UNAIDS annual report on the global HIV epidemic estimates that in 2002 there were 5 million new HIV infections, 3.1 million AIDS deaths and that 42 million people world-wide are now HIV-positive.
The report found that, although HIV continued to hit Africa hard, HIV prevalence was increasing to epidemic proportions in countries and regions previously little affected by the disease.
Last year over 3.5 million Africans are estimated by UNAIDS to have been newly infected with HIV, with 2.4 million AIDS deaths. Head of UNAIDS Dr Peter Piot highlighted the link between AIDS and famine (see separate story).
Noting 700,000 new cases of HIV in south and south east Asia, UNAIDS predicts that “the window of opportunity for bringing the HIV/AIDS epidemic” under control in this region was “narrowingly rapidly.” Sharing drug injecting equipment is though to be driving the epidemic in Asia, but said Dr Gro Harlem Brundtland, Director General of the World Health Organisation, “it does not take long before the partners of injecting drug users become part of a steadily widening epidemic.” Indonesia in particular was highlighted by UNAIDS. A decade ago injecting drug use was virtually unknown in the country, but had “sky-rocketed’ in recent years, with an estimated 200,000 users in Jakarta alone, of whom 100,000 are thought to be HIV-positive. The city had an HIV prevalence rate of zero as recently as 1988.
In China, eastern Europe and the former states of the Soviet union, injecting drug use is, again, thought to be at the heart of rapidly expanding HIV epidemics. In China alone over 200,000 new infections are estimated to have occurred in 2002, with a further 250,000 in eastern Europe and central Asia.
What little hope was contained in the report came from statistics suggesting that health education campaigns were having an impact on younger people, with HIV prevalence rates in South African pregnant women under 20 falling from 21% in 1998 to 15.4% in 2001. HIV prevalence also continued to fall in parts of Uganda and the HIV rate also appeared to be falling amongst young women in the Ethiopian capital, Addis Ababa. Prevention efforts with sex workers in Cambodia also appeared to be paying dividends, with a 13% reduction in HIV prevalence between 1998 and 2001. Neverthess, the report noted that as many men as women were now HIV-positive and the burden of HIV was likely to fall most heavily on women in the years to come.
HIV also continued to spread in north Africa and the Middle East with an estimated 83,000 new infections and 37,000 deaths. Prevention efforts were, UNAIDS suggested, being hampered by poor surveillance.
In Latin America and the Caribbean 210,000 new infections and 102,000 deaths are thought to have occurred over the past twelve months with twelve countries in the region now having HIV prevalence rates over over 1%. Brazil’s HIV prevention efforts and provision of generic antiretroviral drugs was praised.
In resource rich countries HIV also continued to spread with 45,000 new infections in the USA, 30,000 in western Europe and 500 in Australia, with an estimated 15,000 Americans dying of HIV related causes, 8,000 western Europeans and fewer than 100 Australians. The report notes with concern “a rise in unsafe sexual behaviour’”and the need to “resist complacency” adding that disadvantaged people were of particular risk of HIV. Regarding gay men, UNAIDS reports “sex between men remains a prominent transmission route in several countries...In most high income countries, the almost legendary successes achieved by, and among, men who have sex with men are clearly now a thing of the past.”
The full report can be read at the UNAIDSwebsite.