Among all countries worldwide those in sub-Saharan Africa have the highest rates of HIV. The countries with the highest rates of HIV include Eswatini, Lesotho, and South Africa. In 2023, Eswatini had the highest prevalence of HIV with a rate of around ** percent. Other countries, such as Zimbabwe, have significantly decreased their HIV prevalence. Community-based HIV services are considered crucial to the prevention and treatment of HIV. HIV Worldwide The human immunodeficiency virus (HIV) is a viral infection that is transmitted via exposure to infected semen, blood, vaginal and anal fluids and breast milk. HIV destroys the human immune system, rendering the host unable to fight off secondary infections. Globally, the number of people living with HIV has generally increased over the past two decades. However, the number of HIV-related deaths has decreased significantly in recent years. Despite being a serious illness that affects millions of people, medication exists that effectively manages the progression of the virus in the body. These medications are called antiretroviral drugs. HIV Treatment Generally, global access to antiretroviral treatment has increased in recent years. However, despite being available worldwide, not all adults have access to antiretroviral drugs. Europe and North America have the highest rates of antiretroviral use among people living with HIV. There are many different antiretroviral drugs available on the market. As of 2024, ********, an antiretroviral marketed by Gilead, was the leading HIV treatment based on revenue.

The states with the highest rates of HIV diagnoses in 2022 included Georgia, Louisiana, and Florida. However, the states with the highest number of people with HIV were Texas, California, and Florida. In Texas, there were around 4,896 people diagnosed with HIV. HIV/AIDS diagnoses In 2022, there were an estimated 38,043 new HIV diagnoses in the United States, a slight increase compared to the year before. Men account for the majority of these new diagnoses. There are currently around 1.2 million people living with HIV in the United States. Deaths from HIV The death rate from HIV has decreased significantly over the past few decades. In 2023, there were only 1.3 deaths from HIV per 100,000 population, the lowest rate since the epidemic began. However, the death rate varies greatly depending on race or ethnicity, with the death rate from HIV for African Americans reaching 19.2 per 100,000 population in 2022, compared to just three deaths per 100,000 among the white population.

United States US: Prevalence of HIV: Total: % of Population Aged 15-49 data was reported at 0.500 % in 2014. This stayed constant from the previous number of 0.500 % for 2013. United States US: Prevalence of HIV: Total: % of Population Aged 15-49 data is updated yearly, averaging 0.500 % from Dec 2008 (Median) to 2014, with 7 observations. The data reached an all-time high of 0.500 % in 2014 and a record low of 0.500 % in 2014. United States US: Prevalence of HIV: Total: % of Population Aged 15-49 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Prevalence of HIV refers to the percentage of people ages 15-49 who are infected with HIV.; ; UNAIDS estimates.; Weighted Average;

The average for 2022 based on 48 countries was 3.95 percent. The highest value was in Swaziland: 25.9 percent and the lowest value was in Algeria: 0.1 percent. The indicator is available from 1990 to 2022. Below is a chart for all countries where data are available.

In 2022, the District of Columbia had the highest HIV disease death rate among all U.S. states where 6.2 out of 100,000 inhabitants died due to HIV in 2022. This statistic shows the U.S. states with the highest HIV disease death rates in 2022.

In 2022, it was estimated that around 16.4 percent of Botswana's population aged 15-49 years was infected with HIV. This statistic shows the 20 countries with the highest prevalence of HIV worldwide as of 2022.

According to Cognitive Market Research, the global HIV drugs market size will be USD 35425.2 million in 2024. It will expand at a compound annual growth rate (CAGR) of 6.80% from 2024 to 2031.

North America held the major market share for more than 40% of the global revenue with a market size of USD 14170.08 million in 2024 and will grow at a compound annual growth rate (CAGR) of 5.0% from 2024 to 2031.
Europe accounted for a market share of over 30% of the global revenue with a market size of USD 10627.56 million.
Asia Pacific held a market share of around 23% of the global revenue with a market size of USD 8147.80 million in 2024 and will grow at a compound annual growth rate (CAGR) of 8.8% from 2024 to 2031.
Latin America had a market share of more than 5% of the global revenue with a market size of USD 1771.26 million in 2024 and will grow at a compound annual growth rate (CAGR) of 6.2% from 2024 to 2031.
Middle East and Africa had a market share of around 2% of the global revenue and was estimated at a market size of USD 708.50 million in 2024 and will grow at a compound annual growth rate (CAGR) of 6.5% from 2024 to 2031.
The multi-class combination drugs held the highest HIV drugs market revenue share in 2024.

