5 countries with the highest HIV rates in 2025

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The Human immunodeficiency virus also known as HIV is one deadly virus that weakens a person’s immune system by attacking CD4 cells – the cells that help the body fight off infection.

If HIV advances, it can lead to acquired immunodeficiency syndrome, or AIDS, a terminal condition.

HIV is usually spread through certain body fluids, most often during unprotected sex, pregnancy and childbirth, transfusion of contaminated blood, or shared use of hypodermic needles.

According to the latest data from World Population Review, here are the top five countries with the highest HIV prevalence rates in 2025.

1. Eswatini – 26.8% Adult HIV Prevalence

Eswatini (formerly Swaziland) has the highest HIV prevalence globally, with 26.8% of adults aged 15–49 living with HIV. Despite significant investments in antiretroviral therapy and public health campaigns, the country continues to face challenges in reducing transmission rates.

2. Lesotho – 21.1% Adult HIV Prevalence

Lesotho ranks second, with 21.1% of its adult population living with HIV. The country’s mountainous terrain and limited healthcare infrastructure contribute to difficulties in accessing treatment and prevention services.

3. Botswana – 19.9% Adult HIV Prevalence

Botswana has a 19.9% HIV prevalence among adults. The government has implemented comprehensive programs to combat the epidemic, including widespread testing and free antiretroviral treatment, yet challenges remain in curbing new infections.

4. South Africa – 19.1% Adult HIV Prevalence

South Africa, with a 19.1% adult HIV prevalence, has one of the highest number of people living with HIV globally. Recent reductions in U.S. aid have impacted testing and treatment programs, potentially exacerbating the epidemic.

5. Zimbabwe – 11.9% Adult HIV Prevalence

Zimbabwe’s adult HIV prevalence stands at 11.9%. Economic challenges and healthcare infrastructure limitations hinder efforts to reduce transmission and provide adequate care for those affected.