Advertisement

The New Epidemiology of Human Immunodeficiency Virus Infection

  • Enrico GirardiEmail author
Chapter
  • 119 Downloads

Abstract

The overwhelming majority of infection with the Human Immunodeficiency Virus (HIV) is acquired worldwide through sexual contacts. Risk of transmission is higher through anal sex, in presence of ulcerative genital lesion and when the source has high HIV viremia. Conversely, it is reduced by male circumcision, consistent condom use and it is virtually zero when the infected persons in under antiretroviral therapy and has undetectable viremia.

Globally, HIV incidence peaked in the mid-1990s and then slowly decreased. Presently, about two million new infections are estimated to occur each year, and more than 38 million people are estimated to live with HIV/AIDS, most of them in sub-Saharan Africa.

Almost in all settings, some population groups, also called key populations, are disproportionately affected by HIV infection. According to WHO key populations are men who have sex with men, people who inject drugs, sex workers, transgender people, and people in prisons and other closed settings.

Providing effective antiretroviral therapy to all those in need is presently a cornerstone of the efforts to end HIV epidemic. In 2014 UNAIDS has launched to 90-90-90 target, whereby, by the year 2020, 90% of people living with HIV globally know their HIV status, 90% of those who know their HIV status had access to antiretroviral therapy, and 90% of people on treatment had suppressed viral loads.

References

  1. 1.
    De Cock KM, Jaffe HW, Curran JW. The evolving epidemiology of HIV/AIDS. AIDS. 2012;26(10):1205–13.CrossRefPubMedGoogle Scholar
  2. 2.
    Fox J, Fidler S. Sexual transmission of HIV-1. Antivir Res. 2010;85(1):276–85.CrossRefPubMedGoogle Scholar
  3. 3.
    Vernazza P, Hirschel B, Bernasconi E, Flepp M. Les personnes séropositives ne souffrant d’aucune autre MST et suivant un traitement antirétroviral efficace ne transmettent pas le VIH par voie sexuelle. Bull Med. Suisse. 2008;89(5):165–9.CrossRefGoogle Scholar
  4. 4.
    Patel P, Borkowf CB, Brooks JT, Lasry A, Lansky A, Mermin J. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014;28(10):1509–19.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    LeMessurier J, Traversy G, Varsaneux O, Weekes M, Avey MT, Niragira O, Gervais R, Guyatt G, Rodin R. Risk of sexual transmission of human immunodeficiency virus with antiretroviral therapy, suppressed viral load and condom use: a systematic review. CMAJ. 2018;190:E1350–60.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Schneider MT, Birger M, Haakenstad A, et al. Tracking development assistance for HIV/AIDS: the international response to a global epidemic. AIDS. 2016;30:1475–9.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Granich R, Gupta S, Hersh B, et al. Trends in AIDS deaths, new infections and ART coverage in the top 30 countries with the highest AIDS mortality burden; 1990–2013. PLoS One. 2015;10:e01313532.CrossRefGoogle Scholar
  8. 8.
    Abdool Karim SS, Hecht R, et al. Defeating AIDS—advancing global health. Lancet. 2015;386:171–218.CrossRefPubMedGoogle Scholar
  9. 9.
    GBD 2015 HIV Collaborators. Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2015: the Global Burden of Disease Study 2015. Lancet HIV. 2016;3:e361–8.CrossRefGoogle Scholar
  10. 10.
  11. 11.
    UNAIDS. Fast-track - ending the AIDS epidemic by 2030. http://www.unaids.org/en/resources/documents/2014/JC2686_WAD2014report.
  12. 12.
    UNAIDS. Making the end of AIDS real: consensus building around what we mean by ‘epidemic control’. 2017. http://www.unaids.org/sites/default/files/media_asset/glion_oct2017_meeting_report_en.pdf.
  13. 13.
    Sidibé M, Loures L, Samb B. The UNAIDS 90–90–90 target: a clear choice for ending AIDS and for sustainable health and development. J Int AIDS Soc. 2016;19(1):21133.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Wilson D, Halperin DT. “Know your epidemic, know your response”: a useful approach, if we get it right. Lancet. 2008;372(9637):423–6.CrossRefPubMedGoogle Scholar
  15. 15.
    World Health Organization Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations – 2016 update. Geneva: WHO; 2016.Google Scholar
  16. 16.
    Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, Brookmeyer R. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Degenhardt L, Peacock A, Colledge S, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Health. 2017;5(12):e1192–207.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Baral S, Beyrer C, Muessig K, et al. Burden of HIV among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Infect Dis. 2012;12:538–49.CrossRefPubMedGoogle Scholar
  19. 19.
    Platt L, Jolley E, Rhodes T, et al. Factors mediating HIV risk among female sex workers in Europe: a systematic review and ecological analysis. BMJ Open. 2013;3:e002836.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Shannon K, Strathdee SA, Goldenberg SM, et al. Global epidemiology of HIV among female sex workers: influence of structural determinants. Lancet. 2015;385:55–71.CrossRefPubMedGoogle Scholar
  21. 21.
    Paz-Bailey G, Noble M, Salo K, Tregear SJ. Prevalence of HIV among U.S. female sex workers: systematic review and meta-analysis. AIDS Behav. 2016;20:2318–31.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Oldenburg CE, Perez-Brumer AG, Reisner SL, et al. Global burden of HIV among men who engage in transactional sex: a systematic review and meta-analysis. PLoS One. 2014;9(7):e103549.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Poteat T, Scheim A, Xavier J, Reisner S, Baral S. Global epidemiology of HIV infection and related syndemics affecting transgender people. J Acquir Immune Defic Syndr. 2016;72(Suppl 3):S210–9.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Dolan K, Wirtz AL, Moazen B, Ndeffo-Mbah M, Galvani A, Kinner SA, Courtney R. Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees. Lancet. 2016;388:1089–102.CrossRefPubMedGoogle Scholar
  25. 25.
    Wirtz AL, Yeh PT, Flath NL, Beyrer C, Dolan K. HIV and viral hepatitis among imprisoned key populations. Epidemiol Rev. 2018;40:12–26.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Clinical Epidemiology UnitNational Institute for Infectious Diseases “L. Spallanzani” – IRCCSRomeItaly

Personalised recommendations