Market Dynamics of HIV drugs Market

Key Drivers for HIV drugs Market

Rising number of HIV-positive individuals to Increase the Demand Globally

The HIV drugs market has experienced growth due to rising number of HIV-positive individuals. As global HIV prevalence increases due to factors like higher transmission rates and improved diagnostic capabilities, demand for effective antiretroviral therapies (ART) surges. This growing patient base necessitates the continuous development and supply of innovative drugs to manage HIV effectively, reduce viral loads, and improve quality of life. Increased awareness and testing also contribute to higher diagnosed cases, further expanding the market for HIV treatments and driving pharmaceutical companies to invest in research and development.

Innovations in HIV diagnostic tools to Propel Market Growth

The HIV drugs market has witnessed steady growth, driven by innovations in HIV diagnostic tools. Advances include rapid, point-of-care tests that deliver results within minutes, improving patient access and reducing diagnostic delays. Integrated technologies, such as multiplex assays, detect multiple markers simultaneously, increasing diagnostic accuracy. Additionally, digital platforms for data management streamline monitoring and personalized treatment plans. These innovations not only improve patient outcomes but also stimulate demand for more effective HIV treatments and management solutions, fostering market growth.

Restraint Factor for the HIV drugs Market

High cost of HIV treatment to Limit the Sales

The high costs of HIV medications constrain the growth of HIV drugs market. It involves expensive medications that can be unaffordable for many patients, especially in low-income regions. The costs are compounded by the need for lifelong treatment, regular monitoring, and potential side effects management, which further burdens healthcare systems and patients. This financial barrier limits access to effective treatment, leading to disparities in care and hindering efforts to control the HIV epidemic globally.

Impact of Covid-19 on the HIV drugs Market

The Covid-19 significantly impacted the market by disrupting supply chains, leading to delays in drug production and distribution, increasing lockdowns and restrictions. Additionally, the focus on COVID-19 diverted resources away from HIV programs, affecting drug availability and patient adherence. However, the pandemic also accelerated the adoption of telemedicine and digital health solutions, which helped maintain patient care continuity. Overall, the pandemic highlighted the need for resilient healthcare systems in managing chronic diseases. Introduction of the HIV drugs Market

HIV drugs are medications used to treat Human Immunodeficiency Virus (HIV) infection. They work by suppressing the virus, preventing its replication, and protecting the immune system. These drugs are typically used in combination as antiretroviral therapy (ART) to reduce viral load, improve patient outcomes, and prevent the progression to AIDS. The rising number of HIV-positive individuals, advancemnets in drug development, increasing government initiatives and funding, increased aw...

Spatial analysis at different levels can help understand spatial variation of human immunodeficiency virus (HIV) infection, disease drivers, and targeted interventions. Combining spatial analysis and the evaluation of the determinants of the HIV burden in Southern African countries is essential for a better understanding of the disease dynamics in high-burden settings.The study countries were selected based on the availability of demographic and health surveys (DHS) and corresponding geographic coordinates. We used multivariable regression to evaluate the determinants of HIV burden and assessed the presence and nature of HIV spatial autocorrelation in six Southern African countries.The overall prevalence of HIV for each country varied between 11.3% in Zambia and 22.4% in South Africa. The HIV prevalence rate was higher among female respondents in all six countries. There were reductions in prevalence estimates in most countries yearly from 2011 to 2020. The hotspot cluster findings show that the major cities in each country are the key sites of high HIV burden. Compared with female respondents, the odds of being HIV positive were lesser among the male respondents. The probability of HIV infection was higher among those who had sexually transmitted infections (STI) in the last 12 months, divorced and widowed individuals, and women aged 25 years and older.Our research findings show that analysis of survey data could provide reasonable estimates of the wide-ranging spatial structure of the HIV epidemic in Southern African countries. Key determinants such as individuals who are divorced, middle-aged women, and people who recently treated STIs, should be the focus of HIV prevention and control interventions. The spatial distribution of high-burden areas for HIV in the selected countries was more pronounced in the major cities. Interventions should also be focused on locations identified as hotspot clusters.

