The states with the highest rates of HIV diagnoses in 2021 included Georgia, Louisiana, and Florida. However, the states with the highest number of people with HIV were California, Texas, and Florida. In California, there were around 4,399 people diagnosed with HIV. HIV/AIDS diagnoses The number of diagnoses of HIV/AIDS in the United States has continued to decrease in recent years. In 2021, there were an estimated 35,769 HIV diagnoses in the U.S. down from 38,433 diagnoses in the year 2017. In total, since the beginning of the epidemic in 1981 there have been around 1.25 million diagnoses in the United States. Deaths from HIV Similarly, the death rate from HIV has also decreased significantly over the past few decades. In 2019, there were only 1.4 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 19.1 per 100,000 population in 2020.

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 2021, the states with the highest number of HIV diagnoses were California, Texas, and Florida. That year, there were a total of around 35,716 HIV diagnoses in the United States. Of these, 4,399 were diagnosed in California. HIV infections have been decreasing globally for many years. In the year 2000, there were 2.8 million new infections worldwide, but this number had decreased to around 1.3 million new infections by 2023. The number of people living with HIV remains fairly steady, but the number of those that have died due to AIDS has reached some of its lowest peaks in a decade. Currently, there is no functional cure for HIV or AIDS, but improvements in therapies and treatments have enabled those living with HIV to have a much improved quality of life.

In 2023, the number of diagnosed HIV cases in Mexico amounted to approximately 17,000. That year, the State of Mexico, Veracruz, and Mexico City were the federative entities with the highest number of people diagnosed with the human immunodeficiency virus (HIV), with more than 1,000 patients each. Moreover, most registered HIV cases in the Latin American country between 1984 and 2021 corresponded to men. People living with HIV in Latin America In the last few years, the number of people living with HIV in Latin America has been increasing. According to recent estimates, the number of individuals living with this condition rose from around 1.6 million in 2013 to almost 2.2 million by 2022. From a country perspective, Brazil and Mexico were the Latin American nations where most people were living with the disease, reaching approximately 990,000 and 370,000 patients, respectively. ART is more costly in Latin America HIV is commonly treated through antiretroviral therapy (ART), a drug-based treatment aimed at reducing the viral load in the blood to help control the development of the disease while improving the health of those infected. Although the share of deaths among people living with HIV due to causes unrelated to AIDS increased globally since 2010, there are still inequalities in the access to ART therapy. As of 2022, Latin America and the Caribbean recorded the highest average price per person for HIV antiretroviral therapy compared to other regions worldwide.

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 25 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 2023, Biktarvy, an antiretroviral marketed by Gilead, was the leading HIV treatment based on revenue.

United States US: Incidence of HIV: per 1,000 Uninfected Population Aged 15-49 data was reported at 0.220 Ratio in 2018. This stayed constant from the previous number of 0.220 Ratio for 2017. United States US: Incidence of HIV: per 1,000 Uninfected Population Aged 15-49 data is updated yearly, averaging 0.250 Ratio from Dec 1990 (Median) to 2018, with 29 observations. The data reached an all-time high of 0.290 Ratio in 1990 and a record low of 0.220 Ratio in 2018. United States US: Incidence of HIV: per 1,000 Uninfected Population Aged 15-49 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United States – Table US.World Bank.WDI: Health Statistics. Number of new HIV infections among uninfected populations ages 15-49 expressed per 1,000 uninfected population in the year before the period.; ; UNAIDS estimates.; Weighted average;

Prevalence of HIV, total (% of population ages 15-49) in United States was reported at 0.4 % in 2021, according to the World Bank collection of development indicators, compiled from officially recognized sources. United States - Prevalence of HIV, total (% of population ages 15-49) - actual values, historical data, forecasts and projections were sourced from the World Bank on March of 2025.

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...

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.

In 2018, São Paulo was the Brazilian state with the highest number of HIV-positive patients in the country, with 3,176 cases. It was followed by Rio de Janeiro, with around 1.7 thousand cases and Rio Grande do Sul, with nearly 1.5 thousand patients.

