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to half of 37.2 million adults living with HIV are women - new report
UNAIDS
November
23, 2004
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Geneva - A new report
released today shows that the number of women living with HIV has risen
in each region of the world over the past two years, with the steepest
increases in East Asia, followed by Eastern Europe and Central Asia. In
East Asia, there was a 56% increase over the past two years, followed
by Eastern Europe and Central Asia with 48%.
Women are increasingly
affected, now making up nearly half of the 37.2 million adults
(aged 15-49) living with HIV worldwide. In sub-Saharan Africa, the worst-affected
region, close to 60% of adults living with HIV are women - or 13.3 million.
These latest findings were published in AIDS Epidemic Update 2004, the
annual report by the Joint United Nations Programme on HIV/AIDS (UNAIDS)
and the World Health Organization (WHO). The joint report was released
today in advance of World AIDS Day, commemorated worldwide on the first
of December.
The report indicates
that there is no single AIDS epidemic worldwide. Many regions and countries
are experiencing diverse epidemics, some still in the early stages. "These
latest trends firmly establish AIDS as a unique development challenge,"
said Dr Peter Piot, UNAIDS Executive Director. "The time of quick
fixes and emergency responses is over. We have to balance the emergency
nature of the crisis with the need for sustainable solutions."
According to the report,
the number of people living with HIV globally has also reached its highest
level with an estimated 39.4 million people, up from an estimated 36.6
million in 2002. The steepest increases in HIV infections occurred in
East Asia, Eastern Europe,and Central Asia over the past two years.
In East Asia, the
50% increase in HIV infections from 2002-2004 is largely attributable
to growing epidemics in China, Indonesia and Viet Nam. The 40% increase
in Eastern Europe and Central Asia is mainly due to Ukraine's expanding
epidemic and the growing number of people living with HIV in the Russian
Federation. With an estimated 860,000 people living with HIV at the end
of 2003, Russia has the largest epidemic in Europe.
As the numbers of
people becoming infected and living with HIV increases, so does the number
of those needing antiretroviral treatment, as well as care for opportunistic
infections. "We do not yet have a vaccine, but we do know that prevention
and treatment work and we have the tools to deliver them. Government leaders,
civil society and the private sector are all affected and we must all
mobilise to save lives," said Dr LEE Jong-wook, Director- General
of the World Health Organization.
Women and
AIDS - A Growing Challenge
Women
are more physically susceptible to HIV infection than men. Male-to-female
HIV transmission during sex is about twice as likely to occur as female-to-male
transmission.
For many women in
developing countries, the "ABC" prevention approach (Abstinence,
Being faithful and reducing number of sexual partners, and Condom use)
is insufficient. "Strategies to address gender inequalities are urgently
needed if we want a realistic chance at turning back the epidemic,"
said Dr Piot. "Concrete action is necessary to prevent violence against
women, and ensure access to property and inheritance rights, basic education
and employment opportunities for women and girls."
According to the report,
millions of young people are becoming sexually active each day with no
access to prevention services. In sub-Saharan Africa, three quarters of
all 15-24 year olds living with HIV are female. Young women are three
times more vulnerable to HIV infection than their male counterparts. In
addition to being biologically more vulnerable to infection, many women
and girls, particularly in Southern Africa, find themselves using sex
as a commodity in exchange for goods, services, money, or basic necessities
- often with older men. This "transactional sex" is mainly driven
by poverty and the desire for a better life.
Latest Trends
in AIDS Epidemic
The
UNAIDS/WHO report clearly indicates that there is no single, "African"
AIDS epidemic. The epidemics throughout the continent are highly varied.
Southern Africa continues to be the worst-hit region with HIV prevalence
rates surpassing 25%. In Botswana, Lesotho, and Swaziland, prevalence
rates still exceed 30% among pregnant women. Life expectancy has dropped
below 40 years in nine countries in the region.
