UNAIDS

In this report, UNAIDS is announcing that 18.2 million people now have access to HIV treatment. The Fast-Track response is working. Increasing treatment coverage is reducing AIDS-related deaths among adults and children. But the life-cycle approach has to include more than just treatment. Tuberculosis (TB) remains among the commonest causes of illness and death among people living with HIV of all ages, causing about one third of AIDS-related deaths in 2015. These deaths could and should have been prevented.

Start Free, Stay Free, AIDS Free initiative aims to galvanize global momentum around a shared and ambitious agenda to build on the progress achieved under the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. The Global Plan resulted in remarkable progress, reducing new HIV infections among children by 60% in 21 of the most affected countries in sub-Saharan Africa. Yet the job is far from done. In 2015, 150,000 [110,000–190,000] children became newly infected with HIV globally, 110,000 [78,000–150,000] of whom lived in the 21 Global Plan priority countries.

Young transgender people’s immediate HIV risk is related primarily to sexual behaviours, especially unprotected anal sex with an HIV positive partner, but structural factors in addition to those already noted make young transgender people especially vulnerable to HIV. Stigma and discrimination against transgender people frequently cause them to be rejected by their families and denied healthcare services, including access to HIV testing, counselling and treatment.

This technical brief is one in a series addressing four young key populations. It is intended for policy-makers, donors, service-planners, service-providers and community-led organizations. This brief aims to catalyse and inform discussions about: how best to provide health services, examples of programmes that may work well in addressing their needs and rights, and approaches and considerations for providing services, programmes and support for young men who have sex with men (MSM).

Greatly expanded access to routine viral load testing will be a game-changer in the global response to AIDS. Routine viral load tests improve treatment quality and individual health outcomes for people living with HIV, contribute to prevention, and potentially reduce resource needs for costly second- and third-line HIV medicines.

The AIDS movement, led by people living with and affected by HIV, continues to inspire the world and offer a model for a people-centred, rights-based approach to global health and social transformation. And yet, today, amid a swirl of competing and complex global concerns, we confront a serious new obstacle: the oppressive weight of complacency. This is happening when we know that if we make the right decisions and the right investments now, the end of AIDS can be within our grasp. This moment is, however, fleeting. We have a fragile window of opportunity—measured in months—in which to scale up.

This document explains the experiences of six countries in financing community responses through governmental mechanisms.

The latest UNAIDS data, covering 160 countries, demonstrate both the enormous gains already made and what can be achieved in the coming years through a Fast-Track approach. In just the last two years the number of people living with HIV on antiretroviral therapy has increased by about a third, reaching 17 million people—2 million more than the 15 million by 2015 target set by the United Nations General Assembly in 2011. Since the first global treatment target was set in 2003, annual AIDS-related deaths have decreased by 43%. In the world’s most affected region, eastern and southern Africa, the number of people on treatment has more than doubled since 2010, reaching nearly 10.3 million people. AIDSrelated deaths in the region have decreased by 36% since 2010.

Sixteen years of progress since the International AIDS Conference was last held in Durban. Millions of lives saved. But to end the AIDS epidemic there are new milestones to reach, barriers to break and frontiers to cross.

The Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive (Global Plan) has been operational at country level for the past four years. It prioritizes the 22 countries that, in 2009, accounted for 90% of the global number of pregnant women living with HIV who were in need of services to prevent mother-to-child transmission. This report presents country performance in 2014 and is based on country-developed models using Spectrum software (see “A note on measurement” at the end of the document).