World AIDS Day: Where are we now with HIV?

HIV statistics and data

According to the World Health Organization, there are 38.4 million people living with test HIV around the world. Additionally, 1.5 million acquired HIV and 650,000 people died of HIV-related causes in 2021. Currently, Africa has the highest number of HIV cases¹.

Despite advancements in treatments, test HIV continues to be a major public health issue. It has claimed more than 40 million lives since the start of the epidemic. However, with increasing access to HIV prevention, diagnosis and treatment, it has become a manageable chronic - long-term - health condition.

Although there are often big news stories about potential cures or vaccines for HIV, it's important to keep focusing on prevention, says Adam Freedman, senior policy and campaigns officer at the National AIDS Trust.

"While we welcome such new developments, and the pursuit for better prevention and treatment must always continue, it’s important to note that we already have the scientific tools we need to end the test HIV epidemic," he says. "These are testing, oral PrEP and effective treatment which means that people living with the virus can't pass it on."

PrEP treatment

Currently, the drug PrEP - short for pre-exposure prophylaxis - is available for people at risk of contracting HIV. It works by helping the body to produce antibodies which prevent HIV from replicating inside the body. Essentially, the drug stops the virus from crossing into the healthy cells and reproducing. PrEP is usually taken in oral pill form, but it can also be administered by a vaginal ring or injection.

People who are test HIV positive go on a lifelong treatment called antiretroviral therapy as soon as possible after being diagnosed. Antiretroviral therapy is a combination of drugs that stop the virus from replicating in the body, allowing the sistema immunitario to repair itself.

HIV injection

In recent years, one of the most significant developments in test HIV medicine has been the introduction of long-acting, injectable treatment for people who are HIV positive. This means that instead of having to take a pill every day, people living with HIV can receive an injection once every two months instead.

"This treatment has recently been approved for use in the UK among some people, though yet to be widely adopted," says Freedman. "It bears repeating that the medication we already have for HIV - antiretroviral therapy - works extraordinarily well. Not only does it prevent transmission, but people living with HIV on effective treatment can now lead as full and healthy lives as anyone."

Search for a HIV cure

For around 40 years, scientists all over the world have been trying to find a cure for test HIV. As of yet, there isn't one - but researchers have still made huge steps forward in their search. Earlier this year, a team of Danish researchers from Aarhus University discovered how experimental medicines can boost the body's own ability to suppress the virus, which is an important move towards a cure².

Researchers at the Universities of California, San Francisco and Davis, are also experimenting with a so-called 'living drug' that could lead to long-term HIV remission without antiretroviral drugs. The first clinical trial participant has been treated with an experimental CAR-T cell therapy, a specialist type of immunotherapy used to treat some cancers³.

HIV vaccine

Another important ongoing avenue of research is the HIV vaccino. In theory, people who are HIV positive would get this vaccine to help strengthen their immune system’s response to the virus without the need for antiretroviral treatment. So far, progress has been slow because most traditional vaccines use a dead or weakened form of a virus to trigger the body to create antibodies against it.

However, that hasn't worked with test HIV - and a live form of the virus is too dangerous. But researchers may be making progress with a different type of vaccine. The HTI vaccine, which is in the early stages of being trialled, teaches immune cells called T-cells to attack a specific part of the virus that allows it to make copies of itself⁴.

HIV implant

Researchers are also exploring the possibility of implants - usually used to provide hormones as a contraceptive - to deliver antiretroviral drugs to people with HIV. Implants are in the early stages of clinical development, but they would potentially provide the treatment for a year or longer without the need for daily pills or frequent injections⁵.

1. World Health Organization: HIV.

2. Gunst et al: Early intervention with 3BNC117 and romidepsin at antiretroviral treatment initiation in people with HIV-1: a phase 1b/2a, randomised trial.

3. Cancer Research UK: CAR-T cell therapy.

4. Bailon et al: Safety, immunogenicity and effect on viral rebound of HTI vaccines in early treated HIV-1 infection: a randomised, placebo-controlled phase 1 trial.

5. Weld et al: Long-acting implants to treat and prevent HIV infection.