The number of HIV tests performed does not by itself show how effectively testing reaches populations in which positive diagnoses are being found. The share of tests that return positive can vary sharply across countries because the underlying epidemic, the populations offered testing, and the way testing services are targeted are different. The latest World Health Organization country extract used here contains 138 observations and ranges from well below 0.1% in several countries to more than 20% in a small number of settings.
The wording of the source indicator can easily be misunderstood. “Percentage of HIV-positive results returned to people in the calendar year” does not mean the percentage of people with a positive result who were successfully notified. In the WHO testing-volume-and-positivity indicator, positivity is the share of HIV tests whose results were returned to the person that were positive. A value of 0.6 therefore means that about 0.6% of returned test results were positive, not that only 0.6% of positive people received their result.
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What HIV testing positivity measures
WHO defines HIV testing volume and positivity using HIV tests for which results were returned to a person. For positivity, the numerator is the number of tests in which an HIV-positive result was returned during the reporting period. The denominator is the total number of HIV tests performed for which the result was returned. Tests without a returned result are therefore outside the denominator under the indicator definition.
This is a test-based measure rather than a count of unique people. WHO explains that if the same person tests more than once during the year and receives the result each time, those tests can be counted more than once. An HIV-positive person tested at a mobile service and then again at a clinic can contribute two positive tests. That feature makes the indicator useful for service monitoring but means it should not be interpreted as population HIV prevalence or the percentage of newly diagnosed people.
The WHO SMART Guidelines HIV indicator table describes HTS.2 as a measure of testing volume and positivity across service-delivery approaches and populations. Testing volume helps with commodity and workforce planning, while positivity can help assess where positive diagnoses are being identified. The two pieces are designed to be interpreted together; positivity alone is not a quality score for a national HIV programme.
The 2024 median across 123 observations is 0.60%
Of the 138 retained latest observations, 123 are dated 2024. Restricting the comparison to those same-year rows gives a median of 0.60% and an unweighted country mean of 1.72%. The mean is much higher than the median because the distribution has a long upper tail, including the Central African Republic at 27.91%, the Dominican Republic at 22.22% and Qatar at 11.37%.
The grouped distribution shows that 79 of the 123 observations are below 1%. Thirteen are below 0.1%, 41 are from 0.1% to under 0.5%, and 25 are from 0.5% to under 1%. Another 16 fall from 1% to under 2%, 19 from 2% to under 5%, and nine are 5% or higher. Only three 2024 observations exceed 10%.
A low positivity rate should not automatically be read as a low HIV burden. A country that offers routine testing to a very broad population can produce many negative tests and a low positivity percentage. A programme that concentrates testing among people with a higher probability of infection can have a higher positivity rate even if the underlying national prevalence is unchanged. Population prevalence, incidence, testing coverage and knowledge of HIV status answer different questions.
Countries with the highest 2024 testing positivity
The highest same-year observation is the Central African Republic at 27.91%, followed by the Dominican Republic at 22.22% and Qatar at 11.37%. Cambodia is at 8.13%, Lesotho at 8.10%, Gabon at 8.03%, Venezuela at 7.71%, Grenada at 6.91%, Dominica at 5.32%, and Malawi at 4.97%.
| Country or area | HIV testing positivity in 2024 |
|---|---|
| Central African Republic | 27.91% |
| Dominican Republic | 22.22% |
| Qatar | 11.37% |
| Cambodia | 8.13% |
| Lesotho | 8.10% |
| Gabon | 8.03% |
| Venezuela | 7.71% |
| Grenada | 6.91% |
| Dominica | 5.32% |
| Malawi | 4.97% |
These values are not a ranking of health-system performance. A testing strategy focused on people with symptoms, known exposure, key-population services or higher-prevalence locations can generate a higher proportion of positive tests. Broad screening of lower-risk populations can lower the percentage even when many positive diagnoses are still found in absolute terms. The number of tests and the population being tested are needed to interpret why positivity differs.
