40 million with HIV/AIDS

The number of people living with HIV/AIDS over the past two years has increased and the worldwide total now stands at nearly 40 million, according to a report released on Tuesday by UNAIDS and the World Health Organization, Reuters UK reports.

The report, titled "AIDS Epidemic Update: December 2006," estimates that 4.3 million new HIV infections occurred worldwide this year and that about 2.9 million people died of AIDS-related illnesses. The report compared adjusted figures from 2004 rather than from 2005 because of changes in methodology and data (Nebehay, Reuters UK, 11/21). According to the report, 40% of new infections among people age 15 and older occurred among young people ages 15 to 24 (Baert, AFP/Yahoo! News, 11/21). In addition, there were 2.8 million new HIV infections in Africa in 2006, and 2.1 million people on the continent died of AIDS-related illnesses, the report said (Reuters, 11/21). The most evident increases in HIV incidence occurred in Eastern Europe and Central Asia, with a nearly 70% increase in new infections over the past two years, according to the report (BBC News, 11/21). The number of new HIV infections in South and Southeast Asia increased by 15% since 2004, and the number of new infections in North Africa and the Middle East since 2004 increased by 12%, according to the report. The number of new HIV infections in Latin America and the Caribbean and North America remained stable. In addition, the number of HIV-positive women worldwide has reached 17.7 million, an increase of more than one million over the past two years, the report said. In sub-Saharan Africa, women account for 59% of people living with HIV/AIDS (Engeler, AP/Kansas City Star, 11/21).

Sub-Saharan Africa continues to be hardest hit, and within the region, Southern Africa in particular. Southern Africa has the highest burden of the disease. Thirty-two percent of HIV-positive people worldwide live in Southern Africa and 34% of deaths from AIDS-related illnesses occur there, according to AFP/Yahoo! News. The epidemic in South Africa, which "emerged a little later than most other HIV epidemics in the sub-region" now has "reached the stage where increasing numbers of people are dying" of AIDS-related illnesses, according to the report. Meanwhile, HIV prevalence in Kenya, Rwanda, Tanzania and Zimbabwe appears to have decreased (AFP/Yahoo! News, 11/21). However, HIV prevalence in Uganda is beginning to increase after the country successfully combated the epidemic in the past, the report said (Reuters, 11/21). By June, the number of people in Africa receiving antiretroviral drugs had increased tenfold since December 2003 to one million, according to AFP/Yahoo! News. However, "the sheer scale of need in this region means that a little less than one-quarter (23%) of the estimated 4.6 million people in need of antiretroviral therapy in this region are receiving it," the report said (AFP/Yahoo! News, 11/21).

According to the report, about 8.6 million people in Asia are HIV-positive, an increase of almost 10% since 2004. There were an estimated 960,000 new HIV infections in Asia in the past year and about 630,000 deaths from AIDS-related illnesses. About 235,000 HIV-positive people living in Asia are receiving antiretrovirals, which is a threefold increase since 2003. However, this accounts for 16% of people living with HIV/AIDS who need the drugs. Southeast Asia continues to have the highest HIV prevalence in the region, the report said, adding that "serious epidemics" among men who have sex with men "are now becoming evident" in Cambodia, China, India, Pakistan, Thailand and Vietnam. However, most of the countries have not implemented programs that address the role of sex among MSM in their national epidemics, the report said. Officials say roughly 44% of the estimated 650,000 people living with HIV/AIDS in China were infected through injection drug use, AFP/inq7.net reports. According to UNAIDS, half of the new HIV infections in China last year occurred through unprotected sex. "This indicates that HIV is spreading gradually from people at higher risk of exposure to the general population, and subsequently the number of women becoming infected with HIV is growing," the report said (AFP/inq7.net, 11/21). In addition there are 1.7 million HIV-positive people living in Eastern Europe and Central Asia, and there were an estimated 270,000 new HIV infections in the regions in 2006, according to the report. Almost one-third of those newly diagnosed in the region are young people between the ages of 15 and 24, the report said. About two-thirds of cases reported in the last year in the region were due to non-sterile injection drug use. Russia and Ukraine are home to 90% of HIV-positive people in the region. The report also said that new HIV infections in the region are increasingly occurring through unprotected sex and that women accounted for 41% of new HIV infections reported in 2005 (Agence-France Presse, 11/21).

According to new data from the report, HIV prevention programs are effective when they are focused, sustained and adapted to address the most vulnerable groups. The report cites examples in China of programs aimed at sex workers that have led to significant increases in condom use and declines in sexually transmitted infections. In addition, Botswana, Burundi, C??te d'Ivoire, Kenya, Malawi, Rwanda, Tanzania and Zimbabwe have seen increased condom use, sexual debut delay and decreased number of sexual partners among young people. "We need to greatly intensify life-saving prevention efforts while we expand HIV treatment programs," UNAIDS Executive Director Peter Piot said. The report also highlighted that many people do not believe they are at risk of becoming infected, even in countries with high HIV prevalence, including South Africa and Swaziland (UNAIDS/WHO release, 11/21).

The Kaiser Family Foundation's Jackie Judd spoke with Paul De Lay, UNAIDS director of monitoring and evaluation, about the report. The interview can be found here.