Nigeria has been ranked fourth among countries with the largest populations of people living with HIV, with an estimated two million people living with the virus.

The ranking, published by World Population Review using data linked to the World Health Organization and the Institute for Health Metrics and Evaluation, placed South Africa first with an estimated 7.8 million people living with HIV.

India ranked second with 2.6 million people, while Mozambique came third with 2.5 million. Nigeria followed in fourth place, ahead of Tanzania, Uganda, Zambia, Zimbabwe and Kenya.

Tanzania was estimated to have 1.8 million people living with HIV, Uganda recorded 1.5 million, Zambia had 1.4 million, while Zimbabwe and Kenya each had about 1.3 million people living with the virus.

Brazil was the only country outside Africa and Asia to feature in the top 10, with an estimated 1.1 million people living with HIV.

The ranking showed that African countries accounted for a large share of the countries with the highest HIV-positive populations, reflecting the continuing burden of the epidemic across the continent.

Other African countries on the list include Malawi with 990,000 people living with HIV, the Democratic Republic of Congo with 610,000, Ethiopia with 600,000, Cameroon with 510,000 and Côte d’Ivoire with 410,000.

Mexico was listed with 400,000 people living with HIV, Angola had 370,000, Botswana 360,000, Pakistan 350,000 and Ghana 330,000.

Myanmar recorded 290,000 people living with HIV, Lesotho had 260,000, Rwanda 240,000, while Colombia, Eswatini, Namibia and the Philippines were each estimated to have between 220,000 and 230,000 people living with the virus.

The World Health Organization defines people living with HIV as those estimated to be alive with HIV infection at the end of a specific year, whether or not they have developed symptoms of AIDS.

While the ranking focuses on the total number of people living with HIV, it differs from HIV prevalence rates, which measure the proportion of a country’s population living with the virus.

For instance, South Africa has the largest number of people living with HIV, but countries such as Eswatini, Lesotho and Botswana have higher adult HIV prevalence rates because of their smaller populations.

Globally, the WHO estimated that about 40.8 million people were living with HIV at the end of 2024, with 65 per cent of them residing in the WHO African Region. The agency said HIV remains a major public health concern, although effective prevention, diagnosis, treatment and care have made it a manageable chronic health condition for many people.