Unit 2: HIV and AIDS
The cornerstone of managing the global HIV epidemic, which has taken over 44.1 million lives
since it was identified, is clinical prevention of HIV and AIDS. Due to the efficacy of
antiretroviral medication, HIV is a chronic illness even though a cure is still unattainable. The
objective of stopping the global HIV pandemic is now achievable when combined with
important developments in prevention. In order to achieve the best possible patient and
population outcomes, current interventions recognize the complexity of clinical management and
take into account socioeconomic issues, patient-centered care, ongoing quality improvement, and
the significance of social and regulatory settings.
In order to prevent the diagnosis of AIDS, this activity thoroughly examines HIV transmission,
pathophysiology, clinical manifestations, evaluation, current treatment, reporting, and
implementation issues for particular demographic groups. Clinicians become more
knowledgeable, skilled, and competent in managing HIV, enhancing patient outcomes, lowering
transmission rates, and supporting international efforts to eradicate the disease. The importance
of the interprofessional team is emphasized, with a focus on cooperation between members of
the clinical, public health, and interdisciplinary teams.
Objectives:
1. Recognize the stage of HIV and accompanying comorbidities so that patients can be
diagnosed and treated timely.
2. Use the principles of antiretroviral therapy and prophylaxis of opportunistic infections to
avoid and treat side effects.
3. Interpret HIV treatment guidelines to be sensitive to the culture and confidentiality of
particular patients and affected populations.
4. Collaborate with interprofessional team members to guarantee continuity of care,
enhance patient outcomes for HIV prevention and treatment, and lower the risk for AIDS.
Introduction
Since its discovery in 1983, HIV has killed about 44.1 million people globally as of 2024. This
figure is startling, and HIV could become a worldwide health emergency if it is not addressed.
,Nonetheless, the HIV epidemic has been contained because to the creation, research, and general
accessibility of highly active antiretroviral treatments (ARTs). Similarly, HIV and opportunistic
infections are becoming treatable chronic illnesses because to advancements in treatment. HIV
patients can lead long, healthy lives. Because of the underlying immunodeficiency in this
population, preventing chronic illnesses is a high concern.
The 95-95-95 goals set forward by the UN General Assembly are achievable with sufficient
funding and scientific advancements in prevention, treatment, and execution. According to
estimates, 87% of all HIV-positive individuals were aware of their condition in 2024, 89% of
those who were aware of their status were on antiretroviral therapy, and 94% of those getting
treatment had a suppressed viral load.[UNAIDS. [Global Statistics Fact Sheet] These figures
were approaching the 2025 targets of guaranteeing that 95% of patients with HIV are diagnosed,
95% of diagnosed patients receive antiretroviral therapy (ART), and 95% of those prescribed
ART achieve viral load suppression prior to a significant funding disruption.[WHO Fact Sheet
on HIV and AIDS] HIV and mortality rates are steadily declining on a global scale. Nonetheless,
other nations report an increase in the number of infections, primarily in areas where HIV is
strongly stigmatized or where political or other unrest is taking place.[UNAIDS, 2023 Global
Report] With 40.8 million people living with HIV and 1.3 million people newly infected in
2024—two-thirds of whom reside in Africa—the number of HIV patients is also rising due to
advancements in treatment.
Both patients and the healthcare system incur significant costs as a result of HIV. HIV infection
raises the chance of long-term illness, especially neurological and cardiac conditions. ART slows
the progression of the disease, but it does not cure HIV, has negative side effects, and
necessitates a continuous, long-term relationship with the healthcare system. Public and self-
stigma, insufficient access to therapy, incorrect care, and expense are some of the obstacles to
universal treatment. Improving patient outcomes and preventing HIV transmission are two
benefits of following local clinical recommendations for HIV management. Clinical
recommendations support high-quality programming for patients with or at risk of contracting
HIV in order to provide timely diagnosis, treatment, and access to care. Increasing the
participation of community-led organizations in HIV testing and treatment, as well as integrating
medical services for linked health conditions, increases service reach, enhances care linkage, and
improves general health. Patients and the community can be protected by supportive social and
,policy contexts for screening, reporting test findings, access to treatments, and anti-
discrimination measures.
