Survey by world’s largest network for sexual and reproductive health shows devastation to services, particularly in Africa and the Middle East, and amplification of anti-rights voices

Cuts to US aid funding have directly led to the closure of more than 1,000 family planning clinics, new figures shared with the Guardian reveal.

Millions of people have been left without access to contraceptives or care, including those who have suffered sexual assault, as part of a “radical shift towards conservative ideologies that deliberately block human rights”, according to the International Planned Parenthood Federation (IPPF).

Papua New Guinea has one of the fastest growing HIV epidemics in the Asia-Pacific region, with many unaware they have the virus

After battling illness for years, Nancy Karipa tested positive for HIV in 1999. She had just given birth to her first child. “It was a crossroads moment for me, with the fear of denial, but I chose action,” Karipa, who is now in her 50s, said at an Aids awareness event in Papua New Guinea’s capital Port Moresby in December. She and the baby received treatment, and her child remains healthy.

Karipa, from East Sepik in northern PNG, is unusual in sharing her story. The stigma around the disease is high in the Pacific nation, but speaking out has never been more important. This year PNG declared HIV a “national crisis”.