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Sunday, 28 July 2013
GLOBAL SCENARIO

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A global assessment of AIDS prevalence

According to the 2007 UNAIDS Global AIDS Report there was a 16% drop in HIV cases over the previous year mainly due to revised estimates in several countries.

  • According to UNAIDS' 2007 Global AIDS report, an estimated 33.2 million (30.6 million–36.1 million) people worldwide were living with HIV in 2007. Of these, 30.8 million were adults (28.2–33.6 million), 2.5 million (2.2–2.6 million) were children under the age of 15 years. Of the adults, 15.4 million (13.9–16.6 million) were women.
  • An estimated 2.5 million (1.8 million–4.1 million) became newly infected with HIV in 2007 – of which 2.1 million (1.4–3.6 million) were adults and 420 000 (350 000–540 000) were children under 15 years
  • An estimated 2.1 million (1.9 million–2.4 million) people and lost their lives to AIDS in 2007. Of these, 1.7 million (1.6–2.1 million) were adults and 330 000 (310 000–380 000) were children under the age of 15 years.

What these estimates mean

The 2007 report found a 16% drop from the 2006 estimates. Seventy per cent of this change is due to revisions from Angola, India, Kenya, Mozambique, Nigeria and Zimbabwe. The single biggest reason of this drop is the revision of India’s estimates using a new, improved methodology.

Overall, estimates can drop because new methods provide more accurate figures, or because prevention programmes are working or because people are dying of AIDS so their numbers are no longer counted. One reason that numbers can go up is that people are living longer because they have access to medication.

The new estimates cannot be compared to other published estimates but it is possible to recalculate the earlier figures to look at trends over the years.

General trends

There is a generalised epidemic in sub-Saharan Africa where AIDS is the leading cause of death. In other parts of the world it is mostly concentrated in populations most at risk, such as men who have sex with men, injecting drug users, sex workers and their sexual partners.

Globally, HIV prevalence—the percentage of people living with HIV —is believed to be level since 2001. In Africa, national prevalence is dropping in Côte d’Ivoire, Kenya and Zimbabwe. In South-East Asia it is declining in Cambodia, Myanmar and Thailand.

The report states that HIV incidence (the number of new HIV infections in a population per year) peaked in the late 1990s at over 3 million new infections per year. In 2007, it was estimated to be 2.5 million. This change is partly the result of prevention programmes.

The ratio of women to men remains stable overall from 2001. The proportions in 2007 are: 61% in sub-Saharan Africa, 43% in the Caribbean, 26% in Eastern Europe and Central Asia, and 29% in Asia. Globally the number of children living with HIV increased from 1.5 million (1.3–1.9 million) in 2001 to 2.5 million (2.2–2.6 million) in 2007. However, estimated new infections among children declined. Nearly 90% of all HIV-positive children live in sub-Saharan Africa.

Regional pictures

More than two-thirds of all people who are HIV-positive live in Sub-Saharan Africa where more than three quarters of all AIDS deaths in 2007 occurred. It is estimated that 1.7 million (1.4 million–2.4 million) people were newly infected with HIV in 2007, bringing to 22.5 million (20.9 million–24.3 million) the total number of people living with the virus. Unlike other regions, the majority of people living with HIV in sub-Saharan Africa are women.

Southern Africa accounts for 35% of all people living with HIV and almost one third (32%) of all new HIV infections and AIDS deaths globally in 2007. In most countries in East Africa, adult HIV prevalence is either stable or has started to decline. West and Central Africa have comparatively smaller epidemics and in most of these countries, adult HIV prevalence has remained stable though there also seems to be a decline in prevalence in some parts.

In Asia, national HIV prevalence is highest in South-East Asia, with wide variation in epidemic trends between different countries. While the epidemics in Cambodia, Myanmar and Thailand all show declines in HIV prevalence, those in Indonesia (especially in the Papua province) and Viet Nam are growing. Although the proportion of people living with HIV in India is lower than previously estimated, its epidemic continues to affect large numbers of people. Overall in Asia, an estimated 4.9 million (3.7 million–6.7 million) people were living with HIV in 2007, including the 440,000 (210,000–1.0 million) people who became newly infected in the past year. Approximately 300,000 (250,000–470,000) died from AIDS-related illnesses in 2007.

