HIV care is the long term work of testing people, starting them on antiretroviral therapy and keeping the virus suppressed for life, and on a medical elective abroad you will see it every week. WHO counts 41.0 million people living with HIV at the end of 2025, 64% of them in its African Region. World AIDS Day falls on 1 December 2026, and this guide explains what HIV care looks like on a ward in Zanzibar, Sri Lanka, Nepal or Bali, and what you can do there.
HIV care is everything a health system does for a person with HIV after the first positive test: confirming the diagnosis, starting antiretroviral therapy (ART), checking that the virus is suppressed, treating infections that take advantage of a weak immune system, and supporting the person to stay on treatment for life. It runs from a rapid test in an outpatient clinic to a ward bed for someone with advanced disease.
WHO's HIV fact sheet, updated on 27 July 2026, defines the virus simply. HIV (human immunodeficiency virus) "attacks the body's immune system", and AIDS (acquired immunodeficiency syndrome) "occurs at the most advanced stage of infection." WHO now defines advanced HIV disease as a CD4 cell count below 200 cells/mm3, or a WHO stage 3 or 4 event, in adults and adolescents. Every child under 5 living with HIV counts as having advanced disease.
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The good news sits in one line of the same fact sheet: with access to effective prevention, diagnosis, treatment and care, "HIV infection has become a manageable chronic health condition." The hard part is the word access. That's what you'll see up close on placement.
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More than ever, because people now survive. UNAIDS, using data from 172 countries for 2025, reports 41.0 million people living with HIV, 1.2 million new infections and 570,000 deaths from AIDS-related illnesses that year. Since the start of the epidemic, 44.2 million people have died.
Treatment has changed the picture completely, and that is what modern HIV care is built on. UNAIDS counts 32.1 million people on antiretroviral therapy at the end of December 2025, up from 7.6 million in 2010. New infections are down 65% from the 1994 peak, when 3.5 million people acquired HIV. AIDS-related deaths are down 73% from the 2004 peak of 2.1 million.
| Global HIV figure (UNAIDS) | Then | 2025 |
|---|---|---|
| People on antiretroviral therapy | 7.6 million (2010) | 32.1 million |
| New HIV infections | 3.5 million (1994 peak) | 1.2 million |
| Deaths from AIDS-related illnesses | 2.1 million (2004 peak) | 570,000 |
| New infections among children aged 0 to 14 | 300,000 (2010) | 93,000 |
Two warnings come with those numbers. First, UNAIDS says progress in children "has stalled in recent years", and only 55% of children aged 0 to 14 with HIV were on treatment in 2025. Second, money is getting tighter. At the end of 2025, US$ 17.6 billion was available for the HIV response in low and middle income countries, about 20% below the US$ 21.9 billion needed each year by 2030, and international resources fell by 18%, the largest drop in almost two decades. You may hear staff talk about stock or staffing gaps in HIV care. This is part of why.
The 95-95-95 targets are the global goals for HIV care: 95% of people with HIV know their status, 95% of those are on treatment, and 95% of those on treatment have a suppressed viral load. WHO reports that in 2025 the world stood at 88%, 89% and 95%. That's close, and the first number, diagnosis, is the one where HIV care lags.
Read the cascade carefully, because the three percentages multiply. UNAIDS spells it out: among all people living with HIV in 2025, 88% knew their status, 78% were on treatment and 74% were virally suppressed. So roughly one person in four with HIV still has a virus that is not under control. For children the first step is far weaker: only 65% of children with HIV knew their status in 2025. For adult men the figures were 86%, 86% and 95%, so men are diagnosed and treated less often than women.
Why does suppression matter so much? Because WHO states that people with HIV who take ART and have an undetectable viral load "will not transmit HIV to their sexual partners." Good HIV care is also prevention.
