The Global HIV Epidemic:
Where We Are in 2025

HIV is the kind of epidemic that demands both honesty about how far we have come and clarity about how much further there is to go. In 2025, both truths are in sharper relief than they have been in decades — because progress is real, but a sudden funding crisis is threatening to reverse it.

This is the state of the global HIV epidemic. The numbers, the geography, the populations being left behind, and the crisis that has put everything at risk.

The numbers: 2024 in full

These numbers come from the 2025 UNAIDS and WHO epidemiological estimates — the most comprehensive and current data available on the global epidemic1.

The progress is real — and remarkable

It is worth pausing on what has actually been achieved. The global HIV response, funded by a combination of PEPFAR, the Global Fund, domestic governments, and multilateral institutions, has produced one of the most significant public health achievements in modern history.

• New infections down 61% since the peak in 1996 — from 3.4 million new infections annually to 1.3 million
• AIDS-related deaths down 70% since the peak in 2004 and down 54% since 2010
• 31.6 million people now on antiretroviral therapy — up from just 7.7 million in 2010
• 87% of people living with HIV now know their status
• 26.9 million lives saved by the HIV response since it began2

These are not abstract statistics. They represent individuals who are alive, raising children, working, and living full lives because treatment reached them. The global HIV response has been, by any measure, one of the great humanitarian achievements of the 21st century.

The epidemic by region

Sub-Saharan Africa: the epicenter

Sub-Saharan Africa carries roughly two-thirds of the global HIV burden. Eastern and southern Africa alone account for more than half of all people living with HIV worldwide. In 2024, women and girls accounted for 63% of all new HIV infections in sub-Saharan Africa — a figure driven by gender inequality, limited access to prevention services, and structural vulnerability. Every week in 2024, 3,300 adolescent girls and young women in sub-Saharan Africa became infected with HIV3.

Eastern Europe and Central Asia: going in the wrong direction

While most regions have seen declining new infections, Eastern Europe and Central Asia have seen them increase. This is the only major region in the world where the epidemic is growing4. The drivers are primarily criminalization of drug use, limited harm reduction services, and punitive policies that push people away from care. Russia accounts for the majority of cases in this region, and its epidemic is almost entirely driven by injection drug use and heterosexual transmission among partners of people who inject drugs.

Latin America and the Caribbean

The epidemic in Latin America is concentrated heavily among gay and bisexual men and transgender women — populations that face significant criminalization and discrimination across much of the region. Brazil, with the largest population in Latin America, has made significant strides in treatment access but continues to face challenges in reaching key populations in remote areas and among Indigenous communities.

Asia-Pacific

The Asia-Pacific region has more than 6 million people living with HIV, with significant variation across countries. The epidemic in most of the region is concentrated among key populations — men who have sex with men, sex workers, and people who inject drugs — all of whom face criminalization and stigma that directly impede care access.

Middle East and North Africa

The Middle East and North Africa region has the lowest HIV burden globally but the slowest progress on the 95-95-95 targets. Criminalization of same-sex relationships, sex work, and drug use across most of the region makes data collection difficult and HIV services nearly impossible to deliver at scale. UNAIDS notes this region is significantly behind on all three targets.

Who is being left behind

The aggregate global numbers mask profound inequalities in who has access to testing, treatment, and prevention. UNAIDS is consistent in its finding that key populations — gay and bisexual men, sex workers, transgender women, and people who inject drugs — bear a disproportionate share of new infections despite representing a small share of the global population.

• 80% of new HIV infections outside sub-Saharan Africa occur among key populations and their partners
• Gay men globally have an HIV prevalence of 7.6% — compared to 0.7% in the general adult population5
• Children are being left furthest behind — only 55% of children living with HIV are on treatment, compared to 78% of adults
• Men consistently lag behind women on all three 95-95-95 targets, particularly on knowing their status

The 95-95-95 targets: where we actually stand

In 2021, UNAIDS set the 95-95-95 targets for 2025: 95% of people living with HIV should know their status, 95% of those diagnosed should be on treatment, and 95% of those on treatment should have a suppressed viral load. These replaced the earlier 90-90-90 targets, which most regions had already approached.

As of 2024, the global picture is: 87% know their status, 77% are on treatment, and 73% are virally suppressed6. Progress is real but the targets will not be met by 2025. The gap between where we are and where we need to be is not evenly distributed — it is concentrated in the regions and populations with the least access to services.

The 2025 funding crisis: what it means

In early 2025, the United States — the single largest funder of the global HIV response — abruptly reduced its international HIV assistance. PEPFAR, which had committed $4.3 billion in bilateral support in 2025, stopped services overnight when US foreign assistance strategies shifted7. The consequences were immediate and severe.

International assistance accounts for 80% of HIV prevention programmes in low- and middle-income countries. UNAIDS modelling suggests that if the funding gap becomes permanent, there could be an additional 6 million HIV infections and 4 million AIDS-related deaths by 20298.

By the end of 2025, at the Fourth International Conference on Financing for Development, nations began forging a new path — including 25 of 60 low- and middle-income countries finding ways to increase domestic HIV spending. The Global Fund raised $11.34 billion in new pledges10. The US announced bilateral agreements with around 70 countries to continue funding during a progressive transition to nationally-led responses.

A reason for hope: the prevention revolution

Against this difficult backdrop, 2025 opened with genuine scientific optimism. Lenacapavir — a long-acting injectable HIV prevention medication developed by Gilead — demonstrated 100% efficacy in preventing HIV in two large clinical trials9. Two injections per year. No daily pill. Potentially transformative for populations who struggle with daily oral PrEP adherence.

UNAIDS described it as a potential "HIV prevention revolution" — but immediately raised the critical question of access. If lenacapavir remains unaffordable for the countries that need it most, it becomes another tool that reaches the wealthy and leaves the rest behind. The fight over generic manufacturing, patent licensing, and equitable pricing that followed is a direct echo of the access battles of the late 1990s that ultimately brought treatment to millions in Africa.

What this means for the United States

The global epidemic is not separate from the US epidemic — it is connected to it. The same structural drivers that produce health inequity globally produce it domestically. The same communities that face the highest HIV burden globally — Black communities, gay and bisexual men, transgender women, people who inject drugs — face the highest burden in the US.

And the US is not an observer of the global epidemic. It is a participant. PEPFAR, created by a Republican president and funded by bipartisan majorities for over two decades, has saved more lives than almost any single government program in modern history. What happens to that program — and why — is not a foreign policy question. It is a question about what kind of country the United States is and wants to be.