Before we dig into where we are now, let’s take a moment to remember and honor those we have lost to HIV/AIDS.
This Nerd lost Stuart and Bob, uncle figures and mentors in my childhood and young adulthood. I credit them for my love and passion for public health.
Here’s a TL;DR of HIV updates:
Quick Facts:
- 40.8 million people worldwide have HIV (about the population of Canada)
- 1.3 million new infections in 2024, and nearly a quarter of people with HIV still aren’t on treatment
- We have powerful tools to prevent and treat HIV, but funding has been declining
Game-Changing Tools:
Long-acting injectable PrEP is a twice-yearly shot that prevents HIV infection — way easier than daily pills.
PEPFAR just announced plans to get this to 2 million people in high-burden countries by 2028!
U=U (Undetectable = Untransmittable) is when someone with HIV takes their daily medication and reaches an undetectable viral load, they cannot transmit the virus to anyone else. Adequate treatment stops transmission.
Why This Matters to Everyone:
Even if you don’t have HIV or know someone who does, treatment access affects all of us. When people can access antiretroviral therapy, they can’t spread the virus, meaning fewer new infections globally.
But right now, massive cuts to PEPFAR (which has saved 26 million lives) are disrupting services worldwide, causing thousands of health worker layoffs and service shutdowns. One study predicts these cuts could lead to 565,000 new HIV infections over the next decade in sub-Saharan Africa alone.
Bottom line: Treatment and prevention work, but only if people can access them. Global health is connected. What happens in one region affects us all.
Click here to reach your representative to let them know how you feel about global health funding.
Read on for a deeper dive.
HIV/AIDS has been a critical health challenge affecting our globe since the early 1980s. As a reminder, HIV (Human Immunodeficiency Virus) is the virus that causes the disease we call AIDS – Acquired Immunodeficiency Syndrome. HIV leads to AIDS when folks don’t have access to treatment.
Approximately 40.8 million people currently have this virus worldwide. For perspective, that’s roughly the entire population of Canada. 1.3 million people globally became newly infected with HIV in 2024.
Approximately 630,000 people in 2024 and 44.4 million people since the start of the epidemic are estimated to have died from HIV-related illnesses worldwide.
31.6 million people were accessing antiretroviral therapy in 2024. We will return to this in a moment.
HIV is not just an issue for gay men, as it was once (wrongly) assumed to be.
Over half of those living with HIV are women and girls. It’s not just a health issue but a window into gender disparities and biology.
Click here for more on why female biology makes women and trans men vulnerable to transmission.
About 1.5 million children have HIV.
Thankfully, we now have a pretty robust toolkit for addressing HIV.
- Behavior change programs: think education, awareness, harm reduction: condom use, needle exchange, etc.
- PrEP: a preventative antiviral medication taken by those who are HIV-negative and want to protect themselves from getting the virus.
- We now have a twice yearly injection that makes PrEP incredibly more accessible!
- The U=U concept, that is, “Undetectable equals Untransmittable,” is a game-changer in how we view HIV transmission. When a person takes treatment medication every day and reaches an undetectable viral load, they are unable to pass the HIV virus on to anyone else.
- Treatment-wise, we use antiretroviral therapy (ART), a blend of medications that are not a cure but a powerful way to manage the virus. Antiretroviral therapy is so powerful that when taken as prescribed, it can make viral load undetectable in the blood, preventing virus transmission.
This toolkit has one glaring exception: a vaccine. Despite massive brainpower and resources funneled into research, an HIV vaccine has been elusive so far. One major reason this is so challenging is that the HIV virus evolves extremely rapidly – it’s common to find different variants even within the same person. HIV makes the SARS-CoV-2 virus look like an evolutionary slowpoke!