Geographic coverage

The survey was conducted in two local communities in the Free State province, one urban (Welkom) and one rural (Qwaqwa), in which the HIV/AIDS epidemic is particularly rife. Welkom and Qwaqwa are situated in the Lejweleputswa and Thabo Mofutsanyane districts of the Free State province.

Analysis unit

Households

Universe

All memebers of the Household

Kind of data

Sample survey data [ssd]

Sampling procedure

The household impact of HIV/AIDS was assessed by means of a cohort study of households affected by the disease. The survey was conducted in two local communities in the Free State province, one urban (Welkom) and one rural (Qwaqwa), in which the HIV/AIDS epidemic is particularly rife. Welkom and Qwaqwa are situated in the Lejweleputswa and Thabo Mofutsanyane districts of the Free State province.

Affected households were sampled purposively via NGOs and other organizations involved in AIDS counselling and care and at baseline included at least one person known to be HIV-positive or known to have died from AIDS in the past six months. Informed consent was obtained from the infected individual(s) or their caregivers (in the case of minors). In order to explore the socio-economic impact on affected households of repeated occurrences of HIV/AIDS-related morbidity or mortality, a distinction is made between affected households in general and affected households that have experienced morbidity or mortality more frequently. Non-affected households represent households living in close proximity to affected households. These households at baseline did not include persons suffering from tuberculosis or pneumonia. The incidence of morbidity and mortality is considerably higher in affected households.

Affected households were sampled purposively via NGOs and other organizations involved in AIDS counselling and care and at baseline included at least one person known to be HIV-positive or known to have died from AIDS in the past six months. Informed consent was obtained from the infected individual(s) or their caregivers (in the case of minors). In order to explore the socio-economic impact on affected households of repeated occurrences of HIV/AIDS-related morbidity or mortality, a distinction is made between affected households in general and affected households that have experienced morbidity or mortality more frequently. Non-affected households represent households living in close proximity to affected households. These households at baseline did not include persons suffering from tuberculosis or pneumonia. The incidence of morbidity and mortality is considerably higher in affected households.

Mode of data collection

Face-to-face [f2f]

Research instrument

Household Questionnaire

Response rate

During the first wave of interviews a total of 404 interviews were conducted. During the second wave of data collection, interviews were conducted with 385 households, which translates into an attrition rate of 4.7% (19 households). During wave III, a total of 354 households were interviewed, with 31 households not being reinterviewed (7.7% of the original sample). In wave IV, 55 new households wererecruited into the study, with particular emphasis on an effort to recruit child-headed households into the survey insofar as the sample to date did not include any such households. During waves IV, V and VI a total of 3, 13 and 9 households respectively could not be re-interviewed.

The payment of a minimal participation fee (R150 per household per survey visit) to those households interviewed in each wave, following the interview and distributed in the form of food parcels, contributed to ensuring sustainability of the sample over the three-year period. The dataset includes data for 331 households interviewed in each of the six rounds of interviews. In almost 90 percent of cases the reasons for attrition are related to migration, given that this study did not intend to follow those households that move outside of the two immediate study areas, i.e. Welkom and Qwaqwa. In the majority of cases, attrition can be ascribed to the failure to establish the current whereabouts of the particular household during follow-up, while in a third of cases it could be established that the household had moved to another country, another province, or another town in the Free State province. Less than ten percent of households had refused to participate in subsequent waves. The reasons for attrition in the original sample illustrate the manner in which migration and the disintegration of households, which are important effects of the epidemic, can act to erode the sample population.

Objective: To examine if the rankings of state HIV age-standardized death rates (ASDRs) changed if different standard population (SP) was used.

Design: A cross-sectional population-based observational study. Setting 36 states in the United States.

Participants: People died from 2015 to 2019.

Main outcome measures: State HIV ASDR using 4 SPs, namely WHO2000, US2000, US2mor020, and Eur2011–2030.

