The epidemiological data on HIV and AIDS in Switzerland and globally presents a differentiated picture: while in Western countries certain groups are particularly affected, in many other countries it is the entire population. In many regions of the world, new infections are on the decline. But Western countries in particular are investing too little to achieve the 2030 targets.

The international community has set itself a goal: no new HIV infections and no more AIDS cases by 2030. This requires as many countries in the world as possible to achieve the UNAIDS 95-95-95 targets. The international community can accomplish this if it has the political will, the required resources and the commitment to strengthening human rights.

HIV cascade: 95-95-95

  • 95% of people living with HIV are aware of it,
  • 95% of them receive life-saving HIV medications and
  • in 95% of them, the drugs work so well that HIV is not sexually transmissible.

If these goals are achieved, millions of people around the world will continue to live with HIV – and have a high life expectancy thanks to good medication. Their healthcare and quality of life are crucial in preventing the transmission of HIV. That’s why there are also the 10-10-10 goals for people with HIV: 

  • less than 10% of countries have a political and social environment that restricts access to health, 
  • less than 10% of people living with HIV experience stigma and 
  • less than 10% of key groups affected by HIV experience inequality, discrimination and violence.

The countries of the world must be measured against these goals.

Situation in Switzerland

The Federal Office of Public Health (FOPH) publishes the number of new HIV diagnoses for the previous year in November. The following figures refer to the FOPH 2022 annual report of 27 November 2023 (in German an French).

In 2022, a total of 372 new HIV diagnoses were reported to the FOPH. This is significantly more than in the previous year (325 cases, + 14%). The number of cases in 2021 was below the long-term trend, which is likely to be due to behavioural changes and lower testing during the Covid pandemic. In 2022, the number of new HIV diagnoses reported was still lower than three years earlier (427), before the pandemic. The 372 new HIV diagnoses correspond to an incidence of 4.2 cases per 100,000 resident population. In particular, the FOPH’s analysis shows that men who have sex with men are proportionally the most affected by HIV and other STIs. 70% of reported cases involved men, with no diagnoses made in trans and intersex people. As in previous years, the most common route of infection for men was sex with other men, while for women it was heterosexual contact. In 2022, as in previous years, infections related to intravenous drug use played only a minor role.

HIV laboratory reports

By gender and test year since the start of testing, 1985-2022

BAG-Bulletin 48/2023 (in German and French).

The 1990s saw an average of 1,300 cases per year. Underlying this decline is a sustained HIV response, as a result of which almost all people living with HIV know their status and receive effective treatment quickly so that they no longer pass on the virus. It is also the result of an annual STI testing campaign by the Swiss AIDS Federation, which was first conducted in May 2017 and has been repeated every year since then. Pre-exposure prophylaxis (PrEP) also contributed to the decrease. At the end of 2022, at least 4,500 people, predominantly gay men, protected themselves against HIV using PrEP.

HIV cascade in Switzerland (2022)

  • Roughly 18,000 people in Switzerland are living with HIV,
  • 93% (approx. 16,700 people) know about their infection,
  • 97% of them (approx. 16,200) have access to HIV treatment and in turn
  • 97% of them (approx. 15,600) have no detectable viral load and HIV can no longer be transmitted (U=U).

Source: BAG-Bulletin 48/2023

Based on statistical projections, which take into account that AIDS cases are sometimes reported up to several years after diagnosis, the FOPH assumes that the number of new AIDS cases has stabilized at about 60 to 80 cases per year. In virtually all AIDS cases in Switzerland, the HIV diagnosis occurs less than a year before the illness – meaning that treatment could not be started in good time to prevent the emergence of AIDS. But even for these people, there is a good chance that their health will improve again if HIV therapy is started immediately.

In Switzerland, the incidence of HIV varies greatly depending on the population group. There are key groups – with some people in multiple groups – in which HIV is more prevalent. The following groups of people are particularly affected by HIV and other sexually transmitted infections (FOPH 2024):

  • People living with HIV and their sexual contacts
  • Gay men and other men who have sex with men
  • People with a connection to countries with an increased HIV prevalence
  • People who inject, inhale or sniff drugs
  • Clients of sex workers
  • Sex workers
  • People in custody
  • Trans people

Global situation

The following information is based on data from UNAIDS (Fact Sheet and Update 2023) and is based on country disclosures, modelling and estimates.

In 2022, roughly 1.3 million people around the world became infected with HIV. 630,000 people died of AIDS – even though these deaths could have been prevented today thanks to antiviral drugs.

HIV cascade in the world (2022)

  • Roughly 39 million people in the world are living with HIV,
  • 86% (approx. 33 million people) are aware of their infection,
  • 89% of them (approx. 29 million) have access to HIV treatment and in turn
  • 93% of them (approx. 27 million) have no detectable viral load and HIV can no longer be transmitted (U=U).

Source: UNAIDS Update 2023

The situation varies greatly from country to country, especially in terms of the population groups particularly affected by HIV. UNAIDS considers men who have sex with men, sex workers, trans people, people who inject drugs, and incarcerated people to be the top five key populations who are disproportionately affected by HIV and at the same time often have difficulty accessing healthcare. Outside of sub-Saharan Africa, 80% of new infections are attributable to these key groups, with around 25% of new infections in these countries also occurring in key groups (UNAIDS 2016).

There are also countries where the entire population is affected by HIV. HIV is endemic in these “high prevalence countries” and is predominantly transmitted heterosexually. HIV prevalence is more than 1% in adults aged 15-49 years. A list of the countries can be found at the Robert Koch Institute or on UNAIDS.