• Violence precipitated by HIV infection

Violence against women precipitated by HIV infection

This report warns that the number of people living with HIV, the virus that causes AIDS, has risen in every region of the world during 2003 and last year five million people became newly infected with HIV - more people than any previous year.

The report highlights the latest global trends and, for the first time, features revised HIV prevalence rates for previous years, allowing for a better understanding of how the epidemic is spreading. It compares new estimates for 2003 with revised estimates for 2001 based on improved methodologies. The report also offers new estimates on resources needed to effectively combat the epidemic in the developing world, finding that current funding levels are less than half of what is needed. The report also identifies a series of major constraints to better treatment and prevention

Key trends in infection include:

• 1.1 million people in Asia became infected with HIV last year alone – more than any previous year. The epidemic is expanding rapidly in this region, with sharp increases in HIV infections in China, Indonesia and Viet Nam. With 60% of the world’s population, Asia’s fast-growing epidemic has global implications.
• India, with an estimated 5.1 million people living with HIV, is home to one in seven HIVpositive people worldwide. This represents the largest number of people infected outside of South Africa.
• An estimated 25 million people are living with HIV in sub-Saharan Africa. There appears to be stabilization in HIV prevalence rates; but this is actually due to a rise in AIDS deaths and a continued increase in new infections.
• In Latin America, some 1.6 million people are living with HIV and the epidemic tends to be concentrated mainly among populations at increased risk of HIV exposure, such as injecting drug users and men who have sex with men. Low national prevalence is disguising some serious epidemics. For example, in Brazil -- the region’s most populous country, and home to more than one in four people living with HIV – national prevalence is well below 1%. However, in some cities, infection levels above 60% were reported among injecting drug users.
• Eastern Europe and Central Asia continue to have expanding epidemics. Some 1.3 million people are living with HIV. Russia, with over three million injecting drug users, remains one of the worst-affected countries in the region. But women account for an increasing share of newly diagnosed cases of HIV - up from one-in-four in 2001 to just one-in-three one year later. The epidemic’s most striking feature is the age of those infected – more than 80% are under 30. Condom use is generally low among this group. By contrast, in North America and Western Europe, only 30% of infected people are under 30.
• Infections are also on the rise in the United States and Western Europe. In the US, an estimated 950,000 people are living with HIV, up from 900,000 in 2001. Half of all new infections in recent years have been among African Americans. In Western Europe, 580,000 people are living with HIV compared to 540,000 in 2001.

The reports estimates the financing needed to combat the epidemic. It argues that (although global spending on AIDS has increased 15-fold from US$300 million in 1996 to just under US$5 billion in 2003) it is less than half of what will be needed by 2005 in developing countries. According to newly revised costing estimates, an estimated US$12 billion (up from US$10 billion) will be needed by 2005 and US$20 billion by 2007 for prevention and care in low- and middle-income countries. The estimated US$20 billion would provide antiretroviral therapy to just over six million people (over four million in sub-Saharan Africa), support for 22 million orphans, HIV voluntary counseling and testing for 100 million adults, school-based AIDS education for 900 million students and peer counseling services for 60 million young people not in school. About 43% of these resources will be needed in sub-Saharan Africa, 28% in Asia, 17% in Latin American and the Caribbean, 9% in Eastern Europe, and 1% in North Africa and the Near East.

Key obstacles and challenges include:

• Access to HIV treatment remains low, according to the report. Only 7% of people in developing countries have access to antiretroviral treatment. Only 20% of people worldwide has access to HIV prevention services.
• AIDS-related stigma and discrimination, lack of human and institutional capacity, and lack of donor coordination. Stigma also acts as a constraint in countries channeling funds to where they are needed most, particularly targeting populations at increased risk of HIV infection. In some countries in Latin America and Asia, prevention programmes have not targeted injecting drug users and men who have sex with men, among the groups most vulnerable to HIV in those regions.
• Several countries in southern Africa face a growing crisis in delivering vital public services that are crucial to the AIDS response. Reasons for this range from migration of key staff from public to private sectors, migration abroad, to the deadly impact of the AIDS epidemic itself.
• As the number of AIDS funding and implementing agencies increases, there is also an urgent need to deal with the now well-documented risks of duplication of the response at a country level. In an effort to achieve greater harmonization of AIDS funding, UNAIDS led an effort with the US, UK and other leading donor countries to agree to what is known as the “Three Ones” – one national AIDS plan, one national AIDS authority and one monitoring and evaluation system in each country.

[adapted from author]

• Full text of document
• Publisher details
• Send to a friend