People aged 15 to 59 years seen at HIV services in the UK, expressed as a rate per 1,000 population.Data is presented by area of residence, and exclude people diagnosed with HIV in England who are resident in Wales, Scotland, Northern Ireland or abroad.RationaleThe geographical distribution of people seen for HIV care and treatment is not uniform across or within regions in England. Knowledge of local diagnosed HIV prevalence and identification of local risk groups can be used to help direct resources for HIV prevention and treatment.In 2008, http://www.bhiva.org/HIV-testing-guidelines.aspx recommended that Local Authority and NHS bodies consider implementing routine HIV testing for all general medical admissions as well as new registrants in primary care where the diagnosed HIV prevalence exceeds 2 in 1,000 population aged 15 to 59 years.In 2017, guidelines were updated by https://www.nice.org.uk/guidance/NG60 which is co-badged with Public Health England. This guidance continues to define high HIV prevalence local authorities as those with a diagnosed HIV prevalence of between 2 and 5 per 1,000 and extremely high prevalence local authorities as those with a diagnosed HIV prevalence of 5 or more per 1,000 people aged 15 to 59 years.When this is applied to national late HIV diagnosis data, it shows that two-thirds of late HIV diagnoses occur in high-prevalence and extremely-high-prevalence local authorities. This means that if this recommendation is successfully applied in high and extremely-high-prevalence areas, it could potentially affect two-thirds of late diagnoses nationally.Local authorities should find out their diagnosed prevalence published in UKHSA's http://fingertips.phe.org.uk/profile/sexualhealth , as well as that of surrounding areas and adapt their strategy for HIV testing using the national guidelines.Commissioners can use these data to plan and ensure access to comprehensive and specialist local HIV care and treatment for HIV diagnosed individuals according to the http://www.medfash.org.uk/uploads/files/p17abl6hvc4p71ovpkr81ugsh60v.pdf and http://www.bhiva.org/monitoring-guidelines.aspx .Definition of numeratorThe number of people (aged 15 to 59 years) living with a diagnosed HIV infection and accessing HIV care at an NHS service in the UK and who are resident in England.Definition of denominatorResident population aged 15 to 59.The denominators for 2011 to 2023 are taken from the respective 2011 to 2023 Office for National Statistics (ONS) revised population estimates from the 2021 Census.Further details on the ONS census are available from the https://www.ons.gov.uk/census .CaveatsData is presented by geographical area of residence. Where data on residence were unavailable, residence have been assigned to the local health area of care.Every effort is made to ensure accuracy and completeness of the data, including web-based reporting with integrated checks on data quality. The overall data quality is high as the dataset is used for commissioning purposes and for the national allocation of funding. However, responsibility for the accuracy and completeness of data lies with the reporting service.Data is as reported but rely on ‘record linkage’ to integrate data and ‘de-duplication’ to prevent double counting of the same individual. The data may not be representative in areas where residence information is not known for a significant proportion of people accessing HIV care.Data supplied for previous years are updated on an annual basis due to clinic or laboratory resubmissions and improvements to data cleaning. Data may therefore differ from previous publications.Values are benchmarked against set thresholds and categorised into the following groups: <2 (low), 2 to 5 (high) and≥5 (extremely high). These have been determined by developments in national testing guidelines.The data reported in 2020 and 2021 is impacted by the reconfiguration of sexual health services during the national response to COVID-19.