HIV care depends heavily on where you are. Our destinations sit in two WHO regions with very different HIV pictures, and even inside one country the numbers can differ sharply. Sri Lanka, Nepal and Indonesia belong to the WHO South-East Asia Region. Tanzania, of which Zanzibar is a semi-autonomous part, belongs to the WHO African Region, home to 64% of everyone living with HIV.
| Destination | WHO region | What the cited sources tell us |
|---|---|---|
| Zanzibar (Tanzania) | African Region | Adult HIV prevalence 0.4% in Zanzibar against 4.5% in Mainland Tanzania (THIS 2022 to 2023). |
| Sri Lanka | South-East Asia Region | Validated by WHO in November 2019 for eliminating mother-to-child transmission of HIV and syphilis. |
| Nepal | South-East Asia Region | No country figure is cited in this post. Check UNAIDS AIDSinfo for current estimates. |
| Bali (Indonesia) | South-East Asia Region | No country or provincial figure is cited in this post. Check UNAIDS AIDSinfo for current estimates. |
We have left the Nepal and Indonesia rows deliberately thin. National figures for those two countries exist on the UNAIDS AIDSinfo data portal, but we have not quoted them here, and a national number would tell you little about Bali in particular. Look them up yourself before you go, and ask your supervisor what the local caseload is really like.
Because the survey says so in plain numbers. The Tanzania HIV Impact Survey 2022 to 2023 (THIS), a household survey of adults aged 15 and over run from November 2022 to March 2023 by the governments of Tanzania and Zanzibar, measured adult HIV prevalence at 4.4% nationally, about 1,548,000 adults. That splits into 4.5% on the mainland and 0.4% in Zanzibar.
Inside Zanzibar, regional prevalence ranged from 0.2% in Kaskazini Pemba to 0.8% in Kusini Unguja, and the survey says HIV prevalence "was below 1% in all the regions of Zanzibar." On the mainland, regions ranged from 1.7% in Kigoma to 12.7% in Njombe.
What does that mean for you? Don't arrive in Zanzibar expecting an HIV ward like the ones in mainland regions with ten times the prevalence. You'll still meet patients on ART, pregnant women being tested in antenatal clinic and people with TB who need an HIV test, but HIV care in Zanzibar is a smaller share of the caseload. One more honest limit: the survey did not report viral suppression for Zanzibar at all, because fewer than 25 adults living with HIV were identified there.
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Sri Lanka is a model worth studying. WHO's South-East Asia Regional Office announced on 10 December 2019 that Sri Lanka had been validated in November 2019 for eliminating mother-to-child transmission of HIV and congenital syphilis. It was the third country in the WHO South-East Asia Region to do so, after Thailand and Maldives. The country had reported no case of mother-to-child HIV transmission since 2017, and congenital syphilis stood at two per 100,000 live births, far under the 50 per 100,000 limit for certification.
WHO credited "high quality maternal and health services" and a strong primary health care base. If you spend time in an antenatal clinic in Sri Lanka, watch how routine screening is built into the visit. That's the system behind the headline, and it's a far better lesson in HIV care than any lecture slide.
Usually with a rapid test that gives a result the same day, and diagnosis is where HIV care starts. WHO notes that most HIV tests detect antibodies, and most people develop them within 28 days of infection. Before that is the "window period", when a rapid test may be negative although the person can already pass the virus on. A negative test after a recent high risk exposure should be repeated after 28 days.
Two more rules from WHO matter at the bedside. No single test gives a full positive diagnosis: confirmatory testing by a trained health worker is required, following the national testing algorithm. And for babies under 18 months, antibody tests are not enough, because the mother's antibodies cross the placenta. They need virological testing, which WHO says should be offered as early as birth or at 6 weeks.
Here is how a student can take part in this first step of HIV care, always under supervision:
Every one of these steps sits inside the host hospital's own policies and Tanzania's, Sri Lanka's, Nepal's or Indonesia's national guidelines. Those take priority over anything written here.
Because TB kills more people with HIV than anything else. WHO's tuberculosis fact sheet says people living with HIV are 12 times more likely to fall ill with TB than people without HIV, and that "HIV and TB form a lethal combination, each accelerating the other's progress." About 150,000 people died of HIV-associated TB in 2024. Only 61% of people with HIV who developed TB that year received ART.
