PHA-Exchange> NUMBER OF WOMEN LIVING WITH HIV INCREASES IN EACH REGION OF THE WORLD

[Claudio]

From: "Vern Weitzel" <vern.weitzel at undp.org>

UNAIDS WHO Press Release

NUMBER OF WOMEN LIVING WITH HIV INCREASES IN EACH REGION OF THE WORLD

Close to half of 37.2 million adults living with HIV are
women, according to new UNAIDS/WHO report

GENEVA, 23 November 2004  –  A new report released today
shows that the number of women living with HIV has risen in
each region of the world over the past two years, with the
steepest increases in East Asia, followed by Eastern Europe
and Central Asia. In East Asia, there was a 56% increase
over the past two years, followed by Eastern Europe and
Central Asia with 48%.

Women are increasingly affected, now making up nearly half
of the 37.2 million adults       (aged 15-49) living with
HIV worldwide. In sub-Saharan Africa, the worst-affected
region, close to 60% of adults living with HIV are women –
or 13.3 million. These latest findings were published in
AIDS Epidemic Update 2004, the annual report by the Joint
United Nations Programme on HIV/AIDS (UNAIDS) and the World
Health Organization (WHO). The joint report was released
today in advance of World AIDS Day, commemorated worldwide
on the first of December.

The report indicates that there is no single AIDS epidemic
worldwide. Many regions and countries are experiencing
diverse epidemics, some still in the early stages. “These
latest trends firmly establish AIDS as a unique development
challenge,” said Dr Peter Piot, UNAIDS Executive Director.
“The time of quick fixes and emergency responses is over. We
have to balance the emergency nature of the crisis with the
need for sustainable solutions.”

According to the report, the number of people living with
HIV globally has also reached its highest level with an
estimated 39.4 million people, up from an estimated 36.6
million in 2002. The steepest increases in HIV infections
occurred in East Asia, Eastern Europe,and Central Asia over
the past two years.

In East Asia, the 50% increase in HIV infections from
2002-2004 is largely attributable to growing epidemics in
China, Indonesia and Viet Nam. The 40% increase in Eastern
Europe and Central Asia is mainly due to Ukraine’s expanding
epidemic and the growing number of people living with HIV in
the Russian Federation. With an estimated 860,000 people
living with HIV at the end of 2003, Russia has the largest
epidemic in Europe.

As the numbers of people becoming infected and living with
HIV increases, so does the number of those needing
antiretroviral treatment, as well as care for opportunistic
infections. “We do not yet have a vaccine, but we do know
that prevention and treatment work and we have the tools to
deliver them. Government leaders, civil society and the
private sector are all affected and we must all mobilise to
save lives,” said Dr LEE Jong-wook, Director-General of the
World Health Organization.

Women and AIDS – A Growing Challenge

Women are more physically susceptible to HIV infection than
men. Male-to-female HIV transmission during sex is about
twice as likely to occur as female-to-male transmission.

For many women in developing countries, the “ABC” prevention
approach (Abstinence, Being faithful and reducing number of
sexual partners, and Condom use) is insufficient.
"Strategies to address gender inequalities are urgently
needed if we want a realistic chance at turning back the
epidemic," said Dr Piot. "Concrete action is necessary to
prevent violence against women, and ensure access to
property and inheritance rights, basic education and
employment opportunities for women and girls."

According to the report, millions of young people are
becoming sexually active each day with no access to
prevention services. In sub-Saharan Africa, three quarters
of all 15-24 year olds living with HIV are female. Young
women are three times more vulnerable to HIV infection than
their male counterparts. In addition to being biologically
more vulnerable to infection, many women and girls,
particularly in Southern Africa, find themselves using sex
as a commodity in exchange for goods, services, money, or
basic necessities – often with older men. This
“transactional sex” is mainly driven by poverty and the
desire for a better life.

Latest Trends in AIDS Epidemic

The UNAIDS/WHO report clearly indicates that there is no
single, “African” AIDS epidemic. The epidemics throughout
the continent are highly varied. Southern Africa continues
to be the worst-hit region with HIV prevalence rates
surpassing 25%. In Botswana, Lesotho, and Swaziland,
prevalence rates still exceed 30% among pregnant women. Life
expectancy has dropped below 40 years in nine countries in
the region.

