Los Angeles Times - November 24, 2004
Rosie Mestel, Times Staff Writer

Women are being infected with HIV at increasing rates in all regions of the world, and their numbers are now nearly equal to those for men, says the United Nations and World Health Organization annual report on AIDS, released Tuesday.

The increase among women has been especially steep in East Asia - which has experienced a 56% climb in the last two years - Eastern Europe and Central Asia, where rates have risen 48%.

In sub-Saharan Africa, 57% of adults living with human immunodeficiency virus, which causes AIDS, are women.

"The whole face of AIDS is changing," said Dr. Peter Piot, executive director of the U.N. AIDS program. "We've got to really put women at the heart of the response to AIDS if we want to stop this epidemic."

The annual update says an estimated 39.4 million people are infected with HIV, up from 36.6 million in 2002. More than 3 million people have died of the effects of AIDS this year.

The report also notes that the world has become a patchwork of AIDS epidemics in different stages of development. Some of the fastest-growing epidemics are in China, Indonesia, Vietnam, Ukraine and Russia.

In sub-Saharan Africa, which has the world's highest infection rate, the number of infected people appears to have stabilized at 25.4 million. But report coauthor Karen Stanecki of UNAIDS cautioned that the statistic was not cause for optimism. The epidemic has simply reached a balance point where the same numbers of people are dying as are being infected, she said.

"This stabilization disguises the worst phases of an epidemic," Stanecki said.

A mix of factors is contributing to the increasing infection among women, the report says.

For biological reasons, women are more likely than men to contract HIV during sex. In many parts of the world, women are less educated and more vulnerable to being coerced into unprotected sex. Infected women also are less likely to have access to antiretroviral drugs.

Researchers are working on microbicide chemicals that can be used by women to block HIV infection during unprotected sex, according to the report.

But Piot said other societal factors must be tackled as well, such as greater legal protections for women and increased access to education.

Female infection is also on the rise in the U.S., disproportionately affecting blacks and Latinas. These groups also have the poorest survival rates, probably because they seek treatment late or have inferior healthcare, Stanecki said.

Piot said funding to fight the AIDS epidemic had increased significantly, with an estimated $6.1 billion used to tackle the problem in developing countries this year. But that still falls short of the $10 billion needed, he said. A lack of coordination between aid groups and difficulties in implementing education programs, delivering drugs and training healthcare workers has hindered efficient use of the money.

"The key challenge now is to make the money work," Piot said.

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