HIV/AIDS

Posted: 27 November 2006

The HIV virus which causes the fatal AIDS disease is mainly transmitted through heterosexual intercourse in the developing world. Women are more easily infected than men, and the presence of other sexually transmitted infections increases the chances of contracting HIV.

AIDS educationSchoolchildren receive AIDS education, Uganda© Jorgen Schytte/Still Pictures

  • Around 40 million people were living with HIV/AIDS at the end of 2006, of whom over 90 per cent were in developing countries.

  • During 2006, some 2.9 million people died of AIDS, including 380,000 children, despite recent improved access to antiretroviral treatment.

  • There were 4.3 million new infections of HIV in 2006, including 530,000 children under 15.

  • AIDS has created some 15 million orphans since the beginning of the epidemic - children who, before the age of 15 lost either their mother or both parents to AIDS.

  • Life expectancy has been cut by 20 years in some areas, down from the mid-60s to mid-40s.

  • Over 70 per cent of HIV infections worldwide occur through sex between men and women, and a further 10 per cent through sex between men. Another 5 per cent or so take place among people who inject drugs, four-fifths of whom are men.

  • The scourge of HIV/AIDS is hitting women hard. Nearly half of the people living with HIV (more than half in Sub-Saharan Africa) are women; their biological vulnerability to the disease is compounded by their lack of social and economic power.

  • Expanded treatment access was estimated to have averted 250,000 to 350,000 AIDS deaths between 2003 and 2005. Globally, however, antiretroviral drugs still reach only one in five who need them.

  • In June 2001, 189 countries at the UN General Assembly's Special Session on AIDS agreed on a course of action to halt and reverse the AIDS pandemic by 2015. The rate of increase in HIV resources has accelerated since the 2001 Special Session, with an annual average increase of US$1.7 billion between 2001–2004, compared with an average annual increase of US$266 million between 1996 and 2001. Available funding in 2005 reached US$8.3 billion.

  • Domestic public expenditure from governments has also significantly increased in low-income sub-Saharan African countries, and more moderately in middle-income countries. In 2005, domestic resources reached US$2.5 billion.

  • Investment by public and philanthropic sectors in microbicide research and development has more than doubled, increasing from US$65 million in 2001 to an estimated US$163 million in 2005.

  • By early 2006, large-scale human trials had been initiated to assess the HIV prevention efficacy of microbicides, the female diaphragm and adult male circumcision.

  • Funding for the development of preventive vaccines nearly doubled from US$327 million in 2000 to nearly US$630 million in 2005.

  • Treatment access has dramatically expanded. From 240,000 people in 2001, 1.3 million people in low- and middle-income countries received antiretroviral therapy in 2005, and 21 countries met or exceeded targets under the “3 by 5” initiative to provide treatment to at least 50% of those who need it.

  • The number of people using HIV testing and counselling services quadrupled in the past five years in more than 70 countries.
Regional facts

Africa

Ethiopian soldier
Ethiopian soldier
A soldier in Humera, Ethiopia. Infection rates for sexually transmitted diseases are up to five times higher in the military than among civilians, according to the United Nations. Credit: ©Pep Bonet/Panos Pictures
  • Africa, which accounts for only one-tenth of the world's population, bears the brunt of the epidemic with more than 75 per cent of all deaths to date. "Sixty million Africans have been touched by AIDS in the most immediate way. They are living with HIV, have died of AIDS or they have lost their parents to AIDS. But the toll of those directly affected is even higher," said Dr Peter Piot, Executive Director of the Joint United Nations Programme on HIV/AIDS.

  • Altogether, nearly 25 million Africans are living with HIV/AIDS and up to 1,000 adults and children die each day of AIDS in some of the worst affected countries in Africa.

  • Of the 40 million adults and children living with HIV/AIDS worldwide, two-thirds live in sub-Saharan Africa. In 2006, 2.8 million people in sub-Saharan Africa were newly infected with HIV and, without treatment, are expected to die in the next 10-15 years.

  • Women account for 59% of HIV infections in sub-Saharan Africa.

  • The price at which antiretrovirals are available to developing countries has dropped significantly, but technical facilities and sustainable financing are still major barriers. In sub-Saharan Africa, only some 50,000 people have access to antiretrovirals out of an estimated 4 million people in need of medicines.

  • 12 million AIDS orphans, out of a world total of 15 million, are in Africa, many of whom are stigmatised, get no schooling and are at risk of illness and crime.

  • At least 10 per cent of those aged 15–49 are infected in 16 African countries, including several in southern Africa, where at least 20 per cent are infected.

  • In Africa, TB is a leading cause of death among those with immune systems weakened by the HIV virus.

  • At the end of 2005, South Africa had 5.5 million people infected with HIV - the largest number of any country in the world. The adult HIV prevalence rate is 20 per cent, and around 30 per cent of pregnant women are HIV-positive.

  • There are no clear signs of declining HIV prevalence elsewhere in southern Africa — including in Botswana, Namibia and Swaziland, where exceptionally high infection levels continue. In Swaziland, national adult HIV prevalence is estimated at 33 per cent.

  • The vast majority of Africans living with HIV do not know they have acquired the virus. One study has found that 50% of adult Tanzanian women know where they could be tested for HIV, yet only 6% have been tested.

Asia & the Pacific

  • Over 8.5 million people are believed to be infected with HIV/AIDS in Asia, more than two-thirds of them in India.

  • More than half of all new HIV/AIDS infections in Asia occur among those under 25.

  • Thailand’s well-funded, politically-supported and comprehensive prevention programmes, which accelerated in the early 1990s, have trimmed annual new HIV infections to about 30,000, from a high of 140,000 a decade ago.