Descriptive statistics Descriptive statistics for the dependent and independent variables of this study were presented in Table 1. Out of 3314 undergraduate students in the sample, 2583 (77.9%) expressed their willingness to accept a free HIV test. More than two thirds (66.9%) of these subjects were females and the majority of respondents (94.5%) were Han. Of college students in this sample, nearly two fifths (37.4%) lived in the local city less than one year and about one third (31.0%) were freshmen. Nearly one half (48.2%) of our participants were medical students. To our surprise, 15.2% reported their sexual orientation is non-heterosexual and 55.9% spent less than one thousand Yuan on their monthly living expenses. HIV/AIDS-related knowledge was lacking with only 39.1% of participants answering more than 10 out of twelve questions correctly. Furthermore, stigma and discrimination towards people living with HIV/AIDS were serious, since the number of correct responses that nearly half (45.5%) of the respondents responded to the 24 specific situations was no more than eighteen. The majority of college students mentioned at least one free HIV testing site and also recognized the necessity to provide a free HIV test in the local university (78.8% and 88.7%, respectively). Beyond our expectation, more than half (56.2%) of college students were ignorant of the "Four Frees and One Care" policy. Despite the fact that 18.9% of college students reported having had sexual behavior, only 49.5% perceived the risk of HIV infection. Bivariable analysis The results of the bivariable analysis were shown in Table 1. Those who expressed greater willingness to accept a free HIV test tended to be medical students, higher levels of HIV-related knowledge, lower levels of stigma and discrimination, awareness of the "Four Frees and One Care" policy, knowledge of free HIV testing centers, recognition of the necessity to provide a free HIV test in the local university, and higher perception of the risk of HIV infection. No significant differences were reported between willingness and unwillingness in gender, race, grade, length of time, sexual orientation, monthly living expense, and history of sexual behavior. Multivariable logistic regression analysis The stepwise multiple logistic regression model predicting willingness to accept a free HIV test was shown in Table 2. When all seven significant variables were included into the logistic regression model, only four variables (i.e., stigma and discrimination towards people living with HIV/AIDS, knowledge of free HIV testing centers, recognition of the necessity to provide a free HIV test in the local university, perceived risk of HIV infection) remained statistically significantly related to willingness to participate in a free HIV test, while three variables including major, HIV-related knowledge, and awareness of the “Four Frees and One Care” policy lost their statistical significance, as indicated in Table 2. Among all these four significant predictors, the odds ratio(OR) was the highest for recognition of the necessity to provide a free HIV test in the local university. The college students having recognized the necessity were more likely to express their willingness to accept to a free HIV test (OR=2.20, 95CI=1.73--2.80, P<0.001) than those having not recognized the necessity. The odds of willingness were 1.41 times (95CI=1.17--1.68, P<0.001) of respondents who had lower levels of stigma and discrimination towards people living with HIV/AIDS, compared to that of those with high levels of stigma and discrimination. In addition, being more knowledgeable about free HIV testing centers (OR = 1.44, 95%CI=1.17--1.77, P<0.001) and having higher HIV risk perception (OR =1.64, 95%CI=1.37--1.95, P<0.001) were significantly associated with greater willingness to use VCT service.

As of 2023, South Africa was the country with the highest number of people living with HIV in Africa. At that time, around 7.7 million people in South Africa were HIV positive. In Mozambique, the country with the second-highest number of HIV-positive people in Africa, around 2.4 million people were living with HIV. Which country in Africa has the highest prevalence of HIV? Although South Africa has the highest total number of people living with HIV in Africa, it does not have the highest prevalence of HIV on the continent. Eswatini currently has the highest prevalence of HIV in Africa and worldwide, with almost 26 percent of the population living with HIV. South Africa has the third-highest prevalence, with around 18 percent of the population HIV positive. Eswatini also has the highest rate of new HIV infections per 1,000 population worldwide, followed by Lesotho and South Africa. However, South Africa had the highest total number of new HIV infections in 2023, with around 150,000 people newly infected with HIV that year. Deaths from HIV in Africa Thanks to advances in treatment and awareness, HIV/AIDS no longer contributes to a significant amount of death in many countries. However, the disease is still the fourth leading cause of death in Africa, accounting for around 5.6 percent of all deaths. In 2023, South Africa and Nigeria were the countries with the highest number of AIDS-related deaths worldwide with 50,000 and 45,000 such deaths, respectively. Although not every country in the leading 25 for AIDS-related deaths is found in Africa, African countries account for the majority of countries on the list. Fortunately, HIV treatment has become more accessible in Africa over the years and now up to 95 percent of people living with HIV in Eswatini are receiving antiretroviral therapy (ART). Access to ART does vary from country to country, however, with around 77 percent of people who are HIV positive in South Africa receiving ART, and only 31 percent in the Congo.

