HIV services in sub-Saharan Africa: the greatest gap is men

40 years ago the first cases of what would become known as AIDS were reported by the US Centers for Disease Control and Prevention. Since then, millions of lives have been lost, but gradually remarkable progress has been made across the HIV continuum of care. By 2019, 81% of people living with HIV (PLHIV) worldwide knew their status, 82% of these were on antiretroviral therapy (ART), and 88% of individuals on ART were virologically suppressed. These averages, however, mask substantial variability between and within regions. The heaviest HIV burden globally is in sub-Saharan Africa, which is home to two-thirds of all PLHIV. Within sub-Saharan Africa, eastern and southern Africa (ESA) is the epicentre of the pandemic. ESA is also the region that has made the most impressive gains in HIV prevention and treatment, with ART coverage second only to western Europe and North America. By 2019, 87% of PLHIV in ESA knew their status, 83% of them were on ART, and 90% of these individuals were virologically suppressed. Between 2010 and 2018, HIV incidence in the region dropped by 28% and HIV/AIDS deaths dropped by 44%.