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This report from Constella Futures Policy Project presents the results of an assessment of the coverage of several key services for the prevention, care and treatment of HIV and AIDS in 2005. It updates similar reports on coverage in 2001 and 2003. This report includes results from 69 countries, including most low- and middle-income countries with more than 10,000 people living with HIV in 2005. The information presented by the authors relies on national service statistics and expert assessment. These data focus on the quantity of services provided and do not address the quality of those services. The results of this analysis suggest that most people in low- and middle-income countries do not have access to many key prevention services. Utilization is very low for voluntary counselling and testing, with an estimated 16.5 million visits per year or 0.5% of adults 15–49. Approximately 10 million pregnant women are offered services for prevention of mother-to-child transmission of HIV, about 11% of all pregnant women in these countries. The level of care available to most people living with HIV does not provide all the essential elements. The services that are available are usually located in capital cities and other urban areas, but not in rural areas.

The report concludes that significant progress has been made in most areas since 2001, but the only programs that provide access to most people who need services are AIDS education in the schools and condoms. In most other areas, greater effort will be required to expand services to meet the goal of universal access. A major development over the past few years is the rapid increase in the use of antiretroviral therapy, its use has quadrupled since 2001. Nonetheless, there are still some important gaps, especially in knowledge of the size of vulnerable population groups and the availability of key services for them.

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