he explained, the National AIDS Council was alerted by the results of a survey and beseeched HIV partners to step up communication and education efforts.

“Despite the fact that young people have more access to information through the internet and social media than ever before, many young people are struggling to make informed decisions about their sexual relations,” said Mr Van Renterghem. For example, the survey revealed that only 40% knew that medicine (anti-retroviral treatment) existed for HIV and 39% of girls (29% of boys) did not know that condoms prevented HIV transmission. Last year, 20% of new HIV infections in the country were among 15–24-year-olds, according to government data.

As a result, UNAIDS staff along with SYL, vetted and increased the number of questions expanding prevention info.

He and his staff were particularly happy because they also succeeded in expanding the scope of the content.

In went the fact that people with HIV on effective treatment can achieve an undetectable viral load and cannot transmit the virus (U=U) plus stuff about stigma & discrimination, human rights, gender equality and gender-based violence – all structural drivers of HIV.

The full game of 400 questions is like a quiz with additional information popping up. Players score points by advancing through 40 sets of ten questions. At least seven correct answers are needed to advance to the next level. It can take up to an hour to get to the last round and when the updated pilot was tested in October and November of 2023, young people responded well.

Two of the young players who scored in the best percentile agreed.

“The game really taught me a lot. There are a lot of facts about HIV and sexually transmitted diseases,” said Marie Koffi. For Wilfried Touré he said, “I learned a lot of things that I had no idea about from tuberculosis to HIV and even on a personal level I picked things up.”

Going forward national partners now want to distribute a scholastic version of the game to all Côte d’Ivoire schools.

During the final awards ceremony at the end of March, Côte d’Ivoire’s Minister of Health, Pierre Dimba, was clear.  “This fun and educational online game is a response to young people's need for true and accurate information via social media,” he said.  “The popularity of this game among teenagers is a real testimony that adapting our communication strategies to the habits and needs of young people pays off.”

In Mr Van Renterghem’s mind, Côte d’Ivoire should be proud.

“This home-grown low-cost tool will help us sustain our HIV prevention efforts as international funding will inevitably dwindle.”

That is in part why Mr Fardon and UN partners are dreaming even bigger.

“We would like to launch the app-based game in neighboring countries and eventually roll this out throughout western and central Africa,” he said.

“The sky is the limit.”

In a modest neighborhood of Bangui, Central African Republic’s capital city, Gniwali Ndangou is rushing to work. She’s a peer educator and community health worker at a youth sexual education centre, CISJEU.  

The same centre that saved her life.

I'm an orphan," she said, “I am the youngest of three sisters.” Throughout her childhood, her legal guardian told her to take pills saying it was anti-malaria and headache medicine. “I was the only one who took treatment every day and it never stopped.”

After threatening to stop taking pills when she was 17 years old, her sister finally told her the truth. She was born with HIV.

Gniwali couldn’t believe the litany of lies. Having recently been forced to quit school as her adopted family struggled to make ends meet, she once again felt abandoned.

 
“Many times, I tried to commit suicide… I wanted to end my life,” she said.

Her sister Astrid said she tried to pull her youngest sibling out of despair and kept hammering to her: “There are no differences between us, we are all humans.”

At her sister’s urging, Gniwali sought help at a youth center, Centre d’information et d’éducation sexuelle des jeunes (Center for Youth Sexual Education and Information) known as CISJEU. Established in 1994, CISJEU has been a beacon of hope for many young people like Gniwali. They offer community-led services ranging from HIV prevention to HIV testing to peer-supported treatment initiation and adherence.  

War and extreme poverty have greatly increased premature death in Central African Republic, leaving seventy-eight percent of the population under 35 years old. Young people struggle to receive an education with less than 4 in 10 adults literate. Gender inequality and gender-based violence also make young girls particularly vulnerable to HIV infection. Out of the 10,000 yearly new HIV infections, 3000 are among 15-24 years old with more than two female infections for every one male infection.

According to a UNICEF survey, less than 20% of young people possess comprehensive knowledge about HIV prevention. The youth center uses peer educators to bridge this knowledge gap and provide youth-friendly services. "We've trained and deployed 160 peer educators (80 in schools while the others are at youth centers) across different districts of Bangui and beyond, ensuring effective outreach and health and body awareness," said Michael Guéret, a program officer at CISJEU.

Chris Fontaine, former UNAIDS Country Director, underscores the importance of peer-led initiatives, “Addressing HIV and sexual health among young people in CAR is not just a health issue but a critical component of sustainable development and peace consolidation.”    

With support from UNAIDS and the Ministry of Health, CISJEU has attained the right to distribute HIV medicine, antiretroviral therapy, among the community.

