HIV epidemic growing, warns UNAIDS

Global HIV/AIDS epidemic continues to grow with an estimated 39.5 million people now living with the virus worldwide even as 4.3 million more have been newly infected this year, the United Nations have warned.

Some 2.9 million people have died this year from AIDS–related illnesses, and Asia with infected cases continues to be a cause of concern, the U.N.'s AIDS epidemic update report has stated.

The disease's spread was most notable in East Asia, eastern Europe and Central Asia.

"This year's report gives us real cause for concern," UNAIDS chief Peter Piot said. "The global epidemic is growing in all areas."

Every eight seconds a person is infected with HIV somewhere in the world, he added.

"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," said WHO acting director–general Dr. Anders Nordstram.

"HIV prevention programmes are failing to address the overlap between injecting drug use and sex work within the epidemics of Latin America, Eastern Europe and particularly Asia," the report stated.

Meanwhile, in Beijing, the Health Ministry said that two months before the end of 2006, the reported number of HIV/AIDS cases already is nearly 30 percent higher than for all of last year, with intravenous drug use as the biggest source of infection.

The increase in reported cases indicates that China is doing "more testing and more reporting and also that the epidemic continues to grow in many parts of the country," said Joel Rehnstrom, coordinator for the China office of UNAIDS, the United Nations' AIDS organization.

After years of denying that AIDS was a problem, Chinese leaders have dramatically shifted gears in recent years, promising anonymous testing, free treatment for the poor and a ban on discrimination against people with the virus.

President Hu Jintao signaled the new approach by recently appearing on national television in late 2004 chatting and shaking hands with AIDS patients.

Rehnstrom said reported HIV cases have been steadily increasing at a rate of about 30 percent annually since 1999, but the real number of HIV cases in China is likely four to five times the reported figure.

AIDS has killed more than 25 million people since the first case was reported in 1981, making it one of the most destructive illnesses in history.

"In a short quarter of a century, AIDS has drastically changed our world," said former U.N. Secretary–General Kofi Annan.

Piot said he was particularly worried by data showing a resurgence in new infections in countries that had made progress in the fight against HIV/AIDS, such as Uganda, Thailand, Western European nations and the United States.

The reversal in Uganda – once a model for the world in its battle against AIDS – can be blamed on a change in behavior, with fewer people using condoms, more people having sex with different partners and young people beginning sex earlier, he said.

According to the joint report by UNAIDS and the World Health Organization, young people between 15 and 24 account for 40 percent of new infections worldwide.

"Even in countries where the epidemic has had a very high impact, such as Swaziland and South Africa, general awareness is still worryingly low," UNAIDS epidemiologist Karen Stanecki said.

But the decline of HIV infections in most eastern African countries, with the exception of Uganda, and the impact of better access to treatment gives rise to hope, Piot said.

Sub–Saharan Africa still bears the highest burden, with 63 percent of the world's infected people, or 24.7 million.

"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."

India is estimated to have around 5.2 million HIV infected cases, the second largest after South Africa.

The virus has spread fastest in eastern Europe and Central Asia over the past two years, with a nearly 70 percent increase in new infections. In South and Southeast Asia, the number of new infections has grown by 12 percent since 2004, while it rose by 15 percent in North Africa and the Middle East. In Latin America, the Caribbean and North America, it remained roughly stable.

All regions of the world have had an increase in the number of people living with HIV over the past two years. In some countries this was due to better access to medicine keeping people alive longer.

There are 17.7 million women worldwide carrying the virus, an increase of more than 1 million compared with two years earlier. The proportion of infected women is particularly striking in sub–Saharan Africa, where they account for 59 percent of HIV/AIDS cases.

The reason for this is partly because the virus passes more easily from men to women than vice versa. Also the high infection rates among teenage girls in some African countries are due to older men having sex with girls. Male infidelity is also thought to account for the increasing HIV incidence among married African women.

"If you don't tackle the gender issue, how men and women relate to each other, we are going to be in deep trouble in the long run," Piot said.

The United States – for which figures were available for 2005 only – had 1.2 million people living with HIV last year. It therefore ranks among the top 10 countries in terms of the number of infected people. About 40,000 people are newly infected every year in the United States.

Unprotected sex with prostitutes and between men, as well as intravenous drug use represent the highest risks for HIV infection and the main reasons for the spread of the disease in Asia, eastern Europe and Latin America.

After sub–Saharan Africa, Asia is the second most infected region. Almost 8 million of the world's people with HIV/AIDS live in South and Southeast Asia. The report cites growing HIV outbreaks among men who have sex with men in Cambodia, China, India, Nepal, Pakistan, Vietnam and Thailand, and criticizes these countries for failing to adequately address the problem.

Referring to India, the report stated that the bulk of HIV infections in the country occur during unprotected heterosexual intercourse. Consequently, women account for a growing proportion of people living with HIV (some 38 percent in 2005), especially in rural areas.

A large proportion of women in India with HIV appear to have acquired the virus from regular partners who were infected during sexual intercourse with prostitutes.

In North America, an estimated 1.4 million people are infected, which represents a steady increase over the past few years mainly due to the life–prolonging impact of antiretrovirals.

People from racial and ethnic minorities are more affected by the epidemic, with half of the AIDS diagnoses in the United States between 2001 and 2004 among African Americans and 20 percent among Hispanics.

But infected people in the U.S. have been benefiting from more effective antiretrovirals, leading to a 21 percent increase of infected people surviving two years or longer since the early 1990s.

The latest report underlines that the HIV/AIDS prevention programmes in regions like Latin America, the Caribbean, the Middle East, North Africa and Asia have failed to adequately reach the people at highest risk – "men who have sex with men, sex workers, and injecting drug users" and little is known about their particular situations and realities.

The report has also revealed that levels of knowledge of safe sex and HIV remain low in many countries, as does perception of personal risk.

Even in countries where the epidemic has very high impact, such as Swaziland and South Africa, a large proportion of the population do not believe they are at risk of becoming infected, it stated.