That's why HIV care and TB care are joined up in most of the hospitals you'll visit. A person newly diagnosed with HIV gets asked about cough, fever, night sweats and weight loss. A person with TB gets offered an HIV test. WHO reports that 82% of people who fell ill with TB in 2024 had a documented HIV test result.
For you, it also means TB is the real occupational risk on an HIV ward, not HIV itself. Read our guide to tuberculosis on a medical elective and plan screening before and after your placement. Chest infections in people with HIV often turn out to be more than they seem, which our guide to pneumonia on a medical elective covers from the paediatric side.
You protect yourself with the same standard precautions you'd use for any patient, done every single time. HIV care asks nothing more exotic of you than that. WHO lists accidental needle stick injuries, including among health workers, as one of the routes for HIV transmission. The risk is real but small, and it's manageable if you plan for it.
If something does go wrong, follow the step by step plan in our needlestick injury guide. It covers first aid, reporting, PEP and the follow-up testing your own occupational health service will want. Hepatitis B is part of the same conversation, so check your immunity with our guide to vaccinations for a medical elective abroad.
Because a careless word can cost a patient their job, their home or their family's support. UNAIDS reports that HIV risk is far higher in groups facing marginalisation, discrimination and in some places criminalisation: 18 times higher among gay men and other men who have sex with men, 17 times higher among sex workers and 34 times higher among people who inject drugs, compared with all adults aged 15 to 49.
Confidentiality is part of HIV care, not an extra. On placement, three habits protect patients:
Our guide to an ethical medical elective abroad goes further into consent, photography and scope of practice. If you need the local words for "test", "result" or "medicine", our guide to language barriers on a clinical internship abroad has practical tips.
World AIDS Day 2026 is on Tuesday, 1 December. WHO's campaign page states that "1 December is World AIDS Day" and calls it "one of the most widely recognized international health days." When we checked the 2026 page on 2 October 2026, WHO had not yet published a theme for the year, so we don't quote one here.
If your placement runs over that week, ask your host hospital whether it's running a testing day, a community event or a teaching session. Offer to help with the logistics. It's often the best week of the year to see community HIV care in action. And if your medical school wants a reflective piece, a week that includes World AIDS Day gives you a strong theme: how HIV care is organised locally, where the gaps are, and what you learned from the staff who run it.
Plenty, as long as you stay inside your scope. Good HIV care is team work, and a student who listens well is useful to the team. You can take histories, including the careful questions about symptoms of TB and other infections. You can join counselling sessions as an observer when the patient agrees, help in a testing clinic, read lab results with your supervisor, and follow a patient on ART through a routine review. You don't give results, change treatment or decide on admission, because those decisions belong to the clinicians who run HIV care locally.
If you want the bigger picture of where this work can lead, the German language overview of what an infectious disease specialist does on dein-medizinstudium.de explains the specialty, and the German language guide to a tropical medicine placement abroad on travel4med.at shows how to plan a placement around infectious diseases. Our own guide to clinical skills on a medical elective helps you set realistic learning goals for HIV care and everything else on your list.
You'll see HIV care at all four destinations, in outpatient clinics, antenatal care and medical wards. travel4med places medical, nursing and physician assistant students in Sri Lanka, Nepal, Bali and Zanzibar, and all four are open for the full range of placements, including the final year clinical placement. Nursing students can find their route in our nursing internship abroad planning guide.
Whether a placement counts towards your degree is decided by your own medical school and national regulator, not by us and not by the host hospital. Ask your elective office which learning outcomes they want evidenced, get the answer in writing, and read our guide to medical elective approval before you book.
Want to learn HIV care where it shapes daily practice? Compare Sri Lanka, Nepal, Bali and Zanzibar on our destinations page or book a free consultation, and we'll help you pick a placement that fits your goals. travel4med is operated by travelformed GmbH in Frankfurt, part of the futuredoctor group.
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