Publications

Cambodia has achieved remarkable success in reducing annual new HIV infections, from an estimated 15,000 in 1996 to 1,400 in 2022. However, rising HIV incidence among young people aged 15-24, particularly among men who have sex with men (MSM), transgender women (TG), and people engaged in sexualized drug use (chemsex) is counteracting reductions in new infections.  

This study was conducted from January to March 2023 with funding support through the Technical Support Mechanism of UNAIDS and was made possible through consultation and collaboration with national and international partners, as well as communities of key populations and people living with HIV.

Marked inequalities and diverse epidemic trends affect progress in the HIV response in Asia and the Pacific. The HIV epidemic in the region disproportionately affects people from key populations, especially young people (15–24 years), and their sexual partners. Young people accounted for around a quarter of new HIV infections in the region in 2022. In Cambodia, Indonesia, the Lao People’s Democratic Republic, Myanmar, the Philippines and Thailand, nearly half of new HIV infections occurred among young people. Median HIV prevalence among people from key populations remains much higher than among the general population. Since 2010, estimated numbers of new HIV infections among gay men and other men who have sex with men increased by six times in the Philippines, tripled in Cambodia and almost doubled in the Lao People’s Democratic Republic. The increasing use of stimulants and synthetic opioids exacerbates the risks of HIV transmission among people who use drugs.

LET COMMUNITIES LEAD - WORLD AIDS DAY 2023 The world can end AIDS, with communities leading the way. Organisations of communities living with, at risk of, or affected by HIV are the frontline of progress in the HIV response. Communities connect people with person-centred public health services, build trust, innovate, monitor implementation of policies and services, and hold providers accountable. But communities are being held back in their leadership. Funding shortages, policy and regulatory hurdles, capacity constraints, and crackdowns on civil society and on the human rights of marginalised communities, are obstructing the progress of HIV prevention and treatment services. If these obstacles are removed, community-led organisations can add even greater impetus to the global HIV response, advancing progress towards the end of AIDS. 2023 World AIDS Day — Let Communities Lead | UNAIDS  

Tuberculosis (TB) remains among the world’s top infectious killers. Each day, around 4000 people lose their lives to TB and around 30,000 people fall ill with this disease. This preventable and curable disease is deeply rooted in communities “left behind” - where poverty is pervasive and human rights and dignity are limited. The devastating social and economic impact on people affected and their families is profound. This Status Update provides an overview of progress towards global TB targets set in the political declaration of the first UN High-Level Meeting on TB, spanning the period 2018- 2022. It is based primarily on data compiled by WHO’s Global TB Programme from all Member States in annual rounds of data collection.

Over more than a decade, the world has made considerable progress in reaching women with services to reduce vertical transmission of HIV. Most countries have adopted lifelong ART to “treat all” pregnant women, regardless of their CD4 count, as part of a public health approach and one of the key objectives to achieve the elimination of mother-to-child transmission (EMTCT) of HIV. Yet, results of efforts to reduce the number of new paediatric HIV infections have fallen short against the 2020 Start Free target, among others; the goal of ending HIV and AIDS in children remains elusive. This key considerations document expands on the 2020 “last mile” operational guidance, with specific considerations for countries with lower HIV prevalence. It builds on the experiences of countries that have been validated for EMTCT of HIV and syphilis and translates the valuable lessons and promising practices of these countries into an operational framework for national programmes, consisting of 12 strategies and enablers to guide efforts towards Fast-Tracking EMTCT in lower prevalence countries.

The Operational guidance on adaptation and implementation of WHO’s Multisectoral Accountability Framework to end TB (MAF-TB) provides practical advice on key approaches and interventions needed to establish the MAF-TB at the national (and local) levels with concrete country examples, best practices and case studies under each suggested approach and interventions. 

PrEP Product Awareness, Preferences, and Past Experiences among Transgender Women and Men Who Have Sex with Men in Asia and Australia (PrEP APPEAL) was a survey study in 16 countries and territories in Asia and Australia. The overall goal of PrEP APPEAL was to identify values and preferences about PrEP, as well as barriers and facilitators to PrEP uptake, among men who have sex with men (MSM) and transgender women (TGW) in Asia and Australia. Key findings

• PrEP awareness was high with 81% of TGW, 80% of MSM in Asian low- and middle-income countries, 91% of MSM in high-income countries and 97% of MSM in Australia having heard of PrEP.
• Among participants who had heard of PrEP, 48% of TGW, 25% of MSM in Asian low- and middle-income countries, 19% of MSM in Asian high-income countries, and 47% of MSM in Australia were current PrEP users.
• Of those who had never taken PrEP, 57% of TGW, 72% of MSM in Asian low- and middle-income countries, 70% of MSM in Asian high-income countries, and 65% of MSM in Australia stated that they would like to take PrEP.
• Across all populations, cost was the most important driver of choice to use PrEP.
• The type of PrEP was the next most important driver of choice to use PrEP for TGW, MSM in Asian low- and middle-income countries, and MSM in Australia.
• Side effects were the second most important driver of choice to use PrEP for MSM in Asian high-income countries.

Drug use continues to be high worldwide. In 2021, 1 in every 17 people aged 15–64 in the world had used a drug in the past 12 months. The estimated number of users grew from 240 million in 2011 to 296 million in 2021 (5.8 per cent of the global population aged 15–64). This is a 23 per cent increase, partly due to population growth. Cannabis continues to be the most used drug, with an estimated 219 million users (4.3 per cent of the global adult population) in 2021. Use of the drug is increasing and although globally cannabis users are mostly men (about 70 per cent), the gender divide is reducing in some subregions; women account for 42 per cent of cannabis users in North America. It is estimated that in 2021, 36 million people had used amphetamines, 22 million had used cocaine and 20 million had used “ecstasy”-type substances in the past year. The proportion of female users is higher in the case of amphetamine-type stimulants (45 per cent of users are women) and non-medical use of pharmaceuticals (between 45 and 49 per cent of users are women), whereas the highest share of men is found in users of opiates (75 per cent) and cocaine (73 per cent). Opioids continue to be the group of substances with the highest contribution to severe drug-related harm, including fatal overdoses. An estimated 60 million people engaged in non-medical opioid use in 2021, 31.5 million of whom used opiates (mainly heroin).

Two decades ago, the global AIDS pandemic seemed unstoppable. More than 2.5 million people were acquiring HIV each year, and AIDS was claiming 2 million lives a year.  UNAIDS data show that today, 29.8 million of the 39 million [33.1 million–45.7 million] people living with HIV globally are receiving life-saving treatment. An additional 1.6 million people received HIV treatment in each of 2020, 2021 and 2022. The path to ending AIDS is clear. We have a solution if we follow the leadership of countries that have forged strong political commitment to put people first and invest in evidence-based HIV prevention and treatment programmes.