Global AIDS epidemic continues to grow despite some positive trends – UN report
Despite some promising trends, the global AIDS epidemic continues to grow, with 2.9 million deaths and 4.3 million new HIV infections in the past year, amid worrying evidence of a resurgence in infection rates in some countries that were previously stable or declining, according to latest United Nations data released today.
“It is imperative that we continue to increase investment in both HIV prevention and treatment services to reduce unnecessary deaths and illness from this disease,” UN World Health Organization (WHO) Acting Director-General Anders Nordström said of the 2006 AIDS Epidemic Update, compiled by WHO and UNAIDS, the Joint UN Programme on HIV/AIDS.
“In sub-Saharan Africa, the worst affected region, life expectancy at birth is now just 47 years, which is 30 years less than most high-income countries,” he added of the data, which show that 2.8 million, or 65 per cent, of new infections occurred in sub-Saharan Africa, with important increases in Eastern Europe and Central Asia where some indications register a more than 50 per cent rise since 2004.
Overall an estimated 39.5 million people are living with HIV worldwide.
Among positive trends noted are declines in infection rates in some countries, changes in young people’s sexual behaviours, and increased access to treatment and prevention programmes. But in many countries prevention programmes are not reaching those most at risk, such as young people, women and girls, men who have sex with men, sex workers and their clients, injecting drug users, and ethnic and cultural minorities.
In North America and Western Europe, prevention programmes have often not been sustained and new infection rates have remained the same. In low- and middle-income countries, there are only a few examples of rate reductions. And some countries that had shown earlier successes in reducing new infections, such as Uganda, have either slowed or are now experiencing increasing infection rates.
“This is worrying – as we know increased HIV prevention programmes in these countries have shown progress in the past – Uganda being a prime example,” UNAIDS Executive Director Peter Piot said. “This means that countries are not moving at the same speed as their epidemics. We need to greatly intensify life-saving prevention efforts while we expand HIV treatment programmes.”
Increased prevention programmes focused to reach those most at risk of infection are making inroads, according to the report. Positive trends in young people’s sexual behaviours – increased use of condoms, delay of sexual debut, and fewer sexual partners – have taken place over the past decade in many countries with generalized epidemics.
Declines in HIV prevalence among young people between 2000 and 2005 are evident in Botswana, Burundi, Côte d’Ivoire, Kenya, Malawi, Rwanda, Tanzania and Zimbabwe.
In other countries, even limited resources show high returns when investments are focused on those most likely to be exposed. In China, some programmes for sex workers have seen marked increases in condom use and decreases in rates of sexually transmitted infections. Programmes with injecting drug users also show progress in some regions.
In Portugal, HIV diagnoses among drug injectors were almost one third lower in 2005, compared with 2001, following special programmes focused on HIV and drug use.
The report outlines how women and girls need increased attention. In sub-Saharan Africa women continue to be more likely than men to be infected with HIV and in most countries in the region they are also more likely to be the ones caring for those infected.
There is increasing evidence of outbreaks among men who have sex with men in Cambodia, China, India, Nepal, Pakistan, Thailand and Viet Nam as well as across Latin America, but most national programmes fail to address the specific needs of these people, the report notes. The overlap between injecting drug use and sex work in Latin America, Eastern Europe and particularly Asia is also not being addressed.
In Latin America, the Caribbean, the Middle East, and North Africa weak surveillance often means that people at highest risk – men who have sex with men, sex workers, and injecting drug users – are not adequately reached through prevention and treatment strategies because not enough is known about their particular situations and realities.