The human immunodeficiency virus (HIV) infects the body’s immune system. As the infection progresses, the immune system becomes weaker, and the person becomes more susceptible to other infections. The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS). It can take as long as 10 to 15 years for an HIV-infected person to develop AIDS. Antiretroviral therapy (ART) can slow down the process even further.

HIV hits hardest among the poor and disenfranchised. It shatters families, impoverishes communities, and thwarts economic and social development of entire nations. More than 16 million children have been orphaned by AIDS, including more than 14 million in Africa alone, according to UNAIDS. In sub-Saharan Africa, HIV has been shown to significantly reduce per capita economic growth, which contributes to the further impoverishment and illness of African communities. 

HIV is transmitted through unprotected sexual intercourse, transfusion of contaminated blood, sharing of contaminated needles, and between a mother and her infant during pregnancy, childbirth, and breastfeeding. Young women are especially vulnerable to infection because they often have less access to adequate information and available medical treatments. In many countries, women’s subordination to men prevents women and girls from negotiating safe sex practices.

History of a disease

Since 1981, more than 60 million people have contracted HIV/AIDS, and more than 30 million have died from the disease. An estimated 33 million people are now living with HIV/AIDS—95 percent of them in developing countries and nearly two-thirds in sub-Saharan Africa, according to UNAIDS.

In 1987, the first effective HIV/AIDS antiretroviral treatment was approved. Limited availability and astronomical costs made it difficult to treat people in resource-poor countries such as Haiti, Rwanda, and Lesotho. As more drugs were developed, HIV/AIDS became a manageable chronic disease.

PIH and other groups have proved that treatment can save lives while strengthening both HIV/AIDS prevention and primary care. Pressured by the Clinton Foundation and HIV/AIDS activists, generic drug manufacturers decreased the price of ART drugs from several thousand dollars a year to less than $150.

The HIV Equity Initiative

In 1998, PIH launched its HIV Equity Initiative in rural Haiti. It was one of the first programs in the world to provide free, comprehensive HIV/AIDS treatment to the poor. The program's incredible success changed how the world approaches and funds diseases of the poor.

PIH adheres to four fundamental pillars when addressing HIV/AIDS in poor settings: providing treatment in the context of primary care, screening for and treating tuberculosis and sexually transmitted infections, and emphasizing women's health.


PIH provides ART to about 23,000 people in Haiti, Rwanda, Lesotho, and Malawi. This is just a small snapshot of a larger effort.

PIH provides housing, water, food, and psychosocial support to thousands of people living with HIV. To paraphrase a Haitian proverb, providing medicine alone is equivalent to asking someone to dry their hands in the dirt after washing them. By providing social and economic support to people living with HIV, PIH addresses the root causes of poverty and disease, and not just the disease itself.