Deaths from HIV/AIDS have declined steadily around the world over the past decade — but the rate of new infections has stayed much the same, an analysis in The Lancet HIV1 shows.The number of new HIV infections peaked at 3.3 million in 1997, and dropped by an average of 2.7% each year to around 2.5 million in 2005. But the infection rate has stagnated since then. In 74 countries, including several in the Middle East, the rate has increased.

A global scale-up in the use of antiretroviral therapy has been one of the crucial contributors to the decline in death rate, says the analysis, led by global-health researcher Haidong Wang at the University of Washington in Seattle. Worldwide, 41% of people with HIV/AIDS now receive antiretroviral drugs. Substantially reducing the number of new infections has proved more challenging, however. Efforts to prevent HIV transmission from mother to child have been a success, but HIV-related aid to developing countries has levelled off since 2010 — and does not look set to rise. Also to blame might be an increase in unprotected sex in places that now have a reduced perception of HIV risk, the report says.The analysis is part of the Global Burden of Disease Study 2015, a systematic effort to map the distribution of an array of diseases, led by the Institute for Health Metrics and Evaluation in Seattle, Washington.