AIDSWEEKLY Plus; Monday, December 30, 2002
Staff Medical Writers

The finding is one of the key findings published in the AIDS Epidemic Update¹, a report on the evolution of the global HIV status produced twice a year by two U.N. agencies, the World Health Organization and UNAIDS.

It found that the AIDS epidemic claimed more than 3 million lives in 2002 and that an estimated 5 million people became infected this year, bringing to 42 million the number of people living with the virus.

"This year, for the first time in the epidemic's history, the number of women living with HIV has risen to 50% of the global total," said Dr. Peter Piot, executive director of UNAIDS.

"The face of AIDS has changed," he said. "You could say there's been a feminization of AIDS."

In Africa, women already make up 70% of the HIV-infected population and that is gradually increasing, Piot said, and elsewhere around the world, women make up a growing proportion of people living with HIV because sex between men and women has taken over as the primary way the disease spreads in many regions.

Sub-Saharan Africa is still by far the worst affected region. About twice as many young women as men are infected there, the report found.

In 2001, 6-11% of young women aged between 15 and 24 had HIV, compared with 3-6% of young men in the same age group.

It is particularly difficult for women there to follow prevention recommendations because of their subordinate position in society in many regions.

A recent study found that in Zimbabwe, rape is common and that negotiating for safe sex to prevent HIV infection is almost impossible for many adolescent girls because involvement with older men in return for such benefits as clothes and school fees is widespread.

The phenomenon of intergenerational sex is driving much of the epidemic in Southern Africa, where between one-quarter and one-third of older men are HIV-positive.

The shift toward women will ultimately exaccerbate the spread of HIV, Piot said, because from women it can be spread not only through sex, but through breastfeeding.

The report also found that the new dynamics of the HIV epidemic aggravate the famine in sub-Saharan Africa, where it is the women who work the fields.

Just as with contraception, where women really got control of their fertility when they got the pill, experts say women need to be able to protect themselves without having to rely on men to use condoms.

"Ideally, it should be something men don't even notice, don't see, don't smell, don't know about," Piot said. Researchers are working to come up with products such as a HIV-killing gel that women can use, perhaps in combination with a diaphragm, to prevent infection.

The fastest-growing HIV problem is in Eastern Europe and Central Asia, where the number of people with HIV in 2002 stood at 1.2 million.

The epidemic is expanding rapidly in the Baltic States, in Russia and several Central Asian countries.

The growth figure for HIV in Asia and the Pacific is largely due to the situation in China, where 1 million people are infected. The report predicted that unless action is taken 10 million Chinese will have become infected by the end of the decade.

The virus could spread farther in India too, where 4 million people are infected and it seems many men who have sex with men in India also have sex with women.

A survey found that almost 31% of men who had sex with men had had sex with women within the preceding 6 months. Condom use was low.

In Indonesia, recent social and economic problems seem to be fueling a sharp rise in the use of injecting drugs, which was virtually unknown in Indonesia a decade ago. Evidence from the largest drug treatment center in the capital, Jakarta, said HIV prevalence is rising very steeply among those drug addicts.

The report also found good news in areas that have stepped up their response, particularly those focusing on young people, such as Ethiopia, South Africa, Uganda and Zambia.

For instance, HIV among pregnant teenagers in South Africa shrank by a quarter between 1998 and 2001.

This article was prepared by AIDS Weekly editors from staff and other reports.

AIDS Epidemic Update 2002 - PDF format
English (1.68mb) | French (1.77mb) | Russian (2.92mb) | Spanish (1.76mb)