According to Cognitive Market Research, the global HIV Diagnostics market size is USD 4158.2 million in 2024. It will expand at a compound annual growth rate (CAGR) of 10.90% from 2024 to 2031. North America held the major market share for more than 40% of the global revenue with a market size of USD 1663.28 million in 2024 and will grow at a compound annual growth rate (CAGR) of 9.1% from 2024 to 2031. Europe accounted for a market share of over 30% of the global revenue with a market size of USD 1247.46 million. Asia Pacific held a market share of around 23% of the global revenue with a market size of USD 956.39 million in 2024 and will grow at a compound annual growth rate (CAGR) of 12.9% from 2024 to 2031. Latin America had a market share of more than 5% of the global revenue with a market size of USD 207.91 million in 2024 and will grow at a compound annual growth rate (CAGR) of 10.3% from 2024 to 2031. Middle East and Africa had a market share of around 2% of the global revenue and was estimated at a market size of USD 83.16 million in 2024 and will grow at a compound annual growth rate (CAGR) of 10.6% from 2024 to 2031. Consumables held the highest HIV Diagnostics market revenue share in 2024. Market Dynamics of HIV Diagnostics Market Key Drivers for HIV Diagnostics Market Increasing Prevalence of Sexually Transmitted Disease to Increase the Demand Globally Throughout the many decades of the HIV pandemic, the number of infected individuals is continually rising. The socioeconomic variables driving this continuous increase also suggest that preventative measures have not been successful. Even though many of these infections are preventable, there are an estimated 20 million new cases of STDs in the US each year, and the rate is still rising. Moreover, there are over 1.2 million HIV-positive individuals residing in the United States. Attempts to encourage testing and screening for sexually transmitted infections can ascertain an individual's likelihood of acquiring one and help those who already have one receive treatment, so enhancing their health and lowering the danger of HIV spreading to others. Approximately 38.4 million people worldwide were HIV positive in 2021. Among these, women and girls made up nearly 54%. Rising Initiatives by Global Agencies to Propel Market Growth HIV is among the world's most important public health concerns. As a result, there is a global commitment to stopping new HIV infections and giving everyone on the planet access to HIV therapy. WHO recommends testing for HIV to anyone who might be at risk. The World Bank was a leader in global financing for HIV/AIDS in the early phases of the pandemic and has contributed US$4.6 billion to programs related to the illness since 1989. Because of assistance from the Bank—more precisely, through the International Development Association—for 1,500 counseling and testing centers, about 7 million people have had HIV tests. Restraint Factor for the HIV Diagnostics Market Lack of Healthcare Infrastructure and Awareness to Limit the Sales A proper infrastructure for healthcare delivery is lacking in many areas, especially in poor nations, which makes it difficult to provide diagnostic services. This covers concerns with the supply chain, inadequate laboratory facilities, and skilled staff. It might be particularly difficult to access diagnostic services in rural and isolated places due to a lack of healthcare facilities and inadequate transportation infrastructure. Furthermore, HIV diagnosis rates are lower in the developing Asia-Pacific, Middle East, and African regions. These areas require a sufficient number of diagnostic facilities. Additionally, the diagnosis process needs to be explained to the majority of patients, which restricts market growth in these areas. Impact of Covid-19 on the HIV Diagnostics Market The COVID-19 pandemic has had a significant impact on the HIV diagnostics market, both in terms of challenges and opportunities. There was a decrease in HIV testing and diagnostic services during the pandemic as a result of the extensive healthcare resources being redirected to handle COVID-19. Some facilities were converted to provide COVID-19 treatment, and clinics and labs had a staffing crisis. Reduced HIV testing rates were the outcome of routine and community-based HIV testing programs being frequently halted to stop the spread of COVID-19. The adoption of telemedicine and remote healthcare services was expedited by the epidem...

