HIV Burden Trends in Kyrgyzstan, 1990-2025: A National Analysis of GBD 2021 Estimates and Short-Term Projections

Kyrgyzstan has experienced sustained HIV transmission, yet comprehensive national assessments of long-term trends and demographic inequalities remain limited. This study evaluated the national HIV burden and benchmarked Kyrgyzstan's progress against Middle-SDI and global patterns.

We obtained HIV prevalence, mortality, and disability-adjusted life years (DALYs) for 1990-2021 from the Global Burden of Disease Study 2021. Age-standardized prevalence (ASPR), death (ASDR), and DALY rates per 100,000 population were examined by age and sex. Estimated annual percentage changes (EAPCs) with 95% confidence intervals were calculated using log-linear regression. Values for 2022-2025 were short-term projections derived by extrapolating 2010-2021 trends and were not official GBD estimates. We obtained transmission-mode information from national surveillance sources and analyzed it descriptively.

HIV prevalence increased throughout 1990-2021 and was projected to reach an ASPR of 22.8 per 100,000 in 2025. Mortality and DALY rates peaked around 2010 and subsequently declined, although improvements were slower than global benchmarks. Adults aged 20-49 years experienced the greatest burden, while males generally had higher mortality and DALY rates than females. Surveillance data indicated an increasing proportion of diagnoses attributed to heterosexual exposure; however, recent evidence suggests possible underreporting of injecting-drug-use and male-to-male sexual exposure.

Kyrgyzstan has achieved partial reductions in fatal HIV burden, but increasing prevalence indicates continuing transmission and long-term treatment needs. Expanded testing, sustained antiretroviral therapy, harm reduction, and differentiated services for key populations and their sexual partners remain essential.