Sexually Transmitted Infections (STI), HIV

Sexually transmitted infections (STIs) are infections that spread from person to person through sexual activity, including anal, vaginal, or oral sex. HIV is the most fatal STI and remains a major public health challenge. In the past 40 years, since the first HIV infection was found, 32.7 million people have died on AIDS and 74.7 million people are infected with HIV globally according to UNAIDS. Person who is on a effective medication and the virus is untransmittable, cannot transmit HIV.

In the last years huge steps have been taken to understand the course, prevention and treatment of the disease and to obtain positive results. Today there is medication, pre-exposure prophylaxis (PrEP) for HIV prevention, which is highly effective in preventing HIV infection.

In 2020, 27.5 million of the 37.7 million people living with HIV were on lifesaving antiretroviral therapy globally.
Globally, AIDS-related deaths have fallen by 47% since 2010, to 680,000 in 2020, while new HIV infections dropped by 31% to 1.5 million in 2020, compared to 2.1 million in 2010.

Despite the positive development, HIV is a global health challenge and affects the lives of millions of people, especially the most vulnerable groups. Access to health care – prevention, testing and treatment, is unequally distributed. Attitudes, legislation, inadequate health services, sexual and gender-based violence, lack of education and financial challenges make access to treatment more difficult and undermine people’s sexual rights.

In 2020, key populations (sex workers and their clients, gay men and other men who have sex with men, people who inject drugs, transgender people) and their sexual partners accounted for 65% of HIV infections globally.
Globally Women and girls accounted for 50% of all new infections in 2020.
- Every week, around 5000 young women aged 15–24 years become infected with HIV. In sub-Saharan Africa, six in seven new HIV infections among adolescents aged 15–19 years are among girls. Young women aged 15–24 years are twice as likely to be living with HIV than men. Around 4200 adolescent girls and young women aged 15–24 years became infected with HIV every week in 2020.

There is a global will to end AIDS. UN member states have committed to “end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases by 2030 “(SDG3: Good Health and Well-being, subgoal 3.3.). In June 2021 United Nations Member States adopted a set of new and ambitious targets in a political declaration at the United Nations General Assembly High-Level Meeting on AIDS to get the world back on track to ending the AIDS epidemic by 2030.

However, there are still lot to do to achieve these goals. To be effective, prevention of HIV and other STIs must focus on reaching out the most vulnerable groups with high proportions of infected people. Access to HIV testing, sex education, harm reduction programmes for people who injected drugs, and access to care for the most vulnerable groups are essential components of HIV prevention strategies. Equally crucial are education and awareness campaigns to improve public knowledge and decrease stigma. In addition of improving health care systems there is a need for legislative changes.

Still 67 UN member states criminalize same-sex intercourse, 92 countries criminalizing exposure, disclosure and spread of HIV and 18 countries criminalize transgender people.

Success in these objectives is based on equality, not only on equality from the point of view of HIV prevention, treatment and access to treatment, but also on legal equality.