Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

The global impact of HIV/AIDS


The scale of the human immunodeficiency virus (HIV)/AIDS epidemic has exceeded all expectations since its identification 20 years ago. Globally, an estimated 36 million people are currently living with HIV, and some 20 million people have already died, with the worst of the epidemic centred on sub-Saharan Africa. But just as the spread of HIV has been greater than predicted, so too has been its impact on social capital, population structure and economic growth. Responding to AIDS on a scale commensurate with the epidemic is a global imperative, and the tools for an effective response are known. Nothing less than a sustained social mobilization is necessary to combat one of the most serious crises facing human development.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Worldwide numbers of adults and children estimated to be living with HIV/AIDS at the end of 2000.
Figure 2: Annual number of newly registered HIV infections in Russia from 1993 until September 2000.
Figure 3: Spread of HIV in Africa, 1984–1999.
Figure 4: Reported sexually transmitted infections in China, 1985 to 1999.
Figure 5: Lifetime risk of dying of AIDS for 15-year-old boys from selected countries, assuming unchanged or halved risk of becoming infected with HIV.
Figure 6: Growth impact of HIV.
Figure 7: Reduction in production in a Zimbabwean household with an AIDS death.

Similar content being viewed by others


  1. Global Programme on AIDS. Current and Future Dimensions of the HIV/AIDS Pandemic (World Health Organization, Geneva, 1991).

  2. Joint United Nations Programme on HIV/AIDS and World Health Organization. AIDS Epidemic Update: December 2000 (UNAIDS, Geneva, 2000).

  3. The CASCADE Collaboration. Survival after introduction of HAART in people with known duration of HIV-1 infection. Lancet 355, 1158–1159 (2000).

  4. Centers for Disease Control and Prevention. HIV/AIDS Surveillance Rep. 12, 35 (2000).

  5. Institut de Veille Sanitaire Surveillance du Sida en France. Bulletin Épidémiologique Hebdomadaire 38 (2000).

  6. Cazein, F. et al. Tendances récentes de l'épidemie de Sida. Sida, VIH et MST, Etat des Données en 2000 (Institut de Veille Sanitaire, Saint-Maurice, 2000).

    Google Scholar 

  7. Public Health Laboratory Service. Diagnosed HIV infected people in England and Wales—projections for the next four years. Communic. Dis. Rep. 10, 453–454 (2000).

  8. Smith, D. K. et al. HIV/AIDS among African Americans: progress or progression? AIDS 14, 1237–1248 (2000).

    Article  CAS  Google Scholar 

  9. Centres for Disease Control and Prevention. Cluster of HIV-infected adolescents and young adults—Mississippi, 1999. Morbid. Mort. Weekly Rep. 49, 861–864 (2000).

  10. Valleroy, L. A. et al. HIV prevalence and associated risks in young men who have sex with men. J. Am. Med. Assoc. 284, 198–204 (2000).

    Article  CAS  Google Scholar 

  11. Dodds, J. P. et al. Increasing high risk sexual behaviour among homosexual men in London 1996-8. Br. Med. J. 320, 1510–1511 (2000).

    Article  CAS  Google Scholar 

  12. Bolding, G. et al. International differences among gay men in HIV optimism and sexual risk behaviour—a report from London, Melbourne, Sydney and Vancouver. Abstract LbPp105, XIIIth International AIDS Conference, Durban, South Africa, 9–14 July 2000. 〈

  13. National Centre in HIV Epidemiology and Clinical Research. HIV/AIDS 2000 Hepatitis C and Sexually Transmissible Infections in Australia Annual Surveillance Report 2000 (National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, 2000).

  14. Monterroso, E. R. et al. Prevention of HIV infection in street-recruited injection drug users, J. Acquir. Immune Defic. Syndr. 25, 63–70 (2000).