Despite modest declines in HIV prevalence rates in East
Africa, notably in Uganda and parts of Ethiopia and Kenya,
the epidemic is far from being reversed. In Addis Ababa, HIV
prevalence fell to 11% by 2003, down from a peak of 24% in
the mid-1990s. In Kenya, HIV prevalence fell from 13.6% in
1997 to 9.4% in 2002. The Caribbean continues to be the
second worst-affected region in the world. HIV transmission
occurs largely through heterosexual sex, although sex
between men, which is highly stigmatized, is also fuelling
the epidemic. AIDS has become the leading cause of death
among adults aged 15-44 in the region.

In North America and Europe, an increasing number of people
are becoming infected through unprotected heterosexual sex.
In the United States, AIDS disproportionately affects
African American and Hispanic women, with AIDS ranked among
the top three causes of death for African American women
aged 35-44 years. According to AIDS Epidemic 2004, there are
strong indications that the main risk factor for many women
acquiring HIV is the often undisclosed risk behaviour of
their male partners.

In Western Europe, HIV infection through heterosexual sex
more than doubled between 1997 and 2002. It is feared that
large numbers of HIV-infected people are still unaware of
their HIV status. In the United Kingdom, HIV has become the
fastest-growing serious health condition.

Injecting drug use is on the rise in many regions and
contributes to an increasingly large share of new HIV
infections, especially in countries with emerging epidemics
in Eastern Europe, Central Asia, and parts of Asia.

“In many countries, we are still seeing a mismatch between
prevention spending priorities and the evolution of the
epidemic,” said Dr Piot. “Men who have sex with men and
injecting drug users continue to be neglected. More needs to
be done to target them and increase access to prevention
programmes for people at high risk of HIV infection.”

As AIDS Funding Increases, Challenges Lie Ahead

Global AIDS spending has tripled since 2001, from US$2.1
billion in 2001 to US$6.1 billion in 2004, and access to key
prevention and care services has improved significantly. Yet
the disease continues to spread. “Obviously more resources
will be needed in the future, but right now the key
challenge is making the money work – ensuring that available
funds are spent effectively on where they are needed most,”
said Dr Piot.

According to a recently published survey in 73 low- and
middle-income countries (representing almost 90% of the
global burden of HIV), the number of secondary-school
students receiving AIDS education has nearly tripled, the
annual number of voluntary counselling and testing clients
has doubled, the number of women offered services to prevent
mother-to-child HIV transmission has increased by 70%, and
the number of people receiving antiretroviral therapy has
increased by 56% between 2001 and 2003.

Despite the improvements, prevention and treatment coverage
remains uneven in various regions. Less than one in five
people has access to HIV prevention services in low- and
middle-income countries. Between 5 and 6 million people are
in need of HIV treatment.  By June 2004, an estimated
440,000 people in the developing world had access to
antiretroviral treatment, up from 200,000 two years before.
Although the number of those receiving treatment has more
than doubled, less than 10% of people who need treatment,
predominantly in sub-Saharan Africa, are receiving it.

“AIDS treatment will only be viable if HIV prevention
efforts are reinvigorated and vice versa,” said Dr LEE
Jong-Wook. “Only by linking prevention and treatment  can
the global spread of AIDS be halted. We know that prevention
works better when it is linked with the promise of
treatment. We also know that unless we prevent new
infections, millions more will be added to the “treatment
list” every year, making treatment unsustainable.”

The annual AIDS Epidemic Update reports on the latest
developments in the global AIDS epidemic. With maps and
regional estimates, the 2004 edition provides the most
recent estimates on the epidemic’s scope and human toll,
explores new trends in the epidemic’s evolution, and
features a special section on women and AIDS.

In January 2005, WHO will issue a formal progress report on
what progress countries have made towards the "3 by 5"
target to get three million on treatment by the end of 2005.
The goal is universal access to treatment.


For more information, please contact Annemarie Hou, UNAIDS,
Brussels, tel. (+41 22 )791 4577, or mobile (+41 79) 500
2123, Dominique de Santis, UNAIDS, London, (+41 22) 791 4509
or mobile (+41 79) 254 6803, Jonathan Rich, UNAIDS, New
York, (+ 1 212) 532 0255, or Iain Simpson, WHO, Geneva, (+41
22) 791 3215. The complete report can be accessed on the
UNAIDS website – www.unaids.org.