UN: HIV cases on the rise worldwide

November 26, 2002

More than 5 million people worldwide will have contracted the AIDS virus in 2002, bringing the total number of those infected to 42 million, up 2 million from a year ago. About 70 percent of the cases are in hard-hit sub-Saharan Africa, according to a new U.N. report on the extent of the global epidemic.

More than nine out of 10 of the estimated 3.1 million people who will die this year of HIV/AIDS live in either sub-Saharan Africa or in south or southeast Asia, the two regions hardest hit by the epidemic, according to the report, released Tuesday by the World Health Organization and the Joint U.N. Program on HIV/AIDS.

Of those who will die from HIV/AIDS this year, 610,000 are younger than 15, and almost half are women, the report said. The two most populous countries in the world -- China and India -- are both facing "serious, localized epidemics," with more than 1 million Chinese and 4 million Indians infected with HIV.

But the world's fastest-growing HIV/AIDS epidemic is happening in Russia, Eastern Europe and Central Asia, where there will be an estimated 250,000 new infections and 25,000 deaths during 2002, according to the report. Most of the infections are attributable to a sharp increase in people who inject heroin and other drugs, and most of those infected are younger than 30, the report found.

In North America, where anti-viral drugs have sharply reduced AIDS deaths, about 15,000 people will die from AIDS in 2002, and the death toll in Western Europe will be about 8,000, the report said. The number of new HIV infections in 2002 will be 45,000 in North America and 30,000 in Western Europe.

By the end of 2002, an estimated 980,000 people in North America will be living with HIV/AIDS; 570,000 in Western Europe.

The report found that the impact of HIV/AIDS in sub-Saharan Africa, where nearly 9 percent of the adult population is infected with HIV, is contributing to a food crisis in the region, as illness and death impact the ability of people to grow food or earn the money to buy it. At least six countries dealing with famine -- Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe -- have high rates of HIV in their populations.

While drought, political turmoil and misguided policies are contributing to famine, the report said HIV/AIDS is also a major factor.

Unable to cope, the report found that people often adopt survival strategies that put them at greater risk for infection and death, including women and children who barter sex for food and people who migrate to urban slums where they lack access to health care.

Despite initiatives by Western countries, drug companies and African nations themselves to increase the availability of antiviral drugs to prolong the lives of people living with HIV, only a "tiny fraction" of those infected with HIV are receiving the drugs, the report said. As a result, the AIDS death toll in Africa is expected to continue rising until the end of the decade.

"The worst of the epidemic clearly has not passed," the report said.

In four southern African countries -- Botswana, Lesotho, Swaziland and Zimbabwe -- more than 30 percent of the adult population is infected, the report said. By contrast, in North America, less than 1 percent of the adult population is HIV-positive.

In Africa, unlike much of the rest of the world, the majority of HIV-positive adults -- 58 percent -- are women who acquired HIV through sex with infected men. By contrast, in North America, about 80 percent of HIV-positive adults are still men, according to the report, although the percentage of women has been rising in recent years.

Despite the mounting toll of infection and death, the report did find some encouraging developments:

- In Cambodia, the Asian country with the highest prevalence of adult HIV infection, high-risk behavior appears to be decreasing and infection rates stabilizing. The report attributes the improvement to a campaign to get sex workers to use condoms consistently.- In South Africa, which has the world's largest HIV-positive population, there has been a marked drop in the number of young pregnant women testing positive for HIV -- 15.4 percent in 2001, compared to 21 percent in 1998.- In Uganda, recent HIV infections appear to be on the decline in several parts of the country, which are attributed to HIV awareness efforts.- HIV prevalence among pregnant women has stabilized and may even be on the decline in the Dominican Republic, where about 2.5 percent of the population is estimated to be infected. Increased condom use among female sex workers and a decrease in the number of sexual partners among men are being credited for the improvement.

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