AIDS BY REGION
Situation in Asia, Africa,
America, Europe
SOUTHERN AND
SOUTHEAST ASIA
The
extensive spread of HIV in South and Southeast Asia began in the mid-1980s, but
its progression has been very rapid. What is happening in Africa now could be
dwarfed by the Asian epidemic.
As of the end of 1995, UNAIDS estimated that over 4,000,000 people were living
with HIV/AIDS in this region. While India and Thailand account or the majority
of infections, rapid HIV spread into specific populations in other counties of
the region has also been noted.
For the region's adults, the predominant modes of transmission are unprotected
heterosexual intercourse and needle sharing. In some Asian countries, a large
proportion of sex outside marriage is not "casual sex" but "commercial sex." One
study found that 44% of Thai men had their first sexual experience with a
commercial sex worker (prostitute) at an average age of about 18 years. In
India, an indication of the population's vulnerability to HIV can be found in
the millions of sexually transmitted diseases (STDS) occurring each year.
The AIDS epidemic in Southern and Southeast Asia gained an early foothold among
injecting drug users. Today, the virus is spreading rapidly in and around the
area known as the Golden Triangle, where most of the world's opium and heroin
are produced.
Apart from unprotected sex and drug injection, contaminated blood transfusions
also contribute to the epidemic in parts of the region.
EASTERN EUROPE
AND CENTRAL ASIA
In
Eastern Europe and Central Asia, it is estimated that more than 25,000 adults
are thought to be infected with HIV/AIDS. While this can still be called low
prevalence, this is likely to rise given that the region has many ingredients of
rapid HIV spread -- economic crisis, rising unemployment, crumbling health
systems, ethnic and religious conflicts, the displacement of civilian
populations, as well as people on the move in search of economic opportunities.
NORTH AFRICA AND
THE MIDDLE EAST
The few studies which are
available regarding this region suggest that the extensive spread of HIV began
in some parts of the Middle East in the late 1980's. As of the end of 1995,
UNAIDS estimates that over 180,00 people are living with HIV/AIDS in this
region.
LATIN AMERICA
AND THE CARIBBEAN
In
Latin America and the Caribbean, over 1,700,000 adults are living with HIV/AIDS.
Rates of infection are rising in Honduras and in other Central American
countries and in the Caribbean.
Since the mid 1980s, there has been increasing heterosexual transmission,
principally among bisexual men and their female sex partners, and among female
sex workers and their clients. This is especially true where heterosexual
transmission is spurred by a high prevalence of STDS and other genital tract
infections, and by social and economic conditions that favor unprotected sex
with many partners (e.g. prostitution).
Transmission through drug injecting is also on the rise. In Argentina, for
example, HIV prevalence among injecting drug users ranges from 30% to 50%, and
in Brazil form 20% to 60%.
NORTH AMERICA
AND WESTERN EUROPE
In
this region, over 1,200,000 adults are living with HIV/AIDS, including more than
750,000 in the USA alone. The people predominantly affected to date have been
homosexual or bisexual men and injecting drug users, together with their sex
partners.
However, the transmission of HIV through heterosexual intercourse is on the
rise, with especially notable increases in urban populations who have high rates
of injecting drug use or STDS.
The USA has by far the highest reported number of AIDS cases in the
industrialized world. The proportion of AIDS cases attributable to sexual
transmission between men decreased from 75% to just over 50% of the cases
between 1985 and 1992. However, by 1992, the proportion of cases due to drug
injecting had risen to 25%. In the US, HIV infection is increasingly a disease
of poverty and exclusion, with disproportionately high rates among black men and
women.
Since the epidemic started, as far back as the late 1970s, AIDS has become the
leading cause of death among adults under age 45 in many US and Western European
cities.
In Western Europe today, about 450,000 people are living with HIV/AIDS . There
is some evidence that HIV prevalence has stabilized in Northern European
countries such as Belgium, Germany, the Netherlands, Sweden and the United
Kingdom. Switzerland has reported reductions in the HIV/AIDS cases. However, the
situation is less encouraging in countries such as Spain and Italy.
SUB-SAHARAN
AFRICA
With
more than 12,900,000 HIV-infected adults today,sub-Saharan Africa is the region
hardest hit.
Heterosexual transmission has predominated since the outset, and currently, the
number of women infected outnumbers men by 6 to 5. More than 6,000,000 women of
childbearing age have been infected and UNAIDS believes that as many as
1,000,000 children may already have been infected prior to, or during birth, or
through breast-feeding.
In a number of countries in the region, the spread of HIV/AIDS has been spurred
by population movements due to situations of conflict or poverty. Another
contributory factor appears to have been the frequent presence of other sexually
transmitted diseases (STDs) which, if left untreated, increase the risk of HIV
infection. The lower status of women in a number of cultures has also
contributed to the rapid spread.
Recent data suggest that the epidemic is continuing to evolve, particularly in
Western and Southern Africa. However, there is also some evidence of a
stabilization in HIV infection rates in certain areas of East and Central
Africa. In one rural district of southwest Uganda, the percentage of those aged
13 and above acquiring HIV infection each year declined from 7.5% in 1989-1990
to 4.5% in 1993. This is attributed to success in changing sexual behavior.
To date, sub-Saharan Africa has lost more than 3,000,000 people to AIDS.
