An estimated 39.4 million people are living with HIV, according to the annual global AIDS epidemic report published by UNAIDS in advance of World AIDS Day. UNAIDS also estimates that almost 5 million people were newly infected with HIV in 2004 and that just over 3 million people died because of HIV.

UNAIDS emphasised the increasing burden of HIV infections in women around the world, and estimated that close to 50% of all HIV infections in adults were in women.

In each region of the world, the HIV epidemic continued to gather pace in 2004, according to UNAIDS, with women and girls often bearing the brunt of new infections.

Current prevention strategies were not protecting women from HIV, said a UNAIDS spokesperson, as they failed to acknowledge the realities of life for most women around the world. Violence and lack of social or economic rights or power meant that strategies emphasising the ‘ABC’ approach - abstinence, be faithful, or condoms - as means of avoiding HIV were just not practicable.

Sub-Saharan Africa

An estimated 25.4 million people are living with HIV in southern Africa, and 3.1 adults and children were newly infected with HIV in the region in 2004. There were 2.3 million deaths due to AIDS in sub-Saharan countries in 2004, and AIDS deaths were now matching the number of new infections in some countries. HIV prevalence in the region was over 7% and eleven countries have a prevalence rate over 10%.

East Asia

Between 2002 and 2004, HIV infections increased in the region by 50%, largely due to the growing epidemics in China, Indonesia and Vietnam. UNAIDS emphasised that this was the fastest growing HIV epidemic in the world and described the situation as “very concerning.”

Eastern Europe

In Russia and Ukraine there has been a rapid expansion in the number of HIV infections, and it is now estimated that 1.4 million people are infected with HIV in Eastern Europe and central Asia. Although HIV was largely confined to injecting drug users, there is now evidence that HIV has spread into the general population. In total, 80% of all HIV infections in the region are in individuals aged under 30 years.

The Caribbean

The Caribbean continues to be the worst effected region of the world outside sub-Saharan Africa with an estimated 2% of the population infected with HIV. AIDS is now the leading cause of death amongst 15-44 year olds in the region.

North America and western Europe

UNAIDS draws attention to statistics suggesting that increasing number of individuals are being infected through heterosexual sex. Amongst African Americans it attributes some of these infections to undisclosed risk behaviour among men, who, although nominally heterosexual, have unprotected sex with other men.

Mention is made of the rapid expansion in the numbers of heterosexuals infected with HIV in western Europe and the UK. The UNAIDS report mentions that this is laregly due to migration into the region by individuals infected with HIV in high prevalence regions, notably southern Africa.

Gay men

Little mention is made in the UNAIDS report about the continuing HIV epidemic amongst gay men. However, a 22% increase in new diagnoses attributable to sex between men in western Europe in 2001-2002 is noted, and this is attributed in part to increased testing, although evidence suggesting an increase in unprotected sex between gay men is mentioned.

Dr Peter Piot, head of UNAIDS said that HIV prevention activities in some countries were still not in step with the reality of the epidemic, adding “men who have sex with men and injecting drug users continue to be neglected. More needs to be done to target them and increase access to prevention programmes for people at high risk of HIV infection.”

Actress speaks of first hand experience to raise awareness of HIV

Actress Emma Thompson spoke at the London launch of the UNAIDS report, and described her HIV awareness work during three trips to Africa and said that sexual violence and lack of economic rights meant the “girls were becoming an endangered species” due to HIV.

aidsmap resources

latest news

• HIV/TB epidemic in Eastern Europe a 'public health disaster'
• Low bone mineral density common in HIV-positive men
• Circumcision may protect HIV-negative gay men from syphilis
• HIV 'exposure' from bite forms basis for terrorism charge in US case
• First hint of a hepatitis C vaccine?
• Pregnancy, not nevirapine cause of liver toxicities in HIV-positive women
• Surviving to die of something else: AIDS is a rare cause of death in old people with HIV
• New EACS guidelines address co-morbidities and diseases of age
• Multiple pregnancies a safe option for women with HIV
• Small case series looks at etravirine during pregnancy