Advances in human immunodeficiency virus (HIV) treatment have led to a steep decline in HIV-related deaths around the world. In 1992, HIV was the leading cause of death among men ages 25–44 in the United States.

By 2019, it dropped to the ninth leading cause of death in people ages 25–34 and the 10th leading cause for those ages 35–44. Similar declines have been seen even in the hardest-hit parts of Africa.

Overall, deaths from HIV have fallen by 51% from the year 2000 through the year 2019, moving from the world’s eighth leading cause of death in 2000 to 19th in 2019. Even so, in underdeveloped countries, it remains among the 10 leading causes of death.

This article will discuss the current data on HIV deaths, how they’ve changed over time, and efforts to reduce them further.

According to the World Health Organization (WHO), more than 36 million people have died of HIV since the start of the HIV/AIDS pandemic. In 2020, 37.7 million people were living with HIV, and around 680,000 died. As grim as these figures are, that’s still down from the 1.3 million people who died of HIV just 10 years earlier.

HIV deaths remain high in sub-Saharan Africa, which accounts for more than half of all infections worldwide. Other countries in Central Africa, Asia, and South America also continue to experience a higher rate of HIV-related deaths.

In 2020, the 20 countries with the highest number of HIV deaths were:

  • South Africa: 71,000Mozambique: 54,000Nigeria: 53,000Indonesia: 38,000Kenya: 25,000United Republic of Tanzania: 24,000Uganda: 23,000Zimbabwe: 22,000Cameroon: 18,000Thailand: 18,000Zambia: 17,000Cote d’Ivoire: 16,000Ghana: 14,000Angola: 14,000Democratic Republic of Congo: 13,000Malawi: 13,000South Sudan: 9,900Ethiopia: 11,000Brazil: 9,900Myanmar: 7,800

U.S. Deaths

In the United States, more than 700,000 adults and children have died of HIV-related complications since the start of the epidemic in 1981.

Recap

More than 36 million people have died of HIV since the start of the HIV/AIDS pandemic. Sub-Saharan Africa continues to account for the lion’s share of HIV infections and deaths worldwide.

Today, more than 1.2 million people are living with HIV in the United States, with more than 35,000 new infections occurring each year. Men who have sex with men (MSM) account for 70% of all new infections. Black people account for 42% of all new infections although they make up just 13% of the U.S. population.

The Department of Health and Human Services (HHS) has reported that 15,815 people with HIV died of any cause in the United States in 2019. Of those, 5,044 were believed to have died of HIV-related complications.

As a sign of hope, the rate of HIV deaths in the United States fell by nearly half from 2010 to 2017.

Gains and Losses

The reduction in HIV deaths worldwide corresponds to the reductions in new HIV cases. Some of the greatest gains have been seen in East Africa and Southern Africa, where HIV deaths have been on the decline since 2010.

Of the estimated 1.2 million people living with HIV in the United States, around 5,000 died of HIV-related complications in 2019. Since the start of the pandemic in 1981, over 700,000 adults and children have died.

The opposite is true in over 50 countries around the world where infection rates continue to climb. This includes countries in Eastern Europe and central Asia where the infection rate increased by 27% between 2010 and 2018. Rates have also increased in parts of the Middle East and North Africa.

Some of these increases are due to high rates of injecting drug use. As opposed to most parts of the world where sex is the main route of infection, shared needles are considered the main route of infection in places like Russia.

The Way Forward

As of 2021, 27.4 million people living with HIV were on antiretroviral therapy, up from 8 million in 2010. While this leaves over 10 million people still untreated, the United Nations intends to narrow the gap with their ambitious 90-90-90 strategy, which aims to end the pandemic by 2030.

While the HIV infection rate has been on the decline even in hardest-hit parts of Africa, other countries have seen increases. This includes Russia, where injecting drug use, not sex, is the main route of infection.

The primary goals of the 90-90-90 strategy were meant to be met by 2020, namely:

  • Diagnosing 90% of people living with HIV worldwide
  • Placing 90% of the diagnosed people on treatment
  • Ensuring 90% of those on treatment have an undetectable viral load

While many countries were able to meet these targets, the strategy fell short overall. By the end of 2020, a total of 81% of people were diagnosed, 67% were treated, and 59% achieved an undetectable viral load. Declining financial support from wealthier countries continues to hinder the efforts of the United Nations.

The United States fared no better by comparison. While 87% of people living with HIV were diagnosed in the United States, only 66% received care and only 57% achieved an undetectable viral load.

Summary

Since the start of the HIV/AIDS pandemic, more than 36 million adults and children have died of HIV, Even so, the death rate worldwide has dropped by more than 50% in the last decade. This includes many of the hardest-hit countries in Africa.

Today, over 27 million people with HIV are on antiretroviral therapy. A push to treat the remaining 10 million has been hindered by dwindling financial support from wealthier nations.

Global efforts to end the pandemic by 2030 have led to increased rates of testing and treatment among the 37.7 million people living with HIV. Even so, targets have fallen short. Increased global support is needed to meet the 2030 goals, but dwindling financial aid from wealthy countries continues to hinder the effort.

Frequently Asked Questions

  • What is antiretroviral therapy?
  • Antiretroviral therapy involves taking multiple HIV medicines daily. While antiretroviral therapy doesn’t cure HIV, it can lower the virus to undetectable levels where it can do the body little harm.
  • Learn More:
  • Antiretrovirals Overview
  • Where did HIV come from?
  • HIV is thought to have originated in Central Africa, where it jumped from monkeys to humans (likely due to the consumption of monkey meat). Studies suggest that the virus may have spread to humans as early as the late 1800s. HIV is believed to have arrived in the United States sometime in the 1970s.

Antiretroviral therapy involves taking multiple HIV medicines daily. While antiretroviral therapy doesn’t cure HIV, it can lower the virus to undetectable levels where it can do the body little harm.

HIV is thought to have originated in Central Africa, where it jumped from monkeys to humans (likely due to the consumption of monkey meat). Studies suggest that the virus may have spread to humans as early as the late 1800s. HIV is believed to have arrived in the United States sometime in the 1970s.