Get on the

Fast-Track
The life-cycle
approach to HIV
Finding solutions for everyone
at every stage of life

UNAIDS | 2016
Introduction
 Proportion of new HIV infections by sex, global
and eastern and southern Africa, 2015
Percentage (%)

Age (years) Age (years)

Men Women
global eastern and southern Africa

Source: UNAIDS 2016 estimates.

 Investments in the AIDS responses of low- and middle-income
countries, by source of funding, 2000–2015
US$ (billion)

Domestic (public and private) Other bilateral governments Other multilaterals and foundations
United States (bilateral) Global Fund to Fight AIDS, Tuberculosis and Malaria

Source: UNAIDS estimates, June 2016 - UNAIDS-Kaiser Family Foundation. Financing the response to AIDS in low- and middle-income countries till 2015 - OECD CRS last accessed June 2016.
 Additional HIV infections averted through a Fast-Track
response, compared to 2015 levels of coverage, 2016–2030
Number (millions)

Eastern and southern Africa Asia and the Pacific Latin America and the Caribbean
Western and central Africa Eastern Europe and central Asia North Africa and the Middle East)

Source: Lamontagne E, Over M, Stover J et al. The economic returns of ending the AIDS epidemic by 2030. 2016, in press.
Additional AIDS-related deaths averted through a Fast-Track response,
compared to 2015 levels of coverage, 2016–2030
Number (millions)

Eastern and southern Africa Asia and the Pacific Latin America and the Caribbean
Western and central Africa Eastern Europe and central Asia North Africa and the Middle East)

Source: Lamontagne E, Over M, Stover J et al. The economic returns of ending the AIDS epidemic by 2030. 2016, in press.
Finding solutions for everyone
at every stage of life

Children (0–14)
 New HIV infections among children (aged 0–14 years) and percentage of pregnant
women living with HIV receiving antiretroviral medicines (either prophylaxis
or lifelong therapy) to prevent mother-to-child transmission, global, 2005–2015

Number Percentage
of new (%) of
HIV pregnant
infections women
among living with
children HIV
(aged accessing
0–14 PMTCT
years) services

New HIV PMTCT Global targets Global PMTCT

infections coverage of new HIV infections target

Source: UNAIDS 2016 estimates.

Note: In 2010, single-dose nevirapine was no longer included in ARV coverage as an effective regimen for the prevention of mother-to-child transmission.
 Children (aged 0–14 years) living with HIV on antiretroviral
therapy and number of AIDS-related deaths among children,
global, 2005–July 2016

Number of
AIDS- Number of
related children
deaths living with
among HIV (aged
children 0–14 years)
(aged on
0–14 antiretroviral
years) therapy

Children living with HIV on antiretroviral treatment AIDS-related deaths among children
Global child antiretroviral treatment target

Source: 2016 Global AIDS Response Progress Reporting; UNAIDS 2016 estimates.
 Distribution of new HIV infections among children
(aged 0–14 years), global, 2015

Remaining Nigeria
countries

India

Zambia
Malawi Kenya
Zimbabwe Mozambique

Indonesia United Republic of Tanzania

South Africa

Source: UNAIDS 2016 estimates.

 Progress toward the elimination of HIV infections
among children (aged 0–14 years), by country, 2015
Decline in new HIV infections Percentage of pregnant women
among children (aged 0-14 years), living with HIV receiving
low- and middle-income countries, antiretroviral medicines (either
2010-2015 prophylaxis or lifelong therapy) to
prevent mother-to-child
transmission, low- and middle-
income countries, 2015
Asia and the Pacific
Afghanistan
Australia
Bangladesh
India
Indonesia
Malaysia
Mongolia
Myanmar
Nepal
Pakistan
Papua New Guinea
Philippines
Sri Lanka
Thailand
Viet Nam

Eastern Europe and Central Asia

Azerbaijan
Belarus
Georgia
Kazakhstan
Kyrgyzstan
Republic of Moldova
Tajikistan
Ukraine
Uzbekistan