Much of the information on national HIV prevalence in Tanzania derives from surveillance of HIV in special populations, such as women attending antenatal clinics and blood donors. For example, Mainland Tanzania currently maintains a network of 134 antenatal care (ANC) sites from which HIV prevalence estimates are generated. However, these surveillance data do not provide an estimate of the HIV prevalence among the general population. HIV prevalence is higher among individuals who are employed (6 percent) than among those who are not employed (3 percent) and is higher in urban areas than in rural areas (7percent and 4 percent, respectively). In Mainland Tanzania, HIV prevalence is markedly higher than in Zanzibar (5 percent versus 1 percent). Differentials by region are large. Among regions on the Mainland,Njombe has the highest prevalence estimate (15 percent), followed by Iringa and Mbeya (9 percent each);Manyara and Tanga have the lowest prevalence (2 percent). Among the five regions that comprise Zanzibar, all have HIV prevalence estimates at 1 percent or below. Consistent with the overall national estimate among men and women, HIV prevalence is higher among women than men in nearly all regions of Tanzania.

Mexico MX: Prevalence of HIV: Male: % Aged 15-24 data was reported at 0.200 % in 2017. This stayed constant from the previous number of 0.200 % for 2016. Mexico MX: Prevalence of HIV: Male: % Aged 15-24 data is updated yearly, averaging 0.200 % from Dec 1990 (Median) to 2017, with 28 observations. The data reached an all-time high of 0.200 % in 2017 and a record low of 0.100 % in 2009. Mexico MX: Prevalence of HIV: Male: % Aged 15-24 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Mexico – Table MX.World Bank.WDI: Health Statistics. Prevalence of HIV, male is the percentage of males who are infected with HIV. Youth rates are as a percentage of the relevant age group.; ; UNAIDS estimates.; Weighted average; In many developing countries most new infections occur in young adults, with young women being especially vulnerable.

IntroductionAlthough HIV infection and its associated co-morbidities remain the commonest reason for hospitalisation in Africa, their impact on economic costs and health-related quality of life (HRQoL) are not well understood. This information is essential for decision-makers to make informed choices about how to best scale-up anti-retroviral treatment (ART) programmes. This study aimed to quantify the impact of HIV infection and ART on economic outcomes in a prospective cohort of hospitalised patients with high HIV prevalence.MethodsSequential medical admissions to Queen Elizabeth Central Hospital, Malawi, between June-December 2014 were followed until discharge, with standardised classification of medical diagnosis and estimation of healthcare resources used. Primary costing studies estimated total health provider cost by medical diagnosis. Participants were interviewed to establish direct non-medical and indirect costs. Costs were adjusted to 2014 US$ and INT$. HRQoL was measured using the EuroQol EQ-5D. Multivariable analyses estimated predictors of economic outcomes.ResultsOf 892 eligible participants, 80.4% (647/892) were recruited and medical notes found. In total, 447/647 (69.1%) participants were HIV-positive, 339/447 (75.8%) were on ART prior to admission, and 134/647 (20.7%) died in hospital. Mean duration of admission for HIV-positive participants not on ART and HIV-positive participants on ART was 15.0 days (95%CI: 12.0–18.0) and 12.2 days (95%CI: 10.8–13.7) respectively, compared to 10.8 days (95%CI: 8.8–12.8) for HIV-negative participants. Mean total provider cost per hospital admission was US$74.78 (bootstrap 95%CI: US$25.41-US$124.15) higher for HIV-positive than HIV-negative participants. Amongst HIV-positive participants, the mean total provider cost was US$106.87 (bootstrap 95%CI: US$25.09-US$106.87) lower for those on ART than for those not on ART. The mean total direct non-medical and indirect cost per hospital admission was US$87.84. EQ-5D utility scores were lower amongst HIV-positive participants, but not significantly different between those on and not on ART.ConclusionsHIV-related hospital care poses substantial financial burdens on health systems and patients; however, per-admission costs are substantially lower for those already initiated onto ART prior to admission. These potential cost savings could offset some of the additional resources needed to provide universal access to ART.

United Arab Emirates AE: Incidence of HIV: per 1,000 Uninfected Population data was reported at 0.130 Ratio in 2020. This records an increase from the previous number of 0.120 Ratio for 2019. United Arab Emirates AE: Incidence of HIV: per 1,000 Uninfected Population data is updated yearly, averaging 0.020 Ratio from Dec 1990 (Median) to 2020, with 31 observations. The data reached an all-time high of 0.130 Ratio in 2020 and a record low of 0.010 Ratio in 2004. United Arab Emirates AE: Incidence of HIV: per 1,000 Uninfected Population data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United Arab Emirates – Table AE.World Bank.WDI: Social: Health Statistics. Number of new HIV infections among uninfected populations expressed per 1,000 uninfected population in the year before the period.;UNAIDS estimates.;Weighted average;This is the Sustainable Development Goal indicator 3.3.1 [https://unstats.un.org/sdgs/metadata/].

