/ 21 November 2005

HIV cases pass 40-million mark

Progress has been made in tackling HIV infection in key African countries, but five million people were infected across the world in 2005 taking the total beyond a record 40-million, a United Nations report said on Monday.

The grim HIV/Aids epidemic claimed about 3,1-million lives during the year, more than half a million of them children, the report said.

”The total number of people living with the human immunodeficiency virus (HIV) reached its highest level, an estimated 40,3-million” up from 37,5-million in 2003, said the Aids Epidemic Update 2005, released in New Delhi.

The report that came ahead of World Aids day on December 1 noted that ”the overall number of people living with HIV continued to increase in all regions of the world except the Carribean”.

”There were an additional five million new infections in 2005,” it said.

The survey warned that growing epidemics were under way in eastern Europe, Central Asia and East Asia and that the spread of HIV/Aids was intensifying in Southern Africa.

Sub-Saharan Africa accounted for 64% of the new infections taking the number cases there to an estimated 25,8-million.

”HIV stigma and the resulting actual or feared discrimination have proven to be perhaps the most difficult obstacles to effective HIV prevention,” the report said, and these factors ”created an ideal climate” for the spread of the epidemic.

Only ”one in 10 Africans and one in seven Asians in need of anti-retrovirals were receiving it in mid-2005”.

But in some parts of Africa there were ”hopeful signs” of declining national HIV prevalence.

”Infection levels were dropping” in Zimbabwe, Uganda and Kenya, it said.

”There is ample evidence that HIV does yield to determined and concerted interventions,” said a statement by Peter Piot, the executive director of the UNAids programme.

”We are encouraged by the gains that have been made in some countries and by the fact that sustained HIV prevention programmes have played a key part in bringing down infections.

”But the reality is that the Aids epidemic continues to outstrip global and national efforts to contain it. It is clear that a rapid increase in the scale and scope of HIV prevention programmes is urgently needed,” he said.

In Asia, which has about 8,3-million cases, the epidemic was propelled by injecting drug use and commercial sex.

Drugs, sex work and weak surveillance of vulnerable groups were fuelling the HIV epidemic in Latin America and Eastern Europe as well as Asia.

Mother-to-child transmission was one of the causes for new infections in sub-Saharan Africa, the report said, predicting about 35% of all children born to HIV-positive women would contract the virus.

Levels of knowledge about safe sex and HIV remain low in many countries, especially in many sub-Saharan nations, and notably Cameroon, Nigeria, Senegal and Uganda.

Two-thirds or more of young women between 15-24 years lacked comprehensive knowledge of how HIV is transmitted, the report said.

A major poll in the Philippines two years ago found more than 90% of respondents believed that HIV could be transmitted by sharing a meal with an affected person.

The report said access to cheaper antiretroviral drugs had improved markedly in the past two years with more than one million people in low-and middle-income countries living longer and having better lives.

”Treatment coverage in … Argentina, Brazil, Chile and Cuba now exceeds 80%, the report said, adding that better access to anti-retrovirals had averted an estimated 250 000 to 350 000 deaths.

”We can now see the clear benefit of scaling up HIV treatment and prevention together and not as isolated interventions,” World Health Organisation (WHO) director general Lee Jong-Wook said.

”Effective prevention can also help reduce the number of individuals who will ultimately require care, making broad access to treatment more achievable and sustainable.”

African Americans worst hit

Young African Americans led the number of new HIV/AIDS cases in the United States while the number of women infected via sex in Western Europe showed a sharp spike.

New cases rose 43 000 in the United States to top one million as prevention efforts lagged despite extensive programmes to treat HIV.

”African Americans accounted for 48% of new HIV cases in the [United States] in 2003. African American women are more than a dozen times as likely to be infected with HIV than their white counterparts.

”Aids has become one of the top three causes of death for African American men aged 25-54 and for African American women aged 25-34,” said the report.

Across the Atlantic, Western Europe accounted for more than half a million infections in 2005, the report said.

”The number continues to grow amid signs in several countries of a resurgence of risky sexual behaviour. The biggest change in Western Europe has been the emergence of heterosexual contact as the dominant cause of new HIV infections in several countries.

The United States and Western Europe, with about 700-million people combined, have extensive prevention and treatment programmes for HIV/Aids, but cases continue to rise as unprotected sex between men remains common, the report said.

”In the United States, unprotected sex between men remains the dominant mode of transmission, accounting for 63% of newly-diagnosed HIV infections,” the report said.

It said that treatment efforts had been successful in prolonging lives, although prevention efforts had not been sustained.

”This reflects the fact that people with HIV are living longer due to anti-retroviral treatment, as well as the failure to adapt and sustain the prevention successes achieved during the epidemics first 10-15 years.”

”On the whole, Western Europe and North America remain the only regions in the world where most people in need of anti-retroviral treatment are able to receive it. In Western Europe, that trend has persisted,” it added.

A quarter of people living with HIV in the United States were unaware they are infected, the report said adding ”ignorance is very likely adding impetus to the epidemic,” the report said.

In Britain, unsafe sex between men accounted for a quarter of new HIV diagnoses and ”is an important factor in the epidemics in France and The Netherlands”, the report said.

As well, the report said immigrants from sub-Saharan Africa are fuelling new cases in Europe.

”A large proportion of new diagnoses are in people originating from countries with serious epidemics, principally countries in sub-Saharan Africa,” the report said, adding that more than 20 000 new HIV infections were reported in 2004. – Sapa-AFP