Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - November 29, 2005
Yolandi Groenewald
Despite some light points, this week's UNAids report paints a bleak picture of a region where the virus is having a devastating toll on human lives.
Just more than 10% of the world's population lives in sub-Saharan Africa, but it is home to more than 60% of all people living with HIV -- 25,8million. In 2005, an estimated 3,2million people in the region became newly infected, while 2,4million adults and children died of Aids.
With the exception of Zimbabwe, the countries of Southern Africa show little evidence of declining rates of infection. HIV prevalence levels remain exceptionally high, and prevention, treatment, care and impact-alleviating strategies need to reflect this if they are to be more effective.
Among people aged 15 to 24, an estimated 4,6% of women and 1,7% of men lived with HIV in 2005.
A high HIV prevalence, that often exceeds 30% among pregnant women, is still being recorded in Bo-tswana, Lesotho, Namibia and Swaziland. But the report says there are a few tentative signs that young women are adopting safer behaviour, for example, teen pregnancies seem to be on the decline.
"However, in an epidemic this rampant, women face overwhelming odds of being infected once they have unprotected sex," UNAids warns. It says that, among pregnant Swazi women in their late twenties, as many as 56% were HIV-positive in 2004.
Like Swaziland, HIV prevalence among pregnant women in Lesotho is exceptionally high, although there are indications that it could be stabi-lising. Mean HIV prevalence was 27% when most recently measured among antenatal clinic attendees, slightly lower than the 29% measured in 2003.
West and Central Africa show no signs of changing HIV infection levels, except in the urban parts of Burkina Faso where prevalence appears to be declining. Historically, this sub-region has been less affected than other parts of sub-Saharan Africa.
According to the report, the national adult HIV prevalence has yet to exceed 10% in any West African country, and there is no consistent evidence of significant changes in prevalence among pregnant women in recent years.
East Africa continues to provide the most hopeful indications that serious Aids epidemics can be reversed.
"The countrywide drop in HIV prevalence among pregnant women, seen in Uganda since the mid-1990s, is now being mirrored in urban parts of Kenya, where infection levels are dropping," says the report.
It seems that, in both countries, behavioural changes are likely to have contributed to the trend shifts. Elsewhere in East Africa, HIV prevalence has either decreased slightly or remained stable in the past several years.
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