Globally, countries and organizations pooled $22.4 billion in 2022 to tackle this virus. HIV funding dropped between 2022 and 2023. Individual countries are giving less money directly, and international organizations haven’t fully made up the difference. HIV funding still hasn’t reached the peak it hit ten years ago. Meanwhile, we’ve made real progress fighting HIV, but new infections are actually increasing in some places. Certain groups face higher risk and can’t get the prevention care they need, and nearly a quarter of people living with HIV still aren’t getting treatment.
Have you heard of PEPFAR?
The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) was created in 2003 to address the global HIV/AIDS crisis.
It is estimated that PEPFAR has saved 26 million lives and prevented 7.8 million babies from being born with HIV. The “spillover” effects include
improvements in childhood vaccinations, economic growth, and kids staying in school.
What is happening in 2025 (from KFF):
- The administration froze all PEPFAR funding and ordered programs to stop work, forcing thousands of staff layoffs and ending services
- A limited exception was granted in February allowing only some HIV services to continue (treatment, testing, and prevention for pregnant women) but not others (like PrEP for most people or programs for kids affected by HIV)
- USAID, which ran 60% of PEPFAR programs, was dissolved
- 86% of all USAID awards were canceled, including 71% of HIV programs
Current Funding:
- 2025 funding stayed level at $4.85 billion
- The proposed 2026 budget cuts PEPFAR by $1.9 billion
Real-World Impacts:
- Thousands of HIV health workers lost jobs in Kenya, Malawi, South Africa, and Mozambique
- Treatment and testing services were disrupted for pregnant people and children in Zimbabwe
- Community outreach stopped partially or completely in Angola and Eswatini
- Ukraine’s largest network of people living with HIV expects to lose 25% of its workforce
- Half of WHO country offices reported moderate to severe disruptions to HIV services
- One study estimated that defunding PEPFAR could cause 565,000 new HIV infections over 10 years in sub-Saharan Africa
One piece of good news:
In September, 2025, the administration announced that PEPFAR would partner with the Global Fund to support providing long-acting injectable PrEP, that twice yearly injection prevention medicine mentioned earlier, to up to 2 million people in high-burden countries by 2028!
Now, let us explore the most vulnerable groups for HIV across the U.S., Canada, the UK, and globally.
Historically, this infection was framed as being limited to gay men, but the truth is people of any gender or sexual orientation are at risk if a person with the virus shares semen, pre-seminal fluid, blood, human milk, vaginal/cervical fluid, or rectal fluid.
Because of the lack of access to health care due to racism, stigma, transphobia, homophobia, economic oppression, and/or misunderstanding in the community of who is at risk, the following groups are particularly vulnerable:
- Women, pregnant women, teens, infants, and children
- Ethnic and racial minoritized people (of a given region)
- Transgender people
- Cis-gender men who have anal sex with other cis-gender men
- People who are economically disadvantaged
- People who exchange sex for money or other necessities
- People who inject drugs
- Indigenous peoples of colonized lands
The impact of HIV on the transgender and nonbinary communities is significant and distinct from the general population, with various factors influencing their risk and experiences. Here’s an overview based on the latest data:
Global Perspective: A study of HIV in transgender populations around the world (2000-2019) found that roughly 1 in 5 trans women and 1 in 40 trans men were affected by HIV (results varied a lot by country). By comparison, roughly 1 in 150 adults aged 15-49 years old worldwide are living with HIV.
Of note, for many regions, data on trans folks is not collected. This lack of data underscores the need for better understanding and targeted support for trans individuals.
Given the diverse and complex nature of the epidemic and the people who are affected, tailored education, prevention, and treatment strategies with an eye toward inclusive, culturally competent, and accessible healthcare is a priority.
In knowledge, in science, and in remembrance,
Those Nerdy Girls &+
References and resources for more information:
Kaiser Family Foundation (KFF). The Global HIV/AIDS Epidemic
Understanding female biology and HIV Risk
A Proclamation on World AIDS Day, 2023 [archived link]
Canada’s progress towards ending the HIV epidemic
UK HIV statistics – National AIDS Trust
