United Press International - November 21, 2005
William M. Reilly, UPI U.N. Correspondent

"AIDS Epidemic Update: December 2005," released in Geneva, Switzerland, and U.N. World Headquarters in New York Monday, said the key reason for the decline in some countries was due to changes in behavior, such as an increased use of condoms, delay of first sexual experience and fewer sexual partners.

At the same time, the report said increased prevention and treatment efforts were needed to slow and reverse the AIDS epidemic.

Focusing on prevention this year, the report was released in advance of World AIDS Day, Dec. 1.

Kenya, Zimbabwe and some countries in the Caribbean region all showed declines in HIV prevalence over the past few years, with overall adult infection rates decreasing in Kenya from a peak of 10 percent in the late 1990s to 7 percent in 2003.

There was evidence of drops in HIV rates among pregnant women in Zimbabwe from 26 percent in 2003 to 21 percent in 2004, the report said. In urban areas of Burkina Faso, prevalence among young pregnant women declined from around 4 percent in 2001 to just under 2 percent in 2003.

The Caribbean region, including Bahamas, Barbados, Bermuda, Dominican Republic and Haiti, had figures that gave cause for guarded optimism with some HIV prevalence declines evident among pregnant women. The report said these were taken as signs of increased condom use among sex workers and expansion of voluntary HIV testing and counseling.

Despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean.

There were an additional 5 million new infections in 2005, the report said.

The number of people living with HIV globally has reached its highest level with an estimated 40.3 million people, up from an estimated 37.5 million in 2003. More than 3 million people died of AIDS-related illnesses in 2005; of these, more than 500,000 were children.

The steepest increases in HIV infections have occurred in Eastern Europe and Central Asia, the report said, citing a 25-percent increase to 1.6 million, and in East Asia. But sub-Saharan Africa continues to be the most affected globally, with 64 percent of new infections, more than 3 million people.

As for the impact of HIV treatment, the report recognized access to HIV treatment has improved markedly over the past two years, with more than 1 million people in low- and middle-income countries now living longer and better lives because they are on anti-retroviral treatment, averting an estimated 250,000 to 350,000 deaths.

The report said a comprehensive response to HIV and AIDS requires the simultaneous acceleration of treatment and prevention efforts with the ultimate goal of universal access to prevention, treatment and care.

New data showed that in Latin America, Eastern Europe and particularly Asia, the combination of intravenous drug use and sex work was fuelling epidemics, and prevention programs were falling short.

The report showed how sustained, intensive programs in diverse settings have helped bring about decreases in HIV incidence among young people in Uganda and Tanzania, among sex workers and their clients in Thailand and India, and among intravenous drug users in Spain and Brazil.

Without HIV prevention measures, about 35 percent of children born to HIV-positive women will contract the virus, the report said.

But mother-to-child transmission has been virtually eliminated from industrialized countries, and service coverage is improving in many other places.

Since it still falls far short in most of sub-Saharan Africa, an accelerated scale-up of services is urgently needed.

Levels of knowledge of safe sex and HIV remain low in many countries, even in countries with a high and growing prevalence.

In 24 sub-Saharan countries, two-thirds or more of young women 15-24 years old lacked comprehensive knowledge of HIV transmission, the report said. The countries included Cameroon, Ivory Coast, Kenya, Nigeria, Senegal and Uganda.

As an example, the report pointed to a major survey carried out in the Philippines in 2003, where more than 90 percent of respondents still believed HIV could be transmitted by sharing a meal with an HIV-positive person.

Weak HIV surveillance in several regions, including in some countries in Latin America, the Middle East and North Africa, is hampering prevention efforts and often means that people at highest risk are not adequately covered or reached through HIV prevention and treatment strategies. That group is men who have sex with men, sex workers and intravenous drug users.
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