Antibodies that assist the body fight off infection are CD4 cells in HIV or human immunodeficiency virus. A fatal illness known as acquired immunodeficiency syndrome (AIDS) is possible if HIV progresses.
Most often, HIV is transmitted by unprotected intercourse (even during pregnancy and delivery), infected blood transfusions, or shared use of hypodermic needles.
HIV cannot be eliminated from the human body. As a result, a person will stay HIV-positive for the rest of their lives if they get the virus.
However, antiretroviral therapy (ART) drugs may be used to manage and reduce the course of HIV. In Africa, where the virus is thought to have originated, the incidence of HIV infection varies greatly from country to country.
List of the 10 countries with the highest percentage of 2020 population HIV prevalence:
- Eswatini — 26.8%
- Lesotho — 21.1%
- Botswana — 19.9%
- South Africa — 19.1%
- Zimbabwe — 11.9%
- Namibia — 11.6%
- Mozambique — 11.5%
- Zambia — 11.1%
- Malawi — 8.1%
- Equatorial Guinea — 7.3%
*Top 10 Countries with the Most HIV Cases (2020):
- South Africa — 7,800,000
- India — 2,300,000
- Mozambique — 2,100,000
- Tanzania — 1,700,000
- Nigeria — 1,700,000
- Zambia — 1,500,000
- Uganda — 1,400,000
- Kenya — 1,400,000
- Zimbabwe — 1,300,000
- Russia — 1,000,000
Additional information may be found in the table that follows.
HIV Around the World
HIV is a global problem. In 2020, the WHO predicts that 37.7 million individuals (approximately 0.7 percent of the global population) will have HIV, including 1.5 million new cases.
More than 700,000 individuals died from HIV-related diseases (such as AIDS) in the same year that 73 percent of those cases were treated with ART.
Africa has the highest rate of HIV infection of any continent, with an estimated 3.9 percent of the population (ranging from 3.3 to 4.5 percent) testing positive.
Symbion immunodeficiency virus (SIV) has been linked to HIV at least twice, most likely when human hunters came into touch with an infected primate’s blood and the virus mutated to become HIV.
In Cameroon, chimpanzees (of the Pan troglodytes subspecies) were the principal source of the HIV-1 strain. The sooty mangabey (Cercocebus atys), which occurs in various nations along Africa’s west coast, has been identified as the source of the less virulent HIV-2 strain.
Since its appearance in the 1900s, researchers think that HIV originally moved across Africa before spreading to other parts of the globe and eventually making its way to the United States in the late 1970s.
The viral infection progresses via three distinct stages:
There are three main phases in the progression of HIV, with severity ranging from mild but treatable to fatal.
The first stage of HIV infection is known as acute HIV infection. Hosts may have flu-like symptoms when HIV cells proliferate fast and begin killing CD4 T lymphocyte cells. There is a considerable chance of spreading the disease via sexual interaction.
The second stage of HIV infection is known as chronic HIV infection (Clinical latency/dormancy). The number of people infected with HIV has declined, yet the problem persists.
Infected people may not show symptoms, and the danger of spreading the infection to others is quite low. Patients on treatment programs may have virus levels that are so low that they cannot be detected, virtually eliminating the possibility of transmission.
HIV infection progresses to the third and final stage, known as acquired immunodeficiency syndrome (AIDS). AIDS, the last stage of HIV infection in which the immune system no longer can fend off infection, develops when chronic HIV infection goes untreated for a lengthy time (many years or more).
The risk of spreading the disease to others rises precipitously, and death usually occurs within three years after infection.
Antiretroviral therapy and HIV treatment (ART)
It is possible to keep HIV patients healthy for many years by using antiretroviral treatment (ART) drugs, which may reduce the quantity of HIV in the body.
ART slows the virus’s development and limits the virus’s ability to spread to others. Most often, ART is administered by administering a tablet containing a mix of three or more drugs.
Patients are termed to be in viral suppression or viral load suppression if their viral loads fall below 200 copies of HIV per milliliter of blood. Some people manage to keep their HIV levels so low that they are undetectable by today’s testing.