For Gniwali, CISJEU became more than a sanctuary. Through training programs, she evolved from a beneficiary to a peer educator and community healthcare provider. “I received various certifications such as mobile HIV testing, and psychosocial support."

Leading discussion groups and dispensing life-saving antiretroviral medications to young people, she inspires young women to take care of their health. Her message is clear and powerful: "Being a young woman isn't easy. We must educate ourselves about this disease, fight against it, and prevent its spread in our country.”

Across the world, spikes in instability, displacement, and conflict are exacerbating people’s vulnerability to gender-based violence and to HIV.

“Gender-based violence is an egregious human rights violation. It is also a driver of the AIDS pandemic, especially in fragile states. Tackling gender-based violence is essential to uphold the right to health and life for everyone,” says UNAIDS Executive Director, Winnie Byanyima.

Efforts to prevent and to respond to HIV and gender-based violence in fragile settings remain partial, isolated, and unstable despite normative commitments made at the global level.

Fragility is described by the Organisation for Economic Co-operation and Development as “…the combination of exposure to risk and insufficient coping capacities of the state, system, and/or communities to manage, absorb or mitigate those risks.”  

The new report, The Missing Link: Rethinking and reprioritizing HIV and gender-based violence in fragile settings,  reveals the results of a study on the linkages between HIV and gender-based violence in fragile settings. This issue is explored through the lens of peace support operations. Work was partially funded through the generous contribution of the Grand Duchy of Luxembourg to UNAIDS.

The study examines the mandates and objectives of peace support operations, revealing that HIV and gender-based violence remain deprioritized, with responses of peace support operations often disconnected. Several challenges in translating agreed-upon principles into actionable results are identified and recommendations are offered to address these barriers.

“This report provides a crucial guide to support strategic decision-making in HIV and GBV advocacy in peace support operations and will be a vital tool for addressing these urgent challenges effectively,” says Sihaka Tsemo, Director, UNAIDS Liaison Office to the African Union & UNECA.   

The report provides guidance to duty bearers across the development, peace and security and humanitarian arenas.

In the Democratic Republic of the Congo, for instance, the UN peacekeeping mission, MONUSCO, is in an active process of withdrawal and transition. UNAIDS Country Director, Susan Kasedde, reflects on the vital role of the UN’s Joint Programme on HIV and AIDS in addressing the multifaceted interlinkages between HIV and gender-based violence in fragile settings:

“The Joint Programme brings together invaluable expertise for a holistic response and  plays a crucial role in strengthening state capacity to lead and deliver, through supporting strengthened  systems for accountability and governance, and through facilitating broad partnerships, including with communities, to enable transformative and sustainable changes and take to scale effective models for integrated delivery of HIV interventions on the ground.”  

In Mali, the decade-old Multidimensional Integrated Stabilization Mission has recently completed its withdrawal. UNAIDS Country Director, Marc Saba, explains the role of the United Nations Gender Thematic Group in supporting internally displaced persons in localities affected by insecurity and the humanitarian crisis.

“In the past 8 months the UN Country Team in Mali, under the leadership of UN Women, has provided capacity building, food support and funds to carry out income-generating activities to over 1000 women, young girls and men in vulnerable situations. In addition, the UN Joint Team on AIDS plans to launch a study on HIV and gender in humanitarian contexts, with the goal of collecting and analysing data to better understand these issues within the humanitarian response.”     

The Missing Link report underscores the critical need for well-coordinated, multisectoral approaches to address HIV and gender-based violence effectively in fragile settings. It contributes to a wider conversation which requires further research, collaboration and multisectoral engagement. It provides recommendations for building a more holistic, human-rights based and gender transformative approach to addressing and eliminating gender-based violence in all its forms in fragile settings.

“To end gender-based violence and to end AIDS, depends on uniting efforts across multiple sectors, on survivor and community-centred approaches, and on sustained investment.” says Winnie Byanyima, UNAIDS Executive Director.  

The issues raised in the report will be discussed in a stakeholder roundtable scheduled for 10 September 2024.

The webinar will be via Zoom on 10 September 2024  at 13:30-15:00, Geneva, Switzerland time. It will be 11:30 in Dakar, Senegal, and 14:30 in Addis Ababa, Ethiopia. Simultaneous interpretation into English and French will be provided.

Kindly click on the link below to register and participate, and do not hesitate to share information about the webinar with your networks.

→ Meeting Registration - Zoom

GENEVA, 19 August 2024—UNAIDS is calling on the international community to respond swiftly and decisively to the World Health Organization’s declaration of the mpox outbreak in several African countries as a public health emergency of international concern. The move came after the Africa Centres for Disease Control and Prevention (Africa CDC) made a similar declaration for the region.

