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(57192167101)NduagubaKandel, Sandhya Neupane (57222966618)Sandhya Neupane (57222966618)KandelNguefack-Tsague, Georges (55198921200)Georges (55198921200)Nguefack-TsagueNguyen, Trang Huyen (59142352200)Trang Huyen (59142352200)NguyenNixon, Molly R. (57204562047)Molly R. (57204562047)NixonNnaji, Chukwudi A. (57204873792)Chukwudi A. (57204873792)NnajiNoubiap, Jean Jacques (55490374000)Jean Jacques (55490374000)NoubiapNuñez-Samudio, Virginia (15063201000)Virginia (15063201000)Nuñez-SamudioNyirenda, Thomas Elliot (6603775882)Thomas Elliot (6603775882)NyirendaOghenetega, Onome Bright (57216588908)Onome Bright (57216588908)OghenetegaOlagunju, Andrew T. (26029995700)Andrew T. (26029995700)OlagunjuOlakunde, Babayemi Oluwaseun (55251697700)Babayemi Oluwaseun (55251697700)OlakundeOwopetu, Oluwatomi Funbi (57219110616)Oluwatomi Funbi (57219110616)OwopetuMahesh, P.A. (57202421244)P.A. (57202421244)MaheshPadubidri, Jagadish Rao (58295062300)Jagadish Rao (58295062300)PadubidriPakhale, Smita (57220937499)Smita (57220937499)PakhaleParekh, Tarang (57205447202)Tarang (57205447202)ParekhKan, Fatemeh Pashazadeh (57222966726)Fatemeh Pashazadeh (57222966726)KanPawar, Shrikant (58594958600)Shrikant (58594958600)PawarPepito, Veincent Christian Filipino (57216890866)Veincent Christian Filipino (57216890866)PepitoPeprah, Emmanuel K. (57195257834)Emmanuel K. (57195257834)PeprahPinheiro, Marina (54397531500)Marina (54397531500)PinheiroPokhrel, Khem Narayan (57189445377)Khem Narayan (57189445377)PokhrelPolibin, Roman V. (36721857100)Roman V. (36721857100)PolibinPollok, Richard Charles G. (6603865038)Richard Charles G. (6603865038)PollokPostma, Maarten J. (7006296502)Maarten J. (7006296502)PostmaSyed, Zahiruddin Quazi (36337182700)Zahiruddin Quazi (36337182700)SyedRadfar, Amir (57194428768)Amir (57194428768)RadfarRadhakrishnan, Raghu Anekal (7103113006)Raghu Anekal (7103113006)RadhakrishnanRahim, Fakher (23052247800)Fakher (23052247800)RahimRahimi-Movaghar, Vafa (6507646446)Vafa (6507646446)Rahimi-MovagharRahimzadeh, Shadi (48061460300)Shadi (48061460300)RahimzadehRahman, Mosiur (55457953000)Mosiur (55457953000)RahmanRahmani, Amir Masoud (57204588830)Amir Masoud (57204588830)RahmaniRam, Pradhum (55961669800)Pradhum (55961669800)RamRanabhat, Chhabi Lal (56719695500)Chhabi Lal (56719695500)RanabhatRanasinghe, Priyanga (6602322079)Priyanga (6602322079)RanasingheRao, Chythra R. (35771430100)Chythra R. (35771430100)RaoRao, Sowmya J. (57195423591)Sowmya J. (57195423591)RaoRathi, Priya (57216633909)Priya (57216633909)RathiRawaf, David Laith (57209228052)David Laith (57209228052)RawafRawaf, Salman (6602475959)Salman (6602475959)RawafRegassa, Lemma Demissie (57208704471)Lemma Demissie (57208704471)Regassaur Rehman, Inayat (57201810654)Inayat (57201810654)ur RehmanRenzaho, Andre M.N. (6505786588)Andre M.N. (6505786588)RenzahoRezaei, Nima (57216077273)Nima (57216077273)RezaeiRezahosseini, Omid (57194737361)Omid (57194737361)RezahosseiniRezai, Mohammad Sadegh (55273796300)Mohammad Sadegh (55273796300)RezaiRezapour, Aziz (55548281300)Aziz (55548281300)RezapourRipon, Rezaul