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Monday, November 21, 2005 

40 million infected with AIDS; but, some good news

The global HIV epidemic continues to expand, with more than 40 million people now estimated to have the AIDS virus, but in some countries prevention efforts are finally starting to pay off, the United Nations says.

AIDS has killed more than 25 million people since it was first recognized in 1981, making it one of the most destructive epidemics in history. An estimated 3.1 million people died from the virus last year and another 4.9 million people became infected, according to a U.N. update published Monday.

However, for the first time there is solid evidence that increased efforts to combat the disease over the last five years have led to fewer new infections in some places, said UNAIDS chief Peter Piot.

Previously improvements had been seen in places such as Senegal, Uganda and Thailand, but those were rare exceptions.

"Now we have Kenya, several of the Caribbean countries and Zimbabwe with a decline," Piot said, adding that Zimbabwe is the first place in Southern Africa, the hardest-hit area, to show improvement.

These are all countries that have invested heavily in safe-sex campaigns and other prevention programs, with the result that prevalence of HIV among the young has declined.

"People are starting later with their first sexual intercourse, they are having fewer partners, there's more condom use," Piot said.

These are key ingredients in the "ABC"s of AIDS, a program first widely used in Uganda. A=abstinence (or delayed sexual experiences), B="be faithful", C=condoms. This simple strategy has resulted in increased awareness of disease transmission, and has resulted in a decrease in the rate of new infections diagnosed--showing just what good sex education and condom availability can do.

However, there is, of course, some bad news as well:
The epidemics continue to intensify in southern Africa. Growing epidemics are under way in Eastern Europe and in Central and East Asia. Five years ago, one in 10 new infections were in Asia. Today the number is one in four or five.

China, Papua New Guinea and Vietnam are facing significant increases. There are also alarming signs that Pakistan and Indonesia could be on the verge of serious epidemics, the report said.

Intravenous drug use and commercial sex are fueling the epidemic in Asia, where few countries are doing enough to inform people about the danger of such behavior, the report warned.

Worldwide, less than one in five people at risk of becoming infected with HIV has access to basic prevention services. Of people living with HIV only one in 10 has been tested and knows that he or she is infected.

That last part is critical. Great strides have been made, but it's not a time to rest on our laurels. Condoms and education have done so much--now we need to work to extend those services into areas where they aren't currently available. We also need to work to have more of those who are at-risk get themselves tested. This is a bit trickier, as there's not only the problem with lack of access to resources, but also stigma that comes from finding out one is HIV-positive. The latter can cause even those who may have access to tests to not take advantage of that--they'd rather not know their status, and thus don't get treatment, and potentially infect others. It's relatively easy to provide supplies; it's much more difficult to provide a shift in the cultural attitudes that will allow HIV+ patients to live a full life even after diagnosis.

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About me

  • I'm Tara C. Smith
  • From Iowa, United States
  • I'm a mom and a scientist, your basic stressed-out, wanna-have-it-all-and-do-it-all Gen Xer. Recently transplanted from Ohio to Iowa, I've spent most of my life in the midwest (with 4 years of college spent out east in "soda" territory). My main interest, and the subject of my research, is infectious disease: how does the microbe cause illness? What makes one strain nasty, and another "avirulent?" Are the latter really not causing any disease, or could some of those be possible for the development of chronic disease years down the road? Additionally, I've spent a lot of time discussing the value of teaching evolution, and educating others about "intelligent design" and other forms of creationism. My interest in history of science and medicine is also useful as a way to tie all of the above interests together. [Disclaimer: the views here are solely my own, and do not represent my employer, my spouse, that guy who's always sitting by the fountain when I come into work, or anyone else with whom I may be remotely affiliated.]
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