2024 年艾滋病预防记分卡概述

Keyinsightsfrom2024GlobalHIVPreventionscorecardsWebinar31October2024WhatWillSuccessLookLikeThe2025high-levelHIVpreventiontargetsandcommitmentsAn82.5%reductioncomparedto20101.3millionnewHIVinfectionsin2023:morethan3timesthe2025targetHIVhasrisenineasternEuropeandcentralAsia,theMiddleEastandNorthAfricaandLatinAmerica-onlyslowdeclinesinAsia-PacificSource:UNAIDSepidemiologicalestimates,2024(/).Declinesinnewinfectionsinsub-SaharanAfrica,butnotfastenough.Globaltargetswillbemissed,primarilyduetostagnationinotherregionsChangeinthenumbersofpeople(allages)acquiringHIV,byregion,2010–2023NewHIVinfectionsdeclinedfasterinGPCfocuscountriesthanothercountriesglobally

(2016-2023)Note:DirectattributionofprogresstoGPCmembershipisnotpossible.However,thecollectiveintensiveeffortsofgovernments,communitiesandinternationalfundersinthesefocuscountriesoverthepastdecadelikelyexplainstheacceleratedprogress.LargevariationofprogressEight

GPCfocuscountrieshavereducedtheirannualnumberofnewHIVinfectionsbyatleast66%since2010.

Themajorityofcountriesneedtoaccelerate

toachieve2025targets.*No2024estimatesreportedforBrazil,

Cameroonand

Central

AfricanRepublic

104%543%609%

.../......./....../...Fiveprioritypillars,accessplatformsandfoundationsguidingtheresponse

[1]Global2025targetsforcondomusevarybylevelofHIVincidenceinageographicalareaandbyindividualrisk.Theyaresetat95%forpeopleathighestriskand70%and50%forpeopleamoderateandlowrisk.Sincedatapresentedhereareforapopulationathighrisk(peoplewithnon-regularpartners)inanentirecountry,abenchmarkof80%hasbeenincludedasaproxyforthetargets.[2]

Thebenchmarkof21.2millionusersisbasedontheglobalPrEPtargets,whichtranslateinto10.6millionperson-yearsofPrEP.AnassumedaveragedurationofPrEPuseof6monthsperyearthusyieldsthebenchmarkof21.2millionusers.Source:UNAIDSepidemiologicalestimates,2024

.Despiteprogressmade,preventionisofftracktomeet2025targetsIncreasingslowlyoverall

(butnotconsistently)Decreasingoverthepast6yearsIncreasinginmostcountriesIncreasingrapidly,butfarfromtargetPillarIndicatorBenchmarkinlinewith2025targets2023reportingKeypopulationsPercentagewhoreceivedatleasttwoHIVpreventioninterventionsintheprevious3monthsSexworkers90%55%Gaymenandothermenwhohavesexwithmen90%30%Peoplewhoinjectdrugs90%40%AdolescentgirlsandyoungwomenLocationswithmoderateandhighHIVincidencewithaprogrammeforadolescentgirlsandyoungwomen90%52%Condomusewithnon-regularpartnersamongyoungwomen80%38%BoysandmenAnnualnumberofvoluntarymedicalmalecircumcisions5million2529595CondomsCondomusewithnon-regularpartnersamongmen80%63%ARV-basedpreventionPercentageofpeoplelivingwithHIVreceivingantiretroviraltherapy90%77%NumberofpeoplewhousedPrEPatleastoncein2022212000003512471Goodcountryexamplesinallpillars:CountrieswithsteeperdeclineswithprogressintreatmentandprimarypreventionPreventionwithkeypopulations(countrieswithmixedepidemics):

Goodexamples(moreforsexwork),butmajorgapsinscale,accessanddataoverallPreventionwithkeypopulations(GPCfocuscountrieswithconcentratedepidemics):

Severalcountrieswithconsistentprogrammesanddata,butmajorgapsincoverageandoutcomesoverall

(largerforgaymenandothermenwhohavesexwithmen,peoplewhoinjectdrugs,transgenderpeople)AccesstosafeinjectingequipmentremainstoolowFourcountriesaboveGPCscorecardbenchmarkshowitcanbedoneKeypopulations–structuralbarriersandenablers(GPCfocuscountrieswithmixedHIVepidemics)