    Article  CAS  Google Scholar 

  15. Dehne, K. L., Pokrovskiy, V., Kobyshcha, Y. & Schwartländer, B. Update on the epidemics of HIV and other sexually transmitted infections in the newly independent states of the former Soviet Union. AIDS 14 (Suppl.), S75–S84 (2000).

    PubMed  Google Scholar 

  16. Joint United Nations Programme on HIV/AIDS. AIDS in Africa, Country by Country (UNAIDS, Geneva, 2000).

  17. Jordan-Harder, B., Koshuma, Y. A., Pervilhac, C. & Vogel, U. Hope for Tanzania: Lessons Learned from a Decade of Comprehensive AIDS Control in Mbeya Region (GTZ Eschborn, Germany, and Ministry of Health, Dar-es-Salaam, 2000).

    Google Scholar 

  18. Kamali, A. et al. Seven-year trends in HIV-1 infection rates, and changes in sexual behaviour, among adults in rural Uganda. AIDS 14, 427–434 (2000).

    Article  CAS  Google Scholar 

  19. Carael, M., Buve, A. & Awusabo-Asare, K. The making of HIV epidemics: what are the driving forces? AIDS 11 (Suppl.), S23–S31 (1997).

    PubMed  Google Scholar 

  20. Beyrer, C. et al. Overland heroin trafficking routes and HIV-1 spread in south and south-east Asia. AIDS 14, 75–83 (2000).

    Article  CAS  Google Scholar 

  21. Qu, S., Sun, X. & Zheng, X. National sentinel surveillance of HIV infection in China from 1995 to 1998. Abstract MoPeC2379, XIIIth International AIDS Conference, Durban, South Africa, 9–14 July 2000. 〈

  22. Joint United Nations Programme on HIV/AIDS. Monitoring the AIDS Pandemic. The Status and Trends of the HIV/AIDS Epidemics in the World. Provisional Report 5–7 July 2000 (UNAIDS Geneva, 2000).

  23. Chen, X.-S., Gong, X.-D., Liang, G.-J. & Zhang, G.-C. Epidemiologic trends of sexually transmitted diseases in China. Sex. Transm. Dis. 27, 138–142 (2000).

    Article  CAS  Google Scholar 

  24. Shaukat, M. HIV sentinel surveillance in India. Abstract MoPeC2416, XIIIth International AIDS Conference, Durban, South Africa, 9–14 July 2000. 〈

  25. AIDS and STD Control Programme. Report on the Sero-Surveillance and Behavioural Surveillance on STD and AIDS in Bangladesh 1998-1999 (Ministry of Health & Family Welfare, Government of the People's Republic of Bangladesh, 2000).

  26. Khamboonruang, C. et al. Sustained low HIV-1 incidence among cohorts of young northern Thai adults: confirmation of Thailand's success in HIV prevention. Abstract ThOr671, XIIIth International AIDS Conference, Durban, South Africa, 9–14 July 2000. 〈

  27. Kilmarx, P. H. et al. Explosive spread and effective control of human immunodeficiency virus in northernmost Thailand: the epidemic in Chiang Rai province, 1988-99. AIDS 14, 2731–2740 (2000).

    Article  CAS  Google Scholar 

  28. Joint United Nations Programme on HIV/AIDS. Report on the Global HIV/AIDS Epidemic, June 2000 (UNAIDS, Geneva, 2000).

  29. Vandemoortele, J. & Delamonica, E. The “education vaccine” against HIV. Curr. Issues Comp. Educ. 3〉 (2000).

  30. Population Division, United Nations, and Joint United Nations Programme on HIV/AIDS. The Demographic Impact of HIV/AIDS. Report of Technical Meeting, New York, 10 November 1998 (United Nations, New York, 1999).

  31. World Health Organization. World Health Report 2000 (WHO, Geneva, 2000).

  32. Schwartländer, B., Garnett, G., Walker, N. & Anderson, R. AIDS in a new millennium. Science 289, 64–67 (2000).

    Article  Google Scholar 

  33. Arndt, C. & Lewis, J. The macro implications of HIV/AIDS in South Africa: a preliminary assessment. S. Afr. J. Econ. 68 (3), 1–32 (2000).

