Ecological and Longitudinal Analysis of the African Continent 2010 to 2024 Modeling AIDS Related Mortality ART Coverage and HIV Incidence Across 54 Countries

Background HIV/AIDS remains a major public health challenge in Africa. Understanding trends in treatment coverage, new infections, and AIDS-related mortality is essential to achieving global targets. However, most studies focus on sub-Saharan Africa, overlooking patterns across the entire continent. Methods This study examined HIV treatment coverage, new infections, and AIDS-related deaths across all African regions, including sub-Saharan and North Africa, from 2010–2024. Data for 54 countries were obtained from UNAIDS and WHO; after cleaning, 51 countries remained . Analyses included Spearman correlation, pooled linear regression, panel regression, and growth curve modelling to assess associations between ART coverage and HIV/AIDS indicators. Results Spearman correlation showed a moderate positive association between ART coverage and HIV incidence, likely reflecting ART scale-up in high-burden countries. Fixed-effects panel regression indicated that each 1% ART coverage increase reduced AIDS-related deaths by 158 per year (p < 0.001), controlling for country effects. Pooled regression showed that when ART coverage and HIV incidence were modelled together, a 1% ART rise was linked to a 122.6-unit drop in AIDS mortality (p < 0.001). Growth curve modelling found mortality increased by ~  326 deaths annually (β = 325.7, p = 0.003), potentially due to improved reporting, delayed ART initiation, or population growth, not reduced ART effectiveness. Additionally, a 1% ART coverage rise was linked to ~ 280 fewer AIDS deaths per year (p < 0.001). Conclusion Findings reconcile ART’s life-saving benefits with rising reported mortality. They provide robust, continent-wide evidence of ART’s impact and stress the need for context-specific interventions, particularly in conflict-affected or fragile health systems.