Global, regional, and national burden of HIV and other sexually transmitted infections, 1990–2021, and forecasts to 2030: A population-based analysis based on the Global Burden of Disease Study 2021

Abstract Background: Monitoring the progression of human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) is crucial for evidence-based decision-making in prevention and control strategies. This study aimed to delineate the global, regional, and national burden of these infections from 1990 to 2021 and forecast trends to 2030. Methods: We retrieved data from the Global Burden of Disease (GBD) study 2021, including incidence and disability-adjusted life-years (DALYs) of HIV and other STIs from 1990 to 2021. Trends were quantified using estimated annual percentage changes (EAPCs) in age-standardized incidence and DALY rates. The Bayesian age-period-cohort (BAPC) model was used to forecast the future burden from 2022 to 2030. Results: In 2021, global epidemiological surveillance documented 1,645,333 incident cases of HIV and 722,752,642 incident cases of other STIs. Concurrently, the burden of disease analysis revealed 40,266,792 DALYs attributable to HIV and 7,953,311 DALYs linked to STIs worldwide. The global age-standardized incidence rate (ASIR) of HIV declined from 36.7 (95% uncertainty interval [UI]: 33.0–40.6) per 100,000 population in 1990 to 20.7 (95% UI: 17.7–24.4) in 2021 per 100,000 papulation, with an EAPC of −2.58% (95% confidence interval [CI]: −2.95% to −2.20%). In contrast, the ASIR of other STIs remained relatively stable, changing from 8692.6 (95% UI: 6256.5–11,811.2) per 100,000 in 1990 to 8871.7 (95% UI: 6388.4–12,055.1) per 100,000 in 2021, with an EAPC of −0.02% (95% CI: –0.07% to 0.03%). The BAPC model predicts a decline in the ASIR of HIV to 12.9 (95% UI: 4.3–21.5) per 100,000 by 2030, whereas the ASIR of other STIs is expected to increase to 9150.0 (95% UI: 7913.6–10,386.3) per 100,000. Regionally, Sub-Saharan Africa is projected to have the highest ASIRs of HIV and other STIs in 2030, with estimates of 38.4 (95% UI: 11.7–65.2) and 13,865.8 (95% UI: 11,915.6–15,816.0) per 100,000 population, respectively. Conclusions: Despite declining HIV ASIRs, DALY burdens remain high, with significant regional disparities. HIV and other STIs continue to pose major public health challenges, necessitating targeted interventions, early sexual health education, enhanced screening, and cost-effective policies informed by GBD 2021 data.