“The emergence of a new and more contagious variant of mpox, and the devastating impact it is having on communities, across Africa, especially those most vulnerable including from HIV and AIDS, is alarming,” said Angeli Achrekar, UNAIDS Deputy Executive Director, Programme. “We must call on international efforts to focus on ensuring vaccines and treatments are accessible and available to all who need them and draw on the experience of the AIDS movement to ensure a response rooted in solidarity, compassion, inclusion, and equity.”

Many communities affected by mpox face discrimination, similar to people who are affected by HIV and AIDS. Stigma and discrimination undermine epidemic responses, driving people with symptoms underground and hindering efforts to protect public health. UNAIDS urges people to show compassion and solidarity to people affected, not intolerance and discrimination. We at UNAIDS, across the entire Joint Programme, also emphasize the crucial role of involving communities in every stage of the response—from development to implementation and monitoring.

The emergence of the 2024 mpox variant once again demonstrates the need for international, multisectoral coordination and solidarity to end pandemics. The Joint United Nations Programme on HIV/AIDS, is committed to bring its expertise and support to countries to help.  UNAIDS urges all media covering the crisis to follow the regular updates being issued by WHO and Africa CDC.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS has launched the 2030 target-setting process that will provide the framework for the next Global AIDS Strategy. A Global Targets Task Team (GTT) composed of 33 experts from governments, civil society and communities, donors, multilateral organizations and academic public health experts will propose the targets building on the targets set for 2025. The Global Task Team is co-chaired by Chewe Luo, former Director HIV at UNICEF and Michel Kazatchkine, former Executive Director at the Global Fund.

The targets and strategy will underpin and inform the June 2026 High Level meeting on AIDS. The 2030 HIV targets will provide milestones within the SDG 2030 targets of reducing new HIV infections and AIDS-related deaths.

As highlighted in the July 2024 Global AIDS Update – the Urgency of Now : AIDS at a crossroads, there will be millions of people living with HIV in 2030 and beyond. The next set of targets will focus on the services and systems that countries need to have in place to ensure a sustainable country-owned response after 2030. 

In defining the targets, the GTT will consider the balance of proposed thematic areas, measurability, evidence of impact of interventions, gender-sensitivity and human rights. These targets will only be successful if they are adopted by countries. Ensuring their relevance to countries and country engagement will be fundamental to this process. 

The GTT has been undertaking an initial scoping phase and will work until November 2024 to develop a set of recommended targets to UNAIDS. These targets will become the foundations of the next Global AIDS Strategy consultation process.

GENEVA/MUNICH, 24 July 2024—An estimated 1.3 million people became infected with HIV in 2023, three times more than the target of fewer than 370 000 by 2025. While there has been marked progress in sub-Saharan Africa, for the first time, in 2023 more than half of the new HIV infections occurred outside of sub-Saharan Africa.

Rising new HIV infections are evident in several countries, particularly in countries where key populations including men who have sex with men, sex workers, transgender people and people who use drugs, are most affected, and investment in prevention was lower. Key populations and their sexual partners now represent the majority (55%) of new HIV infections globally, up from 44% to 2010.

The Global HIV Prevention Coalition (GBC), established in 2017, is addressing the HIV prevention crisis. Focusing on 40 countries the GPC, a coalition of United Nations Member States and partners including UNAIDS, donors, civil society and private sector organizations, is working to strengthen and sustain political commitment for HIV prevention.

“The HIV epidemic has evolved – now more than ever, we need resilient capacity to deliver and manage integrated, differentiated and equitable HIV prevention interventions,” said Prof. Sheila Tlou, GPC Co-chair and Former Minister of Health, Botswana.

There has been great variation in progress among GPC member countries; the biggest declines occurred in countries within eastern and southern Africa including Kenya, Malawi and Zimbabwe, where new HIV infections were reduced by more than 66% and which are on track to achieve the global target of 90% reduction by 2030 – and, to a lesser extent, in western and central Africa. Expansion of access to effective HIV treatment, combined with an ongoing focus on primary prevention, are driving those achievements.

“The moment of opportunity for HIV prevention is now,” said Angeli Achrekar, UNAIDS Deputy Executive Director for Programmes. “Today, we have a wider range of prevention options including new long-acting antiretroviral prevention—with the new results about lenacapavir—a twice yearly injection to prevent HIV—providing a promising game-changing option—and new opportunities to communicate about HIV prevention and health.”

Long-acting technologies like pre-exposure prophylaxis (PrEP) will play a major role in preventing new infections in the coming years. Access is increasing, but only in a few countries. Around 3.5 million people were accessing PrEP (antiretroviral medicine which prevents HIV) in 2023 up from just 200 000 in 2017, but this remains far short of the 10 million target set for 2025.

