Algeria has one of the lowest HIV/AIDS prevalence rates in Africa. In 2022, the United Nations estimated that there were 28, 000 adults and children living with the disease in the country, accounting for 0.1% of the total population. ^{[1] [2]} While overall prevalence rates are low, the number of new infections continues to rise. ^[3] This has been attributed to different factors, including a lack of knowledge around transmission among Algerian citizens, alongside a greater public awareness of the disease itself. ^[4]

Prevalence

HIV/AIDS was first identified in Sétif in 1986. Around 500 Algerians have died of AIDS-related complications since the epidemic began. ^{[5] [6]}

During the early years of the epidemic, national understanding of the disease was low, which led to a likely discrepancy in the number of Algerians contracting HIV/AIDS with the number of reported cases. The traditionally conservative culture often meant that discussing the disease, either publicly or privately, was considered a social taboo. ^[7]

The World Health Organization has identified drug users, sex workers and men who have sex with men as being the key populations among whom the HIV/AIDS epidemic is concentrated. ^[8]

The number of women infected with HIV/AIDS has sharply increased, with the ratio of men to women having contracted the disease changing from 5:1 at the beginning of the epidemic to 1:1 by 2004. This has been attributed to the prevalence of married Algerian men having extra-marital affairs, contracting HIV/AIDS and subsequently transmitting it to their wives. ^[9]

Subtype B is the most common type of HIV in northern Algeria, accounting for 56% of cases. There is more variety of strains in southern Algeria, which has been linked to its closer proximity with sub-Saharan countries where HIV/AIDS is more prevalent. ^[9]

National response

On 1 December 2003, then- President of Algeria Abdelaziz Bouteflika made a speech commemorating World AIDS Day, marking the first time he had extensively discussed HIV/AIDS. He stressed the importance of breaking the cultural taboo around discussing the disease, in addition to raising public awareness about HIV/AIDS, its transmission, symptoms, testing, and treatment; addressing women's social vulnerability to contacting the disease; the importance of maintaining confidentiality within the health service; and addressing the disease in a culturally appropriate way. ^[10]

The Algerian government's subsequent response to the HIV/AIDS epidemic has been praised by the Joint United Nations Programme on HIV/AIDS, which described the country as a "pioneer in the region" for its prioritisation of cross-sectoral action, community involvement, and innovative policies, which it said had led to a sustained low-level epidemic. ^{[4] [11]} Universal health care is enshrined in the Constitution of Algeria, and free antiviral therapy has been offered to patients since 1998. ^{[10] [12]}

In 2012, Algeria partnered with UNAIDS to build the first HIV/AIDS research centre in the Middle East and North Africa, to be based in Tamanrasset, close to the country's borders with several countries and on a popular route for migrants. ^[3] As of 2016, all health centres in Algeria have HIV/AIDS testing facilities, with the Algiers Centre of Excellence for Research on Health and HIV/AIDS serving as a regional hub for research, training, and medicine production pertaining to HIV/AIDS. ^[12]

In 2016, the Algiers Declaration was signed, vowing to eradicate HIV/AIDS in North Africa and the Middle East by promoting increased testing and treatment, particularly among drug users, sex workers, and men who have sex with men. ^[12]

The role of non-governmental organisations such as Solidarité AIDS and El-Hayat have been attributed to Algeria's successful response to the epidemic. ^[4] This has included completing outreach work with vulnerable groups, such as offering condoms and testing to sex workers. ^{[9] [10]}

Difficulties in treatment

While the overall prevalence of HIV/AIDS is low in Algeria, public understanding of the disease and how it is transmitted has been described as "mediocre" among the population, particularly among young people. ^{[6] [8]} While it is taught as part of secondary education, access to HIV/AIDS services like testing, treatment and advice is only available to people under 18 with parental consent. ^[8] The stigmatisation of people with HIV/AIDS has led to some parents not consenting, as well as to adults with the disease declining testing or antiretroviral drugs. ^[3]

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