The World Health Organization (WHO) leads the global response to HIV, setting the guidelines that countries use to test, treat, and prevent the virus. As of the end of 2024, an estimated 40.8 million people worldwide are living with HIV. That year, 1.3 million people newly acquired the virus, and 630,000 died from HIV-related causes. These numbers represent significant progress from the epidemic’s peak, but they also show how far the world still has to go.
Global Targets: The 95-95-95 Goal
WHO and UNAIDS have set a framework known as 95-95-95, meant to be achieved by 2030. The three targets are: 95% of people living with HIV know their status, 95% of those diagnosed receive antiretroviral therapy (ART), and 95% of those on treatment achieve viral suppression, meaning the virus is at undetectable levels in their blood.
Progress has been uneven. Currently, about 86% of people living with HIV know their status, which means an additional 3.4 million people still need to be reached with testing. By the end of 2023, 30.7 million people were receiving ART globally. These are historic highs, but the gaps are concentrated in specific regions and populations where stigma, poverty, and weak health systems create barriers to care.
Who Is Most Affected
WHO identifies five “key populations” that face disproportionately high HIV risk: men who have sex with men, people who inject drugs, sex workers, transgender people, and people in prisons or other closed settings. These groups often face legal barriers and social stigma that make it harder to access testing, prevention, and treatment. In many countries, the behaviors associated with these populations are criminalized, which drives people away from health services.
Sub-Saharan Africa remains the hardest-hit region, home to the majority of people living with HIV worldwide. Women and girls in this region are particularly vulnerable, often acquiring HIV at younger ages than men.
How WHO Classifies HIV Progression
WHO uses a four-stage clinical system to describe how HIV progresses in adults and adolescents. This staging helps healthcare workers in resource-limited settings assess disease severity even without lab tests.
- Stage 1: No symptoms, or only persistently swollen lymph nodes. A person can feel entirely healthy.
- Stage 2: Mild symptoms such as moderate weight loss (under 10% of body weight), recurring skin conditions, shingles, or frequent upper respiratory infections like sinusitis and bronchitis.
- Stage 3: More serious symptoms including severe weight loss (over 10% of body weight), unexplained chronic diarrhea or fever lasting more than a month, persistent oral thrush, tuberculosis, or severe bacterial infections such as pneumonia or meningitis.
- Stage 4: The most severe stage, corresponding to AIDS. Conditions include a wasting syndrome, certain cancers like Kaposi sarcoma and lymphoma, brain infections, and severe opportunistic infections that a healthy immune system would normally fight off.
WHO defines “advanced HIV disease” as having a CD4 cell count below 200 cells per cubic millimeter, or presenting with Stage 3 or 4 illness. CD4 cells are the immune cells that HIV destroys, so a low count signals serious immune damage. All children under five with HIV are automatically considered to have advanced disease, because their immune systems are more vulnerable.
Treatment: Start Early, Start Fast
WHO recommends that everyone diagnosed with HIV begin antiretroviral therapy as soon as possible, regardless of CD4 count or how they feel. This is a shift from older guidelines that waited until the immune system showed significant damage. Starting early provides the best chance for immune recovery and dramatically reduces the risk of transmitting the virus to others.
For people with advanced HIV disease, WHO recommends rapid initiation, defined as starting treatment within seven days of diagnosis. This is paired with screening and preventive treatment for the major opportunistic infections that cause most HIV-related deaths, along with intensive adherence support such as counseling, follow-up phone calls, and home visits. The goal is to prevent the cascade of infections that can become fatal when the immune system is severely weakened.
Modern ART typically involves taking one or two pills daily. The drugs work by blocking the virus at different stages of its life cycle, keeping viral levels so low they become undetectable. A person with an undetectable viral load cannot transmit HIV sexually, a principle known as U=U (undetectable equals untransmittable).
Prevention Tools
WHO recommends a combination approach to HIV prevention. Condoms remain a cornerstone, but the toolkit has expanded significantly. Pre-exposure prophylaxis (PrEP) is a medication taken by HIV-negative people to prevent infection, and it is now available as a daily pill or a long-acting injection given every two months. Post-exposure prophylaxis (PEP) is a short course of medication taken within 72 hours of a possible exposure.
In a 2024 update, WHO expanded its recommendations for HIV self-testing, allowing people to test themselves at home with a rapid oral or blood-based kit. Self-testing is now recommended not only for general screening but also for people starting, restarting, or continuing PrEP and PEP. WHO has also introduced dual self-test kits that screen for both HIV and syphilis simultaneously.
Voluntary male circumcision remains a recommended intervention in high-prevalence settings, as it reduces the risk of female-to-male sexual transmission by roughly 60%. Harm reduction programs for people who inject drugs, including needle exchange and opioid substitution therapy, are also part of the WHO prevention package.
Preventing Mother-to-Child Transmission
Without treatment, a mother living with HIV has a 15 to 45% chance of passing the virus to her baby during pregnancy, delivery, or breastfeeding. With proper interventions, that risk drops below 5% in breastfeeding populations and below 2% where breastfeeding is not practiced.
WHO has created a certification process for countries that eliminate mother-to-child transmission. To qualify, a country must demonstrate that fewer than 50 out of every 100,000 live births result in a new pediatric HIV infection due to transmission from mother to child. It must also show a transmission rate below 5% in breastfeeding settings or below 2% in non-breastfeeding settings, maintained for at least one year. Several countries have already achieved this certification.
The 2030 Strategy
WHO’s Global Health Sector Strategy on HIV for 2022 to 2030 sets the overarching goal of ending AIDS as a public health threat by the end of the decade. The strategy is built around five strategic directions that emphasize equity, integration of HIV services with broader health systems, and community-led responses. Rather than treating HIV in isolation, the approach calls for linking HIV care with services for tuberculosis, hepatitis, sexual health, and maternal care.
Reaching these goals will require closing the gaps that persist in testing coverage, treatment access, and prevention uptake, particularly among key populations and in the regions where the epidemic remains most concentrated.