This clinical reference, which focuses mostly on HIV-1, is intended to give clinicians clear and
current advice for managing HIV by reviewing the etiology, clinical symptoms, and suggested
treatment options for individuals with HIV. The World Health Organization (WHO), the Joint
United Nations Programme for HIV/AIDS (UNAIDS), the United States Centers for Disease
Control (CDC), and state legislatures recommend the best social and policy environments to
support the HIV response; Florida legislation is used as an example. For additional information,
please refer to "HIV-2 Infection," StatPearls' related site. [1]
Etiology
HIV belongs to the Lentivirus genus' Retroviridae family. The virus primarily targets CD4+ T-
lymphocyte helper cells, which results in severe immunological suppression and ongoing cell
death. The immune system is weakened by this suppression, which also results in numerous
clinical symptoms. AIDS eventually develops from untreated HIV. Opportunistic infections
cause death at this point because the immune system is unable to stop infections. HIV-1 and
HIV-2 are the two primary forms of the virus. Despite having structurally identical genomes,
they differ greatly in terms of amino acids. The severity, transmissibility, and prognosis of the
two viruses varies significantly because they are the products of two distinct zoonotic
transmissions of simian immunodeficiency viruses. It should be noted that HIV-1 and HIV-2
have only 48% identity similarity at the nucleotide level and only 60% identity at the amino acid
level.
HIV-1 and HIV-2 particles are made up of a protein capsid encased in a lipid membrane. Two
identical copies of RNA and the proteins nucleocapsid, integrase, and reverse transcriptase make
up the nucleoprotein complex, or core, that is contained within the capsid. The capsid's
distinctive conical form results from the capsid protein organizing into a lattice structure.
Numerous bodily fluids, including blood, amniotic fluid, breast milk, semen, pre-ejaculate, rectal
fluids, and vaginal fluids, can spread HIV. Sexual contact, pregnancy and childbirth, and fomites
like needles or reusable medical equipment can all spread HIV. For additional information,
please refer to "HIV Prevention," StatPearls' companion page. [1] [2]
, Epidemiology
HIV is a major global public health concern. At the end of 2024, there were 40.8 million HIV
patients, with over 60% of them residing in Sub-Saharan Africa, according to the WHO HIV
factsheet. [UNAIDS. UNAIDS Global AIDS Update 2025: AIDS, Crisis, and the Potential for
Change. Joint United Nations Programme on HIV/AIDS, Geneva, 2025] Globally, 1.3 million
new HIV diagnoses and 630,000 HIV-related deaths were reported in 2024. Only 1 to 2 million
prevalent infections are caused by HIV-2; the remaining infections are caused by HIV-1; only
Guinea-Bissau, Senegal, the Gambia, Sierra Leone, and the Ivory Coast have more than 1% of
HIV-2 infections.
The global trend of HIV incidence has declined, despite reports of an increase in new cases in
some nations. Since 2010, the number of new HIV infections has decreased by 40% in 2024.
Significant progress has been achieved in treating and preventing HIV, especially in eastern and
southern Africa, where the infection is most common. The region saw 57% fewer AIDS-related
deaths and 59% fewer new infections between 2010 and 2023. Other places, primarily those with
significant disparities and poor prioritization of the HIV response, see slower progress. However,
between 2010 and 2022, new HIV infections rose by 32% among males who have sex with men
and by 85% among non-client sex partners of individuals from critical populations in Asia and
the Pacific area, which has the greatest epidemic after eastern and southern Africa.
In certain areas, the prevalence of HIV is rising. Between 2010 and 2024, the incidence of HIV
increased by 94% in the WHO Middle East and North Africa areas, the highest increase in the
world. In comparison to the predicted 130,000 newly infected individuals in Eastern Europe and
Central Asia in 2024, the number of HIV-positive individuals in this region (about 23,000 in
2024) is low. Between 2019 and 2024, the number of new HIV cases in the Middle East and
North Africa rose by 94%. The HIV response has been hampered by difficult legal frameworks,
human rights abuses, and armed conflicts.
Rates of HIV diagnosis, treatment, and viral suppression differ between and within nations and
areas. In 2024, 45% of new HIV cases worldwide were among women and girls. Men, however,
had lower rates of diagnosis, treatment availability, and viral suppression than women (84% vs.
