World AIDS Day 2005

Stop AIDS. Keep the Promise.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) released their annual report about the AIDS pandemic. An estimated 40.3 million people worldwide are living with HIV. Despite recent, improved access to antiretroviral treatment and care in many regions of the world, the AIDS epidemic claimed 3.1 million [2.8–3.6 million] lives in 2005; more than half a million (570 000) were children. Close to 5 million people were newly infected with the virus in 2005.

Sustained efforts in diverse settings have helped bring about decreases in HIV incidence among men who have sex with men in many Western countries, among young people in Uganda, among sex workers and their clients in Thailand and Cambodia, and among injecting drug users in Spain and Brazil. Now there is new evidence that prevention programmes initiated some time ago are finally helping to bring down HIV prevalence in Kenya and Zimbabwe, as well as in urban Haiti.

Despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean. According to the report, the steepest increases in HIV infections have occurred in Eastern Europe and Central Asia (25% increase to 1.6 million) and East Asia. But sub-Saharan Africa continues to be the most affected globally– with 64% of new infections occurring here (over three million people).

“We are encouraged by the gains that have been made in some countries and by the factthat sustained HIV prevention programmes have played a key part in bringing downinfections. But the reality is that the AIDS epidemic continues to outstrip global and national efforts to contain it,” said UNAIDS Executive Director Dr Peter Piot.

One of the striking facets of the epidemic in the United States is the concentration of HIV infections among African Americans. Despite constituting only 12.5% of the country’s population, African Americans accounted for 48% of new HIV cases in 2003 (US Centers for Disease Control and Prevention, 2004a). While men comprise the majority of African Americans living with HIV, African American women, too, are disproportionately affected. By some estimates, African American women are more than a dozen times as likely to be infected with HIV than are their white counterparts. Among young men (aged 23–29 years) who have sex with men, HIV prevalence among African Americans (at 32%) is more than four times that among white counterparts (7%) and more than twice that among Latino counterparts (14%). One half of the people who died of AIDS in 2003 were African Americans (US Centers for Disease Control and Prevention, 2004a).

Human Rights Watch has documented numerous cases of AIDSactivists and non-governmental organizations being harassed,intimidated, or jailed for their work. In China, government officialshave jailed activists seeking to expose government complicity in atainted blood scandal that infected millions of impoverished peoplewith HIV in the 1990s. In India and Bangladesh, outreach workersdelivering services to sex workers, to men who have sex with men, andto other hidden populations, have faced widespread police harassmentand violence.

Overall, HIV stigma and the resulting actual or feared discrimination have proven to be perhaps the most difficult obstacles to effective HIV prevention. Stigma and discrimination simultaneously reduce the effectiveness of efforts to control the global epidemic and create an ideal climate for its further growth.