New Data Also Show Hiv Prevention Programmes Getting Better Results If
Focused On Reaching People Most At Risk And Adapted To Changing National
Epidemics
GENEVA, Nov, 22 /Xinhua-PRNewswire/ -- The global AIDS epidemic continues
to grow and there is concerning evidence that some countries are seeing a
resurgence in new HIV infection rates which were previously stable or
declining. However, declines in infection rates are also being observed in
some countries, as well as positive trends in young people’s sexual
behaviours.
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According to the latest figures published today in the UNAIDS/WHO 2006
AIDS Epidemic Update, an estimated 39.5 million people are living with HIV.
There were 4.3 million new infections in 2006 with 2.8 million (65%) of these
occurring in sub-Saharan Africa and important increases in Eastern Europe and
Central Asia, where there are some indications that infection rates have
risen by more than 50% since 2004. In 2006, 2.9 million people died of AIDS-
related illnesses.
New data suggest that where HIV prevention programmes have not been
sustained and/or adapted as epidemics have changed-infection rates in some
countries are staying the same or going back up.
In North America and Western Europe, HIV prevention programmes have often
not been sustained and the number of new infections has remained the same.
Similarly in low- and middle-income countries, there are only a few examples
of countries that have actually reduced new infections. And some countries
that had showed earlier successes in reducing new infections, such as Uganda,
have either slowed or are now experiencing increasing infection rates.
"This is worrying-as we know increased HIV prevention programmes in these
countries have shown progress in the past-Uganda being a prime example. This
means that countries are not moving at the same speed as their epidemics,"
said UNAIDS Executive Director Dr Peter Piot. "We need to greatly intensify
life-saving prevention efforts while we expand HIV treatment programmes."
HIV prevention works but needs to be focused and sustained
New data from the report show that increased HIV prevention programmes
that are focused and adapted to reach those most at risk of HIV infection are
making inroads.
Positive trends in young people’s sexual behaviours-increased use of
condoms, delay of sexual debut, and fewer sexual partners-have taken place
over the past decade in many countries with generalized epidemics. Declines
in HIV prevalence among young people between 2000 and 2005 are evident in
Botswana, Burundi, C-te d’Ivoire, Kenya, Malawi, Rwanda, Tanzania and
Zimbabwe.
In other countries, even limited resources are showing high returns when
investments are focused on the needs of people most likely to be exposed to
HIV. In China, there are some examples of focused programmes for sex workers
that have seen marked increases in condom use and decreases in rates of
sexually transmitted infections, and programmes with injecting drug users are
also showing progress in some regions. And in Portugal, HIV diagnoses among
drug injectors were almost one third (31%) lower in 2005, compared with 2001,
following the implementation of special prevention programmes focused on HIV
and drug use.
Addressing the challenges: Know your epidemic
In many countries, HIV prevention programmes are not reaching the people
most at risk of infection, such as young people, women and girls, men who
have sex with men, sex workers and their clients, injecting drug users, and
ethnic and cultural minorities. The report outlines how the issue of women
and girls within the AIDS epidemic needs continued and increased attention.
In sub-Saharan Africa for example, women continue to be more likely than men
to be infected with HIV and in most countries in the region they are also
more likely to be the ones caring for people infected with HIV.
According to the report, there is increasing evidence of HIV outbreaks
among men who have sex with men in Cambodia, China, India, Nepal, Pakistan,
Thailand and Viet Nam as well as across Latin America but most national AIDS
programmes fail to address the specific needs of these people. New data also
show that HIV prevention programmes are failing to address the overlap
between injecting drug use and sex work within the epidemics of Latin
America, Eastern Europe and particularly Asia.
"It is imperative that we continue to increase investment in both HIV
prevention and treatment services to reduce unnecessary deaths and illness
from this disease," said WHO Acting Director-General, Dr Anders Nordstrom "In
sub-Saharan Africa, the worst affected region, life expectancy at birth is
now just 47 years, which is 30 years less than most high-income countries."
The AIDS Epidemic Update underlines how weak HIV surveillance in several
regions including Latin America, the Caribbean, the Middle East, and North
Africa often means that people at highest risk-men who have sex with men, sex
workers, and injecting drug users-are not adequately reached through HIV
prevention and treatment strategies because not enough is known about their
particular situations and realities.
The report also highlights that levels of knowledge of safe sex and HIV
remain low in many countries, as well as perception of personal risk. Even in
countries where the epidemic has a very high impact, such as Swaziland and
South Africa, a large proportion of the population do not believe they are at
risk of becoming infected.
"Knowing your epidemic and understanding the drivers of the epidemic such
as inequality between men and women and homophobia is absolutely fundamental
to the long-term response to AIDS. Action must not only be increased
dramatically, but must also be strategic, focused and sustainable to ensure
that the money reaches those who need it most," said Dr Piot.
The annual AIDS Epidemic Update reports on the latest developments in the
global AIDS epidemic. With maps and regional estimates, the 2006 edition
provides the most recent estimates on the epidemic’s scope and human toll
and explores new trends in the epidemic’s evolution. The report is available
at http://www.unaids.org .
UNAIDS, the Joint United Nations Programme on HIV/AIDS, brings together
the efforts and resources of ten UN system organizations to the global AIDS
response. Cosponsors include UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO,
UNESCO, WHO and the World Bank. Based in Geneva, the UNAIDS Secretariat works
on the ground in more than 75 countries worldwide.
As the directing and coordinating authority on international health work,
the World Health Organization (WHO) takes the lead within the UN system in
the global health sector response to HIV/AIDS. WHO provides technical,
evidence-based support to Member States to help strengthen health systems to
provide a comprehensive and sustainable response to HIV/AIDS including
treatment, care, support and prevention services through the health sector.