Legend L
Measures not available Measures not available
For countries not
shown, both ≤ 19% ≤ 32%
measures are not 20–49% 33–65%
available or 50–79% 66–94%
under review. ≥80% ≥95%
 Progress toward the elimination of HIV infections
among children (aged 0–14 years), by country, 2015
Decline in new HIV infections Percentage of pregnant women
among children (aged 0-14 years), living with HIV receiving
low- and middle-income countries, antiretroviral medicines (either
2010-2015 prophylaxis or lifelong therapy) to
prevent mother-to-child
transmission, low- and middle-
income countries, 2015
Latin America and the Caribbean
Argentina
Bahamas
Belize
Bolivia (Plurinational State of)
Brazil
Colombia
Costa Rica
Cuba
Dominican Republic
Ecuador
El Salvador
Guatemala
Guyana
Haiti
Honduras
Jamaica
Mexico
Nicaragua
Panama
Paraguay
Peru
Suriname
Trinidad and Tobago
Uruguay
Venezuela (Bolivarian Republic of)

Legend L
Measures not available Measures not available
For countries not
shown, both ≤ 19% ≤ 32%
measures are not 20–49% 33–65%
available or 50–79% 66–94%
under review. ≥80% ≥95%
 Progress toward the elimination of HIV infections
among children (aged 0–14 years), by country, 2015
Decline in new HIV infections Percentage of pregnant women
among children (aged 0-14 years), living with HIV receiving
low- and middle-income countries, antiretroviral medicines (either
2010-2015 prophylaxis or lifelong therapy) to
prevent mother-to-child
transmission, low- and middle-
income countries, 2015
Eastern and southern Africa
Angola
Botswana
Eritrea
Kenya
Lesotho
Madagascar
Malawi
Mozambique
Namibia
Rwanda
South Africa
South Sudan
Swaziland
Uganda
United Republic of Tanzania
Zambia
Zimbabwe

Middle East and North Africa

Algeria
Djibouti
Egypt
Iran (Islamic Republic of)
Morocco
Somalia
Sudan
Yemen

Legend L
Measures not available Measures not available
For countries not
shown, both ≤ 19% ≤ 32%
measures are not 20–49% 33–65%
available or 50–79% 66–94%
under review. ≥80% ≥95%
 Progress toward the elimination of HIV infections
among children (aged 0–14 years), by country, 2015
Decline in new HIV infections Percentage of pregnant women
among children (aged 0-14 years), living with HIV receiving
low- and middle-income countries, antiretroviral medicines (either
2010-2015 prophylaxis or lifelong therapy) to
prevent mother-to-child
transmission, low- and middle-
income countries, 2015
Western and central Africa
Benin
Burkina Faso
Burundi
Cameroon
Cabo Verde
Central African Republic
Chad
Côte d’Ivoire
Democratic Republic of the Congo
Equatorial Guinea
Gabon
Gambia
Ghana
Guinea
Liberia
Mali
Mauritania
Niger
Senegal
Sierra Leone
Togo

Western & Central Europe & North America

Greece
Italy
Latvia
Spain

Legend L
Measures not available Measures not available
For countries not
shown, both ≤ 19% ≤ 32%
measures are not 20–49% 33–65%
available or 50–79% 66–94%
under review. ≥80% ≥95%
 Six-week and final mother-to-child transmission rates,
by country, 2015
Angola
Chad
Ghana
Côte d’Ivoire
Democratic Republic of the Congo
Cameroon
Lesotho
Malawi
Kenya
United Republic of Tanzania
Zimbabwe
Burundi
Mozambique
Zambia
Namibia
Swaziland
Uganda
Botswana
South Africa

Mother-to-child transmission rate (%)

Six-week Final
transmission rate transmission rate

Source: UNAIDS 2016 estimates.

 AIDS-related deaths among children by age group,
global, 2000–2015

Number

0–4 5–9 10–14

years years years

Source: UNAIDS 2016 estimates.

 Percentage of infants born to women living with HIV receiving
a virological test within the first two months of life, by country, 2015

Percentage (%)

Source: 2016 Global AIDS Response Progress Reporting.

Four prongs to eliminate mother-to-child transmission
of HIV and improve maternal health

Prong 1
Women of
Primary prevention of
reproductive age
HIV among women of
childbearing age

Prong 4 Women living with HIV

Provision of appropriate Prong 2
treatment, care and Prevention of
support to women, unintended
children living with HIV pregnancies among
Pregnant women living
and their families women living with HIV
with HIV

Prong 3
Prevention of HIV from a
Children living with HIV woman living with HIV to
her infant
Finding solutions for everyone
at every stage of life

Young people
(15–24)
 New HIV infections among young women
Number
(aged 15–24 years), global, 2005–2015

New HIV infections Global target

Source: UNAIDS 2016 estimates.

