On a day meant to remind the world that the fight against HIV is far from over, India stands at a crossroads. The country has made remarkable strides in reducing new HIV infections since the early 2000s, yet the pace of progress has plateaued and in some high-burden pockets, even reversed.
As the world marks World AIDS Day 2025, public health experts warn that complacency could undo years of gains.
According to the latest data from the National AIDS Control Organisation (NACO), India currently has an estimated 24 lakh people living with HIV (PLHIV). While overall prevalence remains low, the sheer size of the population means India still carries the world’s third-largest burden. The national programme’s success in expanding treatment has pushed ART coverage to nearly 85 per cent, yet critical gaps persist, especially among adolescents, rural women, and marginalised communities like sex workers, trans persons, and persons who inject drugs (PWID).
One concerning trend this year has been the rise in new HIV infections among young people aged 15–24. Urban metros such as Mumbai, Delhi, Bengaluru, and Hyderabad continue to report steady infections among men who have sex with men (MSM), though many cases remain hidden due to stigma and fear of discrimination in healthcare settings.
At the same time, states in the Northeast continue to fight dual epidemics of drug use and HIV, with Manipur, Mizoram and Nagaland reporting prevalence levels far above the national average.
Despite the public image of HIV affecting primarily men, women and girls now account for nearly 44 per cent of India’s HIV burden. Many contract the virus from long-term partners, yet are often the last to be diagnosed due to patriarchal barriers, lack of testing in antenatal settings and limited autonomy in seeking care.
As per information shared by the government's press information bureau, India has recorded an 81.4 per cent reduction in AIDS-related deaths, dropping from 1.73 lakh deaths in 2010 to 32,200 in 2024. Public health officials attribute this dramatic decline to the rapid expansion of free antiretroviral therapy (ART), which is projected to reach over 1.8 million people living with HIV by 2025. India has also achieved 94 per cent ART retention and 97 per cent viral suppression rates, two critical indicators in preventing HIV from progressing to AIDS. This places India among the strongest performers globally in long-term disease control.
However, maternal transmission continues to remain a critical challenge. "In 2023, around 2350 new paediatric infections were estimated by vertical transmission. However, 44 per cent of these transmissions resulted from incident HIV infections among pregnant and breastfeeding women," says Pradeep Kumar, NACO, Ministry of Health and Family Welfare, in a paper titled, ' Progress and challenges towards eliminating vertical transmission of HIV in India.'
India’s ART programme provides free medications, yet several states have reported stockouts and erratic supplies this year. For many patients, the challenge is not treatment cost but time and travel. Long commutes to ART centres, lost wages, and stigma from pharmacists and health workers keep many away from care, experts tell THE WEEK.
Community-led models, such as peer navigators, mobile clinics, and decentralised ART dispensing, have shown promise, but they remain pilot-scale. " It has been years that I have been living with HIV; while I'm on medicines, it is the societal stigma that has really affected me. One cannot live like this. I hate socialising," a domestic worker working in Mumbai's Sewri tells THE WEEK on condition of anonymity.
Nearly four decades into the epidemic, stigma remains one of the biggest barriers to testing and treatment. Young people hesitate to get tested, women fear blame and violence, and LGBTQ+ individuals worry about discrimination. As experts warn, the window for controlling the HIV epidemic is narrowing. India needs a sharper focus on young people through school and community-based awareness and routine testing for women, especially in antenatal care.
India’s current strategy, National AIDS Control Programme Phase V (2021–2026), is a Central Sector Scheme with an allocation of Rs 15,471.94 crore. The programme builds on the gains of earlier phases while addressing persistent gaps in high-burden districts and vulnerable populations.
World AIDS Day this year is about reminding governments, donors, and societies that HIV hasn’t gone away. The virus thrives in silence and the moment the world stops paying attention, it adapts.
This year’s theme, 'Overcoming disruption, transforming the AIDS response,' is a call to keep research alive, keep rights protected, and keep people at the centre of the response.
"There is no room for complacency. Traditional interventions, such as early identification of HIV-positive mothers and initiating them on life-long ART, remain essential to eliminating vertical transmission of HIV in India. Generating local evidence on the effectiveness of interventions, such as adoption of safe practices, repeat testing during pregnancy and breastfeeding, and feeding practices, will inform policy formulation for prevention and detection of incident infections," says Kumar.