The new report by the UN agency leading the fight against HIV/AIDS has revealed that people living with the human immunodeficiency virus face the double jeopardy of HIV and COVID-19 – as widening inequalities continue to prevent them from accessing services.

According to the UNAIDS Global AIDS Update 2021, people living with HIV are at a higher risk of severe COVID-19 illness and death, yet the vast majority are denied access to life-saving vaccines. 

Although key populations and their sexual partners account for 65 percent of new HIV infections, they are largely left out of both HIV and COVID-19 responses, including 800,000 children living with HIV.

"We are 40 years into the fight against HIV. Both the successes and the failures have taught us that we cannot prepare for or defeat a pandemic unless we tear down inequalities, promote people-centred, rights-based approaches and work together with communities to reach everyone in need", said UNAIDS chief Winnie Byanyima.

Startling statistics

Studies from England and South Africa have found that the risk of dying from COVID-19 among people living with HIV is double that of the general population. 

In sub-Saharan Africa, home to 67 percent people living with HIV, less than three percent have received even one dose of a COVID-19 vaccine to date. 

At the same time, HIV prevention and treatment services are eluding key populations, as well as children and adolescents.

"We have failed to learn the lessons of HIV, when millions were denied life-saving medicines and died because of inequalities in access", said Ms. Byanyima. 

Global South  'in crisis’

As wealthy nations and corporations hold on tightly to the lucrative monopoly of producing and delivering COVID-19 supplies, millions of lives in the developing world are in the balance, due to lack of access.

This is severely impacting the world as health systems in developing countries become overwhelmed, such as in Uganda, where football stadiums are being turned into makeshift hospitals.

"Rich countries in Europe are preparing to enjoy the summer as their populations have easy access to COVID-19 vaccines, while the global South is in crisis", said Ms. Byamyima.

Key populations

The new UNAIDS report illustrates how COVID-19 lockdowns and restrictions have badly disrupted HIV testing, with many countries showing steep drops in HIV diagnoses, referrals to care services and HIV treatment initiations.

Some 1.5 million new HIV infections recorded last year were predominantly among transgender women, sex workers, gay men, intravenous drug users and their sexual partners – key populations that account for 65 percent of the world's infections. 

These populations also accounted for 93 percent of new HIV infections outside sub-Saharan Africa, and 35 percent within. 

However, in most countries they remain marginalized and largely unable to access HIV services.

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Children more vulnerable

While HIV testing and treatment have been scaled up massively over the past 20 years, service gaps remain much larger for children than for adults, according to the report. 

Last year, treatment coverage was 74 percent for adults but just 54 percent for children – leaving some 800,000 in the lurch. 

Moreover, many children were not tested for HIV at birth and remain unaware of their HIV status, making it difficult to find and care for them. 

(With input from UNAIDS)