Despite modest declines
in HIV prevalence rates in East Africa, notably in Uganda and parts of
Ethiopia and Kenya, the epidemic is far from being reversed. In Addis
Ababa, HIV prevalence fell to 11% by 2003, down from a peak of 24% in
the mid-1990s. In Kenya, HIV prevalence fell from 13.6% in 1997 to 9.4%
in 2002. The Caribbean continues to be the second worst-affected region
in the world. HIV transmission occurs largely through heterosexual sex,
although sex between men, which is highly stigmatized, is also fuelling
the epidemic. AIDS has become the leading cause of death among adults
aged 15-44 in the region.
In North America and
Europe, an increasing number of people are becoming infected through unprotected
heterosexual sex. In the United States, AIDS disproportionately affects
African American and Hispanic women, with AIDS ranked among the top three
causes of death for African American women aged 35-44 years. According
to AIDS Epidemic 2004, there are strong indications that the main risk
factor for many women acquiring HIV is the often undisclosed risk behaviour
of their male partners.
In Western Europe,
HIV infection through heterosexual sex more than doubled between
1997 and 2002. It is feared that large numbers of HIV-infected people
are still unaware of their HIV status. In the United Kingdom, HIV has
become the fastest-growing serious health condition.
Injecting drug use
is on the rise in many regions and contributes to an increasingly large
share of new HIV infections, especially in countries with emerging epidemics
in Eastern Europe, Central Asia, and parts of Asia.
"In many countries,
we are still seeing a mismatch between prevention spending priorities
and the evolution of the epidemic," said Dr Piot. "Men who have
sex with men and injecting drug users continue to be neglected. More needs
to be done to target them and increase access to prevention programmes
for people at high risk of HIV infection."
As AIDS Funding
Increases, Challenges Lie Ahead
Global AIDS
spending has tripled since 2001, from US$2.1 billion in 2001 to US$6.1
billion in
2004, and access to key prevention and care services has improved significantly.
Yet the disease continues to spread. "Obviously more resources will
be needed in the future, but right now the key challenge is making the
money work - ensuring that available funds are spent effectively on where
they are needed most," said Dr Piot.
According to a recently
published survey in 73 low- and middle-income countries
(representing almost 90% of the global burden of HIV), the number of secondary-school
students receiving AIDS education has nearly tripled, the annual number
of voluntary counselling and testing clients has doubled, the number of
women offered services to prevent mother-to-child HIV transmission has
increased by 70%, and the number of people receiving antiretroviral therapy
has increased by 56% between 2001 and 2003.
Despite the improvements,
prevention and treatment coverage remains uneven in various regions. Less
than one in five people has access to HIV prevention services in low-
and middle-income countries. Between 5 and 6 million people are in need
of HIV treatment. By June 2004, an estimated 440,000 people in the developing
world had access to antiretroviral treatment, up from 200,000 two years
before. Although the number of those receiving treatment has more than
doubled, less than 10% of people who need treatment, predominantly in
sub-Saharan Africa, are receiving it.
"AIDS treatment
will only be viable if HIV prevention efforts are reinvigorated and vice
versa," said Dr LEE Jong-Wook. "Only by linking prevention and
treatment can the global spread of AIDS be halted. We know that prevention
works better when it is linked with the promise of treatment. We also
know that unless we prevent new infections, millions more will be added
to the "treatment list" every year, making treatment unsustainable."
The annual AIDS Epidemic
Update reports on the latest developments in the global AIDS epidemic.
With maps and regional estimates, the 2004 edition provides the most recent
estimates on the epidemic's scope and human toll, explores new trends
in the epidemic's evolution, and features a special section on women and
AIDS.
In January 2005, WHO
will issue a formal progress report on what progress countries have made
towards the "3 by 5" target to get three million on treatment
by the end of 2005. The goal is universal access to treatment.
For more
information, please contact
- Annemarie Hou,
UNAIDS, Brussels, tel. (+41 22 )791 4577, or mobile (+41 79) 500 2123,
- Dominique de Santis,
UNAIDS, London, (+41 22) 791 4509 or mobile (+41 79) 254 6803,
- Jonathan Rich,
UNAIDS, New York , (+ 1 212) 532 0255, or
- Iain Simpson, WHO,
Geneva, (+41 22) 791 3215.
The complete report
can be accessed on the UNAIDS website - www.unaids.org
Please credit www.kubatana.net if you make use of material from this website.
This work is licensed under a Creative Commons License unless stated otherwise.
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