Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.
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Wall Street Journal - November 24, 2004
Marilyn Chase, marilyn.chase@wsj.com
About 3.1 million died of AIDS and 4.9 million adults and children became infected with HIV , the human immunodeficiency virus, world-wide in 2004.
Explosive growth in East Asia and Eastern Europe and increasing vulnerability of females around the globe were spotlighted by the United Nations Joint Program on HIV/AIDS and the World Health Organization in their annual update on the epidemic. Southern Africa remains the hardest-hit region of the world, with 25.4 million people affected at the end of 2004, up 4% from 24.4 million in 2002.
In East Asia, a 56% increase in HIV/AIDS to 1.1 million over the past two years is attributed to surging epidemics in China, Indonesia and Vietnam. China's one million people with HIV/AIDS reflect a broadening of the epidemic from poor farmers who sold their blood a decade ago into the ranks of prostitutes and drug users and their partners. [aids]
Asia overall has about 8.3 million people with the virus. Though India has the largest share, with 5.1 million infected people, that figure represents less than 1% of its population. India's official figures, not updated since 2003, have prompted skepticism. UNAIDS Executive Director Peter Piot said he is optimistic that India's new government will "tackle AIDS in a more vigorous way" than the previous government.
The epidemic expanded gained 48% in Eastern Europe and Central Asia to reach 1.1 million people over the past two years.
Women represent an increasing share of HIV/AIDS world-wide, even in the West, where the epidemic formerly had a narrower focus on gay men and intravenous drug users. The growing gender parity of AIDS world-wide increasingly resembles the African epidemic, where heterosexual relations drive the spread of the virus and about 60% of patients are women.
Dr. Piot said that for women in the developing world, prevention isn't adequate to halt an epidemic compounded by sexual violence, poverty, poor education and unequal access to medicines.
In an AIDS clinic in Ethiopia recently, Dr. Piot said he found that only 30% of the 1,500 patients getting antiviral drugs were women, because they couldn't afford the fees. Keeping young girls in school, punishing rape, equalizing inheritance laws and offering micro-credit loans to widows and orphans could bolster the social systems and help equalize care.
"When a woman's husband dies of AIDS, and she loses her house, she is at risk for AIDS because she has only her body to sell," he said.
Eventually, Dr. Piot said, microbicide gels now in development will put prevention tools in the hands of women who now lack power to enforce condom use by men.
In the U.S., the latest analysis by the Centers for Disease Control and Prevention shows that of the nearly one million people with HIV/AIDS, the death rate for African-Americans is more than twice that of whites due to delayed diagnosis and poorer access to treatment.
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