Results: The rankings of 19 states did not change when ASDRs were calculated using US2000 and US2020. Of the 17 states whose rankings changed, the rankings of 9 states calculated using US2000 were higher than those calculated using US2020; in 8 states, the rankings were lower. The states with the greatest changes in rankings between US2000 and US2020 were Kentucky (12th and 9th, respectively) and Massachusetts (8th and 11th, respectively).

Conclusions: State ASDRs calculated using the current official SP (US2000) weigh middle-age HIV death rates more heavily than older-age HIV death rates, resulting in lower ASDRs among states with higher older-age HIV death rates.

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.

HIV prevalence among men who have sex with men attending HIV testing and counseling services at the Thai Red Cross Anonymous Clinic and Silom Community Clinic Bangkok, 2014–2018.

In 2020, the prevalence of HIV among individuals aged 15 to 49 years was nearly two percent in Haiti, the highest among selected Latin American countries. Meanwhile, Nicaragua and Bolivia reported a prevalence rate of the virus of 0.2 percent that year. In 2019, Brazil was home to the most people living with HIV in the region.

Abstract

The 2018 Nigeria AIDS Indicator and Impact Survey (NAIIS) is a cross-sectional survey that will assess the prevalence of key human immunodeficiency virus (HIV)-related health indicators. This survey is a two-stage cluster survey of 88,775 randomly-selected households in Nigeria, sampled from among 3,551 nationally-representative sample clusters. The survey is expected to include approximately 168,029 participants, ages 15-64 years and children, ages 0-14 years, from the selected household. The 2018 NAIIS will characterize HIV incidence, prevalence, viral load suppression, CD4 T-cell distribution, and risk behaviors in a household-based, nationally-representative sample of the population of Nigeria, and will describe uptake of key HIV prevention, care, and treatment services. The 2018 NAIIS will also estimate the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) infections, and HBV/HIV and HCV/HIV co-infections.

Geographic coverage

National coverage, the survey covered the Federal Republic and was undertaken in each state and the Federal Capital.

Analysis unit

Household Health Survey

Universe

1. Women and men aged 15-64 years living in residential households and visitors who slept in the household the night before the survey
2. Children aged 0-14 years living in residential households and child visitors who slept in the household the night before the survey

Kind of data

Sample survey data [ssd]

Sampling procedure

This cross-sectional, household-based survey uses a two-stage cluster sampling design (enumeration area followed by households). The target population is people 15-64 and children ages 0-14 years. The overall size and distribution of the sample is determined by analysis of existing estimates of national HIV incidence, sub-national HIV prevalence, and the number of HIV-positive cases needed to obtain estimates of VLS among adults 15-64 years for each of the 36 states and the FCT while not unnecessarily inflating the sample size needed.

From a sampling perspective, the three primary objectives of this proposal are based on competing demands, one focused on national incidence and the other on state-level estimates in a large number of states (37). Since the denominator used for estimating VLS is HIV-positive individuals, the required minimum number of blood draws in a stratum is inversely proportional to the expected HIV prevalence rate in that stratum. This objective requires a disproportionate amount of sample to be allocated to states with the lowest prevalence. A review of state-level prevalence estimates for sources in the last 3 to 5 years shows that state-level estimates are often divergent from one source to the next, making it difficult to ascertain the sample size needed to obtain the roughly 100 PLHIV needed to achieve a 95% confidence interval (CI) of +/- 10 for VLS estimates.

An equal-size approach is proposed with a sample size of 3,700 blood specimens in each state. Three-thousand seven hundred specimens will be sufficiently large to obtain robust estimates of HIV prevalence and VLS among HIV-infected individuals in most states. In states with a HIV prevalence above 2.5%, we can anticipate 95% CI of less than +/-10% and relative standard errors (RSEs) of less than 11% for estimates of VLS. In these states, with HIV prevalence above 2.5%, the anticipated 95% CI around prevalence is +/- 0.7% to a high of 1.1-1.3% in states with prevalence above 6%. In states with prevalence between 1.2 and 2.5% HIV prevalence estimates would remain robust with 95% CI of +/- 0.5-0.6% and RSE of less than 20% while 95% CI around VLS would range between 10-15% (and RSE below 15%). With this proposal only a few states, with HIV prevalence below 1.0%, would have less than robust estimates for VLS and HIV prevalence.