 Percentage of young women (aged 15–24 years) reporting use of a condom
at last sexual intercourse with a non-regular partner in the 12 months prior
Percentage (%)
to the survey, eight countries in sub-Saharan Africa, 2012–2015

Lesotho Namibia Kenya Rwanda South Nigeria Zambia Comoros

Africa*

Source: Population-based surveys, 2012–2015.

* Data for South Africa refers to condom use at last sex among young women aged 15-24 who reported being sexually active.
 Demand for family planning satisfied by modern methods
among young women (aged 15–24 years), by country, 2010–2015
Percentage (%)

Source: Demographic and Health Surveys, 2010-2015.

 Percentage of people living with HIV (aged 15–59 years) who have
ever been tested for HIV and received the results, by age group,
19 low- and middle-income countries, 2011–2015
Percentage (%)

15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59

Age (years)

Source: Demographic and Health Surveys, 2011–2015.

 Distribution of new HIV infections among men and women
by five-year age groups, nine locations in eastern
and southern Africa, 2010–2014

Percentage (%)

Age (years) Age (years)

eastern African countries southern African countries

Men Women

Source: Network for Analysis of Longitudinal Population-based HIV/AIDS Data on Africa (ALPHA), 2016.
 Cycle of HIV transmission, results from a phylogenetic study,
KwaZulu-Natal, South Africa, 2016

Among men linked to young women (<25),

39% were simultaneously linked to a 25-40-
year-old woman

Most HIV transmission is likely Most HIV transmission is likely

from higher prevalence (men 25-40 from higher prevalence (women
years old) to lower 25-40 years old) to lower
prevalence )women under 25 years prevalence (men 25-40 years old)
old)

As women age, the cycle repeats

Source: Centre for the AIDS Programme of Research in South Africa, 2016.
 Number of young people living with HIV (aged 15–19 years)
by mode of HIV acquisition, 25 countries,* 1970–2015

Number

Sexual and unsafe Mother-to-child transmission

injection transmission

** The 25 countries included in the analysis are Botswana, Brazil, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Haiti, India, Indonesia,
Iran (Islamic Republic of), Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Swaziland, Thailand, Uganda, Ukraine, United Republic
of Tanzania, Zambia and Zimbabwe.
Source: UNAIDS special analysis, 2016; for more details, see annex on methodology.
Detailed strategy mix for HIV prevention
among young women–a menu of options

Support choices of
women who have
agency

Reduce
susceptibility
and transmissibility

Enhance agency
among adolescent
girls and young
women
 Programmes for adolescent girls and young women
(aged 15–24 years) in Swaziland, 2016

DREAMS
*
The Global Fund to Fight AIDS,
Tuberculosis and Malaria
(Global Fund)
DREAMS and
the Global Fund
PEPFAR Country
Operational Plan
PEPFAR Country Operational
Plan and the Global Fund

*DREAMS is supported by the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation, Girl Effect, Johnson & Johnson,
Gilead Sciences, and ViiV Healthcare.

Source: Swaziland Central Statistics Office 2016; PEPFAR Swaziland 2016.

1
Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe Women. The partnership is supported by the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation,
Girl Effect, Johnson & Johnson, Gilead Sciences and ViiV Healthcare.
2
Kenya, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Uganda, United Republic of Tanzania, Zambia and Zimbabwe. Together, these countries accounted for an estimated 55% of new HIV infections among
adolescent girls and young women in 2015.
 Past-week adolescent antiretroviral therapy non-adherence,
by access to various social protection measures,
South Africa, 2016
Percentage (%)

No social Support Food Monitoring Support Food security Food

protection group security Food security group and and security,
and support monitoring monitoring support
group group and
monitoring

Source: L. D. Cluver, E. Toska, F. M. Orkin, F. Meinck, R. Hodes, A. R. Yakubovich & L. Sherr (2016) Achieving equity in HIV-treatment outcomes: can social protection improve adolescent ART-adherence in South Africa?,
AIDS Care, 28:sup2, 73-82, DOI: 10.1080/09540121.2016.1179008.