Very low positivity does not mean zero HIV risk
At the lower end of the 2024 subset, Kazakhstan and Tonga are at 0.01%, the Maldives at 0.02%, Bulgaria and Czechia at 0.03%, and Tajikistan at 0.04%. Bahrain, Belarus and Malaysia are each at 0.05%. Estonia and Sri Lanka are at 0.07%, while Bangladesh and Uzbekistan are at 0.08%.
| Country or area | HIV testing positivity in 2024 |
|---|---|
| Kazakhstan | 0.01% |
| Tonga | 0.01% |
| Maldives | 0.02% |
| Bulgaria | 0.03% |
| Czechia | 0.03% |
| Tajikistan | 0.04% |
| Bahrain | 0.05% |
| Belarus | 0.05% |
| Malaysia | 0.05% |
| Estonia | 0.07% |
| Sri Lanka | 0.07% |
Low positivity can result from broad testing coverage, a low-risk testing population, or other aspects of programme design. It can also be difficult to interpret if the total testing volume is small or if the populations most likely to benefit from testing are not being reached. This is why WHO presents testing volume and positivity as related programme-monitoring information rather than treating positivity as a standalone success indicator.
The latest-value map mixes 2022, 2023 and 2024 observations
The latest-value map contains 138 country and area rows, but they are not all from the same year. There are 123 observations from 2024, 11 from 2023 and four from 2022. Pakistan’s retained latest value is 8.86% in 2022; Afghanistan is 0.40%, Costa Rica 0.64% and Timor-Leste 0.21% in 2022. Among the 2023 rows, Madagascar is 3.33%, South Sudan 2.10%, Ecuador 1.58% and Mexico 1.28%.
For that reason the world map is best read as a latest-available snapshot, not a 2024 league table. All summary statistics, grouped counts and ranking tables in this article use only the 123 observations whose reported year is 2024. Separating those two uses prevents a change in reporting year from being mistaken for a cross-country difference.
Testing positivity is different from HIV prevalence
HIV prevalence estimates the share of a population living with HIV at a point or period in time. Testing positivity is conditional on actually receiving an HIV test and having the result returned. The people who use testing services are not necessarily representative of the total population, and the mix of testing entry points differs among countries.
A programme that successfully targets testing to higher-risk groups can increase positivity without any increase in population prevalence. Expanding routine testing to antenatal clinics, emergency services or other broad settings can reduce positivity because more negative tests enter the denominator. The map therefore describes the yield of reported testing services rather than how common HIV is in the entire population.
Why testing volume matters alongside positivity
A 5% positivity rate among 10,000 returned test results corresponds to a very different programme scale from 0.5% among one million returned results. The first would imply roughly 500 positive test results and the second roughly 5,000 if the simple percentages were applied to those hypothetical volumes. The current dataset does not include a matched testing-volume series, so this article does not calculate national counts from the positivity percentages.
WHO notes that annual testing volume and positivity are useful for monitoring programmes, planning test commodities and staffing, validating routine newly diagnosed case reports, and assessing the effectiveness of testing approaches. They can also contribute inputs to modelling progress toward the first 95, the target that 95% of people living with HIV know their status. Positivity by itself is not the first-95 indicator.
Data source and calculation method
The statistical source is the WHO Global Health Observatory indicator HIV_POSITIVITY. The definition and measurement notes are documented on the WHO indicator page, and country observations are available through the WHO GHO OData API. The retained table contains one latest available total observation for each of 138 countries or areas.
The latest-value map uses all 138 observations and hatches countries whose retained latest value is older than 2024. The 2024 median, unweighted mean, grouped distribution and high/low tables use only the 123 observations dated 2024. Missing observations are not converted to zero and older values are not imputed forward. The 1.72% mean is an unweighted mean of country observations, not a testing-volume-weighted global positivity rate.
For broader HIV context, the WHO HIV data and statistics pages distinguish testing, diagnosis awareness, antiretroviral therapy and viral suppression. These indicators can all be expressed as percentages but use different denominators, so the figures should not be substituted for one another.
Frequently Asked Questions
What does HIV testing positivity measure?
It is the percentage of HIV tests with results returned to the person that were positive. It is not the share of positive people who received their result and it is not population HIV prevalence.
Are all observations on the map from 2024?
No. Of 138 latest observations, 123 are from 2024, 11 from 2023 and four from 2022. Same-year distribution and ranking statistics use only the 123 observations dated 2024.
Does higher testing positivity mean a country has a worse HIV situation?
Not necessarily. Positivity depends on who is being tested and how testing is targeted. Testing volume, population prevalence and the mix of testing settings are needed for interpretation.
Can one person be counted more than once?
Yes. WHO defines this as a test-based measure. If a person is tested more than once and receives each result, multiple tests can be counted in the numerator and denominator as applicable.
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