Mode of data collection

Face-to-face [f2f]

Research instrument

Three questionnaires were used for the 2018 NAIIS: Household Questionnaire, Adult Questionnaire, and Early Adolescent Questionnaire (10-14 Years).

Cleaning operations

During the household data collection, questionnaire and laboratory data were transmitted between tablets via Bluetooth connection. This facilitated synchronization of household rosters and ensured data collection for each participant followed the correct pathway. All field data collected in CSPro and the Laboratory Data Management System (LDMS) were transmitted to a central server using File Transfer Protocol Secure (FTPS) over a 4G or 3G telecommunication provider at least once a day. Questionnaire data cleaning was conducted using CSPro and SAS 9.4 (SAS Institute Inc., Cary, North Carolina, United States). Laboratory data were cleaned and merged with the final questionnaire database using unique specimen barcodes and study identification numbers.

Response rate

A total of 101,267 households were selected, 89,345 were occupied and 83,909 completed the household interview . • For adults aged 15-64 years, interview response rate was 91.6% for women and 88.2% for men; blood draw response rate was 92.9% for women and 93.6% for men. • For adolescents aged 10-14 years, interview response rate was 86.8% for women and 86.2% for men; blood draw response rate was 91.2% for women and 92.3% for men. • For children aged 0-9 years, blood draw response rate was 68.5% for women and men.

Sampling error estimates

Estimates from sample surveys are affected by two types of errors: non-sampling errors and sampling errors. Non-sampling errors result from mistakes made during data collection, e.g., misinterpretation of an HIV test result and data management errors such as transcription errors during data entry. While NAIIS implemented numerous quality assurance and control measures to minimize non-sampling errors, these were impossible to avoid and difficult to evaluate statistically. In contrast, sampling errors can be evaluated statistically. Sampling errors are a measure of the variability between all possible samples.

The sample of respondents selected for NAIIS was only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples could yield results that differed somewhat from the results of the actual sample selected. Although the degree of variability cannot be known exactly, it can be estimated from the survey results. The standard error, which is the square root of the variance, is the usual measurement of sampling error for a statistic (e.g., proportion, mean, rate, count). In turn, the standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of approximately plus or minus two times the standard error of that statistic in 95% of all possible samples of identical size and design.

NAIIS utilized a multi-stage stratified sample design, which required complex calculations to obtain sampling errors. The Taylor linearization method of variance estimation was used for survey estimates that are proportions, e.g., HIV prevalence. The Jackknife repeated replication method was used for variance estimation of more complex statistics such as rates, e.g., annual HIV incidence and counts such as the number of people living with HIV.

The Taylor linearization method treats any percentage or average as a ratio estimate, , where y represents the total sample value for variable y and x represents the total number of cases in the group or subgroup under consideration. The variance of r is computed using the formula given below, with the standard error being the square root of the variance: in which Where represents the stratum, which varies from 1 to H, is the total number of clusters selected in the hth stratum, is the sum of the weighted values of variable y in the ith cluster in the hth stratum, is the sum of the weighted number of cases in the ith cluster in the hth stratum and, f is the overall sampling fraction, which is so small that it is ignored.

In addition to the standard error, the design effect for each estimate is also calculated. The design effect is defined as the ratio of the standard error using the given sample design to the standard error that would result if a simple random sample had been used. A design effect of 1.0 indicates that the sample design is as efficient as a simple random sample, while a value greater than 1.0 indicates the increase in the sampling error due to the use of a more complex and less statistically efficient design. Confidence limits for the estimates, which are calculated as where t(0.975, K) is the 97.5th percentile of a t-distribution with K degrees of freedom, are also computed.

