Transcript OVERVIEW OF THE HIV/AIDS EPIDEMIC

OVERVIEW OF
THE HIV/AIDS EPIDEMIC
Marie Laga 23-2-2005
www.unaids.org
Adults and children estimated to be living
with HIV as of end 2004
Western & Central Eastern Europe
& Central Asia
Europe
610 000
North America
1.0 million
[540 000 – 1.6 million]
Caribbean
1.4 million
[480 000 – 760 000] [920 000 – 2.1 million] East Asia
North Africa & Middle East
440 000
[270 000 – 780 000]
Latin America
1.7 million
[1.3 – 2.2 million]
540 000
[230 000 – 1.5 million]
Sub-Saharan Africa
25.4 million
[23.4 – 28.4 million]
1.1 million
[560 000 – 1.8 million]
South & South-East Asia
7.1 million
[4.4 – 10.6 million]
Oceania
35 000
[25 000 – 48 000]
Total: 39.4 (35.9 – 44.3) million
00003-E-2 – December 2004
Global estimates for adults and
children end 2004
• People living with HIV
39.4 million
[35.9 – 44.3 million]
• New HIV infections in 2004
4.9 million
[4.3 – 6.4 million]
• Deaths due to AIDS in 2004
3.1 million
[2.8 – 3.5 million]
00003-E-3 – December 2004
About 14 000 new HIV infections a day
in 2004
• More than 95% are in low and middle income
countries
• Almost 2000 are in children under 15 years of
age
• About 12 000 are in persons aged 15 to 49
years, of whom:
— almost 50% are women
— about 50% are 15–24 year olds
00003-E-4 – December 2004
Trends in Number of People Living
with HIV infection 1980 - 2002 by WHO
Region
30.000.000
25.000.000
20.000.000
15.000.000
8.8%
AFRO
EURO
AMRO
WPRO
SEARO
EMRO
Growth of the African
epidemic
slowed down since 1997
10.000.000
5.000.000
19
80
19
82
19
84
19
86
19
88
19
90
19
92
19
94
19
96
19
98
20
00
20
02
0
Changes in the African epidemic
will greatly affect global numbers
HIV prevalence in adults
in sub-Saharan Africa, 1986-2001
1986
1991
1996
2001
20 – 39%
10 – 20%
5 – 10%
1 – 5%
0 – 1%
trend data unavailable
outside region
Source: UNAIDS/WHO July 2002
Source: UNAIDS/WHO July 2002
Large differences in severity within Africa:
Southern >> Eastern and Central > Western
Trends in median HIV prevalence in the
same antenatal sites by country and
period, Southern Africa, 1997-2002
40
30
20
10
N
am
ib
So
ia
ut
h
A
fri
ca
Sw
az
ila
nd
Zi
m
ba
bw
e
qu
e
i
M
oz
am
bi
al
aw
M
B
ot
sw
an
a
0
2001
1999 -2002
1997 -2000
-199
8
The epidemic is leveling off at
extremely high levels of prevalence
HIV prevalence by age and sex,
Zambia DHS 2001-02
35
30
25
20
Men
Women
15
10
5
0
15-19
20-24
25-29
30-34
35-39
40-44
45-49
Women get infected earlier
than men, often under 25 years
Kisumu: Multicentre Study
Sex- and age-specific HIV prevalence,
1997-98 (n=370)
33
35
29
Per cent (%)
30
25
22
18
20
15
9
10
6
4
5
0
0
2
0
15
*Buve et al, AIDS 2001
16
17
Age (years)
18
19
Men
Women
Deaths at ages 15-34
South Africa: 1980-2025
(Estimated and projected )
Deaths (thousands)
2,000
1,600
Without AIDS
With AIDS
1,200
800
400
0
1980-1985 1985-1990 1990-1995 1995-2000 2000-2005 2005-2010 2010-2015 2015-2020 2020-2025
Lifetime risk of AIDS death for 15-year-old boys,
assuming unchanged or halved risk of becoming
infected with HIV, selected countries
100%
Risk of dying of AIDS
90%
Botswana
80%
Zimbabwe
70%
60%
50%
Côte d’Ivoire
Cambodia
Burkina
20% Faso
10%
0%
Zimbabwe
South Africa
Zambia
Kenya
40%
30%
Botswana
South Africa
Zambia
0%
risk halved over next 15 years
current level of risk maintained
Kenya
Côte d’Ivoire
Cambodia
Burkina Faso
5%
10%
15%
20%
25%
30%
35%
40%
Current adult HIV prevalence rate
Source: Zaba B, 2000 (unpublished data)
Changes in life expectancy
in selected African countries
with high and low HIV prevalence: 1950-2005
65
Life expectancy (years)
60
with high HIV prevalence:
Zimbabwe
South Africa
Botswana
55
50
45
with low HIV prevalence:
Madagascar
Senegal
Mali
40
35
30
1950–1955- 1960- 1965- 1970- 1975- 1980- 1985- 1990- 1995- 20001955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
AIDS orphans in South Africa
2000000
1500000
1000000
500000
0
HIV prevalence and deaths due to
AIDS 2004
Living with
HIV
% of
total
Death due
to AIDS
%
Sub-saharan
Africa
Asia
25.4 mill
64%
2.3 mill
74%
8.2 mill
21%
541.000
17%
Latin America
1.7 mill
4%
95.000
3%
West Eur/US
1.6 mill
4%
22.500
0.7%
Eastern Europe
1.4 mill
3.6%
60.000
2%
Total
39.4 million
3.1 million
The Cycle of HIV Disease
1. Incidence of HIV Infection
3. Incidence AIDS
2. Prevalence of HIV
Infection
4. Prevalence of AIDS
5. Mortality from AIDS
Prevention of new HIV infections ?
• No preventive vaccine in near future
• <20% of people at risk have access to
proven HIV prevention interventions
– condom programs
– needle exchange
• Contextual factors such as stigma and
gender inequality remain major barriers