2025 review: Four key moments in HIV and sexual health in 2025

Every year, we look back on the most significant things that happened in HIV and sexual and reproductive health (SRH) over the last 12 months.

These moments shape the fields of HIV and SRH, globally, regionally and locally. Understanding what they mean for you, your community, services and advocacy is essential for understanding what’s happening now. And what next year is likely to bring.

1. The changing funding landscape 

The US administration began 2025 by freezing, then slashing, official development assistance. USAID all but closed. And programmes like PEPFAR were greatly reduced. Then in November, the Global Fund replenishment fell short by more than US$6.5 billion. 

This is already causing huge problems for many African countries’ HIV responses. The biggest hit has been to HIV prevention services, which are often donor-funded. In Nigeria, for example, the number of people starting PrEP has fallen from 40,000 to 6,000 per month. Community-led services are also being rolled back. But these are essential for reaching young people and others most affected by HIV. 

According to UNAIDS, these cuts mean there could be 6 million extra HIV infections and 4 million AIDS-related deaths by 2029.

But there is some good news. Many countries have already begun to increase domestic funding. South Africa has committed to expand HIV treatment. Malawi has allocated US$13·3 million to the Ministry of Health and will recruit 6,000 new HIV health workers. 

This shows what is possible. In the coming year, advocating for increased domestic resources will be vital. Policymakers need to see evidence of what underfunded HIV and SRH services mean for people, public health and the economy. And what could be gained if they fund the right kind of services. 

2. Twice-yearly PrEP 

In October, it was announced that a type of PrEP injection which gives six months of protection from HIV will be provided to two million people in low- and lower-middle-income countries by 2028. The news came a month after a deal was reached to reduce the price of twice-yearly PrEP from US$28,000 per person per year to US$40.

Twice-yearly PrEP could be a gamechanger. But barriers like national regulatory approval and who will be prioritised for the shots means there is still a long way to go until everyone who needs it can get it. Zimbabwe has already announced that adolescent girls, young women and pregnant or breastfeeding women will be prioritised. Organisations led by these groups now need to make sure they are involved in the rollout so that is has maximum impact.

3. Putting mental health and HIV on the map

For years, HIV and SRH advocates have being calling for mental health and well-being to get more attention. This was the year these calls broke through. In September, the World Health Organization updated its HIV service delivery guideline to strongly recommend that mental healthcare for depression, anxiety and alcohol-use disorder are part of HIV services. UNAIDS released a summary of tools, best practices and guidelines on how to integrate mental health and HIV services. We have lots of mental health guidance and tools which you can use to support others, or yourself, in 2026.

4. Stepping up to support youth-led organisations

Funding cuts have hit youth-led and youth-serving organisations hard. Many spent 2025 struggling to survive. Others have shut completely. 

In March 2025, evidence was released of the devastating impact this is having on young people. Responses from 45 youth-led organisations (half in East and Southern Africa) found two-thirds have disrupted their services. HIV prevention, treatment, care and support for young people is reducing at an alarming rate. SRH, mental health and life-skills programmes are also shrinking. 

This is despite UNAIDS releasing evidence showing the value that youth-led groups and other community-led organisations bring, even beyond the HIV response. 

But all is not lost. Youth-led organisations are running crowdfunding campaigns and developing new partnerships. And many are continuing their work, despite limited resources. Supporting these organisations matters now more than ever. Whether you volunteer, donate, provide your expertise or advocate, getting involved will help to protect the services and support that so many young people rely on.  

Many of 2025’s biggest moments bring challenges. But they also present an opportunity for a more unified, rights-based, youth-centred HIV and SRH response. As ever, it will be communities and people like you that will keep making the difference and driving progress forward.