Patients with HIV are in the best possible health when their viral load is undetectable. 72 percent of people diagnosed with HIV are now receiving antiretroviral therapy (ART). There has been a remarkable increase in HIV testing and treatment coverage worldwide.
However, in many countries, HIV prevention and treatment are hampered by factors such as extreme poverty, gender inequality, and widespread HIV stigma and prejudice.
A coordinated and comprehensive worldwide effort to combat this epidemic, and UNAIDS is the major champion for that effort.
For the first time, UNAIDS has set a target of 90 percent of individuals living with HIV being identified, 90 percent being enrolled in treatment, and 90 percent having suppressed viral levels by 2020.
Some facts on HIV prevalence in high-risk countries, such as these:
Ezwatini, with a prevalence of approximately 27%, is the world’s most HIV-positive nation, according to the WHO. In Eswatini, HIV/AIDS is the main cause of mortality, which is maybe not unexpected.
Eswatini’s HIV rate, however, is decreasing. Between 2011 and 2016, the country’s incidence of new infections was cut in half because of the introduction of enhanced treatment and preventative programs.
It also climbed from 34.8 percent to 71.3 percent of adult HIV patients who received ART therapies. Even though Eswatini is grappling with a widespread HIV pandemic, individuals on the margins and in the criminal justice system are particularly hard hit.
For example, Eswatini has the world’s highest HIV prevalence rate of 60.5% among sex workers.
Lesotho, the second-highest HIV incidence in the world at 21.1 percent, is also the major cause of death in Lesotho. Approximately 280,000 persons in Lesotho are infected with HIV.
13,000 new HIV infections and 6,100 AIDS-related deaths occurred in the United States in 2018. In Lesotho, 71% of persons with HIV will be getting ART by 2020.
Lesotho has a life expectancy of 52 years for males and 56 years for women, resulting from the country’s high poverty rate of 57 percent. HIV/AIDS medication is sometimes difficult to get because of this.
Botswana, with an estimated HIV prevalence of 19.9%, is the nation with the third-largest number of infected citizens. Gender discrimination, punitive policies targeting disadvantaged groups, and removing foreign support are just a few of the considerable obstacles faced by those living with HIV in Botswana.
However, the number of persons living with HIV is steadily decreasing, as in many other African countries.
Botswana provides free antiretroviral therapy to all persons living with HIV, thanks to the support of organizations like the Centers for Disease Control and Prevention (CDC). The mother-to-child transmission rate of HIV was lowered from 1.91 percent in 2000 to 1.91 percent in 2020 due to the widespread use of antiretroviral therapy (ART).
4. South Africa
South Africa has the fourth-highest HIV prevalence in the world, with a rate of 19.10 percent. The number of persons living with HIV in the nation is 7.8 million, which is greater than any other country and accounts for around one-fifth of all HIV infections worldwide.
According to government estimates, 68% of persons living with HIV will be on antiretroviral therapy (ART) in the United States by 2021, and 93% of those patients will have achieved viral load suppression.
Since the ART program began in 2010, the average South African’s life expectancy has risen from 56 to 63. HIV transmission from mother to child after delivery has decreased from 3.5 percent in 2010 to around 1 percent by 2021, according to the Centers for Disease Control and Prevention.
Girls and young women who are most likely to get pregnant are 2.5 times more likely to be infected with HIV than men of the same age.
Zimbabwe has a world-leading HIV prevalence rate of 11.9%. Zimbabwe has 1.3 million persons with HIV. In Zimbabwe, ART is available to 82% of adult males, 88% of women, and 78% of children living with HIV.
As a result of PMTCT services, the number of new HIV infections among children in Zimbabwe has decreased, and virtually every pregnant woman now has access to ART.
Adolescent girls and young women in Zimbabwe, as in South Africa, bear a disproportionate share of the burden of HIV infection.
HIV services in Zimbabwe are hampered by the fact that sex work and homosexuality are banned in the nation, making it harder for at-risk populations to get prevention and treatment.
11.60 percent of Namibians have HIV, making it the sixth highest prevalence globally. In this nation, HIV/AIDS is the main cause of mortality.
