NEW DELHI: India has an estimated 25.61 lakh people living with HIV (PLHIV), the second largest number globally in 2024, although the annual HIV incidence rate remains very low in the country, according to a government report released on Monday to mark World AIDS Day.
The India HIV Estimation 2025 technical report, released by Union Health Minister JP Nadda, states that in 2024–25, 73% of newly detected HIV-positive persons reported acquiring the infection through heterosexual transmission. This was followed by injecting drug use, which accounted for 11.5% of reported transmissions. Another 5.4% of cases were attributed to homosexual/bisexual transmission, while 3.5% were due to vertical transmission.
“The HIV epidemic in India continues to be low, with adult HIV prevalence at 0.20% in 2024. While overall prevalence is low, India has 25.61 lakh people living with HIV (PLHIV), the second largest PLHIV population globally. The annual HIV incidence rate also remains very low at 0.05 per 1,000 uninfected population,” the report said.
Of the total 25.61 lakh PLHIV, 13.97 lakh are males and 11.64 lakh are females.
Maharashtra (3.99 lakh) has the highest PLHIV burden, followed by Andhra Pradesh (3.10 lakh) and Karnataka (2.91 lakh). Uttar Pradesh, Tamil Nadu, Telangana, Bihar, Gujarat and Punjab also have estimated PLHIV figures ranging from one lakh to two lakh.
“Together, these nine states account for 74% of the total PLHIV burden in India,” the annual report said. It added that the total PLHIV population in India in 2024 contributed 6.3% to the global HIV burden of 4.08 crore and 37.1% of the 69 lakh cases in the Asia-Pacific region.
“In 2024, India’s population living with HIV was second only to South Africa’s 78 lakh, owing to its population size,” the report noted.
In 2024, around 64,470 new HIV infections and 32,160 AIDS-related deaths were estimated nationally, marking declines of 48.69% and 81.42%, respectively, compared to 2010. “These reductions far exceeded the global averages of 40% and 54%,” the report added.
Highlighting India’s sustained progress under the National AIDS and STD Control Programme (NACP), Nadda reaffirmed the government’s commitment to a rights-based, stigma-free, and inclusive HIV response. He emphasised that under NACP-V, access to prevention, testing, and treatment services has continued to expand, demonstrating strong and sustained momentum across key programme areas.
Nadda said that between 2010 and 2024, new HIV infections declined by 48.7%, AIDS-related deaths by 81.4%, and mother-to-child transmission by 74.6%. Testing coverage increased from 4.13 crore in 2020–21 to 6.62 crore in 2024–25, while the number of people on treatment rose from 14.94 lakh to 18.60 lakh. Viral load testing also expanded significantly—from 8.90 lakh to 15.98 lakh tests.
He noted that these achievements surpass global averages for the same period and reflect strong political commitment, sustained domestic investment, evidence-based programme strategies, and consistent community engagement.
The report also found that AIDS-related mortality was highest in Manipur, Mizoram and Nagaland. However, it noted that AIDS-related deaths have declined between 2010 and 2024 in nearly all states and UTs except Chandigarh, Punjab, Arunachal Pradesh and Tripura, where more PLHIV died of AIDS-related causes in 2024 compared to 2010. Globally, annual AIDS-related deaths declined by 54% between 2010 and 2024.
The report stated that two states—Mizoram and Nagaland—had an HIV prevalence of more than 1%.
It also highlighted a “noticeable increasing trend in the prevalence of new infections” in the northeastern states of Tripura, Arunachal Pradesh, Meghalaya and Assam, as well as in the northern state of Punjab, primarily driven by the rise in new infections.
Nationally, annual new cases were estimated to decline by around 48.70% between 2010 and 2024, but increased by more than 400% in Arunachal Pradesh and Tripura. Similarly, in Punjab and Meghalaya, the annual new infections estimated for 2024 have nearly doubled compared to 2010.
In 2024, 30 districts were estimated to have an adult HIV prevalence of 1% or more, with 29 of these located in Nagaland (11 districts), Mizoram (10), Manipur (5), Meghalaya (2) and Arunachal Pradesh (1). The only other district in this category is in Karnataka.