Data appraisal

Remote data quality check was carried out using data editor

United States US: Newly Infected with HIV: Adults: Aged 15-24 data was reported at 5,600.000 Number in 2021. This records a decrease from the previous number of 5,900.000 Number for 2020. United States US: Newly Infected with HIV: Adults: Aged 15-24 data is updated yearly, averaging 7,200.000 Number from Dec 2010 (Median) to 2021, with 12 observations. The data reached an all-time high of 10,000.000 Number in 2010 and a record low of 5,600.000 Number in 2021. United States US: Newly Infected with HIV: Adults: Aged 15-24 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s United States – Table US.World Bank.WDI: Social: Health Statistics. Number of young people (ages 15-24) newly infected with HIV.;UNAIDS estimates.;;This indicator is related to Sustainable Development Goal 3.3.1 [https://unstats.un.org/sdgs/metadata/].

Note. Data include persons with diagnosed HIV infection regardless of stage of disease at diagnosis. HIV diagnosis data were statistically adjusted for missing transmission category, but not for reporting delays or incomplete reporting. All results for each outcome of interest in the models are based on controlling for all other variables.MSM, men who reported ever having had sexual contact with other men.CI, confidence interval.aBlack non-MSM is the reference group.bThe prevalence odds is defined as (#MSM+1)/(#non-MSM+1), where adding 1 to both the numerator and the denominator avoids the prevalence odds undefined when there are no diagnosed HIV infections among black non-MSM. PORs>1 indicates that among black males, as the proportion of a SDH variable of interest increases, the probability of black MSM diagnosed with HIV is higher compared to black non-MSM.Prevalence odds ratiosa of HIV infection diagnosis for black/African American MSM vs. non-MSM, by selected census tract-level social determinants of health (SDH), 2005–2009—17 areas.

United States US: Newly Infected with HIV: Adults (Aged 15+) and Children (Aged 0-14) data was reported at 39,000.000 Number in 2015. This stayed constant from the previous number of 39,000.000 Number for 2014. United States US: Newly Infected with HIV: Adults (Aged 15+) and Children (Aged 0-14) data is updated yearly, averaging 40,500.000 Number from Dec 2008 (Median) to 2015, with 8 observations. The data reached an all-time high of 44,000.000 Number in 2009 and a record low of 39,000.000 Number in 2015. United States US: Newly Infected with HIV: Adults (Aged 15+) and Children (Aged 0-14) 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. Number of adults (ages 15+) and children (ages 0-14) newly infected with HIV.; ; UNAIDS estimates.; ;

IntroductionOnly 45% of people currently living with HIV infection in sub-Saharan Africa are aware of their HIV status. Unmet testing needs may be addressed by utilizing the Emergency Department (ED) as an innovative testing venue in low and middle-income countries (LMICs). The purpose of this review is to examine the burden of HIV infection described in EDs in LMICs, with a focus on summarizing the implementation of various ED-based HIV testing strategies.Methodology and resultsWe performed a systematic review of Pubmed, Embase, Scopus, Web of Science and the Cochrane Library on June 12, 2016. A three-concept search was employed with emergency medicine (e.g., Emergency department, emergency medical services), HIV/AIDS (e.g., human immunodeficiency virus, acquired immunodeficiency syndrome), and LMIC terms (e.g., developing country, under developed countries, specific country names).The search returned 2026 unique articles. Of these, thirteen met inclusion criteria and were included in the final review. There was a large variation in the reported prevalence of HIV infection in the ED population ranging from to 2.14% in India to 43.3% in Uganda. The proportion HIV positive patients with previously undiagnosed infection ranged from 90% to 65.22%.ConclusionIn the United States ED-based HIV testing strategies have been front and center at curbing the HIV epidemic. The limited number of ED-based studies we observed in this study may represent the paucity of HIV testing in this venue in LMICs. All of the studies in this review demonstrated a high prevalence of HIV infection in the ED and an extraordinarily high percentage of previously undiagnosed HIV infection. Although the numbers of published reports are few, these diverse studies imply that in HIV endemic low resource settings EDs carry a large burden of undiagnosed HIV infections and may offer a unique testing venue.