Publications

This annual surveillance report is an initiative of Special Preventive Programme, Centre for Health Protection, Department of Health. The report aims to provide strategic information to facilitate planning of services and intervention activities for the prevention, care and control of HIV/AIDS. Following a commentary, data collected from the five main components of our surveillance programme (the HIV/AIDS voluntary reporting system, HIV prevalence surveys, sexually transmitted infections caseload statistics, behavioural studies and HIV-1 genotyping studies) were presented as tables and graphs. Findings of the risk behavioural surveys such as the HIV and AIDS Response Indicator Survey (HARiS) and other studies were also included in this report.

After years of neglect, greater global attention is being paid to the increasing incidence of sexually transmitted infections (STIs). A recently published WHO report highlights that, annually, there are an estimated 376 million new cases of four curable STIs: chlamydia, gonorrhoea, syphilis and trichomoniasis. The need for greater focus on STIs has also been highlighted in the context of expanded use of pre-exposure prophylaxis (PrEP) for HIV prevention, where high STI prevalence at baseline and incidence during PrEP use have been observed. The epidemiological situation demands a call to action to ensure that these STIs are addressed, and that populations at risk have access to comprehensive STI prevention and care. Integration of STI services and PrEP has challenges, but it also provides an opportunity not only to induce much- needed progress in STI control, but also to optimize broader sexual and reproductive health services for key, underserved and overlooked populations.

These guidelines provide further reassurance of DTG as the preferred antiretroviral (ARV) drug in first- and second-line regimens due to the declining estimate of neural tube defect risk and observed efficacy. This reassurance comes at a time when pretreatment resistance to non-nucleoside reverse-transcriptase inhibitors (NNRTI) is increasing in low- and middle-income countries, creating demand for access to alternative non-NNRTI ARV drugs.

Although significant progress has been made towards ending AIDS as a public health threat, with 23.3 of the 37.9 million (62%) people living with HIV receiving antiretroviral therapy (ART) by the end of 2018, many gaps in service access and quality remain. The objective of this brief is to consolidate WHO guidance to support the implementation of high-quality HIV services through approaches to policy, strategy and service delivery, to suggest considerations for selecting measures of high-quality services and to provide case examples of quality management in HIV services in low- and middle- income countries.

An increasing number of countries are adopting policies endorsing PrEP for HIV prevention. Emerging evidence from clinical research that different dosing strategies can be effective provides an opportunity to offer flexibility, choice and convenience to individuals who can benefit from PrEP and is considered by WHO in updating its guidance to countries. Based on the available evidence published so far, this technical brief updates the current WHO recommendation on oral PrEP to include an option of event-driven dosing for men who have sex with men.  

The Start Free Stay Free AIDS Free report reveals a mixed story. The global targets set for 2018 have been missed by a wide margin in some subregions and countries. Some countries, however, have shown impressive progress and achieved success across all the target areas. These country examples demonstrate that success is possible and highlight the need for a paradigm shift in action across all focus countries to reach the targets by 2020. Fewer children newly infected with HIV and improved health for mothers living with HIV stand out as achievements of the global AIDS response in recent years.

The World Drug Report 2019 is again presented in five separate parts that divide the wealth of information and analysis contained in the report into individual reader-friendly booklets in which drugs are grouped by their psychopharmacological effect for the first time in the report’s history.  

Gains continue to be made against the epidemic, but those gains are getting smaller year-on-year. There has been steady progress in the reduction of AIDS-related deaths, but efforts to reach the 2020 target for reductions in HIV infections are clearly off-track.  Gains in eastern and southern Africa are driving global progress. In much of the rest of the world, there are worrying setbacks in key countries and entire regions. More than half of new HIV infections in 2018 were among key populations and their sexual partners. An epidemic transition metric suggests that a diverse group of 19 countries are on the path to ending AIDS. Many more countries are not.

This report provides the latest data on donor government resources available to address HIV in low- and middle-income countries, reporting on disbursements made in 2018. It is part of a collaborative tracking effort between UNAIDS and the Kaiser Family Foundation that began more than 15 years ago, just as new global initiatives were being launched to address the epidemic.  

The report highlights how communities are central to ending AIDS. Across all sectors of the AIDS response, community empowerment and ownership has resulted in a greater uptake of HIV prevention and treatment services, a reduction in stigma and discrimination and the protection of human rights. However, insufficient funding for community-led responses and negative policy environments impede these successes reaching full scale and generating maximum impact.