New HIV prevention products in the pipeline such as long-acting injectable cabotegravir (CAB-LA) and most recently, lenacapavir, are raising expectations due to their combination of convenience and high efficacy. However, the key is accessibility and affordability. The cost of the new long-acting injectable PrEP options, and the speed with which they are made available to potential users in the countries with the most need will be critical in expanding access to these life-saving technologies.

Persistent gaps remain in HIV prevention coverage (only 61% of areas with high incidence of HIV have programmes for young women, less than half of sex workers, and only about a third of gay men and other men who have sex with men and people who inject drugs regularly access prevention in GPC focus countries).

Condoms remain the most effective low-cost HIV prevention tool, however global condom procurement or distribution in low- and middle-income countries declined by an average of 27% between 2010 and 2022 and procurement by major donors fell by an average 32% in that period. Socially marketed distribution declined from a peak of about 3.5 billion condoms in 2011 to about 1.8 billion in 2022.

Condoms, PrEP, post exposure prophylaxis, antiretroviral therapy to ensure viral suppression thus preventing transmission of the virus, harm reduction and voluntary medical male circumcision are all HIV prevention options that should be real choices available for people at risk of HIV infection. Addressing structural and gender inequalities faced by these priority and key populations is essential in ensuring access to prevention services. The urgency to secure and sustain gains for HIV prevention cannot be overemphasized – programmes need to be community-led and country-led.

“No matter how good the science or community leadership, HIV will not end unless we have significant policy change to reverse criminalization and lessen stigmatization of affected populations. If we can’t protect human rights, then we can’t end HIV. This is never just about the virus—it’s about people, and the people must lead,” said Mitchell Warren, GPC co-chair and Executive Director, AVAC.

An enormous unmet need for resources for HIV prevention and societal enabler programmes in almost all regions persists. An estimated US$ 2.4 billion was available for primary prevention programmes in low- and middle-income countries in 2023 compared to the estimated need of USD 9.5 billion in 2025. Investing in HIV prevention now is essential to scale up programmes.

If 1.3 million people continue to acquire HIV every year, the response will become more challenging, more complex and more costly in 2030 and 2050. Increased investments in HIV prevention, strengthened political leadership, enabling legal and policy environments are urgently needed to effectively implement programmes. The time to act is now!   

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Women living with HIV including women from key populations continue to suffer widespread reproductive coercion, mistreatment, and neglect when seeking reproductive health services and rights around the world, a new report by the International Community of Women Living with HIV (ICW) has revealed today. The report was launched at a joint ICW/UNAIDS event at the 25^th International AIDS Conference taking place in Munich, Germany.

The report, Confronting Coercion: A global scan of coercion, mistreatment and abuse experienced by women living with HIV in reproductive and sexual health services, shows that women living with HIV face practices that undermine their bodily autonomy. Reproductive choices are monitored, and women are subjected to various coercive practices.

The report documents experiences of sexual and reproductive health and rights (SRHR) violations and violence faced by women living with HIV and women from key populations from more than 60 countries across 3 regions and offers concrete actions for the reduction of coercive practices.

“This report offers a chilling reality of what women living with HIV experience every day in their struggle to realize their full sexual and reproductive health rights,” said Charity T. Mkona, Global Coercion Scan Committee, ICW ISC Global Chairperson. "For women living with HIV who have been subjected to coercive practices, mistreatment or abuse, the ability to heal and realize their full sexual and reproductive health and rights, demands accountability and justice."

The report reveals that reproductive coercion and mistreatment of women and gender diverse people living with HIV in SRHR services are a common, persistent, and widespread issues that require urgent action. Women living with HIV who reported engagement in sex work, drug use, or had disabilities reported experiencing coercive practices at higher rates than other women living with HIV.

Younger women living with HIV and women living with HIV who were migrants were also more likely to have experienced coercive practices than older women and women who were not migrants. Women have reported experiencing a lack of confidentiality and consensual care, as well as inappropriate medical interventions, such as unnecessary caesarean sections and forced or coerced abortions. Denial of care, stigmatizing comments or insults, and various forms of abuse - verbal, emotional, physical and sexual - were also documented.

While information about sexual and reproductive health and rights of women may be supplied to them, it is not always accurate, comprehensive, or up-to-date to empower them to claim their rights and often does not reflect the realities of women's lives.

"To end coercive practices experienced by women living with HIV, we must recognize the systemic and entrenched nature of these violations and understands that reform requires a systemic sea change and culture shift that respects women's bodily autonomy.” Sophie Brion, Director of Global Programmes at ICW.

