At a glance
- Nearly 38 million people around the world are living with human immunodeficiency virus (HIV), nearly 21 million of them in eastern and southern Africa.
- An estimated one-fifth of all people living with HIV are unaware of their status.
- A major challenge in controlling HIV is the large increase in the number of young people in sub-Saharan Africa who are reaching the age of highest risk for sexually transmitted HIV.
- We work to expand access to and improve prevention, diagnosis, and treatment approaches; develop new prevention tools; and advocate for needed resources and policy changes.
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We focus our efforts in some of the countries hardest hit by HIV in sub-Saharan Africa, particularly among populations that are at greatest risk of infection, including adolescent girls and young women. To date, we have committed more than US$3 billion in HIV grants to organizations around the world and nearly US$3 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Because our resources represent only a small portion of worldwide funding to combat HIV, we concentrate our efforts in areas where existing funds are insufficient, our support can have potentially catalytic impact, and we can assume risks that others may not be able to.
We work with an array of partners, including government agencies, donors, multilateral organizations, nongovernmental organizations, academic institutions, community organizations, and private industry. We also work to ensure that adequate funding and appropriate policies are in place to support HIV prevention and treatment efforts, research and development, and efforts to understand the needs of high-risk populations.
Areas of focus
An estimated one in five people living with HIV, particularly men, do not know they have the virus. We support the development and appropriate use of novel tools that can greatly increase the number of people who know their status and who seek treatment.
HIV treatment programs are often expensive and inflexible, leading many individuals living with HIV to discontinue the treatment they need. We support partners who are working to simplify the delivery of HIV treatment and introduce models of care that are more tailored to the needs of particular populations and their circumstances. We also fund efforts to create better patient data systems, which are crucial to keeping people living with HIV on effective treatment.
Viral load testing—the measuring of HIV particles in the blood—can be critical to helping people living with HIV understand their health status and be motivated to continue treatment. We support the improved use of viral load testing, as well as the development of novel virus load testing systems, as a means of sustaining effective treatment.
Several existing measures have proven effective in preventing HIV infection. They include voluntary medical male circumcision, condoms, and drugs that reduce the risk of acquiring the virus after exposure. These measures can be effective only if they are affordable and reach high-risk populations—and only if those populations are aware of their risk of contracting HIV.
Widespread voluntary medical male circumcision could play a major role in limiting the spread of HIV, and efforts by global partners have greatly improved access to and demand for circumcision. We support circumcision-related efforts in several high-burden countries in sub-Saharan Africa.
We also support efforts to improve consistent condom use and the use of drugs that reduce the risk of contracting HIV. In addition, understanding and addressing the obstacles to accessing and using these measures among high-risk populations is central to our overall prevention strategy.
New, more effective prevention methods are essential to reducing HIV transmission. We support efforts to develop, evaluate, and introduce innovative approaches to protecting those at risk. These include potential long-acting prevention interventions that can provide continuous protection over a period of time.
We continue to invest in efforts to develop an HIV vaccine. Although developing a highly effective vaccine remains a substantial scientific challenge, even a vaccine with partial efficacy and limited duration could help dramatically reduce the global incidence of HIV.
Why focus on HIV?
Nearly 38 million people around the globe are living with HIV, and nearly as many people have died from HIV-related complications since the earliest cases were detected in the 1980s. Sub-Saharan Africa is the hardest-hit region, with more than half of the world’s people living with HIV.
While substantial progress has been made in increasing access to HIV treatment and new cases of HIV have declined substantially in some regions, controlling the epidemic will require improved efforts to increase the number of people living with HIV who know their status, as well as the effective use of better treatment and prevention measures.
Sub-Saharan Africa has an estimated 970,00 new infections per year at a time when young people account for a significant and rapidly growing percentage of the population. In particular, adolescent girls and young women are now disproportionately affected. They are more than twice as likely to acquire HIV than their male peers. As young people reach the age of highest risk for HIV, a rebound in the epidemic may be inevitable unless efforts to combat the infection are greatly enhanced.
In the past decade, the world has made significant progress in the fight against HIV due to large-scale treatment programs and efforts to prevent infection among infants born to mothers with HIV. The global incidence of HIV declined by 23 percent between 2010 and 2019, and 25.4 million people worldwide are receiving antiretroviral treatment.
Accelerating progress will require a renewed commitment to the HIV response. Countries and global partners will need to sustain and in some cases increase their investments to improve the efficiency and effectiveness of HIV prevention and treatment programs and support research into new and better prevention methods.
We partner with the Global Fund, which aims to accelerate progress toward ending the AIDS, tuberculosis, and malaria epidemics. It mobilizes and invests more than US$4 billion a year to support programs run by local experts in more than 100 countries.
We collaborate with PEPFAR, the U.S. government's initiative to help save lives of those at risk from HIV/AIDS around the world; to date, its funding has totaled more than US$90 billion.
We support UNAIDS, a partnership that advocates for globally coordinated, comprehensive action on the HIV/AIDS pandemic. UNAIDS champions universal access to HIV prevention, treatment, care, and support.
We partner with the NIH, the U.S. government’s primary agency responsible for biomedical and public health research. At the NIH, researchers supported by the National Institute of Allergy and Infectious Diseases are conducting research on all aspects of HIV infection.