2024 in review: Five stand-out moments in HIV and sexual health

As we say goodbye to 2024, we look back on five of the most significant moments for HIV and sexual and reproductive health this year. 

1. Progress on prevention 

The rise of PrEP continued, with more countries trialling, approving and rolling out different versions of the HIV prevention medication than ever before. In February, Zambia became the first African country to offer long-acting cabotegravir (CAB-LA), otherwise known as bi-monthly injectable PrEP, outside of clinical trials. In May, we reported on the rollout of injectable PrEP in Zimbabwe, as advocates and health officials grappled with the challenge of making it more widely available to those who need it most, such as young people.  

In October, ViiV Healthcare, the makers of CAB-LA, used the 5th HIV Research for Prevention (HIVR4P) conference to commit to providing at least 2 million doses of injectable PrEP to low- and middle-income countries in 2025 and 2026, triple the supply for 2024. We reported from HIVR4P on a range of new PrEP options currently being researched. This includes six-monthly injectable PrEP, a combined PrEP and contraception injection and a PrEP implant, plus findings from South Africa on a three-month PrEP vaginal ring. Momentum appears to be building around the one-month PrEP vaginal ring, which is now approved for use in at least eight African countries.  

To learn more about the current three main PrEP options, check out our video made earlier this year, plus the new talking about PrEP page. 

2. Worsening rights for LGBT+ people  

Sadly, this year marked the continuing spread of anti-LGBT+ legislation, putting more people at greater risk of HIV. In February, Ghana’s parliament passed a bill criminalising people who identify as LGBT+ and organisations that support LGBT+ people. Although Ghana’s President Nana Akufo Addo has yet to sign the bill into law, the move reflects a worrying trend in Africa and elsewhere.  

In April, Uganda’s Constitutional Court upheld the Uganda’s Anti-Homosexuality Act (AHA), which became law in 2023. The law imposes the death sentence for ‘aggravated homosexuality’, and its consequences are being widely felt. Around the time of the court’s decision, we spoke to Dr Rosemary Ayebazibwe of the AIDS Support Organization, who said the law had “caused [a] decline in LGBT+ clients”, some of whom have stopped HIV treatment. “Some were scared, became lost [to follow-up] and started missing their drugs,” she told us. 

Mali and Tanzania also passed homophobic legislation this year. And Kenya and Burundi are reported to be considering similar moves. Crackdowns are also happening in other parts of the world, such as Bulgaria and Georgia. A new Trump Presidency in the USA could further rollback LGBT+ rights in America, which may embolden other countries. 

In the midst of these crackdowns, providing sexual health services in a way that makes LGBT+ people feel welcomed and included has never been more important. This year, we developed resources to help practitioners do this, including practical tips on creating an inclusive LGBT+ environment and a guide on providing sexual healthcare for LGBT+ people. 

3. Ending AIDS by 2030?  

In August, UNAIDS warned that the world is facing a “critical moment” on the path to ending AIDS by 2030, and that the decisions governments take now will determine whether the world succeeds or fails in this mission. 

Its annual Global AIDS Update reported that nine countries have now reached the 95-95-95 testing and treatment targets, including Eswatini, Kenya, Malawi, Rwanda, Zambia and Zimbabwe. But many countries have fallen behind, and a number of regions are now critically off track. This includes Eastern Europe and Central Asia where HIV infections and AIDS-related deaths are rising. Only half of the 2.1 million people with HIV in the region are accessing treatment, and only 42% of people with HIV have a suppressed viral load, the lowest rate globally.  

4. A spike in sexually transmitted infections  

In June, the World Health Organization reported a worrying rise in STIs. One million infections are happening each day, and 2.5 million people are dying annually from HIV, STIs and hepatitis, combined. STIs are rapidly increasing in many regions, particularly syphilis and drug-resistant gonorrhoea. 

But hope is on the horizon. In August, trials in the USA of doxycycline post-exposure prophylaxis (otherwise known as doxy PEP) found that it reduced the risk of syphilis and chlamydia infection by more than 70% and gonorrhoea by 55%, if taken within 72 hours after sex. The fact that doxycycline is inexpensive and easily tolerated gives it great potential as an STI prevention tool, if countries approve doxy PEP’s use. 

5. Be In the KNOW begins a new era  

This year, Be in the KNOW’s parent company, the UK-based global sexual health charity Avert, has been busy transferring Be in the KNOW into the expert arms of the Kenya Comms Hub as part of Avert's transition and localisation strategy. The Kenya Comms Hub is led by Well Made Strategy and partners Love Matters and Komons, and it has big plans for Be in the KNOW. So expect a wealth of new, sex positive, sexual and reproductive health information next year and beyond. 

Commenting on the move, Mumbi Kanyogo, Strategic Communications Consultant at Well Made Strategy and Terry Gachie, Country Director at Love Matters Africa, said: “We’re energized by the chance to innovate, collaborate and address real needs in a culturally sensitive and locally relevant way. This work is about fostering conversations, breaking down stigma, and ensuring that everyone involved – from  parents to influencers to healthcare providers – feels equipped and supported to create lasting change.”