Mixed results seen in global AIDS fight

Caseload rises while Africa shows progress

November 22, 2006|By McClatchy-Tribune

NAIROBI, Kenya -- The number of people across the globe living with HIV infections has increased over the past two years, but the African countries hit hardest by AIDS are making progress in fighting the disease, United Nations experts said yesterday.

The worldwide increase in HIV cases - to 39.5 million this year from 36.9 million two years ago - is due partly to people living longer thanks to greater access to life-saving anti-retroviral drugs, the U.N. AIDS agency and the World Health Organization said in their annual report on the epidemic.

Eastern Europe and Central Asia have seen the most significant increases in new infections, from an estimated 160,000 in 2004 to 270,000 this year. The epidemic is spreading fastest in Ukraine, especially among needle-drug users; annual HIV diagnoses there have more than doubled since 2000.

AIDS may still be expanding in southern Africa, home to one-third of the world's HIV infections, and also, more worrying to experts, in China, where despite a stepped-up government response, HIV is slowly spreading from needle-drug users and sex workers to the general population.

There also are signs that Uganda and Thailand, two countries that were hailed as success stories in the fight against AIDS, are seeing HIV infection rates creep back up in groups previously considered at lesser risk of infection.

"The AIDS epidemic is continuing to grow, and it is definitely growing everywhere in the world," said Dr. Badara Samb of the WHO's HIV/AIDS department.

Worldwide, 2.9 million people died from AIDS in 2006, the highest annual figure ever recorded - nearly three-quarters of them in sub-Saharan Africa, the report said. Africa's 2.8 million new infections in 2006 were more than all other regions of the world combined.

In the United States, which has 1.2 million infected people, greater access to anti-retroviral drugs reduced AIDS death rates by 80 percent from 1990 to 2003. But new infections continue to occur, especially among minority groups. Blacks and Hispanics, who make up about 26 percent of the population, account for 70 percent of AIDS diagnoses.

There are some promising signs in Africa, where the epidemic has ravaged the general population. In East Africa, HIV rates continue to hold steady or decline in most countries. And Zimbabwe, despite its recent economic collapse, is the first country in southern Africa to show declines in HIV rates; surveys suggest that men are having less casual sex and that condom use is increasing.

"A combination of increased AIDS awareness, relatively extensive health infrastructure and growing anxiety about AIDS mortality appears to have prompted such behavior changes," the report said.

In several African countries, young people also appear to be adopting safer sexual behaviors, suggesting that the multibillion-dollar efforts to encourage safe sexual practices are having some effect.

According to surveys, the proportion of people ages 15-24 who have sex with nonregular partners has decreased in Kenya and Malawi since 2001, while condom use with non-regular partners has increased in Cameroon, Tanzania and Uganda. There's evidence of a decline in HIV rates among young people in all those countries.

But in Uganda, a public health triumph in the 1990s for reducing HIV rates, there's evidence of more new infections and increased casual sex in rural areas, which has fueled the disease's spread through the continent.

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