    Google Scholar 

  34. Engh, I. D., Stloukal, L. & du Guerny, J. HIV/AIDS in Namibia: The Impact on the Livestock Sector (Food and Agriculture Organization, Rome, 2000).

    Google Scholar 

  35. Ayieko, M. From single parents to child headed households: the case of children orphaned by AIDS in Kismu and Siaya districts. Study No. 7 (UNDP, New York, 1998).

  36. Botswana Institute for Development Policy Analysis. Macroeconomic Impacts of the HIV/AIDS Epidemic in Botswana (BIDPA, Botswana, 2000).

  37. Nampanya-Serpell, N. Social and economic risk factors for HIV/AIDS—affected families in Zambia. AIDS and Economics Symposium, Durban, 7–8 July 2000. 〈

  38. United Nations Children's Fund. The Progress of Nations 2000 (UNICEF, New York, 2000).

  39. International Labour Organization. HIV/AIDS A Threat to Decent Work, Productivity and Development (ILO, Geneva, 2000).

  40. Evian, C. Anonymous HIV surveillance: a powerful tool for advocacy and for managing HIV in the workplace. Abstract MoPeC2365, XIIIth International AIDS Conference, Durban, South Africa, 9–14 July 2000. 〈

  41. Michael, K. A critique of best practices: company activities on HIV/AIDS in South Africa. Abstract MoPeD2852, XIIIth International AIDS Conference, Durban, South Africa, 9–14 July 2000. 〈

  42. Sena, A. et al. Trends of gonorrhea and chlamydial infection during 1985–1996 among active-duty soldiers at a United States Army installation. Clin. Infect. Dis. 30, 742–748 (2000).

    Article  CAS  Google Scholar 

  43. Mendoka Mjr, M. Speech to the 18th Commission for Human Settlement Conference, Gigiri, Kenya. Reported in the East African Standard, 17 February 2001.

  44. Joint United Nations Programme on HIV/AIDS. Force for Change: World AIDS Campaign with Young People (UNAIDS, Geneva, 1998).

  45. Blumenthal, R. N., Kral, A. H., Erringer, E. A. & Edlin, B. R. The effect of syringe exchange use on high-risk injection drug users: a cohort study. AIDS 14, 605–611 (2000).

    Article  Google Scholar 

  46. Egger, M. et al. Promotion of condom use in a high-risk setting in Nicaragua: a randomised controlled trial. Lancet 355, 2101–2105 (2000).

    Article  CAS  Google Scholar 

  47. Grosskurth, H., Gray, R., Hayes, R., Mabey, D. & Wawer, M. Control of sexually transmitted diseases for HIV-1 prevention: understanding the implications of the Mwanza and Rakai trials. Lancet 355, 1981–1987 (2000).

    Article  CAS  Google Scholar 

  48. The Voluntary HIV-1 Counseling and Testing Efficacy Study Group. Efficacy of voluntary HIV-1 counselling and testing in individuals and couples in Kenya, Tanzania, and Trinidad: a randomised trial. Lancet 356, 103–112 (2000).

  49. Sweat M et al. Cost-effectiveness of voluntary HIV-1 counselling and testing in reducing sexual transmission of HIV-1 in Kenya and Tanzania. Lancet 356, 113–121 (2000).

    Article  CAS  Google Scholar 

  50. Bonnel, R. Economic Analysis of HIV/AIDS. Background Paper for the African Development Forum, September 2000 (The World Bank, Washington DC, 2000).

    Google Scholar 

  51. Bollinger, L. & Stover, J. The Economic Impact of AIDS (The Futures Group International, Washington DC, 1999).

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Peter Piot.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Piot, P., Bartos, M., Ghys, P. et al. The global impact of HIV/AIDS. Nature 410, 968–973 (2001).

Download citation

  • Issue Date:

  • DOI:


By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing