A newly released United Nations report has found that the global HIV prevention effort is experiencing its “most serious setback in decades”.

The report, which was published on Tuesday, November 25, found that abrupt funding cuts and a “deteriorating” human rights environment are significantly disrupting prevention and treatment services in a number of countries.

According to current projections, a failure to reinstate funding and prevention efforts could result in an additional 3.3 million new HIV infections over the next five years, leaving adolescent girls and young women particularly at risk.

As the UN reports, low and middle income countries have been particularly affected by these disruptions, with testing and community-led programmes declining.

Ethiopia and the Democratic Republic of Congo have experienced shortages of HIV test kits and essential medicines, while distribution of preventive drugs has declined by 31% in Uganda, 21% in Vietnam and 64% in Burundi since 2023. In that same time period, Nigeria has recorded a 55% drop in condom distribution.

Additionally, 450,000 women in sub-Saharan Africa have lost access to trusted community workers who connected them to HIV care programmes.

The UN has said that in addition to a funding crisis, a rise in punitive laws – such as those criminalising same-sex relationships and transgender people – is “deepening” the setback. Together with the criminalisation of sex work and small-scale drug possession, this type of legislation undermines access to HIV services.

UNAIDS’ Executive Director Winnie Byanyima has said a crisis in HIV funding has “exposed the fragility of the progress we fought so hard to achieve”.

She said: “Behind every data point in this report are people… babies missed for HIV screening, young women cut off from prevention support, and communities suddenly left without services and care. We cannot abandon them.”

The UN is calling on world leaders to reaffirm commitments made at G20 in South Africa, to maintain and increase HIV funding, to invest in innovation, including affordable long-acting prevention and to uphold human rights.