Despite decades of progress, HIV remains a major public health challenge.
While advances in prevention, testing, and treatment have transformed outcomes for many people living with or at risk of HIV, significant inequities continue to prevent high-income countries from achieving global HIV goals. Migrants, women, racial and ethnic minorities, indigenous populations, people who inject drugs, transgender people, sex workers, and other underserved groups continue to face barriers across the HIV care continuum.
In this report, experts from Charles River Associates’ Life Sciences Practice examine inequities across prevention, testing and diagnosis, treatment access, and long-term retention in care across eight high-income countries: Australia, Canada, France, Germany, Italy, Japan, Spain, and the United Kingdom. Drawing on national policy reviews and published evidence, the report identifies the extent of inequities, their root causes, and emerging best practices that can help policymakers accelerate progress toward ending AIDS as a public health threat by 2030.
Key takeaways
- HIV inequity persists in high-income countries, particularly among key populations facing stigma, exclusion, financial barriers, or limited access to tailored services.
- Inequities are driven by a combination of individual, social, and health system barriers, including limited awareness, fragmented care pathways, restrictive access policies, and gaps in data collection.
- Ending AIDS by 2030 will require people-centred, rights-based responses that close gaps across prevention, testing, treatment, and long-term care.
Policy recommendations
- Expand equitable access to PrEP, ART, and HIV testing by reducing costs, broadening reimbursement, and supporting decentralised delivery through pharmacies, telehealth, and mobile services.
- Strengthen culturally tailored education, anti-stigma campaigns, peer outreach, and patient navigation to help key populations access and remain engaged in care.
- Improve provider training, update national HIV strategies, and build stronger disaggregated data systems to close gaps and track progress toward 2030 targets.
As countries work toward achieving the UNAIDS goal of ending AIDS as a public health threat by 2030, addressing inequity will be essential to ensuring that no population is left behind.
Read the full analysis on ending the HIV epidemic here.
