Gambia Falls Short of HIV Targets as Study Reveals Stark Gender Gaps in Treatment

Written by: Seringe ST Touray

A new peer-reviewed study by Gambian researcher Amadou Barrow has revealed major gaps in the country’s HIV response, with men significantly less likely to be tested, treated, or successfully managed compared to women.

Published in BMC Infectious Diseases, the study shows that while The Gambia maintains a relatively low HIV prevalence of about 1.29 percent, the burden remains substantial, with an estimated 25,000 people living with the virus, over 1,100 new infections, and around 1,200 AIDS-related deaths each year .

Despite decades of progress, the country is far from meeting global treatment targets. By 2024, only 64 percent of people living with HIV knew their status, 44 percent were receiving treatment, and just 35 percent had achieved viral suppression, well below the global “95-95-95” targets aimed at ending AIDS as a public health threat .

The study points to a sharp gender divide at every stage of care. While 72 percent of women living with HIV are diagnosed, only 53 percent of men know their status, a gap that suggests the true number of people living with HIV could be significantly higher than current estimates, given how many remain undiagnosed. Treatment coverage is even more uneven, with 55 percent of women on medication compared to just 27 percent of men. Viral suppression follows the same pattern, with 44 percent of women achieving it against only 21 percent of men .

Researchers identified treatment initiation as the biggest bottleneck, noting that only about half of diagnosed men actually begin therapy. “ART initiation remains the main cascade bottleneck,” the study states, adding that “only 51% of diagnosed individuals” start treatment, with men particularly affected .

The report also warns that the country’s apparent progress may be misleading. While new infections are declining, the study notes that the shift reflects “deaths exceeding new infections rather than treatment-mediated viral suppression,” raising concerns about long-term control of the epidemic .

Looking ahead, projections show that if current trends continue, new infections will fall only slightly by 2030, far short of elimination goals. However, even modest improvements in testing and treatment could prevent more than 1,300 new infections and over 1,000 deaths within the next five years.

The study calls for urgent, targeted interventions, particularly focused on men, including expanded testing, faster treatment initiation, and more accessible care models to close the widening gap and bring the country closer to global HIV targets.