DANGEROUS INEQUALITIESWORLD AIDS DAY REPORT|2022DANGEROUS INEQUALITIES Joint United Nations Programme on HIV/AIDS(UNAIDS),2022Some rights reserved.This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence(CC BY-NC-SA 3.0 IGO;https:/creativecommons.org/licenses/by-nc-sa/3.0/igo/).Under the terms of this licence,you may copy,redistribute and adapt the work for non-commercial purposes,provided the work is appropriately cited,as indicated below.In any use of this work,there should be no suggestion that UNAIDS endorses any specific organization,products or services.The use of the UNAIDS logo is not permitted.If you adapt the work,then you must license your work under the same or equivalent Creative Commons licence.If you create a translation of this work,you should add the following disclaimer along with the suggested citation:“This translation was not created by UNAIDS.UNAIDS is not responsible for the content or accuracy of this translation.The original English edition shall be the binding and authentic edition”.Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization(http:/www.wipo.int/amc/en/mediation/rules).Suggested citation.Dangerous inequalities:World AIDS Day report 2022.Geneva:Joint United Nations Programme on HIV/AIDS;2022.Licence:CC BY-NC-SA 3.0 IGO.Third-party materials.If you wish to reuse material from this work that is attributed to a third party,such as tables,figures or images,it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder.The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user.The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of UNAIDS concerning the legal status of any country,territory,city or area or of its authorities,or concerning the delimitation of its frontiers or boundaries.Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by UNAIDS in preference to others of a similar nature that are not mentioned.Errors and omissions excepted,the names of proprietary products are distinguished by initial capital letters.All reasonable precautions have been taken by UNAIDS to verify the information contained in this publication.However,the published material is being distributed without warranty of any kind,either expressed or implied.The responsibility for the interpretation and use of the material lies with the reader.In no event shall UNAIDS be liable for damages arising from its use.UNAIDS/JC3068EDANGEROUS INEQUALITIESWORLD AIDS DAY REPORT|2022DANGEROUS INEQUALITIES2Foreword 4Introduction 6References 11Gender inequalities hold back the end of AIDS 12The vulnerability of adolescent girls and young women 15New HIV infections among adolescent girls and young women are declining slower than among males of the same age in sub-Saharan Africa 15Policy reform and intensified investment in HIV programmes for adolescent girls and young women are needed to close gaps in the AIDS response 17Concrete action beyond the health sector is critical to reducing the vulnerability of adolescent girls and young women 18Masculinities and HIV services 21Gender disparities in service access and treatment outcomes 23Addressing the HIV-related needs of both women and men is an urgent priority 26References 29Decriminalization,destigmatization and inclusion of key populations 30New HIV infections in epidemics that are concentrated among key populations are not declining globallyone reason why the global response is not on track to reach the 2030 target 32Access to combination HIV prevention and treatment services among key populations remains limited across most of the world 36PrEP has the potential to markedly lower HIV incidence,but PrEP services are not reaching key populations 41TABLE OF CONTENSDANGEROUS INEQUALITIES3We can end epidemics among people who inject drugs,but we are failing to do so because we are not ensuring meaningful access to harm reduction services 44We cannot end AIDS among key populations unless we effectively address the societal factors that increase their vulnerability and block their ability to access services 46References 47Ending AIDS in children 48The treatment gap for children can be closed if more pregnant and breastfeeding women and their infants are supported to confirm the childs HIV status at birth and at the end of breastfeeding.53Intensified,mother-centred strategic efforts are needed to prevent vertical transmission.55Recent optimization of child treatment has led to increases in viral load suppression among childr