'Significant declines' reported in the global AIDS epidemic

23 November 2010

Source: UNAIDS

At least 56 countries have either stabilized or achieved significant declines in rates of new HIV infections, marking the beginning of a reversal in the global AIDS, according to a new UNAIDS report.

Promising signs

New HIV infections have fallen by nearly 20% in the last 10 years and AIDS-related deaths are down by nearly 20% in the last five years. Together, this is contributing to the stabilization of the total number of people living with HIV in the world.

"We are breaking the trajectory of the AIDS epidemic with bold actions and smart choices," said Mr Michel Sidibé, Executive Director of UNAIDS. "Investments in the AIDS response are paying off, but gains are fragile-the challenge now is how we can all work to accelerate progress."

Prevention is working

The report, which contains data from 183 countries, gives new evidence that investments in HIV prevention programming are producing significant results in many of the highest burden countries.

From 2001 to 2009, the rate of new HIV infections stabilized or decreased by more than 25% in at least 56 countries around the world, including 34 countries in sub-Saharan Africa. Of the five countries with the largest epidemics in the region, four countries-Ethiopia, South Africa, Zambia and Zimbabwe-have reduced rates of new HIV infections by more than 25%, while Nigeria's epidemic has stabilized.

Sub-Saharan Africa continues to be the region most affected by the epidemic with 69% of all new HIV infections. In seven countries, mostly in Eastern Europe and Central Asia, new HIV infection rates have increased by 25%.

Among young people in 15 of the most severely affected countries, the rate of new HIV infections has fallen by more than 25%, led by young people adopting safer sexual practices. Condom use and availability have also increased significantly.

New HIV infections slowing but still outpace treatment success by 2:1

Even though the number of new HIV infections is decreasing, there are two new HIV infections for every one person starting HIV treatment.

Investments in HIV prevention programmes as whole have not been adequate or efficiently allocated. HIV prevention investments comprise about 22% of all AIDS-related spending in low- and middle-income countries.

Human rights are part of AIDS strategies but not fully implemented

The report also contains new data which shows that human rights efforts are increasingly being integrated into national AIDS strategies, with 89% of countries explicitly acknowledging or addressing human rights in their AIDS strategies and 91% having programmes in place to reduce stigma and discrimination. However, punitive laws continue to hamper access to AIDS-related services-79 countries worldwide criminalize same sex relations and six apply the death penalty. In the Asia-Pacific region, 90% of countries have laws which obstruct the rights of people living with HIV.

A sharper focus on gender equality is needed

Levels of new HIV infections in sub-Saharan Africa continue to remain higher among women. 80% of all women in the world living with HIV live in this region. In other regions, men are more likely to be infected with HIV than women, often in concentrated epidemics involving men who have sex with men or people who inject drugs.

Efforts to promote universal access to HIV prevention, treatment, care and support services require a sharper focus on women and girls. Fewer than half of countries report having a specific budget for HIV-related programmes addressing women and girls. Despite evidence that beneficial behaviour change can be achieved, few HIV programmes engage men and boys.

Resource demand outstripping supply and the need for integrated services

UNAIDS estimates that a total of US$ 15.9 billion was available for the AIDS response in 2009, US$ 10 billion short of what is needed in 2010 and funding from international sources appears to be reducing. At the same time, international investment in sexual and reproductive health services is vastly insignificant, and contributes to the great unmet need for family planning, with implications for the AIDS epidemic.

The report highlights that strengthening family planning services and the delivery of maternal, newborn and child health care would produce better outcomes for both mothers and babies affected by HIV. Ensuring that all people living with HIV have access to integrated quality HIV and sexual and reproductive health services will also help them to exercise their rights and overcome AIDS-related stigma and discrimination.

The full report from UNAIDS is available here.