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AFRICA: New figures show AIDS epidemic spreading
IRIN News
November 21, 2006

http://www.irinnews.org/report.asp?ReportID=56460

JOHANNESBURG, - The global HIV/AIDS epidemic is expanding, according to new figures released on Tuesday by UNAIDS and the World Health Organisation (WHO), with sub-Saharan Africa still carrying the heaviest burden. Of the estimated 4.3 million new infections in 2006, 65 percent occurred in the region.

Despite a major scale-up in antiretroviral treatment, which reached more than one million people in sub-Saharan Africa by June 2006, the area accounted for almost three-quarters of AIDS-related deaths. Overall, the region is now home to an estimated 24.7 million HIV-infected people, up from 22.6 million two years ago.

The '2006 AIDS Epidemic Update', compiled from the most recent worldwide HIV/AIDS surveillance, records alarming evidence of a resurgence of HIV infection in countries that previously had some success in stabilising or reducing prevalence.

"This is worrying, as we know increased HIV prevention programmes in these countries have shown progress in the past, Uganda being a prime example. This means that countries are not moving at the same speed as their epidemics," commented UNAIDS Executive Director Dr Peter Piot.

A study of some rural areas in Uganda found a rise in prevalence from a low of 5.6 percent in men and 6.9 percent in women in 2000, to 6.5 percent in men and 8.8 percent in women in 2004. The increase appears to correspond with studies suggesting that older men in those areas are engaging in more casual sex.

With a few exceptions, including Mali and Burundi, most countries in East and West Africa are experiencing stabilising or declining HIV prevalence rates.

Southern Africa is still hardest hit. In this region, Zimbabwe is the only country where HIV data from antenatal clinics indicate a decline in adult HIV prevalence from around 30 percent in the early 2000s to 24 percent in 2004. The report says that while behaviour change resulting from increased AIDS awareness probably accounts for some of the decrease, "inconsistencies and biases in some of the data mean that the extent of the decline in HIV prevalence might not be as substantial as indicated by the antenatal clinic data."

In other countries, such as Lesotho and Malawi, UNAIDS points out that sharply rising mortality rates could be masking the impact of new infections, rather than the success of HIV prevention efforts creating an apparently stable level of HIV infection.

In countries where the epidemic emerged a little later, such as Mozambique, Swaziland and South Africa, HIV levels are rising. Among pregnant women attending antenatal clinics in South Africa, HIV prevalence rose from 22.4 percent in 1999 to 30.2 percent in 2005. According to the report, young women in South Africa are four times more likely to be HIV-infected than young men. In the region as a whole, there are around 14 women living with HIV for every 10 men.

Worldwide, 40 percent of new HIV infections were among people aged 15 to 24, but new data suggests that focused HIV prevention programmes can have a positive impact on young people's sexual behaviour. In several African countries young people reported using condoms more frequently, having fewer sexual partners and even delaying their first experience of sex.

Countries recording falling HIV prevalence among young people in the last five years include Botswana, Kenya, Rwanda and Zimbabwe. In many other coutries, however, the report notes a lack of sufficient data to measure either behavioural trends or HIV prevalence in young people.

According to UNAIDS, HIV prevention programmes in some countries are failing to reach people most at risk of infection. In Kenya, for example, 53 percent of injecting drug users in a study in the capital, Nairobi, were found to be HIV positive, while a Senegalese study of men who have sex with men found that 22 percent of them had HIV, while the national adult prevalence is just under 1 percent.

"Knowing your epidemic and understanding the drivers of the epidemic, such as inequality between men and women and homophobia, is absolutely fundamental to the long-term response to AIDS," said Piot.

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