BackgroundIn the generalised epidemics of sub-Saharan Africa (SSA), human immunodeficiency virus (HIV) prevalence shows patterns of clustered micro-epidemics. We mapped and characterised these high-prevalence areas for young adults (15–29 years of age), as a proxy for areas with high levels of transmission, for 7 countries in Eastern and Southern Africa: Kenya, Malawi, Mozambique, Tanzania, Uganda, Zambia, and Zimbabwe.Methods and findingsWe used geolocated survey data from the most recent United States Agency for International Development (USAID) demographic and health surveys (DHSs) and AIDS indicator surveys (AISs) (collected between 2008–2009 and 2015–2016), which included about 113,000 adults—of which there were about 53,000 young adults (27,000 women, 28,000 men)—from over 3,500 sample locations. First, ordinary kriging was applied to predict HIV prevalence at unmeasured locations. Second, we explored to what extent behavioural, socioeconomic, and environmental factors explain HIV prevalence at the individual- and sample-location level, by developing a series of multilevel multivariable logistic regression models and geospatially visualising unexplained model heterogeneity. National-level HIV prevalence for young adults ranged from 2.2% in Tanzania to 7.7% in Mozambique. However, at the subnational level, we found areas with prevalence among young adults as high as 11% or 15% alternating with areas with prevalence between 0% and 2%, suggesting the existence of areas with high levels of transmission Overall, 15.6% of heterogeneity could be explained by an interplay of known behavioural, socioeconomic, and environmental factors. Maps of the interpolated random effect estimates show that environmental variables, representing indicators of economic activity, were most powerful in explaining high-prevalence areas. Main study limitations were the inability to infer causality due to the cross-sectional nature of the surveys and the likely under-sampling of key populations in the surveys.ConclusionsWe found that, among young adults, micro-epidemics of relatively high HIV prevalence alternate with areas of very low prevalence, clearly illustrating the existence of areas with high levels of transmission. These areas are partially characterised by high economic activity, relatively high socioeconomic status, and risky sexual behaviour. Localised HIV prevention interventions specifically tailored to the populations at risk will be essential to curb transmission. More fine-scale geospatial mapping of key populations,—such as sex workers and migrant populations—could help us further understand the drivers of these areas with high levels of transmission and help us determine how they fuel the generalised epidemics in SSA.

Introduction AIDS, caused by HIV, is a disease characterized by profound immune-suppression to the individuals and this manifests in the form of opportunistic infections, wasting, malignant tumors, and central nervous system degeneration (1). 85.6 million people have become infected with HIV and 40.4 million people have died from AIDS-related illnesses since the start of the epidemic (2). As of 2022, the global statistics indicated that a total of 39 million people were living with HIV, 1.3 million people were newly infected and 630,000 died from AIDS-related illnesses. In east and southern Africa, 20.8 million people were living with HIV, 0.5 million were people newly infected and there were 260,000 HIV-related deaths (2). Although research shows that incident HIV infections are declining in many countries across sub-Saharan Africa it remains the continent’s most affected region by HIV with an estimated 22.9 million people living with HIV and accounting for more than two-thirds of new HIV infections globally (3). As much as the HIV prevalence rates are currently lower than what they were before (4), HIV is still claiming many lives yearly (5). In Uganda, with a population projection of 45.5 million people (6), the HIV prevalence has declined from 30% in the 1990s to 5.1% in 2022 with a 40% decline in new infections and a 65% decline in deaths in 2022 as compared to 2010 (7). In Mbarara, unlike other districts in Uganda, the prevalence was noted to be generally higher. In addition, a higher prevalence was noted in the Banyankole tribe, who are the primary inhabitants of this region as compared to other tribes of Uganda, especially among females (5).