“In a world where significant scientific advancements have been made in the treatment of HIV—including breakthroughs that allow women living with HIV whose viral load is undetectable to give birth to HIV negative babies—it’s shocking that some health care workers are not informed that women living with HIV can give birth without transmitting the virus,” said Christine Stegling, UNAIDS Deputy Executive Director for Policy, Advocacy and Knowledge. “This lack of education and coercive practices, including the forced sterilization of women living with HIV, must stop immediately.”

ICW is calling on governments worldwide, including donors and ministries of health, to eliminate these harmful practices. The organization is also calling on governments to ensure that health systems support women living with HIV to realize their full right to health, including sexual and reproductive health and rights, bodily autonomy and rights to informed consent.

"This report issues a powerful call to action to put the autonomy, desires and needs of women living with HIV at the centre of their sexual and reproductive health care programmes." said Immaculate Owomugisha Bazare, Global Coercion Scan Committee,  ICW Global Steering Committee Member.

Background

The Confronting Coercion report was developed through a blend of qualitative and quantitative research, incorporating insights from a gendered analysis of recent Stigma Index 2.0 data, a desk review of literature, and a qualitative study involving women, trans and gender non-binary people living with HIV who shared experiences of reproductive coercion over the past 3 years. The qualitative part of the study looked at coercion, mistreatment and neglect related to the SRHR of women and gender diverse people living with HIV in HIV, SRH and maternity care settings.

UNAIDS has supported the development of the report to address systematic gender inequalities, in particular gender-based discrimination and violence against women living with HIV, which fuels the HIV epidemic.

Despite significant gains in many countries, critical gaps continue to undermine efforts to end AIDS in children

GENEVA/MUNICH, 22 July 2024—Despite progress made in reducing HIV infections and AIDS-related deaths among children, a new report released today by the Global Alliance for Ending AIDS in Children by 2030 shows that an urgent scale up of HIV services in countries worst affected by the pandemic is required to end AIDS by 2030.

The report, Transforming Vision Into Reality, shows that programmes targeting vertical transmission of HIV have averted 4 million infections among children aged 0-14 years old since 2000. Globally, new HIV infections among children aged 0-14 years old have declined by 38% since 2015 and AIDS-related deaths have fallen by 43%.     

Among the 12 Global Alliance countries, several have achieved strong coverage of lifelong antiretroviral therapy among pregnant and breastfeeding women living with HIV, with Uganda nearing 100%, United Republic of Tanzania at 98%, and South Africa at 97%. Mozambique has achieved 90% coverage, with Zambia at 90%, Angola at 89%, Kenya at 89%, Zimbabwe at 88%, and Cote d'Ivoire at 84%.

“I applaud the progress that many countries are making in rolling out HIV services to keep young women healthy and to protect babies and children from HIV,” said UNAIDS Executive Director, Winnie Byanyima. “With the medicines and science available today, we can ensure that all babies are born – and remain – HIV-free, and that all children who are living with HIV get on and stay on treatment. Services for treatment and prevention must be ramped up immediately to ensure that they reach all children everywhere. We cannot rest on our laurels. The death of any child from AIDS related causes is not only a tragedy, but also an outrage. Where I come from, all children are our children. The world can and must keep its promise to end AIDS in children by 2030.”

Global Alliance countries are innovating to overcome barriers and accelerate progress towards ending AIDS in children. However, despite advances neither the world nor Global Alliance countries are currently on track to reach HIV-related commitments for children and adolescents and the pace of progress in preventing new HIV infections and AIDS-related deaths among children has slowed in recent years.

“Accelerating the delivery and uptake of HIV services for children and adolescents is a moral obligation, and a political choice,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Twelve countries are demonstrating they have made that choice, but significant challenges remain. While we have made progress in increasing access for pregnant women to testing and treatment to prevent vertical transmission of HIV, we are still far from closing the paediatric treatment gap. We need to further strengthen the collaboration and reach of the Global Alliance, and we must do this work with focus, purpose and in solidarity with all affected mothers, children, and adolescents.”

Around 120 000 children aged 0-14 years old became infected with HIV in 2023, with around 77 000 of these new infections occurring in the Global Alliance countries. AIDS-related deaths among children aged 0-14 years old numbered 76 000 globally with Global Alliance countries accounting for 49 000 of these unnecessary deaths. Vertical transmission rates remain extremely high in some locations, particularly in Western and Central Africa, with rates exceeding 20% in countries including Nigeria and the Democratic Republic of the Congo.

“In the fight against HIV, we must do a much better job for children,” said Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which provides funding for HIV programmes in over 100 countries through a country-led partnership model. “In support of national programmes, we have been procuring the latest dolutegravir-based paediatric treatment regimens at negotiated prices. Our investments in laboratory systems are helping ensure exposed infants are rapidly tested and that those that test positive are quickly initiated on age-appropriate antiretroviral treatment. Differentiated testing and treatment approaches are helping close the diagnostic gap and ensuring more child-centred service delivery.”