92%, 87% vs. 91%, and 94% vs. 95%, respectively). UNAIDS and WHO have identified five
The cornerstone of managing the global HIV epidemic, which has taken over 44.1 million lives
since it was identified, is clinical prevention of HIV and AIDS. Due to the efficacy of
antiretroviral medication, HIV is a chronic illness even though a cure is still unattainable. The
objective of stopping the global HIV pandemic is now achievable when combined with
important developments in prevention. In order to achieve the best possible patient and
population outcomes, current interventions recognize the complexity of clinical management and
take into account socioeconomic issues, patient-centered care, ongoing quality improvement, and
the significance of social and regulatory settings.
In order to prevent the diagnosis of AIDS, this activity thoroughly examines HIV transmission,
pathophysiology, clinical manifestations, evaluation, current treatment, reporting, and
implementation issues for particular demographic groups. Clinicians become more
knowledgeable, skilled, and competent in managing HIV, enhancing patient outcomes, lowering
transmission rates, and supporting international efforts to eradicate the disease. The importance
of the interprofessional team is emphasized, with a focus on cooperation between members of
the clinical, public health, and interdisciplinary teams.
Objectives:
1. Recognize the stage of HIV and accompanying comorbidities so that patients can be
diagnosed and treated timely.
2. Use the principles of antiretroviral therapy and prophylaxis of opportunistic infections to
avoid and treat side effects.
3. Interpret HIV treatment guidelines to be sensitive to the culture and confidentiality of
particular patients and affected populations.
4. Collaborate with interprofessional team members to guarantee continuity of care,
enhance patient outcomes for HIV prevention and treatment, and lower the risk for AIDS.
Introduction
Since its discovery in 1983, HIV has killed about 44.1 million people globally as of 2024. This
figure is startling, and HIV could become a worldwide health emergency if it is not addressed.
,Nonetheless, the HIV epidemic has been contained because to the creation, research, and general
accessibility of highly active antiretroviral treatments (ARTs). Similarly, HIV and opportunistic
infections are becoming treatable chronic illnesses because to advancements in treatment. HIV
patients can lead long, healthy lives. Because of the underlying immunodeficiency in this
population, preventing chronic illnesses is a high concern.
The 95-95-95 goals set forward by the UN General Assembly are achievable with sufficient
funding and scientific advancements in prevention, treatment, and execution. According to
estimates, 87% of all HIV-positive individuals were aware of their condition in 2024, 89% of
those who were aware of their status were on antiretroviral therapy, and 94% of those getting
treatment had a suppressed viral load.[UNAIDS. [Global Statistics Fact Sheet] These figures
were approaching the 2025 targets of guaranteeing that 95% of patients with HIV are diagnosed,
95% of diagnosed patients receive antiretroviral therapy (ART), and 95% of those prescribed
ART achieve viral load suppression prior to a significant funding disruption.[WHO Fact Sheet
on HIV and AIDS] HIV and mortality rates are steadily declining on a global scale. Nonetheless,
other nations report an increase in the number of infections, primarily in areas where HIV is
strongly stigmatized or where political or other unrest is taking place.[UNAIDS, 2023 Global
Report] With 40.8 million people living with HIV and 1.3 million people newly infected in
2024—two-thirds of whom reside in Africa—the number of HIV patients is also rising due to
advancements in treatment.
Both patients and the healthcare system incur significant costs as a result of HIV. HIV infection
raises the chance of long-term illness, especially neurological and cardiac conditions. ART slows
the progression of the disease, but it does not cure HIV, has negative side effects, and
necessitates a continuous, long-term relationship with the healthcare system. Public and self-
stigma, insufficient access to therapy, incorrect care, and expense are some of the obstacles to
universal treatment. Improving patient outcomes and preventing HIV transmission are two
benefits of following local clinical recommendations for HIV management. Clinical
recommendations support high-quality programming for patients with or at risk of contracting
HIV in order to provide timely diagnosis, treatment, and access to care. Increasing the
participation of community-led organizations in HIV testing and treatment, as well as integrating
medical services for linked health conditions, increases service reach, enhances care linkage, and
improves general health. Patients and the community can be protected by supportive social and
,policy contexts for screening, reporting test findings, access to treatments, and anti-
discrimination measures.
