How Many People Die From HIV Each Year?

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In the early days of the AIDS epidemic in the early 1980s, roughly half of people diagnosed with HIV in the United States died of an AIDS-related condition within two years. With the introduction of combination antiretroviral therapy in 1996, the HIV death rate plummeted.

Today, people living with the virus can enjoy normal to near-normal life expectancy even in countries where infection rates are high.

A single tulip rests on the engraved names of people who have died of AIDS on the Circle of Friends memorial before a service at the National AIDS Memorial Grove December 1, 2009 in San Francisco
Justin Sullivan / Getty Images News

This article takes a closer look at how antiretroviral therapy transformed the AIDS epidemic and how that has impacted HIV death rates today. It also looks at specific populations that continue to be disproportionately affected by HIV infections and deaths.

Advances in HIV Treatment

HIV is not the same disease that it was 30 or even 20 years ago. In 1996, a 20-year-old newly infected with HIV had an average life expectancy of 10 years. By 2013, the same 20-year-old could expect to live well into their 70s.

So effective are current antiretroviral therapies that the United Nations Programme on HIV/AIDS reported a 60% drop in HIV-related deaths since the peak of the pandemic in 2004. In fact, HIV is no longer on the World Health Organization's list of top 10 causes of death. As of 2020, HIV/AIDS was the 19th leading cause of death worldwide.

Even so, in some low-income countries where access to healthcare is poor, HIV remains among the most common causes of death, even above stroke, tuberculosis, malaria, and infant mortality.

With a greater push toward universal drug coverage, UNAIDs and others are hoping that the number of HIV-related deaths will continue to drop even in the most hard-hit population. According to the World Bank, around 73% of the 38 million people living with HIV today have been able to access antiretroviral therapy.

HIV-related deaths have dropped by around 60% since the height of the pandemic in 2004. This is due to the effectiveness of antiretroviral therapy and increased access to treatment across the planet.

HIV Deaths in the United States

In the United States, no less than 675,000 people have died of HIV since the first cases were reported back in 1981. In 1995, during the height of the AIDS crisis in the U.S., over 65,000 deaths were reported in that one year alone.

With the introduction of combination antiretroviral therapy in 1996 (known then as HAART, or highly active antiretroviral therapy), the death rate plummeted.  Within the span of three short years, the death rate in North America and Europe dropped by more than 50%—the first such downturn since the start of the pandemic.

With the introduction of newer drugs and newer classes of antiretrovirals, the death rate has continued to decline.

According to a 2019 report from the Centers for Disease Control and Prevention (CDC), there were 15,815 deaths reported among the 1.2 million people living with HIV in the United States. That is a 7% drop from just five years earlier.

Despite the advances, there remains a clear disparity in the populations affected by HIV. Among some of the factors influencing mortality (death) rates are geography, sex orientation, and race.

Geographic Location

In 2018, the distribution of HIV-related deaths in the United States occurred as follows:

  • 47% in the South
  • 22% in the Northeast
  • 17% in the West
  • 12% in the Midwest
  • 2% in U.S. territories like Puerto Rico and Guam

This is due in part to the fact that the South has the highest poverty rate and lowest median household income compared to other parts of the U.S. On top of this, nearly half of all people living in the South have no health insurance.

According to a 2019 study in the American Journal of Public Health, many of the states with the highest HIV infection rates are those that have not adopted Medicaid expansion, depriving vulnerable populations of the HIV-specific care that they need.

Men Who Have Sex With Men

Men who have sex with men (MSM) account for 70% of all new HIV infections in the United States despite only accounting for 2% of the population. According to the 2019 CDC report, around 53% of HIV-associated deaths (8.373 in total) were are among gay and bisexual men.

Homophobia and stigmatization play a central role in this disparity, discouraging many MSM from seeking HIV testing, treatment, and care. These factors alone translate to a higher death rate.

According to a 2011 study in the American Journal of Public Health, MSM with HIV are 160 times more likely to die from HIV-related complications than men who exclusively engage in vaginal sex.

Blacks

Blacks in the United States are disproportionately affected by HIV. In 2021, they accounted for 42% of all new infections. Blacks living with HIV also die at a higher rate than any other racial or ethnic group.

in 2019, 42% of death (6,678 in total) were reported among Blacks with HIV. This, despite the fact that Blacks only account for 12% of the U.S. population.