In Pakistan, HIV prevalence is increasing among injecting drug users. One study in Karachi showed an increase in HIV prevalence among injecting drug users from under 1% in early 2004 to 26% in March 2005 while other studies have found that HIV prevalence among injecting drug users has reached 24% in Quetta, 12% in Sargodha, nearly 10% in Faisalabad and 8% in Larkana. HIV prevalence remains low in other populations at higher risk of infection.

In Eastern Europe and Central Asia, An estimated 150,000 people (70,000–290,000) people were newly infected with HIV in 2007 bringing the number of people living with HIV in Eastern Europe and Central Asia to 1.6 million (1.2 million–2.1 million) compared to 630,000 (490,000–1.1 million) in 2001, a 150% increase over that time period. Nearly 90% of newly reported HIV diagnoses in this region in 2006 were from two countries: the Russian Federation (66%) and Ukraine (21%).

Elsewhere, the annual numbers of newly reported HIV diagnoses are also rising in Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, Tajikistan and Uzbekistan (which now has the largest epidemic in Central Asia). Of the new HIV cases reported in 2006 in Eastern Europe and Central Asia for which there was information on the mode of transmission, nearly two thirds (62%) were attributed to injecting drug use and more than one third (37%) were ascribed to unprotected heterosexual intercourse.

Adult HIV prevalence in the Caribbean is estimated at 1.0% (0.9%–1.2%) in 2007. Prevalence in this region is highest in the Dominican Republic and Haiti, which together account for nearly three-quarters of the 230,000 (210,000–270,000) people living with HIV in the Caribbean, including the 17,000 (15,000–23,000) who were newly infected in 2007. An estimated 11,000 (9,800–18,000) people in the Caribbean died of AIDS in this year and AIDS remains one of the leading causes of death among persons aged 25 to 44 years.

The HIV epidemics in Latin America remain generally stable, and HIV transmission continues to occur among populations at higher risk of exposure, including sex workers and men who have sex with men. The estimated number of new HIV infections in Latin America in 2007 was 100,000 (47,000–220,000), bringing to 1.6 million (1.4 million–1.9 million) the total number of people living with HIV in this region. An estimated 58,000 (49,000–91,000) people died of AIDS in the past year. Unprotected sex between men is an important factor in the epidemics of Bolivia, Chile, Ecuador and Peru in South America, as well as in several Central American countries, including El Salvador, Guatemala, Honduras, Mexico, Nicaragua and Panama.

In North America, Western and Central Europe, the total number of people living with HIV is increasing. This increase is due mainly to the life-prolonging effects of antiretroviral therapy and an increase in the number of new HIV diagnoses in Western Europe since 2002, combined with a relatively stable number of new HIV infections each year in North America. Overall, approximately 2.1 million (1.1 million–3.0 million) people in North America, Western and Central Europe were living with HIV in 2007, including the 78,.000 (19,000–86,000) who acquired HIV in the past year. In the context of widespread access to effective antiretroviral treatment, comparatively few people died of AIDS—32,000 (20,000–84,000) in 2007.

Despite recent improvements in some countries, epidemiological surveillance in Middle East and North Africa remains limited (Obermeyer, 2006). Nevertheless, using available HIV information it is estimated that 35,000 (16,000–65,000) people acquired HIV in 2007, bringing to 380,000 (270,000–500,000) the total number of people living with HIV in the region. As a result of AIDS-related illnesses, an estimated 25,000 (20,000–34,000) people died in 2007.

An estimated 14,000 (11,000–26,000) people acquired HIV in Oceania in 2007, bringing to 75,000 (53,000–120,000) the number of people living with the virus in this region.

InfoChange News & Features, March 2008




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