This clinical reference, which focuses mostly on HIV-1, is intended to give clinicians clear and
current advice for managing HIV by reviewing the etiology, clinical symptoms, and suggested
treatment options for individuals with HIV. The World Health Organization (WHO), the Joint
United Nations Programme for HIV/AIDS (UNAIDS), the United States Centers for Disease
Control (CDC), and state legislatures recommend the best social and policy environments to
support the HIV response; Florida legislation is used as an example. For additional information,
please refer to "HIV-2 Infection," StatPearls' related site. [1]
Etiology
HIV belongs to the Lentivirus genus' Retroviridae family. The virus primarily targets CD4+ T-
lymphocyte helper cells, which results in severe immunological suppression and ongoing cell
death. The immune system is weakened by this suppression, which also results in numerous
clinical symptoms. AIDS eventually develops from untreated HIV. Opportunistic infections
cause death at this point because the immune system is unable to stop infections. HIV-1 and
HIV-2 are the two primary forms of the virus. Despite having structurally identical genomes,
they differ greatly in terms of amino acids. The severity, transmissibility, and prognosis of the
two viruses varies significantly because they are the products of two distinct zoonotic
transmissions of simian immunodeficiency viruses. It should be noted that HIV-1 and HIV-2
have only 48% identity similarity at the nucleotide level and only 60% identity at the amino acid
level.
HIV-1 and HIV-2 particles are made up of a protein capsid encased in a lipid membrane. Two
identical copies of RNA and the proteins nucleocapsid, integrase, and reverse transcriptase make
up the nucleoprotein complex, or core, that is contained within the capsid. The capsid's
distinctive conical form results from the capsid protein organizing into a lattice structure.
Numerous bodily fluids, including blood, amniotic fluid, breast milk, semen, pre-ejaculate, rectal
fluids, and vaginal fluids, can spread HIV. Sexual contact, pregnancy and childbirth, and fomites
like needles or reusable medical equipment can all spread HIV. For additional information,
please refer to "HIV Prevention," StatPearls' companion page. [1] [2]
, Epidemiology
HIV is a major global public health concern. At the end of 2024, there were 40.8 million HIV
patients, with over 60% of them residing in Sub-Saharan Africa, according to the WHO HIV
factsheet. [UNAIDS. UNAIDS Global AIDS Update 2025: AIDS, Crisis, and the Potential for
Change. Joint United Nations Programme on HIV/AIDS, Geneva, 2025] Globally, 1.3 million
new HIV diagnoses and 630,000 HIV-related deaths were reported in 2024. Only 1 to 2 million
prevalent infections are caused by HIV-2; the remaining infections are caused by HIV-1; only
Guinea-Bissau, Senegal, the Gambia, Sierra Leone, and the Ivory Coast have more than 1% of
HIV-2 infections.
The global trend of HIV incidence has declined, despite reports of an increase in new cases in
some nations. Since 2010, the number of new HIV infections has decreased by 40% in 2024.
Significant progress has been achieved in treating and preventing HIV, especially in eastern and
southern Africa, where the infection is most common. The region saw 57% fewer AIDS-related
deaths and 59% fewer new infections between 2010 and 2023. Other places, primarily those with
significant disparities and poor prioritization of the HIV response, see slower progress. However,
between 2010 and 2022, new HIV infections rose by 32% among males who have sex with men
and by 85% among non-client sex partners of individuals from critical populations in Asia and
the Pacific area, which has the greatest epidemic after eastern and southern Africa.
In certain areas, the prevalence of HIV is rising. Between 2010 and 2024, the incidence of HIV
increased by 94% in the WHO Middle East and North Africa areas, the highest increase in the
world. In comparison to the predicted 130,000 newly infected individuals in Eastern Europe and
Central Asia in 2024, the number of HIV-positive individuals in this region (about 23,000 in
2024) is low. Between 2019 and 2024, the number of new HIV cases in the Middle East and
North Africa rose by 94%. The HIV response has been hampered by difficult legal frameworks,
human rights abuses, and armed conflicts.
Rates of HIV diagnosis, treatment, and viral suppression differ between and within nations and
areas. In 2024, 45% of new HIV cases worldwide were among women and girls. Men, however,
had lower rates of diagnosis, treatment availability, and viral suppression than women (84% vs.
92%, 87% vs. 91%, and 94% vs. 95%, respectively). UNAIDS and WHO have identified five
