The national Burden of HIV/AIDS in Tunisia, 2024

Abstract Introduction In Tunisia, the infection with the human immunodeficiency virus (HIV) has been a mandatory notifiable disease since 1986. We aimed to assess the burden of the HIV and the Acquired Immunodeficiency Syndrom (AIDS) in Tunisia for 2024. Methods Data from the national HIV/AIDS program, collecting information from the community and public Counseling and Anonymous Testing Centers (CCDATs), the Prevention of Mother-to-Child Transmission (PMTCT) programs, and from blood banks and laboratories for ELISA testing confirmation, were used. Treatment and follow-up data were also gathered from the four specialized HIV care centers. For 2024, Spectrum softawre (V 6.40) was used for annual AIDS deaths estimates using HIV prevalence, ART coverage and effectiveness, CD4 decline, stage-specific mortality rates, non-AIDS mortality, and treatment failure/dropout. Results Overall, the HIV-positive population was estimated at 9750 (69,4% were men). The number of new HIV cases was 1030 (75.4% were men), and the annual mortalities due to HIV were estimated at 484.7 (69.6% were men). Besides, the number of years lived with disability (YLD) attributable to AIDS was estimated at 2.4 thousands, while the total number of disability-adjusted life years (DALYs) reached 13.7 thousands. Conclusions Despite the availability of diagnosis and treatment services, the annual AIDS-related mortality remains significant, particularly among men. The burden of HIV underscores its ongoing impact on population health. Therefore, strengthening HIV primary prevention, screening, and retention in care remains crucial to improve health outcomes. Key messages • The HIV epidemic in Tunisia is a concentrated epidemic, with non-negligible mortality estimates. • Enhancing primary prevention, early screening, and sustained engagement in care for individuals with HIV remains essential for improving health outcomes.