Last year, new infections and deaths from the human immunodeficiency virus (HIV) reached their lowest level since the late 1980s, according to the UNAIDS agency, which however considers this decline still too slow.
- New HIV infections and AIDS-related deaths reached their historic low in 2023, thanks to advances in treatment and prevention, particularly in sub-Saharan Africa.
- But disparities persist: infections are increasing in Eastern Europe and the Middle East, and 10 million people still do not have access to antiretrovirals.
- As for pre-exposure prophylaxis (PrEP), essential to prevent infection, it remains underused, hampered by repressive laws and limited deployment. Ending the epidemic by 2030 remains a distant goal.
The figures demonstrate major progress. New human immunodeficiency virus (HIV) infections fell to historic low in 2023 “since the late 1980s”peak of the AIDS epidemic. According to the annual report published Tuesday by the UNAIDS agencyin charge of the disease within the United Nations, between 1 and 1.7 million cases were recorded last year, a marked decline compared to previous decades. Deaths linked to HIV – caused by opportunistic diseases against which the body can no longer defend itself – have also decreased, reaching around 600,000 deaths, a drop of 40% since their peak around twenty years ago.
Unequal progress depending on the country
These encouraging results, published a few days before World AIDS Day on December 1, are largely due to progress in sub-Saharan Africa, a region historically very affected by the epidemic. However, other areas, such as Eastern Europe and the Middle East, are seeing a surge in infections. In total, 28 countries are recording an increase in contamination. Although the fight against HIV is progressing, it is far from being homogeneous on a global scale.
Pre-exposure prophylaxis (PrEP) is emerging as a key strategy in HIV prevention. This treatment, taken by people who are not infected but at risk, significantly reduces the chances of contracting the virus. In France, recent recommendations recommend broadening its access beyond men having homosexual relations, to include anyone exposed to a risk. But despite its effectiveness, PrEP remains underused: in 2023, only 15% of individuals who need it will have access to it, according to UNAIDS. This situation is exacerbated in certain countries (such as Uganda) where repressive laws, particularly anti-LGBT, dissuade vulnerable populations from seeking these treatments.
Eradicate the AIDS epidemic by 2030
Antiretroviral drugs, which enable infected people to live with HIV, continue to be an essential weapon. However, around a quarter of patients worldwide, or 10 million people, still do not have access to it, due to financial and logistical constraints, particularly in low-income countries. We are therefore still far from the UN objective of almost completely eradicating the epidemic by 2030. As a solution, UNAIDS invites political leaders to strengthen health infrastructures, to reduce the cost of medicines and to remove social and legal obstacles.
In France, 5,500 people will discover that they carry HIV in 2023, according to the latest estimates from Public Health France. This figure has not declined for several years, which is worrying, as is the fact that 40% of HIV infections are discovered at a late stage. On average, almost two years pass between contamination and diagnosis in France. In the country, more than 10,000 people are unaware of their HIV status.
