How many people are living with HIV in Gaza is now unknown, a review says

A viewpoint published in the Journal of the International AIDS Society on 27 May argues that HIV in the Gaza Strip has moved from a chronically under-detected condition to what the authors call an acute, invisible public-health emergency [s1]. The piece is an analysis of the existing record rather than new surveillance, and its central point is about what can no longer be measured.

The last reliable numbers

Before the escalation of violence in 2023, the Palestinian Ministry of Health had officially documented 125 people living with HIV and AIDS across Palestine, including 50 in Gaza [s1]. The authors are explicit that this was almost certainly an undercount, reflecting long-standing barriers to detection — stigma, limited screening, and fragile surveillance — rather than a true measure of how many people were infected [s1].

HIV care in Gaza before 2023 sat within a constrained but functioning framework, the authors write: diagnosis and treatment were formally integrated into the Palestinian health system, with free testing and antiretroviral therapy supported by international partners including WHO, UNRWA, the Global Fund, UNFPA, UNICEF and the European Union [s1]. The service package extended beyond drugs to sexually transmitted infection counselling, condom distribution, peer education, psychosocial support after diagnosis, and awareness campaigns, and routine screening was applied to blood donors and selected occupational groups [s1]. The most recent pre-2023 data, from 2021, indicate that approximately 42,000 Palestinians were tested for HIV, hepatitis B and C, and syphilis through blood-bank channels rather than through voluntary or community-based screening [s1].

The authors are careful to characterise the pre-2023 system as functional but incomplete. Testing among key and priority populations, antenatal women and the general public remained limited, and the 50 documented cases in Gaza reflected that limited reach as much as the true level of infection [s1]. Stigma, fear of disclosure and moralised perceptions of HIV, the review argues, suppressed help-seeking in ways that a case count cannot capture — which is why the authors treat the recorded figures as a floor rather than a measure [s1].

What the authors say has changed

Following the destruction of medical infrastructure, the displacement of health personnel, and the depletion of essential medicines, the actual number of people living with HIV in Gaza is now unknown, according to the review [s1]. The authors describe the breakdown of testing, treatment and reporting systems as having erased epidemiological visibility — leaving people who need continuous antiretroviral therapy at immediate risk of interruption [s1].

That is the specific health concern the piece raises. Antiretroviral therapy is not a course that can be paused without consequence. Interruption raises the risk of the virus rebounding, of drug resistance developing, and of onward transmission. A surveillance system that can no longer locate patients is also one that cannot ensure their treatment continues.

The invisibility runs in both directions. People already diagnosed may lose access to the drugs that keep them well and non-infectious, while new infections go undetected because the testing that would find them has stopped. In a population that is displaced and crowded, with disrupted health services, the conditions that the review associates with rising transmission are present at the same moment that the ability to measure transmission has been lost — which is the core of the authors' argument that the emergency is real precisely because it cannot be seen [s1].

Reading this carefully

This is a viewpoint article, and its strongest claims are about absence — the loss of data rather than a new measured figure. The 125 and 50 counts are pre-2023 ministry figures the authors themselves flag as under-detections [s1]. The assertion that the current number is unknown is, by its nature, not something that can be quantified; it is an argument that the measurement apparatus has stopped working.

Health Newspapers is reporting these as the review's characterisation of the Palestinian health record. We are not independently verifying the pre-2023 case counts or the current state of HIV services, and the piece does not present a new prevalence estimate.

Why it matters beyond Gaza

The authors situate HIV within a broader pattern seen across conflict-affected health systems, where chronic conditions requiring continuous care — HIV, tuberculosis, diabetes, dialysis-dependent kidney disease — are among the first to fail when infrastructure collapses, because they depend on uninterrupted supply and follow-up rather than one-time intervention [s1]. The visible emergencies of trauma and acute infection tend to dominate reporting; conditions that require a patient to be found, tested and treated month after month are, in the authors' framing, the ones that disappear from the record first.