Problem statement For long, Mbarara has existed as a focus of high HIV prevalence compared to the other districts in Uganda. Prevalence figures according to the Uganda population-based HIV impact assessment (8) showed that Mbarara had 9.6% compared to the national average of 5.5% and the southwestern region at large was 6.3%. However, despite the increasing and higher HIV rates observed in Mbarara over the years, there is limited research on the probable causes and compound risk factors that have led to the surge in infection. The current scientific discourse surrounding the high prevalence of HIV in Mbarara, Uganda, reflects a fragmented landscape, with studies often confined to the examination of specific variables. This scoping review endeavors to bridge this gap by systematically mapping and consolidating the diverse scientific literature on HIV in Mbarara. By adopting a holistic perspective, we aim to unravel the intricate web of risk factors influencing HIV prevalence as well as contributing to the existing body of knowledge on the subject.

Drugs for HIV Market Outlook

The global Drugs for HIV market size was valued at approximately USD 30.5 billion in 2023 and is projected to reach around USD 42.7 billion by 2032, growing at a CAGR of 3.8% from 2024 to 2032. This market is primarily driven by the increasing prevalence of HIV infections globally, advancements in drug development, and supportive governmental and non-governmental initiatives aimed at combating the HIV epidemic.

One of the significant growth factors for the Drugs for HIV market is the rising awareness about HIV/AIDS and the importance of early diagnosis and treatment. Efforts by global health organizations, such as the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS), to promote awareness and preventive measures have significantly contributed to early diagnosis rates, thus driving the demand for antiretroviral therapy (ART). Moreover, the reduction in stigma associated with HIV/AIDS has encouraged more individuals to seek treatment, further bolstering market growth.

Another crucial factor contributing to the market's expansion is the continuous innovation in HIV drug development. The introduction of novel drug classes, combination therapies, and long-acting injectable formulations has improved the efficacy and convenience of HIV treatment regimens. These innovations not only enhance patient compliance but also reduce the risk of drug resistance, thereby improving treatment outcomes. Furthermore, the ongoing research and development (R&D) efforts to discover new therapeutic targets and the development of vaccines offer promising avenues for future market growth.

The supportive regulatory environment and favorable reimbursement policies in several regions also play a pivotal role in the growth of the Drugs for HIV market. Governments and healthcare systems in developed countries, as well as some developing nations, provide substantial funding and reimbursement for HIV treatment, making it more accessible to patients. Initiatives such as the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis, and Malaria have been instrumental in expanding access to HIV drugs, particularly in low- and middle-income countries.

Regionally, North America and Europe are expected to maintain a significant share of the market due to the high prevalence of HIV, advanced healthcare infrastructure, and robust R&D activities. The Asia Pacific region is anticipated to witness the highest growth rate, driven by increasing HIV cases, rising awareness, and improving healthcare facilities. Africa remains a critical focus area due to the high burden of HIV, with efforts being directed towards improving access to treatment and preventive measures.

Drug Class Analysis

Nucleoside Reverse Transcriptase Inhibitors (NRTIs) Analysis

Nucleoside Reverse Transcriptase Inhibitors (NRTIs) form the backbone of most HIV treatment regimens. These drugs work by inhibiting the reverse transcriptase enzyme, which is crucial for viral replication. The effectiveness of NRTIs, combined with their relatively well-tolerated safety profiles, makes them a cornerstone of antiretroviral therapy (ART). The market for NRTIs is bolstered by the continuous development of newer drugs with improved efficacy and reduced side effects. Drugs such as tenofovir alafenamide and emtricitabine are widely used due to their potent antiviral activity and favorable safety profiles.

The demand for NRTIs is also driven by their inclusion in fixed-dose combination therapies, which simplify treatment regimens and enhance patient adherence. For instance, combination drugs like Truvada and Descovy, which contain NRTIs, are used both for treatment and as pre-exposure prophylaxis (PrEP) to prevent HIV infection. The market growth is further supported by ongoing research to develop next-generation NRTIs that can overcome resistance issues and provide better treatment outcomes.

Despite their widespread use, NRTIs face challenges such as the development of drug resistance and potential long-term side effects, including renal toxicity and bone density loss. To address these concerns, pharmaceutical companies are investing in the development of novel NRTIs with improved safety profiles. Additionally, the use of pharmacogenomics to tailor NRTI therapy based on individual genetic profiles is an emerging trend that holds promise for personalized medicine in HIV treatment.

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