  • Although an estimated 700,000 Thais are living with HIV today, Thailand’s prevention efforts probably averted millions of HIV infections.

  • Still, one in 60 Thais is infected with HIV, and AIDS has become the leading cause of death. There are indications that transmission between spouses is now responsible for more than half of new infections.

  • In Vietnam, HIV has now spread to all 59 provinces, and in Myanmar the adult HIV prevalence rate is believed to be 1.3 per cent.

  • Indonesia — the world’s fourth-most populous country — offers an example of how suddenly an HIV/AIDS epidemic can emerge. After more than a decade of negligible rates of HIV, the country is now seeing infection rates increase rapidly among injecting drug users and sex workers.

  • HIV infection in injecting drug users was not considered worth measuring until 1999/2000, when it had already reached 15%. Within another year, 40% of injectors in treatment in Jakarta were already infected.and among drug-using prisoners tested in Bali, prevalence was 53%.

  • In India, some 5.7 million people were living with HIV/AIDS at the end of 2005 — more than in any other country except possibly South Africa.

  • Some 650,000 people in China were living with HIV in 2005, nearly half of them injecting drug users. China's low national HIV prevalence obscures the fact that serious epidemics have been under way in several regions. HIV prevalence rates of 18-56 per cent have been found among injecting drug users in the southern provinces of Guangdong and Guangxi in 2002, and 20 per cent among those in Yunnan in 2003. A severe HIV epidemic has affected communities where unsafe blood-collection practices occurred in the 1990s.

  • Several constraints hinder a more effective AIDS response in China. They include poor public awareness about the epidemic, and the stigma and discrimination experienced by people living with HIV.

Latin America & the Caribbean

  • More than 2 million people are living with HIV/AIDS in Latin America and the Caribbean.

  • In Central America and the Caribbean, HIV is mainly heterosexually transmitted, with unsafe sex and frequent partner exchange among young people high among the factors driving the epidemic.

  • The Caribbean is the second-most affected region in the world, with adult HIV prevalence rates only exceeded by those of sub-Saharan Africa.

  • In several Caribbean countries, HIV/AIDS has become a leading cause of death. Worst affected are Haiti and Bahamas, where the adult HIV prevalence rate is over 3 per cent.

  • Almost three-quarters of AIDS cases reported in Central America are the result of sex between men and women.

  • On some Caribbean islands, the phenomenon of young women having sex with older men is especially prominent, and is reflected in the fact that the HIV rate among girls aged 15–19 is up to five times that of boys in the same age group.

  • Research among sex workers in Guyana’s capital, Georgetown, has found that 46% of surveyed sex workers were living with HIV/AIDS, that more than one-third of them never used a condom with their clients, and that almost three-quarters did not use condoms with their regular partners.

  • In Costa Rica, Mexico, Nicaragua and parts of the Andean region, sex between men is the more prominent route of HIV transmission. HIV prevalence among men who have sex with men is uniformly high in Central American countries, ranging from 9% in Nicaragua to 18% in El Salvador.

  • Prevalence rates among heterosexual sex workers and sexually transmitted infection patients in Mexico, meanwhile, appear still to be low. Injecting drug use is a main route of HIV transmission in Argentina, Chile and Uruguay.

  • In Brazil, a substantial decline in HIV prevalence among injecting drug users has been observed recently in several large metropolitan areas. This suggests that HIV/AIDS prevention and harm reduction programmes in those cities have made possible safer injection habits among these populations.

  • Brazil’s prevention efforts are being balanced with an extensive treatment and care programme that guarantees state-funded antiretroviral therapy for those living with HIV/AIDS.

  • The number of people living with the virus in Brazil is over 600,000. An estimated 105,000 Brazilians are receiving antiretroviral drugs through the public health system.

Eastern Europe and Central Asia

  • This region has the unfortunate distinction of having the world's fastest growing HIV/AIDS epidemic.

  • In countries of the former Soviet Union and Eastern Europe, the estimate of the number of adults and children living with HIV or AIDS has risen to 1.5 million in December 2005 - a 20-fold increase in less than a decade.

  • Most of the 220,000 adults who became infected in 2005 are men, most of them injecting drug users.

  • An estimated 860,000 were living with HIV in the Russian Federation at the end of 2003.

  • The proportion of registered infections in Russia related to sexual transmission has increased from 6 per cent in 2001 to 25 per cent in 2004. About 38 per cent of total registered HIV cases are in women - a bigger share than ever before.

  • Ukraine is the worst affected country in Europe after Russia, with an estimated adult HIV prevalence rate of 1.4 per cent. The annual number of newly reported HIV cases continues to rise and exceeded 12,400 in 2004, almost double the number diagnosed in 2000. These figures understate the actual size of the epidemic by a wide margin since they only reflect infections among people who have been in direct contact with official testing facilities.
High-income countries

  • Unless averted with renewed and more effective prevention efforts, resurgent epidemics will continue to threaten high-income countries, where over 65,000 people became infected with HIV in 2005.

  • In high-income countries there is evidence that HIV is moving into poorer and more deprived communities, with women at particular risk of infection.

  • Young adults belonging to ethnic minorities (including men who have sex with men) face considerably greater risks of infection than they did five years ago in the USA. African-Americans, for instance, make up only 12 per cent of the population of the USA, but constituted 48 per cent of AIDS cases reported there in 2003.

  • In Japan, the number of HIV infections detected in men who have sex with men has risen sharply in recent years, with male-male sex now accounting for 60 per cent of new HIV cases in 2004.