Karim (57219948722)Rezaul Karim (57219948722)RiponRodrigues, Voilet (57222324984)Voilet (57222324984)RodriguesRoshchin, Denis O. (57194175724)Denis O. (57194175724)RoshchinRwegerera, Godfrey M. (56033523400)Godfrey M. (56033523400)RwegereraSaeed, Umar (36612315100)Umar (36612315100)SaeedMoghaddam, Sahar Saeedi (56071020000)Sahar Saeedi (56071020000)MoghaddamSagar, Rajesh (26643103100)Rajesh (26643103100)SagarSaif-Ur-Rahman, K.M. (55990659300)K.M. (55990659300)Saif-Ur-RahmanSalem, Marwa Rashad (57194137372)Marwa Rashad (57194137372)SalemSamaei, Mehrnoosh (57225273791)Mehrnoosh (57225273791)SamaeiSamy, Abdallah M. (36973661300)Abdallah M. (36973661300)SamySantric-Milicevic, Milena M. (57211144346)Milena M. (57211144346)Santric-MilicevicSaroshe, Satish (36125578600)Satish (36125578600)SarosheSathian, Brijesh (27467953500)Brijesh (27467953500)SathianSatpathy, Maheswar (57202563691)Maheswar (57202563691)SatpathySawhney, Monika (57217153893)Monika (57217153893)SawhneySchutte, Aletta Elisabeth (57216814352)Aletta Elisabeth (57216814352)SchutteSeylani, Allen (57222325334)Allen (57222325334)SeylaniShaikh, Masood Ali (57203122601)Masood Ali (57203122601)ShaikhShaka, Mohammed Feyisso (57205107107)Mohammed Feyisso (57205107107)ShakaShamshad, Hina (24722237000)Hina (24722237000)ShamshadShamsizadeh, Morteza (57195940127)Morteza (57195940127)ShamsizadehShannawaz, Mohammed (56349680200)Mohammed (56349680200)ShannawazShetty, Adithi (57315189400)Adithi (57315189400)ShettyShin, Jae Il (57964880100)Jae Il (57964880100)ShinShivakumar, K.M. (57221603938)K.M. (57221603938)ShivakumarSingh, Jasvinder A. (7404421736)Jasvinder A. (7404421736)SinghSkryabin, Valentin Yurievich (57226830981)Valentin Yurievich (57226830981)SkryabinSkryabina, Anna Aleksandrovna (57218875198)Anna Aleksandrovna (57218875198)SkryabinaSomayaji, Ranjani (6507727557)Ranjani (6507727557)SomayajiSoshnikov, Sergey (57195195606)Sergey (57195195606)SoshnikovSpurlock, Emma Elizabeth (57218543838)Emma Elizabeth (57218543838)SpurlockStein, Dan J. (55769747595)Dan J. (55769747595)SteinSufiyan, Mu'awiyyah Babale (58294633600)Mu'awiyyah Babale (58294633600)SufiyanTadbiri, Hooman (57138410000)Hooman (57138410000)TadbiriTadesse, Birkneh Tilahun (56811144600)Birkneh Tilahun (56811144600)TadesseTadesse, Eyayou Girma (57221591705)Eyayou Girma (57221591705)TadesseTamiru, Animut Tagele (57218877788)Animut Tagele (57218877788)TamiruTarkang, Elvis Enowbeyang (55351474900)Elvis Enowbeyang (55351474900)TarkangTaveira, Nuno (6602731390)Nuno (6602731390)TaveiraTekalegn, Yohannes (57201033519)Yohannes (57201033519)TekalegnTesfay, Fisaha Haile (57203977293)Fisaha Haile (57203977293)TesfayTessema, Gizachew Assefa (57196316304)Gizachew Assefa (57196316304)TessemaThapar, Rekha (36337431900)Rekha (36337431900)ThaparTovani-Palone, Marcos Roberto (56644977900)Marcos Roberto (56644977900)Tovani-PaloneTraini, Eugenio (57211137081)Eugenio (57211137081)TrainiTran, Bach Xuan (57209107515)Bach Xuan (57209107515)TranTsai, Alexander C. (35362700200)Alexander C. (35362700200)TsaiTusa, Biruk Shalmeno (57216200356)Biruk Shalmeno (57216200356)TusaUllah, Saif (57219395828)Saif (57219395828)UllahUmeokonkwo, Chukwuma David (57204448015)Chukwuma David (57204448015)UmeokonkwoUnnikrishnan, Bhaskaran (12790012100)Bhaskaran (12790012100)UnnikrishnanTahbaz, Sahel Valadan (57216154072)Sahel Valadan (57216154072)TahbazVillafañe, Jorge Hugo (57197861057)Jorge Hugo (57197861057)VillafañeVladimirov, Sergey Konstantinovitch (57195959162)Sergey Konstantinovitch (57195959162)VladimirovVo, Bay (35147075900)Bay (35147075900)VoVongpradith, Avina (57216661011)Avina (57216661011)VongpradithVu, Giang Thu (57202424871)Giang Thu (57202424871)VuWaheed, Yasir (35303643700)Yasir (35303643700)WaheedWamai, Richard G. (23969762700)Richard G. (23969762700)WamaiWang, Guan (55503825500)Guan (55503825500)WangWang, Yanzhong (59417336500)Yanzhong (59417336500)WangWard, Paul (7402101951)Paul (7402101951)WardWesterman, Ronny (57218361023)Ronny (57218361023)WestermanWinkler, Andrea Sylvia (58323746700)Andrea Sylvia (58323746700)WinklerYadav, Lalit (57211483937)Lalit (57211483937)YadavJabbari, Seyed Hossein Yahyazadeh (57207954055)Seyed Hossein Yahyazadeh (57207954055)JabbariYazie, Taklo Simeneh (57207254034)Taklo Simeneh (57207254034)YazieYi, Siyan (16837551600)Siyan (16837551600)YiYiğit, Vahit (57222328239)Vahit (57222328239)YiğitYirdaw, Birhanu Wubale (57219148502)Birhanu Wubale (57219148502)YirdawYonemoto, Naohiro (57204947657)Naohiro (57204947657)YonemotoYu, Chuanhua (57208140344)Chuanhua (57208140344)YuYunusa, Ismaeel (57202137670)Ismaeel (57202137670)YunusaZastrozhin, Mikhail Sergeevich (56728932200)Mikhail Sergeevich (56728932200)ZastrozhinZastrozhina, Anasthasia (57210832491)Anasthasia (57210832491)ZastrozhinaZhang, Zhi-Jiang (56068578400)Zhi-Jiang (56068578400)ZhangZumla, Alimuddin (7006170723)Alimuddin (7006170723)ZumlaSalomon, Joshua A. (56745638600)Joshua A. (56745638600)SalomonEaton, Jeffrey W. (58553535300)Jeffrey W. (58553535300)EatonNaghavi, Mohsen (57207906323)Mohsen (57207906323)NaghaviDwyer-Lindgren, Laura (50461317900)Laura (50461317900)Dwyer-LindgrenWang, Haidong (16507828100)Haidong (16507828100)WangLim, Stephen S. (57201800433)Stephen S. (57201800433)LimHay, Simon I. (7101875313)Simon I. (7101875313)HayMurray, Christopher J.L. (57224556036)Christopher J.L. (57224556036)MurrayKyu, Hmwe H. (57217040073)Hmwe H. (57217040073)Kyu2025-06-122025-06-122021https://doi.org/10.1016/S2352-3018(21)00152-1https://www.scopus.com/inward/record.uri?eid=2-s2.0-85117526510&doi=10.1016%2fS2352-3018%2821%2900152-1&partnerID=40&md5=52f0cdec12847ef15f2097ab3d68ab75https://remedy.med.bg.ac.rs/handle/123456789/4041Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was 1·94 (1·76–2·12). No regions met suggested thresholds for progress. Interpretation: Sub-Saharan Africa had both the highest HIV burden and the greatest progress between 1990 and 2019. The number of incident cases and deaths in males and females approached parity in 2019, although there remained more females with HIV than males with HIV. Globally, the HIV epidemic is far from the UNAIDS benchmarks on progress metrics. Funding: The Bill & Melinda Gates Foundation, the National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license