A multitude of intersecting risk factors—including poverty, lack of access to healthcare, high rates of unemployment, and stigma—contribute to higher rates of death in Black people living with HIV.

Recap

Since the introduction of combination antiretroviral therapy in 1996, annual HIV deaths have dropped in the United States by 78%. Even so, certain groups remain at higher risk of HIV-related death, including Blacks, men who have sex with men, and people who live in the South.

Global HIV Mortality

Since the start of the pandemic, around 75.7 million people worldwide have been infected with HIV. Of these, 32.7 million (roughly 43%) have died. In 2019, UNAIDS reported an estimated 690,000 people died of HIV worldwide.

While the number of deaths has dropped steeply since 2004 when over two million deaths were reported, HIV still hits certain population groups hard.

A snapshot of the HIV mortality rate from 2010 to 2018 illustrates the advances made in some, but not all, of the hardest-hit countries:

Global HIV-Related Deaths—Top 15 Countries
  Country 2018 2010 2000 Most Recent Trend
1 South Africa 71,000 140,000 100,000
2 Mozambique 54,000 64,000 40,000
3 Nigeria 53,000 72,000 78,000
4 Indonesia 38,000 24,000 19,000
5 Kenya 25,000 56,000 19,000
6 Tanzania 24,000 48,000 80,000
7 Uganda 23,000 56,000 85,000
8 Zimbabwe 22,000 54,000 120,000
9 Thailand 18,000 27,000 54,000
10 Zambia 17,000 26,000 62,000
11 Côte d'Ivoire 16,000 24,000 44,000
12 Cameroon 15,000 22,000 19,000
13 Brazil 15,000 15,000 15,000
14 Ghana 14,000 17,000 18,000
15 Angola 14,000 10,000 48,000

Rate of New Infections

According to UNAIDS, around 38 million people are living with HIV around the world. in 2020, approximately 1.7 million were newly diagnosed.

These remain sobering figures, in part because infection rates are not declining at the pace needed to end the pandemic. While the rate of new infections dropped by around 23% between 2010 and 2019, a number of "hotspots" around the globe experienced an increase.

In Russia and parts of Eastern Europe and Central Asia, the rate of new infections has increased due in part to the lack of access to HIV-specific care and treatment. Also, unlike in the United States and Europe, injecting drug use is one of the primary causes of infection.

Meanwhile, in countries like South Africa, which accounts for 7.5 million of the world's HIV cases, over 200,000 new infections were reported in 2019 despite significant declines in the previous decade.

There are several reasons for this. Infection rates remain among women 15 to 24 in many African countries due to gender inequality, poverty, rape, and other factors. HIV testing among younger Africans is also lower, translating to higher rates of HIV-related deaths.

With declining economic support from richer nations (due in part to the COVID pandemic), public health experts worry that infection and death rates may once again take an upswing in many developing countries.

Recap

In 2019, around 690,000 people died of HIV around the globe. Despite steep declines in HIV-related deaths since the height of the pandemic in 2004, death rates remain high in Russia, parts of Central Asia, and other hotspots around the planet.

Summary

Since the start of the pandemic during the 1980s, 75.7 million people have been infected with HIV and 32.7 million have died. Currently, around 38 million people are living with HIV worldwide. In 2019, 690,000 died as a result of HIV. Even so, this represents a 60% decline in deaths since the height of the pandemic in 2004.

In the United States, the HIV mortality rate has dropped by 78% since the introduction of combination antiretroviral therapy in 1996. Even so, certain groups remain disproportionately affected by HIV-associated deaths, including Blacks, men who have sex with men (MSM), and people who live in the South (who experience higher rates of poverty and lower rates of health coverage.)

In 2019, the CDC reported 15,815 deaths among people living with HIV in the United States.

A Word From Verywell

With increased access to antiretroviral therapy, the risk of disease and death had dropped dramatically in people living with HIV. To live a long and healthy life, it is important to get tested if you think you have HIV and to start treatment if you test positive for the disease.

If you are in need of HIV information or referrals, contact your state's HIV/AIDS hotline, many of which are available 24 hours a day.

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