·       HIV prevalence among 15 – 49: 1.1%

·       HIV prevalence among key populations:

o   SW:13,7% 

o   MSM: 4,8% 

o   Prisons: 5,2% 

·       With 856 deaths for every 100,000 live births, Chad has one of the highest maternal mortality rates in central Africa, a phenomenon aggravated by the high number of early pregnancies (164.5 births per 1,000 adolescents between the ages of 15 and 19). 

·       Estimated number of new infections among adults (15+ years old): 2400

·       Estimated number of new infections among children (0-14 years old): 950

·       Number of people on ARV treatment:82 755

·       Only 30% of children living with HIV are on life-saving treatment,
far behind adults of whom 70% are receiving antiretrovirals.

In 2021, it has a total population of 2,96 million,  and a large diaspora estimated to be eight to ten million ethnic Armenians globally. 

Armenia is a developing country and ranks 85th on the Human Development Index (2021). Armenia ranked 63rd out of 180 countries on Environmental Performance Index (EPI) in 2018. 
HIV epidemic in Armenia is concentrated among KP. HIV overall prevalence of 0.3 and HIV incidence of 0.2/1000 population. The number of new HIV diagnoses was increased, in 2022 were detected 535 HIV cases. HIV epidemic in Armenia is concentrated among key populations (KPs) and labour migrants. According to 2021 IBBS, HIV prevalence among people who inject drugs (PWID) is 2.6% and men who have sex with men (MSM) is 5.0% and among female sex workers (FSW) – 0.2%.  Based on 2018 survey, HIV prevalence was 1.2% among 900 urban male labour migrants tested for HIV under. According to 2021 IBBS, a very high proportion of PWID have used sterile equipment during the last injection – 99%. The condom use among FSW was 93.2%, among MSM – 79.6% and PWID – 32.4%. HIV testing and status awareness were the highest among MSM – 100%, followed by PWID - 95.4%., but was low among FSWs – 77.2%․ However, according to the programmatic data, the HIV testing coverage in 2022 among MSM was 35․3%, FSW – 39․3% and PWID – 39.4%. The testing yield through lay providers was the highest among MSM - 2.8% and below 1% for other KPs (0% for Transgender (TG)). Out of the positive tests results provided by lay providers, only 37.9% were confirmed by the National Center for Infectious Diseases (NCID) for FSW , 64.8% for MSM and 76.2% for PWID. Other cases either were not linked to NCAP or were not confirmed. 

According to 2022 Spectrum estimates, the number of people living with HIV (PLHIV) in the country is 4,850. Out of this number, 82,6% were diagnosed; 77,2% of the diagnosed were put on antiretroviral (ARV) treatment; and 70,5% of PLHIV who were on treatment had viral suppression. 

Between 1988 and 2022, the main reported mode of transmission in Armenia was heterosexual contacts (81.3%), followed by sex between men (11.4%) and injecting drug use (5.8%). Mother-to-child transmission and unknown 0.6% and 0.9%, respectively. 

The alarmingly attributed to the migration factor (migrants and their partners), with 41.3% of newly diagnosed HIV infections in the last five years. 

Between 2020 and 2022, 60.5% of all HIV patients who had CD4 test result at the time of diagnoses were diagnosed at the late stage of HIV infection with a CD4 count <350 cells/mm3. In 2022, 230 AIDS cases and 74 deaths were reported. 

Stigma and discrimination towards key populations (sex workers, people who inject drugs, men who have sex with men, transgender people, people living with the diseases) remain high, with 0.3% of MSM, 18.3% of FSWs and 17% of PWID having reported in the 2021 IBBS avoiding healthcare because of fear of stigma and discrimination. The Legal Environment Assessment underway, and a desk review of legal barriers completed in February 2018 in response to the TRP recommendation, have identified legal and policy barriers that may hinder access of KPs to HIV-related prevention and health care.

South Sudan is far from achieving the 2025 global targets. For example, in 2022, there were an estimated 165,000 PLHIV of which 39% knew their status, 32% were accessing treatment and 27% were virally suppressed. In addition, while deaths from HIV have fallen in the last five years the rate of decline is insufficient for epidemic control.

Sustained and significantly higher investment is required to scale up the HIV response to accelerate the HIV response in the country. There is low domestic investment in the public health sector overall, with critical health system weakness unaddressed, including those relating to infrastructure, facilities and equipment, and human resources for health (HRH) recruitment and retention. This has led to an almost complete reliance on the financial, technical, and operational capacity of international partners to deliver the national HIV response. The programme is therefore donor-driven, mostly parallel, with inadequate integration across the PHC, particularly family planning, ANC, reproductive maternal neonatal and child health, sexually transmitted infections and other SRH programmes, including tailored services for adolescents and young people where they are available.

The country requires investment in national data and information for decision-making and quality improvement at all levels, resulting in the ongoing inability of stakeholders to 'know the HIV epidemic' in such detail as to effectively prioritise investment for higher impact. 

Gender inequality is a key driver of the HIV epidemic globally. Unequal power relations, unequal access to opportunities including education and employment, gender-based violence, and many other factors including culture and harmful traditional practices such as child marriages, leave groups of people, particularly, women, girls, and key populations, vulnerable to HIV infection and unable to access lifesaving services.

South Sudan has a very high incidence of sexual and gender-based violence (SGBV). While it is impossible to obtain national level estimates due to chronic under-reporting, it is accepted that rates of GBV are very high. 

Gender inequality, discriminatory and harmful traditional and cultural practices, such as girls being a source of family wealth (bride price), unpaid female labour, and child/forced marriage, limit access to opportunities, resources and participation for women and girls. Both child marriage (45%) and teenage pregnancy (300 per 1,000 adolescent girls) contribute to the lack of educational attainment.  South Sudan has the lowest proportion of female students enrolled in primary school and the second lowest proportion enrolled in secondary school in Sub-Saharan Africa. HIV is not only driven by the socio-cultural norms of a people, but the legal environment plays a critical role in reducing vulnerability to HIV infection and improving the lives of PLHIV.