In the 41 years since AIDS was first discovered in 1981, extraordinary progress has been made in the global response to HIV. Deaths caused by acquired immunodeficiency syndrome (AIDS) - a condition caused by the human immunodeficiency virus (HIV) - have been reduced by 68% since the peak in 2004.
Improvements in treatment options have helped ensure people with HIV can live long and productive lives. New technologies to prevent HIV transmission mean people have more options for pleasurable sex with reduced risk of acquiring HIV.
But there is still a long way to go. In recent years, global progress towards eliminating HIV has slowed and funding has decreased. In 2021, 1.5 million new people were diagnosed with HIV; a total of 38.4 million people currently live with HIV globally.
Fortunately, important innovations in HIV prevention technologies have sparked hope that the global AIDS response can get closer to its targets for ending the pandemic. We need to increase access and affordability to these technologies while continuing to invest in new ways to prevent transmission, expand testing, and treat patients.
HIV prevention technologies to know about
The toolkit for technologies to prevent HIV transmission is expanding. In addition to the condom, which reduces transmission of HIV and many other sexually transmitted infections, and prevents pregnancy, we now have multiple ways to prevent HIV transmission.
- Prevention of Perinatal Transmission uses Antiretroviral drugs (ARVs) to reduce transmission from a woman with HIV to her fetus during pregnancy, and from a woman to her infant during childbirth and breastfeeding.
- Post-exposure prophylaxis (PEP) uses ARVs to reduce transmission when someone without HIV has had a possible exposure to HIV. PEP should be used in emergency situations and be started within 72 hours after a recent possible exposure to HIV.
- Voluntary medical male circumcision (VMMC) is used to reduce heterosexual transmission in men who do not have HIV.
A variety of new and existing forms of Pre-exposure prophylaxis (PrEP) also need to be made available, accessible, and affordable to all.
- Oral PrEP uses ARVs to help people who do not have HIV reduce their risk of acquiring HIV. PrEP was first recommended by the WHO in 2012. While over 3 million people have initiated oral PrEP globally since then, many more people need access to this highly effective method of HIV prevention.
- Dapivirine Vaginal Ring is a ring that is placed in the vagina and contains ARVs to reduce sexual transmission of HIV for women. The ARVs are slowly released over the course of a month; a new ring is inserted for each month that a woman wants to reduce her risk of acquiring HIV. It was recommended by the WHO in January 2021 and has received regulatory approval in Lesotho, South Africa and Zimbabwe. It is currently under regulatory review in Botswana, Kenya, Malawi, Namibia, Rwanda, Tanzania, Uganda, and Zambia.
- Long-acting Injectable PrEP using Cabotegravir-LA is a new form of PrEP that is injected intramuscularly every two months to prevent HIV. It was recommended by the WHO in 2022 and has received regulatory approval in Australia, the United States, and Zimbabwe. It is currently under regulatory review in Botswana, Brazil, Kenya, Malawi, Namibia, Rwanda, South Africa, and Uganda.
Equalizing access for all
Adolescent girls and women account for 49% of new infections globally and 63% of new infections in sub-Saharan Africa. It is essential that we reach them and key populations -- including gay men, men who have sex with men, transgender people, people who use drugs, sex workers, and prisoners – and their partners -- with new and existing prevention technologies by making them more widely available, accessible and affordable.
In addition to improving global HIV prevention response, we must eliminate barriers including stigma, discriminatory laws, denial of sexual and reproductive health and rights, criminalization, and punitive approaches that cause harm and negatively impact people’s sexual and reproductive health and rights. We must also encourage supportive policies for HIV self-testing, and we must invest in and expand access to innovative prevention and treatment options such as long-acting injectable PrEP and long-acting injectable treatment.
All individuals have a right to make decisions about their bodies and to access the services they need to live a healthy and productive life. IPPF, through its member associations (MAs), is committed to offering all clients integrated sexual and reproductive health services, in a welcoming, inclusive, and non-discriminatory environment. As part of our new 2028 Strategy: Come Together, we outline the importance of accelerating integration of HIV and SRHR care.
Investments in developing and rolling out new technologies that protect against pregnancy and HIV, such as the Dual Prevention pill, are key to reducing HIV globally.
IPPF and our MAs will continue to join forces with technical experts and community and youth-led organizations working at every level of society — globally, nationally, and locally – to eradicate AIDS for good.