Number of HIV Cases Worldwide Increases to 40.3M; Prevalence Down in Caribbean, Some African Countries, Report Says

The estimated total number of HIV-positive people worldwide has reached its highest level ever, increasing from 39.4 million in 2004 to 40.3 million currently, but some countries that have "invested heavily" in prevention programs -- including Kenya, Zimbabwe and some Caribbean countries -- have lowered their HIV prevalence rates, according to a report released on Monday by UNAIDS and the World Health Organization, the AP/Las Vegas Sun reports. The report, titled "AIDS Epidemic Update: December 2005," estimates that nearly five million new HIV cases occurred this year and about 3.1 million people died of AIDS-related illnesses in 2005, bringing the total number of deaths from the disease to more than 25 million since 1981 (Ross, AP/Las Vegas Sun, 11/21). Of those who died last year, 500,000 were children and 2.4 million lived in sub-Saharan Africa (BBC News, 11/21). The number of HIV cases increased in every region of the world except the Caribbean last year, the report notes. Access to HIV treatment has improved over the last two years, with more than one million people in middle- and low-income countries receiving antiretroviral treatment, leading to an estimated 250,000 to 300,000 avoided deaths in 2005, according to the report (UNAIDS/WHO release, 11/21). "We are encouraged by the gains that have been made in some countries and by the fact that sustained HIV prevention programs have played a key part in bringing down infections," UNAIDS Executive Director Peter Piot said in a statement, adding, "But the reality is that the AIDS epidemic continues to outstrip global and national efforts to contain it. It is clear that a rapid increase in the scale and scope of HIV prevention programs is clearly needed" (AFP/Yahoo! News [1], 11/21).

Successes in Caribbean, Mixed Results in Sub-Saharan Africa
Despite declines in HIV prevalence in Kenya, Uganda and Zimbabwe, HIV/AIDS is keeping Africa in a "death grip," AFP/Yahoo! News reports. According to the report, the epidemic appears to be worsening in Mozambique and Swaziland, and HIV prevalence among pregnant women is 20% or higher in Botswana, Lesotho, Namibia, South Africa, Swaziland and Zimbabwe (AFP/Yahoo! News [2], 11/21). Although 21% of pregnant women in Zimbabwe were HIV-positive in 2004, the prevalence rate for the group has decreased from 35% in 1999 (AP/Las Vegas Sun, 11/21). About two-thirds of all people estimated to be living with HIV reside in sub-Saharan Africa, according to the report (BBC News, 11/21). In the Caribbean, Piot said declines in prevalence have occurred in Barbados, the Bahamas and Bermuda (AP/Las Vegas Sun, 11/21).

'Spike' in Number of Cases in Eastern Europe, Central Asia
Many Eastern European and former Soviet Union nations this year experienced a "spike" in the number of estimated HIV cases, Reuters reports (Zaheer, Reuters, 11/21). The number of HIV-positive people living in Eastern Europe and Central Asia increased 25% over the last year to 1.6 million (UNAIDS/WHO release, 11/21). According to the report, Russia has "the biggest AIDS epidemic in all of Europe," fueled primarily by a large number of injection drug users (AFP/Yahoo! News [3], 11/21). Western Europe accounted for more than 500,000 new HIV cases in 2005, with the "biggest change" in many countries being the emergence of heterosexual contact as the primary transmission route (AFP/Yahoo! News [4], 11/21).

Report Critical of China, Myanmar; Praise for Thailand
China has made "slow progress" in fulfilling a 2003 plan to provide universal access to antiretroviral drugs; Myanmar's "limited prevention efforts" have allowed HIV to spread unchecked; and Indonesia and Pakistan are on the verge of major epidemics, according to the report, AFX/Forbes reports. Although Asia's HIV prevalence rate remained at a "relatively low" 0.4%, the region accounts for about 20% of the number of HIV cases worldwide, or about 8.3 million. Indonesia's epidemic is attributed primarily to injection drug use, while limited knowledge about the disease among IDUs and commercial sex workers in Pakistan could be facilitating the spread of the virus in that country, the report said (AFX/Forbes [1], 11/21). Piot said that India -- where about 5.1 million HIV-positive people live, the second-highest number of any country in the world -- has experienced far more new HIV cases than the 28,000 cases the government reported in 2004. "There are a number of states where reporting of cases is weak," Piot said (Zaheer, Reuters, 11/20). The report called Thailand the only "success story" in Asia, with an HIV prevalence rate of about 1.5% in 2003, AFX/Forbes reports. However, the report noted that only 51% of commercial sex workers in the country use condoms, according to AFX/Forbes (AFX/Forbes [1], 11/21).

Other Regions
An estimated 510,000 HIV-positive people are living in the Middle East, with approximately 67,000 new cases each year. The report said that Sudan is "[b]y far the worst-affected country in the region," adding that many residents have a lack of knowledge about HIV/AIDS (AFP/Yahoo! News [5], 11/21). The report also said that Western Europe and North America "remain the only regions in the world where most people in need of antiretroviral treatment are able to receive it" (AFP/Yahoo! News [4], 11/21). WHO Director-General Jong-Wook Lee said, "We can now see the clear benefit of scaling up HIV treatment and prevention together and not as isolated interventions," adding, "Effective prevention can also help reduce the number of individuals who will ultimately require care, making broad access to treatment more achievable and sustainable" (AFX/Forbes [2], 11/21).