Over 40 million people are living with HIV worldwide, according to figures released by UNAIDS, who estimate that there were 5 million new infections in 2005.

A 25% leap in the number of new infections was recorded in Eastern Europe and Central Asia, and increases were seen in every other region of the world with the exception of the Caribbean.

However, UNAIDS highlights evidence that prevention efforts are working in certain parts of the world. “Increased condom use, delay in first sexual experience and fewer sexual partners” have led to a fall in overall HIV prevalence in parts of Kenya, Zimbabwe and the Caribbean region according to UNAIDS. Although the latest prevalence figures apparently show the success of the ABC prevention model – abstain, be faithful, use a condom- UNAIDS conceded that “increased mortality also led to a drop in HIV prevalence.”

Nevertheless, in Zimbabwe testing of pregnant women suggested that HIV prevalence had fallen from 26% to 21%, and voluntary testing and counselling programmes and increased availability of condoms were helping to promote HIV prevention in the Caribbean where the latest prevalence figures were grounds for “guarded optimism.”

Proven models of HIV prevention praised by UNAIDS included youth-targeted initiatives in Uganda, work with gay and bisexual men in western countries, programmes for sex workers in South East Asia, and Spain’s HIV and hepatitis prevention schemes for injecting drug users.

Despite some notable successes, UNAIDS stressed that HIV prevention remained patchy worldwide and that only 10% of HIV-positive individuals knew that they were infected with the virus. Comprehensive HIV prevention programmes could prevention 55% of all new HIV infections southern Africa in the next 15 years, UNAIDS estimates.

“We are encouraged by the gains that have been made by some countries and by the fact that sustained HIV prevention gains have played a key part in bringing down infections. But the reality is that the AIDS epidemic continues to outstrip global and national efforts to contain it,” said Dr Peter Piot, executive director of UNAIDS. “It is clear that a rapid increase in the scale and scope of HIV prevention programmes is urgently needed. We must move from small projects with short-term horizons to long-term, comprehensive strategies,” he added.

The latest UNAIDS data also furnished further evidence of the feminisation of the HIV epidemic, with an estimated 17.5 million women living with HIV worldwide. Figures from UNAIDS also show how HIV prevention campaigns which only stress sexual abstinence or fidelity would do little to protect many women from infection, “among women surveyed in Harare, Durban and Soweto, 66% reported having only one lifetime partner, 79% had abstained from sex until the age of 17, yet 40% of young women were HIV-positive.”

Although more people than ever before received antiretroviral treatment in 2005, only a fraction of people who needed treated were receiving it. In southern Africa, only 10% of HIV-positive individuals were treated with anti-HIV drugs this year, and only marginally more – one in seven – received antiretroviral therapy in Asia. Most of the 3 million HIV-related deaths which occurred in 2005 could have been prevented with appropriate HIV treatment, UNAIDS stresses. However, thanks to treatment access programmes including the “3 X 5” initiate between 250,000 and 350,000 HIV deaths were prevented due to improved access to anti-HIV drugs last year.

UNAIDS also stressed that HIV prevention and treatment initiates were mutually reinforcing, with the provision of treatment offering an incentive to test. Indeed UNAIDS highlighted how some voluntary testing and counselling programmes in Uganda were closing due to lack of demand until antiretroviral therapy became available. In addition, treatment can also help change perceptions of HIV according to UNAIDS by helping to fight the belief that the virus inevitably leads to death and counter the stigma and discrimination that often accompanies the disease. Other serious illness can also be diagnosed and treated as part of antiretroviral treatment programmes, emphasise UNAIDS, including tuberculosis, malaria and sexually transmitted infections, all of which causes significant amounts of illness and death in HIV-positive people. Finally UNAIDS emphasised that HIV treatment can lower the infectiousness of HIV-positive individuals and by reducing new HIV infections, lower demand for already over-stretched health services.

“We can now see the clear benefit of scaling up HIV treatment and prevention together”, said Dr Lee Jong-wook of the World Health Organization, “treatment availability provides a powerful incentive for governments to support, and individuals to seek out, HIV information and voluntary testing and counselling. Effective prevention can also help reduce the number of individuals who will ultimately require care, making broad access to treatment more achievable and sustainable.”

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