Wall Street Journal - November 27, 2002
Rachel Zimmerman, Staff Reporter of The Wall Street Journal

These are among the findings in what has become an annual compilation of grim statistics by the United Nations AIDS agency and the World Health Organization. This year, for the first time, women account for 50% of the adults living with AIDS or HIV, which causes the disease.

In addition to the 38.6 million adults world-wide with AIDS or HIV, there are 3.2 million children under age 15 who are living with AIDS or HIV.

Five million people world-wide became infected this year; there were about 3.1 million deaths in 2002.

In sub-Saharan Africa, which has been the hardest-hit region, 3.5 million new infections are estimated for 2002; there have been 2.4 million African deaths. In Asia, 7.2 million people are living with HIV.

Peter Piot, executive director of UNAids, said it is becoming clear the epidemic is exacerbating other crises, notably the famine in southern Africa. More than 14 million people are at risk of starvation in Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe -- primarily agricultural societies battling the AIDS epidemic.

In those six countries, Dr. Piot said, more than five million adults and 600,000 children under age 15 are living with HIV out of a total population of about 26 million. "Agricultural production was going down before the drought because of illness and people dying of AIDS," Dr. Piot said.

Now, with households scrambling to pay for medical care and funerals, there is less investment in seeds, leading to a further decline in production. The report said seven million agricultural workers in 25 African countries have died of AIDS since 1985.

The report said the epidemic is spreading fastest in Eastern Europe and Central Asian republics, with 250,000 new infections in that region this year and a total of 1.2 million people living with HIV or AIDS.

Although the number of new infections appears to be relatively low, the increase is substantial. In Uzbekistan, for example, there were 620 new infections reported for the first six months of 2002, almost as many as reported for the entire previous decade.

In the Middle East, "lingering denial among both social and political leaders in some countries provides the epidemic with an ideal environment for continued spread," the report said. In Iran, where injection-drug use is driving transmission, the report said high-risk behavior is "widespread" among the largely male population, including users sharing needles, having extramarital sex and rarely using condoms.

In high-income countries, such as the U.S. and those in Western Europe, unsafe sexual behavior was cited as a primary risk factor. About 76,000 new cases of HIV infections were reported in high-income nations so far in 2002, with a continuing shift into "poorer and marginalized sections of society," the report said. A study by the federal Centers for Disease Control and Prevention earlier this year found AIDS-related illnesses remain the leading cause of death for African-American men ages 25 to 44 and the third-leading cause of death for Hispanic men in that age group.

The UNAids report also noted a shift in Western Europe, where the main mode of transmission is through heterosexual relations, Dr. Piot said.

Write to Rachel Zimmerman at rachel.zimmerman@wsj.com

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