Worldwide, around 14 per cent of people currently infected with the virus don't know their HIV status. In West and Central Africa, one in five people living with HIV didn't know their HIV-positive status at the end of 2022. Once someone is diagnosed with the disease, viral load monitoring - measuring the levels of HIV virus in the blood - is essential to measure whether treatment is working. While annual viral load tests are standard in wealthy countries, access in developing countries still lags far behind.

There is no cure for HIV, although life-long treatment using combinations of drugs known as antiretrovirals (ARVs) helps manage the virus and enables people to live longer, healthier lives if taken regularly. While 22 million more people are on treatment today than in 2010, deadly treatment gaps still exist, especially among children.  In the Middle East and North Africa; in the latter, only half of people living with HIV receive ARVs, while the number in Eastern Europe and Central Asia is 51 per cent.

While most people living with HIV can stay healthy on first-line antiretrovirals - which cost around US$63 per person per year – some people develop resistance to this regimen and have to switch to second-line regimens. But the price of doing so is high - literally. Second- and third-line regimens are over four times the price of first-line regimens.

In conflict settings and when people are displaced, ensuring the continuity of care for people with HIV - including long-term supply of drugs - can be difficult. Logistical and security issues are barriers for both our teams and patients in ensuring that people living with HIV can access the care and treatment they need to stay healthy. In Yemen, providing uninterrupted treatment during years of war has proved logistically challenging - and dangerous to our staff and patients.

So called ‘key populations’, or groups of people, include people who are disproportionately affected by HIV, including sex workers, people who inject drugs, men who have sex with men, and prisoners. Despite their higher risk of acquiring HIV, these key groups are often excluded from accessing HIV treatment and prevention as well as comprehensive health services. Stigma, discrimination, social exclusion, violence and criminalisation are part of their daily struggles. In Mozambique, MSF provides packages of HIV and sexual and reproductive healthcare services for sex workers and men who have sex with men in key sites.

HIV lowers the body's immune response, and without effective treatment, leaves people living with the disease much more vulnerable to deadly opportunistic infections like tuberculosis (TB). TB is the single biggest killer of people living with HIV, accounting for  the death of 214,000 people living with HIV in 2020.