Statistics for the end of 2010 indicate that around 34 million people are living with HIV, the virus that causes AIDS. Each year around 2.7 million more people become infected with HIV and 1.8 million die of AIDS.1
Although HIV and AIDS are found in all parts of the world, some areas are more afflicted than others. The worst affected region is sub-Saharan Africa, where in a few countries more than one in five adults is infected with HIV. The epidemic is spreading most rapidly in Eastern Europe and Central Asia, where the number of people living with HIV increased by 250% between 2001 and 2010.2
People living with HIV around the world: a South African child; a Guatemalan mother; American activist and writer Larry Kramer
People living with HIV around the world: a South African child; a Guatemalan mother; American activist and writer Larry Kramer
People living with HIV around the world: a South African child; a Guatemalan mother; American activist and writer Larry Kramer
AIDS is caused by HIV, a virus that can be passed from person to person through sexual fluids, blood and breast milk. Worldwide the majority of HIV infections aretransmitted through sex between men and women, and half of all adults living with HIV are women.3 But certain groups of people have been particularly affected and these include injecting drug users, sex workers and men who have sex with men. In many people’s minds, HIV and AIDS are closely linked with these groups, which can lead to even greater stigma and prejudice against people already treated as outsiders.
Many Western countries, such as the UK, have increasing rates of HIV transmission through heterosexual sex. In America, where more than a million people are living with HIV, heterosexual sex accounts for one third of new diagnoses.4
As a sexually transmitted disease, AIDS particularly affects adolescents and young adults. Three thousand new infections occur among young people aged between 15-24 every day and people in this age group account for more than a third of all new HIV infections.5 Deaths of young adults have an especially damaging impact on their families and communities: skills are lost, workforces shrink and children are orphaned. In some African countries, life expectancies have fallen below 40 years, whereas they would have been above 60 without AIDS. There are around 16.6 million children who have lost a parent to AIDS.6
There is much that can be done to reduce the impact of AIDS, beginning with the prevention of HIV transmission. Averting sexual transmission involves encouraging safer sexual behaviour including delayed first sex, partner reduction and condom use. The spread of HIV through injecting drug use can be slowed by outreach work,needle exchange and drug substitution treatment. Mother-to-child transmission can be almost eliminated through use of medicines and avoidance of breastfeeding.
There is still no cure for HIV but HIV treatment for people with HIV has improved enormously since the mid-1990s. Those who take a combination of three antiretroviral drugs can expect to recover their health and live for many years without developing AIDS, as long as they keep taking the drugs every day.
Yet although it is known how to prevent and treat AIDS, few people have access to the necessary services. Most rich countries and eleven low- and middle-income countries, for example Botswana, Cambodia, Chile and Cuba, have achieved universal treatment access. But only 47% of people who need antiretroviral drugs across low- and middle-income countries are receiving them (based on 2010 WHO treatment guidelines).7Access to prevention tools such as HIV education, condoms, clean needles and programmes to prevent mother-to-child transmission is inadequate. Figures show that in 2010, only 35% of pregnant women in low- and middle-income countries were tested for HIV and an estimated 48% of pregnant women living with HIV were given the most effective antiretroviral regimens to prevent HIV transmission to their child.8
AIDS funding comes from various sources; from governments, multilateral organisations like the Global Fund, national governments and private organisations like the Bill & Melinda Gates Foundations. In recent years, efforts to fight AIDS around the world have stepped up, with much greater funding being supplied by the US, other rich nations and developing country governments. However, the amount of money available has remained short of what is needed for an effective response and in 2009 the increase in funding seen in previous years was not repeated. In 2009, there was a funding shortfall of US$10 billion.9
Certain prominent international organisations, such as World Health Organisation (WHO) and UNAIDS, do not provide funding but coordinate and monitor global HIV and AIDS treatment, care and prevention efforts. WHO routinely issues guidelines to help countries achieve the highest attainable standards when addressing HIV and AIDS issues, including guidelines on when to begin antiretroviral treatment for people living with HIV. UNAIDS monitors the global HIV and AIDS epidemic through an annual reporting system and the release of annual reports on the global AIDS epidemic and other HIV and AIDS issues.
Apart from inadequate funding, major obstacles in tackling the global AIDS epidemic include weak infrastructure and shortages of health workers in the worst affected countries. Political or cultural attitudes are also significant: for example some authorities are opposed to condom promotion, while others refuse to support needle exchanges for injecting drug users. Many are reluctant to provide young people with adequate education about sex and sexual health.
Another very serious issue is stigma and discrimination. People known to be living with HIV are often shunned or abused by community members, employers and even health workers. As well as causing much personal suffering, this sort of prejudice discourages people from seeking HIV testing, treatment and care.
A wide range of interventions, including a strong commitment to preventing new HIV infections as well as treating people already infected, is necessary to tackle the global AIDS epidemic.
source: avert
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