-Packagesinplaceforsexworkers&menwhohavesexwithmenbutincomplete-largegapsforotherpopulations

-Lackofdataonstigmainhealthcare

-Criminalizationpersists

Keypopulations–structuralbarriersandenablers(GPCfocuscountrieswithconcentratedepidemics)

-Packagesinplacebutincomplete

-Lackofdataonstigmainhealthcare

-Criminalizationpersists,mostwidelyforsexworkanddruguse

Adolescentgirlsandyoungwomen:DecliningnewHIVinfections,butwithgreatvariationTrendsbroadlyalignedtoadulttrends8countrieswithdeclinesofmorethan2/34countrieswithstagnatingorrisingtrendsDeclinesslowerthanamongmalepeersAdolescentgirlsandyoungwomen:BehavioralandcondomusepatternsGreatvariationincondomusebetweencountries,butdeclinesincondomuseamongyoungwomenandmenincountrieswithrecentsurveysYoungwomenlagbehindmenincondomaccessinsomecountriesIncreasesincoverageoflayeredAGYWprogrammesindistrictswithhighHIVincidenceinAGYWfocuscountriesofPEPFARandGF–lackofdataandprogrammesinothersAdolescentgirlsandyoungwomen–selectedstructuralbarriers(GPCfocuscountrieswithmixedepidemics)

-Variationincompletionofsecondaryeducation

-CSEpoliciesinplace(implementation?)

-Sixcountrieswithageofaccessrestrictionsforallbelowage18Condoms:Gainsmadearebeinglost:DeclinesincondomuseCondomuseatlasthigherrisksex(withanon-marital,non-cohabitingpartner)[Women,15-49]

InequitiesinaccessWomenandmenwithlowerincomeinAfricaconsistentlyleftbehindTrendsincondomdistributionviamajorcondomprocurersanddistributors,2010-2022DeclininginvestmentandvolumesincondomprocurementandsocialmarketingA27%reductioncomparing2010-16and2016-2022A37%reductionfromthepeakSocialmarketingvolumesreducedbyhalf37.5millionmenandboysaccessedVMMCpackageofservicesby2023-

ButVMMC,otherpreventionandtreatmentcoverageformen&boysremainsfarfromtargetsSources:Coveragemaps-specialanalysisbyAvernirHealththroughtheUNAIDS-ledVMMCdataworkstream.AnalysisdoneusingDMPPT2Toolandintegrated3MCmodelusingdataupanduntil2023.VMMCprogressovertime:UNAIDSGlobalAIDSMonitoring,2023;)IntegratedmaleSRHRforboysandmenincludingHTS/ARTandgender-transformativeapproachesNofullrecoveryafterCOVID-19NumberofmenandboysaccessingVMMCpackageofservicesEstimatedcoverageofVMMCamongmen15-49GrowingnumbersofpeopleusingPrEP:3.5millionin2023,butthisisjust16%ofestimatedglobalneedNumberofpeopleusingPrEPin2023,relativeto2025targetsSource:UNAIDSepidemiologicalestimates,2024.

.Smallerepidemics LargerepidemicsSomecountriesaregettingclosetothelevelofPrEPcoverageimpliedinglobaltargets,

butthemajorityarefarbelowInsummary:Programmaticoutcomesimprovedinfouroffiveprioritypillars,butmajorgapsremaininallMoreareaswithhighHIVincidencehaveprogrammeswithAGYWSmallincreasesincoverageofprogrammeswithkeypopulations

(eventhoughthisislimitedtoKPswithavailabledata,inparticularsexworkers,inanumbercountrieswithavailabledata,andcoveragestagnatesinotherareas)Anadditional20millionmenaccessedVMMCsincetheonsetoftheGPC

(eventhoughuptakedeclinedafter2020inacontextofdecliningfunding)RapidincreasesinthenumberofpeopleusingPrEP

(butlargegapstotargetsremain)Condomdistributionandusecontinuestodeclineinseveralcountrieswithrecentdata

(butmorerecentlyincreasesinGFin