/ 11 November 2003

HIV/Aids barometer – November 2003

Estimated worldwide HIV infections: 54 862 417 at 12.30pm on Thursday November 27

Step up prevention: About 30% of people living with HIV/Aids worldwide live in Southern Africa, an area that is home to just 2% of the world’s population.

‘The most devastating social and economic impacts of Aids are still to come,” said Dr Peter Piot, UNAids executive director. ‘Widespread treatment access would substantially mitigate the devastating impact of HIV/Aids, which affects everything from agriculture to national defence. Effective HIV prevention programmes must be scaled up dramatically if we want a realistic chance at reducing the number of new infections.”

The epidemic is particularly devastating for women in sub-Saharan Africa, where they are more likely to be infected with HIV than men. Among young people this discrepancy is particularly high, with young women aged 15 to 24 up to 2,5 times more likely to be infected than young men in the same age group.

Source: UNAids

Estimated worldwide HIV infections: 54 761 439 at noon on Thursday 20 November

High cost: Financial constraints were reported to be the most significant barrier to anti-retroviral adherence in patients living with HIV and Aids in Botswana prior to the introduction of free treatment. Reports say that though 54% of the patients said they took their drugs as prescribed, if cost were not a barrier 74% would have been adherent.

Treatment adherence has been closely correlated with viral suppression, while non-adherence has contributed to progression to Aids, the development of multi-drug resistance and death.

The study highlights several problems that will affect decision-making by governments, donors and public health officials throughout the developing world as anti-retroviral treatment is introduced. Decisions about the balance of free treatment provision and cost recovery will need to be taken in the light of evidence suggesting that the cost of treatment is the biggest single determinant of non-adherence in all studies carried out in Africa.

Source: Aidsmap

Estimated worldwide HIV infections: 54 661 987 at 1.40pm on Thursday November 13

Double trouble: HIV and malaria can independently cause complications during pregnancy, endangering the health of both the pregnant woman and her baby. But when the two diseases occur together, the dangers are compounded, according to recent studies.

The first study, published in November’s Journal of Acquired Immune Deficiency Syndromes, found that the symptoms of malaria were about four times more likely to develop in HIV-infected women than in those without HIV. Dual infection was associated with an increased risk of maternal, perinatal, and early infant death. A second study, published as a letter in this month’s AIDS, found an increased risk of placental malaria in HIV-infected women. This was also associated with a greater risk of HIV transmission to the infant.

An increase in incidence and fatality from malaria in pregnant women and their infants is a cause for concern because these women and infants are already at great risk from the mosquito-borne illness.

Source: Aidsmap

Estimated worldwide HIV infections: 54 560 319 at 1pm on Thursday November 6

‘Morning-after’ HIV medication: A new Californian law could mark the first step toward increasing access to medication that many Aids experts believe can prevent HIV infection if taken immediately after exposure.

The measure, AB 879, offers new hope to people who find themselves at risk for reasons ranging from a broken condom to the sharing of a dirty needle. Like a ‘morning-after” pill to avert pregnancy, the medication has the goal of preventing something from occurring — in this case, HIV infection — rather than waiting for laboratory tests and subsequent treatment.

For years the anti-retroviral treatment has been used in cases involving sexual assaults or accidental needle sticks to health-care workers. Doctors have not been prohibited from prescribing it for the public, but many know little or nothing about it.

AB 879 will create a state task force to develop guidelines to help doctors determine whether to prescribe the medication.

Source: Sacramento Bee (US)