It is concerning that the treatment gap between adults and children continues to widen.

“Just 57 per cent of children living with HIV receive life-saving treatment, compared to 77 per cent of adults,” said UNICEF Associate Director HIV/AIDS, Anurita Bains. “Without early and effective testing and treatment, HIV remains a persistent threat to the health and well-being of children and adolescents and puts them at risk of death. To close the treatment gap, we must support governments to scale up innovative testing approaches and ensure children and adolescents living with HIV receive the treatment and support they need.”

In 2023, there were 210 000 new infections globally among young women and girls aged 15—24 years old (130 000 in Global Alliance countries), four times higher than the 2025 goal set at 50 000. Preventing new infections among this age group is critical both to protect the health and wellbeing of young women and to reduce the risk of new infections among children.

Gender inequalities and human rights violations are increasing women’s vulnerability to HIV and diminishing their ability to access essential services. Globally, nearly one in three women have encountered some form of violence during their lifetime, with adolescent girls and young women disproportionately affected by intimate partner violence. In the four Global Alliance countries with available data, countries are not currently on track to achieve the target of ensuring that by 2025 less than 10% of women, key populations and people living with HIV experience gender-based inequalities and gender violence.

"It has been remarkable to see how many more children's lives can be saved when all stakeholders and partners come together to commit to end AIDS in children. While much progress has been made, notably through the successful introduction of pediatric dolutegravir, large gaps still remain across the pediatric cascade and we must recommit ourselves with purpose and innovation to fulfill the promises we have made by 2025 and beyond,” said Ambassador John N. Nkengasong, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy.

The Global Alliance for Ending AIDS in Children by 2030 was launched in 2022 by WHO, UNICEF and WHO to reinvigorate the paediatric HIV agenda. It has now grown, and in addition to the United Nations agencies, the alliance includes civil society movements, including the Global Network of People living with HIV, national governments in the most affected countries, and international partners, including PEPFAR and the Global Fund. Twelve countries are members: Angola, Cameroon, Côte d'Ivoire, The Democratic Republic of the Congo (DRC), Kenya, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Every pain yields a lesson, and every lesson transforms a person

Parisa's life was forever altered by HIV 25 years ago. The virus struck her family, snatching her husband's job and halting her child's education. Tragically, her husband passed away two years later, leaving Parisa to navigate the daunting landscape of loss and discrimination.

Undeterred by adversity, Parisa embarked on a relentless mission for human rights, determined to combat the pervasive stigma and discrimination surrounding HIV. Initially, she immersed herself in seminars and conferences, volunteering tirelessly at counselling centres, where she shared her own experiences to chip away at the stigma and discrimination.

Her unwavering dedication caught the attention of Dr Minoo Mohraz, the former director of the Iranian Research Centre for HIV/AIDS (IRCHA), who offered her a pivotal role in a Positive Club—a sanctuary for those grappling with similar challenges. Thus began Parisa's transformative journey, marked by a series of initiatives aimed at raising awareness, eradicating stigma and discrimination, and supporting her peers.
 

WHAT IS THE POSITIVE CLUB INITIATIVE? The Positive Club is a meeting place for people living with HIV, who run the club themselves, with supervision from Parisa and colleagues. At the club, people receive training in arts, and sports, and as peer educators.  The Positive Club initiative was one of the successful programmes aimed at promoting positive health, dignity, and HIV prevention; it has been running for over 12 years with support from UNAIDS in collaboration with national partners and civil society organizations. Through this initiative, over 10,000 people living with HIV have been supported across 25 Positive Clubs, empowering them through training classes, workshops on HIV prevention, care and treatment, counselling sessions, and psychosocial support.

Over the years, Parisa's efforts have been nothing short of extraordinary. From managing a Positive Club in Tehran to representing people living with HIV in various influential platforms, including Iran's Country Coordinating Mechanism, its Oversight Committee, and Global Fund, she has been a relentless advocate for change. 

Her initiatives have spanned diverse arenas, from radio shows and collaborations with filmmakers to training workshops for religious leaders and healthcare providers. Parisa's impact reverberates across borders, as she leverages regional platforms like MENA Rosa --the first regional network dedicated to women living with HIV in the Middle East and North Africa-- to exchange experiences and champion global efforts against HIV stigma and discrimination with a particular focus on Women living with and affected by HIV.

Amid the COVID-19 pandemic, Parisa's compassion for people living with and affected by HIV was once again evident. She mobilized support networks to provide essential supplies for Positive Club members and vulnerable families, ensuring that the crisis does not exacerbate the challenges faced by PLHIV.

