The HIV response is at a tipping point. If HIV prevention is deprioritized and defunded, gains made in stopping new HIV infections could be reversed.
With 1.3 million new HIV infections per year in both 2023 and 2024, the world remains off-track to end the pandemic. Yet, global HIV prevention targets are achievable. At the end of 2024, five countries-Lesotho, Malawi, Nepal, Rwanda and Zimbabwe-had achieved a 75% reduction in new HIV infections compared to 2010. New targets for 2030, co-developed with countries and communities, have informed the new Global AIDS Strategy 2026-2031 .
The Global HIV Prevention Coalition (GPC), which was established in 2017 to strengthen and sustain political and financial commitment to primary prevention, has used these targets and the Strategy to develop the HIV Prevention 2030 Global Access Framework .
"Our vision is that everyone in need has access to HIV prevention options. This is achievable if investments in prevention are robust and sustained, if countries ensure effective use of resources, and if programmes are evidence-based and grounded in human rights with communities at the centre," said Angeli Achrekar, Deputy Executive Director of UNAIDS.
The Access Framework outlines how, by 2030, countries can ensure that 90% of people in need of prevention services have access and that 90% of people living with HIV are virally suppressed. This, in combination, would lead to a 90% reduction in new HIV infections globally.
To attain these targets in a time of limited resources, the 2030 Prevention Access Framework defines five Ps for prioritization: put the People in greatest need at the centre; Place-focus on the highest-burden locations; the right Platforms-for service delivery; the right Package-of prevention options to offer people choices; Price-cost effectiveness to ensure sustained country implementation.
Ensuring access to HIV prevention now means shifting towards country-led and domestically funded programmes, finding local solutions for sustained impact.
Topline targets for prevention options were translated into key numeric milestones for 2030: 40 million people living with HIV globally on HIV treatment; 20 million people accessing pre-exposure prophylaxis (PrEP) options to prevent HIV; 20 billion condoms, and at least 20% of domestic HIV financing dedicated to prevention.
The future of the HIV response will be determined by whether we can deliver combination prevention at scale, rooted in human rights and dignity, driven by governments, communities and young people, and integrated within sexual and reproductive health. UNFPA is committed to meeting the needs of all population groups, particularly those of adolescent girls and young women. We will continue working with partners to address critical gaps to ensure no one is left behind." said Pio Smith Deputy Executive Director ai UNFPA
HIV prevention innovations have further expanded choice for populations at risk. New long-acting options for prevention such as lenacapavir-twice yearly injections to prevent HIV-are becoming available. Trusted access platforms such as stigma-free health services integrating HIV prevention, community outreach, pharmacies, youth-innovative virtual and telehealth platforms, supported by generative AI, are critical in facilitating access to prevention options.
"The cost of inaction is detrimental. Innovations, including new and emerging long-acting prevention options, especially lenacapavir, have added toto the array of prevention choices. Now, speed, scale and equity are still needed to translate exciting science into public health impact," said Mitchell Warren, GPC Co-chair and Executive Director of AVAC. "History will judge us harshly if we as a global community fail to meet this scientific moment."
Despite global commitments, primary prevention investments remain far below required levels particularly in many low- and middle-income countries. Governments need to commit at least one fifth of domestic HIV funding to HIV prevention programmes and ensure prevention commodities such as anti-retroviral-based prevention, condoms, needles and syringes and voluntary medical male circumcision for HIV prevention should be available and accessible to users at affordable prices.
"A fit-for-purpose global prevention mechanism must reinforce country leadership, safeguard and optimize prevention financing, and align partners and resources to country priorities and systems,, which will reduce fragmentation and strengthen prioritization and timely decision making so that available resources are fully leveraged for impact," said Dr. Nduku Kilonzo, GPC co-chair, Secretary of the HIV Multisector Leadership Forum
UNAIDS, UNFPA, GPC and partners will continue to steer progress through a global campaign to sustain momentum and reach the 2030 prevention targets.
UNAIDS
The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations-UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank-and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org