200,000 Namibians have HIV, with roughly 6,100 persons contracting the disease so far this year. Almost all adults and children with HIV in the nation are getting antiretroviral therapy (ART).
An assessment conducted by NAMPHIA found that Namibia has met or surpassed several UNAIDS goals, including 90% testing, 90% treatment, and 90% viral suppression, as well as the country’s goal of achieving viral suppression by the end of 2015.
There has been a 50% decrease in the number of HIV/AIDS-related fatalities since 2002.
As of 2020, 2.1 million individuals in Mozambique have HIV, with an additional 150,000 newly infected persons. More than 60% of individuals in Mozambique are women, and young women (years 15-24) are almost twice as likely to get HIV as young men.
HIV-infected pregnant women may get antiretroviral therapy (ART) to prevent the transmission of the virus to their unborn children, which may have prevented thousands of new cases of HIV infection in children as a result.
The HIV rate in Zambia is 11.10 percent, making it the eighth-highest in the world. In Zambia, where an estimated 1.5 million individuals live with HIV, it is the primary cause of mortality.
Since December 2021, 88 percent of those infected have received antiretroviral therapy (ART), and 75 percent of those infected are in a state of viral suppression.
People living with HIV have a far better life expectancy as a consequence. AIDS-related fatalities in Zambia are mostly caused by TB, which immunocompromised HIV patients are more likely to get than in other African nations.
Tuberculosis screening was performed on 88% of HIV-positive individuals in 2021.
Malawi has the lowest HIV prevalence, at 8.1%, of any country on this list. In 2020, between 970,000 and 990,000 persons in Malawi were infected with HIV, with young people most at risk. Most new HIV infections in the United States occur among persons aged 15 to 24.
About 870,000 people with HIV were taking antiretroviral therapy (ART) as of June 2021, up from 80.9 percent a year earlier. There is a high HIV stigma in Malawi, which deters some would-be patients from seeking medical attention and treatment.
Despite this, the UNAIDS 90-90-90 goals for Malawi are extremely near to being met.
10. Equatorial Guinea
It is possible that Equatorial Guinea’s 2020 HIV prevalence of 7.3 percent may not constitute an increase from the anticipated 6.2 percent in 2014. Like most of Africa, Equatorial Guinea’s medical system has long struggled with HIV detection and diagnosis.
Equatorial Guinea and other nations with a high prevalence of HIV have a large number of individuals who have not been tested, diagnosed, or informed about their infection status.
Also See: Healthiest Countries 2022
In light of this, it’s possible that Equatorial Guinea’s rising HIV statistics aren’t due to an increase in the virus’s prevalence but rather to better testing.
HIV/AIDS prevalence and death rates should continue to decline in the future years if the government implements comprehensive treatment programs that are both aggressive and thorough.
|Country||HIV Cases||Year of Data||% Adults w/ HIV||HIV/AIDS Deaths|
|South Africa||7800000||2020 est.||0.1910||83000|
|Equatorial Guinea||68000||2020 est.||0.0730||2300|
|Republic of the Congo||110000||2020 est.||0.0330||6100|
|Central African Republic||88000||2020 est.||0.0290||3200|
|South Sudan||180000||2020 est.||0.0230||8900|
|Ivory Coast||380000||2020 est.||0.0210||13000|
|Sierra Leone||80000||2020 est.||0.0150||3200|
|Saint Vincent and the Grenadines||1200||2018||0.0150||100|
|Dominican Republic||72000||2020 est.||0.0090||1900|
|Papua New Guinea||55000||2020 est.||0.0090||500|
|DR Congo||510000||2020 est.||0.0070||17000|
|Burkina Faso||97000||2020 est.||0.0070||3300|
|Trinidad and Tobago||10000||2020 est.||0.0070||200|
|El Salvador||25000||2020 est.||0.0050||1000|
|Saint Kitts and Nevis||2018||0.0050||100|
|Costa Rica||16000||2020 est.||0.0040||500|
|Sao Tome and Principe||2020||0.0030||100|
|United Arab Emirates||2020||0.0010||100|
|Saudi Arabia||12000||2020 est.||200|
|Sri Lanka||3700||2020 est.||200|
|New Zealand||3600||2020 est.||100|