HIV/AIDS on the up all over the world

According to figures released ahead of World Aids Day on December 1, the spread of HIV/AIDS continues unabated across the globe.

The United Nations (UN) says the number of people infected and living with HIV has now reached 39.5 million and 4.3 million of those were infected in 2006; 400,000 more than were infected in 2004.

The UNAIDS annual report says numbers are rising even in some countries which thought they were beating the disease and most worrying is the increase is also being seen in Uganda, long held up as a good role model of what could be achieved in Africa with campaigning, education and widespread condom use.

The report shows a rise in Uganda from a low of 5.6% infection among men and 6.9% among women in 2000 to 6.5% in men and 8.8% in women in 2004.

The reasons for the increase in Uganda are not clear, but during the early 1990s and early 2000s, HIV prevalence fell sharply in major cities among pregnant women, the group most commonly monitored because they have contact with health services, due to the efforts on the part of President Yoweri Museveni who worked to raise awareness of the dangers of HIV and supported the use of condoms.

But it is believed the message on condoms has been clouded in recent years because Uganda was concerned the millions of American dollars for HIV prevention and treatment may have been jeopardised if they did not toe the Bush administration's line that sexual abstinence until marriage was the way forward.

As critics on the ground have repeatedly pointed out many women are not in a position to abstain from sex and many are infected by their husbands.

The report says further research is needed to check whether the erosion of the gains Uganda made against Aids in the 1990s is down to erratic condom use and more men having sex with multiple partners.

The epidemic appears to be growing in Mali as well after remaining stable for some years, with HIV prevalence among pregnant women rising from 3.3% in 2002 to 4.1% in 2005 and while Kenya's epidemic is in decline, the report says there are suggestions that this could be because of the high death rate and "the saturation of infection among people most at risk".

The gains made by programmes aimed at preventing infection have not been maintained in North America and western Europe either, and the number of infections in the U.S. have been seen in a far greater proportion in African-Americans and Hispanics, which though stable is not on the decline.

In the UK, there is also a steady rise and HIV remains one of the principal "communicable disease threats" with new cases increasing in areas other than London, which has the most cases.

The number of gay men with HIV has now reached an all-time high, and there were more than 2,350 new cases of the disease in homosexual and bisexual men in the UK last year - up 55 per cent up on the year 2000.

Experts say safe sex messages were still being ignored by many gay men and though new HIV diagnoses in the general population have stabilised at 7,450 per year, 63,500 adults are suspected to be living with the disease, and almost a third do not know they are infected.

It seems most of those with HIV were infected in sub-Saharan Africa and concerns over the stigma and discrimination associated with the disease is discouraging Africans in the UK from being tested.

Peter Piot, UNAIDS's executive director, says the trends are a worry as experience has shown that increased HIV prevention programmes have shown progress in the past.

He says Uganda was a good example of this and countries are possibly not moving at the same speed as their epidemics.