Reflecting on the progress made over the last 25 years, Parisa acknowledged the remarkable strides in combating HIV-related stigma and discrimination. Efforts to eliminate HIV-related stigma and discrimination have been led by the UNAIDS Country Office for Iran, alongside national partners of the AIDS Control Programme. Notably, the first PLHIV Stigma Index study, conducted in 2010, laid the foundation for understanding the landscape of stigma in Iran. Subsequently, a second PLHIV Stigma Index study, was carried out by the network of PLHIV in collaboration with UNAIDS, Global Network of PLHIV (GNP+), International Community of Women Living with HIV (ICW), Johns Hopkins Medical University (JHMU), National AIDS Programme (NAP), and with financial support from Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) /UNDP. Parisa played an important role in implementing the Stigma Index 2.0 which provided updated insights.
 

COMPARING OF BOTH OF IRAN’S STIGMA INDEX STUDIES A comparison between the two Stigma Index studies conducted ten years apart, using updated methodologies, revealed promising changes. The prevalence of self-stigma among PLHIV decreased significantly from 80% to 40%. Similarly, the percentage of PLHIV refraining from seeking medical help has decreased from 80% to 19%, underscoring improved accessibility to healthcare services and increased health-seeking behaviour among affected individuals. Overall, reports of stigma and discrimination have decreased from 71% to 47%, reflecting tangible improvements in societal attitudes to HIV.

Parisa reflects on these notable shifts in HIV-related Stigma observed between the two studies. In the initial Stigma Index conducted a decade ago, internal stigma was predominant among PLHIV, followed by societal and healthcare provider stigma. However, in the subsequent study, internal stigma was significantly reduced, while stigma and discrimination from healthcare providers emerged as the most prevalent issue. The improvement observed in internal stigma among PLHIV could be partly attributed to the work of the empowering Positive Clubs. Additionally, this improvement highlights the importance of ongoing efforts to address stigma and discrimination comprehensively, with a particular focus on healthcare settings. By acknowledging these shifts and persisting in their efforts, UNAIDS Iran, Parisa and her colleagues remain committed to building a future free from the burdens of HIV-related stigma and discrimination.

Through her nearly two decades of hotline counselling experience, Parisa has witnessed a shift in attitudes, with increased awareness and openness surrounding HIV discourse. 

She credits grassroots campaigns and community-led initiatives for driving this transformation, paving the way for a more inclusive society.

In 2019, Iran joined the Global Partnership to Eliminate all forms of HIV-related stigma and discrimination, prioritizing a strong emphasis on interventions within communities, emergency/humanitarian settings, and healthcare facilities. With support from UNAIDS, protocols and training packages were developed to address stigma and discrimination in these critical areas. These efforts were carried out in close collaboration with national partners and civil society organizations, with training workshops being a key component of the initiative.
 

OVERVIEW OF GLOBAL PARTNERSHIP The Global Partnership for action to eliminate all forms of HIV-related stigma and discrimination is a critical vehicle for action to mobilise all countries to reach the political declaration and Global AIDS Strategy targets. It leverages partnerships to enhance coordination of interventions and funding; it provides knowledge and evidence-guided technical support; and increases accountability mechanisms and community leadership.

Parisa was actively involved in the implementation phase of these projects. Her contributions have been instrumental in advancing the work to eradicate HIV-related stigma and discrimination across humanitarian, healthcare, and community settings.

However, Parisa acknowledges the persistent challenges faced by PLHIV, from sporadic bouts of self-doubt to occasional rejections and the lingering shadows of depression and fear. Despite these hurdles, she remains steadfast in her belief that we can achieve a future free from stigma and discrimination.

As Parisa continues her tireless advocacy, her journey stands as a testament to the resilience of the human spirit and the power of collective action in fostering a world where every individual, regardless of their HIV status, is embraced with dignity and compassion. 

UNAIDS has played a pivotal role in the establishment and sustained operation of Positive Clubs for over a decade, catalyzing transformative changes in the lives of people living with HIV such as Parisa and in the fight against stigma and discrimination. Nonetheless, the journey towards eliminating stigma and discrimination remains unfinished, albeit considerably smoother and more steadfast with the collaborative efforts and political commitment of initiatives such as the Global Partnership.

MUNICH, 22 JULY 2024 – A new United Nations report released today shows that the HIV response in Eastern Europe and Central Asia is critically off track. Data in UNAIDS’ global report The Urgency of Now: AIDS at a Crossroads reveals that in this region, new HIV infections have risen by 20% and AIDS-related deaths have risen by 34%, since 2010. Only half of the 2.1 million people living with HIV in the region are accessing treatment, and only 42% of all people living with HIV in the region have suppressed viral load, the lowest rate globally. The report shows that it is still possible to end AIDS as a public health threat by 2030, but only if governments reform laws to protect everyone’s human rights and increase resources to ensure services are available for all.

