The figure, drawn from HIV serology testing of nearly 13,000 women and men, confirms a steady decline in the country's epidemic: prevalence held at 3.0% from 2005 through 2014–15, before easing to 2.7% in the 2019–20 RDHS and now 2.2% in 2025. The report describes the drop between 2019–20 and 2025 as statistically significant.
But the national average masks wide disparities that the survey's authors say still call for targeted intervention, by sex, by geography, and by wealth and education.
A persistent gender gap
Women continue to bear a heavier burden of HIV. The survey found prevalence among women aged 15–49 at 2.8%, nearly double the 1.5% recorded among men.
This gap persists even though women account for a slight majority of Rwanda's population. The 2022 Rwanda Population and Housing Census recorded 13,246,394 people, comprising 6,817,067 females (51.5%) and 6,429,326 males (48.5%).
Compared with the 2019–20 survey, HIV prevalence among women declined from 3.5% to 2.8%, a statistically significant reduction, while prevalence among men decreased slightly from 1.7% to 1.5%, a change that was not statistically significant.
The gap widens further with age. Among women aged 45–49, prevalence reaches 7.8%, compared with 3.5% among men in the same age bracket, and 4.3% among men aged 50–59. Prevalence generally climbs with age for both sexes, from under 1% among teenagers to its peak in the 40s and 50s.
Marital and relationship status also shapes risk. Widowed respondents have the highest prevalence of any group at 10.9%, followed by those who are divorced or separated at 7.3%. Women in polygynous unions show notably higher prevalence (6.5%) than those in non-polygynous unions (2.3%).
Male circumcision continues to show a protective association: HIV prevalence is 1.2% among circumcised men, compared with 2.5% among men who are not circumcised or do not know their status.
Cities carry a heavier burden than the countryside
Geography remains one of the sharpest dividing lines in Rwanda's HIV epidemic. Prevalence in urban areas stands at 3.3%, almost double the 1.7% recorded in rural areas, a pattern consistent with previous rounds of the survey and with the country's broader urban–rural health disparities.
The provincial breakdown tells a similar story. The City of Kigali has the highest prevalence in the country at 3.7%, more than triple the 1.0% recorded in the Northern Province, which posts the lowest rate nationally. Southern Province (2.3%), Western Province (2.2%), and Eastern Province (2.0%) fall in between.
Education levels also showed clear differences in HIV prevalence. The survey found HIV prevalence was highest among people with no formal education (4.9%), followed by those with primary education (2.4%), secondary education (1.6%), and more than secondary education (0.9%). By household wealth, the poorest quintile recorded the highest prevalence (3.3%), though the pattern across the remaining wealth groups was less consistent.
Testing coverage remains high
The survey's underlying data quality is bolstered by near-universal participation: 99% of eligible women and 97% of eligible men consented to HIV testing and provided a blood sample for the survey's testing algorithm, carried out through Rwanda's National Reference Laboratory. Fewer than 1% of eligible respondents refused testing outright.
Rwanda has been widely recognized as a regional leader in HIV control, having met the UNAIDS 95–95–95 targets for diagnosis, treatment, and viral suppression ahead of the 2025 deadline.
With prevalence now confirmed at 2.2% nationally, the survey gives policymakers a clearer map of where continued gains are still to be made, particularly among older women, urban populations, and the City of Kigali, building on a strategy that has already brought the country this far.
Meanwhile, the HIV findings sit alongside a wider set of health gains captured in the 2025 RDHS. Fertility has continued its long decline, with the total fertility rate now at 3.7 children per woman. Child survival has also improved: under-5 mortality has fallen to 36 deaths per 1,000 live births, down from 45 in the previous survey, while infant and neonatal mortality have declined in tandem.
Chronic child malnutrition is down too, 27% of children under five are stunted, compared with 51% two decades ago, and contraceptive use among married women has climbed to 69%, with the government sector remaining the primary source of family planning services nationwide.