“The promise to end AIDS is off track in Eastern Europe and Central Asia. But leaders can get on the path that ends AIDS. Programmes need to focus especially on people most affected by HIV, who are often the most marginalized and vulnerable. Community organizations need to be properly funded, supported and enabled to provide HIV services to people affected by HIV. The barriers of stigma and discrimination need to be broken down,” said Winnie Byanyima, UNAIDS Executive Director. 

The new data shows that in 2023, there were 140,000 new HIV infections across the region, with 93% occurring in Russia, Ukraine, Uzbekistan, and Kazakhstan. Eight out of 13 countries in the region reported increases in new infections.

Because stigma, discrimination and harmful punitive laws obstruct marginalised communities’ access to vital services, 94% of new infections were among people from key populations - including men who have sex with men, people who inject drugs, and sex workers - and the sexual partners of people from key populations. Only 58% of sex workers, 43% of gay men, 52% of people who inject drugs, and 65% of transgender people receive HIV prevention services. Only 12% of resources are dedicated to prevention programmes for key populations.

The criminalization of small amounts of drug possession for personal use, of sex work, and of HIV transmission and exposure, are driving the people most in need underground and out of reach of HIV services. All 16 countries in the region criminalize sex work, 13 criminalize the non-disclosure, exposure, or transmission of HIV, and 7 criminalize small amount of drug possession for personal use. Studies show criminalization increases HIV prevalence among key populations. Unless countries can ensure fear-free access to HIV prevention services for everyone, new infections will continue to grow.

“Restrictive legal environments and stigma are obstructing progress in the region,” said Eamonn Murphy, UNAIDS Regional Director for Eastern Europe and Central Asia and Asia Pacific. “Restrictive laws, along with aggressive policing and stigma, push people away from medical care. If people are pushed underground, the HIV response will not succeed.”

Powerful prevention technologies like PrEP are also not widely accessible for the same reason.  Criminalization fuels stigma, with many avoiding medical care due to discrimination. Nearly half of people surveyed who inject drugs in Kyrgyzstan and 32% of people living with HIV in Tajikistan reported avoiding medical care due to stigma and discrimination. UNAIDS data shows that people in key populations are experiencing high levels of violence.

"Supporting the leadership of communities is essential for reaching marginalised people providing vital outreach services. Without community leadership and the integration of community services into the health system, reaching these groups is too difficult," said Yelena Rastokina, lead of the ‘Answer-Kazakhstan’ Association.

Recent years have seen worrying restrictions of civic space and limits to communities’ involvement in public health initiatives, including those related to harm reduction, access to public health services for LGBTQ+ people, sex workers and other marginalised people. Restrictive systems at local, national, and regional levels are holding back communities’ contribution to public health.

Ganna Dovbach, Executive director of the Eurasian Harm Reduction Association, highlighted: “The shrinking of civic space and attacks on human rights threaten our response to HIV, which is based on community-led or civil society provided services. Addressing these interconnected issues is essential for a sustainable response to the AIDS epidemic in our region.”

The region’s HIV response has also been hurt by the war in Ukraine.

But despite the conflict, Ukraine remains committed to its HIV response. Through a strong coalition of the government, civil society, international organizations and donors, HIV services have been maintained, with 143,600 people receiving treatment in 2023. This collaboration has ensured vital supplies of antiretroviral and tuberculosis medicine, and opioid agonist therapy, contributing to uninterrupted HIV treatment and other services. As of January 2024, 7,900 Ukrainian refugees in other countries and 1,900 returnees were accessing antiretroviral therapy.

Many community organizations working on HIV in Ukraine refocused their efforts to addressing humanitarian issues and supporting community members while continuing national advocacy for access to HIV services and the protection of human rights.

With support from the UNAIDS and other donors ALLIANCE.GLOBAL oversees a network of five specialized shelters across the country, providing shelter, humanitarian aid, and access to specialised services, including HIV prevention and treatment, for key populations and LGBTQ+ people who are internally displaced.

Despite the war, ALLIANCE.GLOBAL together with other community-led organisations continue advocating for laws that better protect LGBTQ+ people from intolerance and from hate crimes, to enhance access to public health services, including HIV-related services.

UNAIDS new report calls on leaders to develop sustainable plans for the HIV response to2030 and beyond. These plans should include enabling legal environments, support for community-led response and a boost in domestic funding. Repealing laws and norms that prevent people from accessing services is crucial.

“Ensuring access to services and treatment for all is how we end AIDS,” said Mr Murphy.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.