Facts, Figures & Fine Points
HIV/AIDS incidence data in the form of epidemiological facts and figures has become increasingly abundant. A significant portion of this data is collected for and consolidated in the Report on the Global AIDS Epidemic, which has been published every other year by UNAIDS since its founding in 1994. The accuracy of this data and some of the motives pertaining to the UNAIDS style of writing have never been without controversies, but increasingly UNAIDS data is viewed as a reliable baseline from which to begin deeper analyses related to HIV/AIDS. This section of the AARG webpage begins by restating some of the baseline epidemiological data published by UNAIDS. In fact, much of the text that falls under the first three headers below is quoted directly from the UNAIDS report. If you would like to download the UNAIDS report in full click here.
Epidemiological data often conveys only part of the story. Therefore, this section of the AARG webpage also provides a small sample of data concerning the finer points surrounding the presence and persistence of HIV/AIDS. Under the fourth header, AARG is pleased to present an annotated bibliography that UNESCO published and generously shared with AARG. The entries in this bibliography focus on the ways in which HIV/AIDS is intertwined with shifting cultural dynamics. Under the fifth header, AARG is pleased to present links to regionally-based organizational newsletters. These are the publications of organizations working on-the ground, with the articles often highlighting the nuances of regional specificities as well as innovative research methods and thoughtfully developed intervention strategies.
| Sub-Saharan Africa |
This region remains the most heavily affected by HIV, accounting for 67% of all people living with HIV and 75% of AIDS deaths in 2007. However, epidemics vary significantly from country to country in both scale and scope. Adult prevalence rates are below 2% in several Central and West African countries, as well as in the horn of Africa, but in 2007 it exceeded 15% in seven southern African countries (Botswana, Lesotho, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe) and was above 5% in parts of Central and East Africa (Cameroon, the Central African Republic, Gabon, Malawi, Mozambique, Uganda, and Tanzania). Most epidemics in the region appear to have stabilized, although often at very high levels, particularly in southern Africa. Additionally, in a growing number of countries adult prevalence is declining. For the region as a whole, women are disproportionately impacted in comparison with men, with particularly stark differences between the sexes in HIV prevalence among young people. |
| Middle East & North Africa |
Sudan has the highest prevalence rate at 1.4%, believed to be driven largely by unprotected heterosexual sex. In the rest of the region prevalence rates are below 1%. The Islamic Republic of Iran is home to a drug-related epidemic, with HIV prevalence between 15% and 23% documented among male injecting drug users who make use of drop-in or drug-treatment centers in Tehran. Use of contaminated drug injecting equipment and sex work constitute main routes of HIV transmission in much of the region. |
| Asia |
The epidemics in Cambodia, Myanmar, and Thailand all show declines in HIV prevalence, notably prevalence in Cambodia decreased from 2% in 1998 to an estimated 0.09% in 2006. However, epidemics in Indonesia (particularly in its Papua province), Pakistan, and Vietnam are increasing, notably in Vietnam where the estimated number of people living with HIV more than doubled between 2000 and 2005. New HIV infections are also increasing steadily, although at a slower pace, in populous countries such as Bangladesh and China. Injecting drug use, sex work (forced and by choice), unprotected heterosexual sex, and unprotected sex between men are each significantly modes of transmission, making Asia’s epidemic on the world’s most diverse. An increasing number of women are injecting drugs in China, and substantial proportions (about 56% in some cities) also sell sex. Many male injecting drug users also buy sex, and often do not use condoms. HIV prevalence of 38% has been found among sex-trafficked females who have been repatriated to Nepal. In India’s Karnataka State, HIV prevalence of 16% has been found among home-based sex workers, 26% among their street-based peers, and 47% among those working in brothels. Thailand’s epidemic has diminished but has also become more heterogeneous, and HIV is increasingly affecting people traditionally considered to be at lower risk of infection. About 43% of new infections in 2005 were among women, most of whom were infected by husbands of partners who had unprotected sex or had used contaminated injecting equipment. As in most other regions in the world, unprotected sex between men is a potentially significant but an under-researched factor in the HIV epidemics. In Bangkok, HIV prevalence among men who have sex with men rose from 17% in 2003 to 28% in 2005. In China, it has been estimated that up to 7% of HIV infections might be the result of unprotected between men. Male sex workers face a particularly high risk of infection. In Vietnam, one in three (33%) male sex workers recruited from more than 70 sites in Ho Chi Minh City tested HIV-positive. Research has also found high levels of HIV infection among transgender sex workers in Indonesia and Cambodia. |
| Latin America |
Overall levels of infection in this region have changed little in the last decade. Research has uncovered hidden HIV epidemics among men who have sex with men. In city-level research in countries such as Argentina, Bolivia, Columbia, Ecuador, Peru, and Uruguay HIV prevalence rates among men who have sex with men range from 10% to 25%. In Central American countries data indicates that new HIV diagnoses increasingly include a significant number attributable among men who have sex with men (and sometimes with women). Levels of HIV infection among female sex workers tend to be much lower than those among men who have sex with men. |
| Caribbean |
Most of the epidemics in this region appear to have stabilized. In Haiti, which has the biggest epidemic in the region, levels of HIV among pregnant women attending antenatal clinics declined from 5.9% in 1996 to 3.1% in 2004, and has subsequently remained stable. The main mode of HIV transmission is unprotected heterosexual sex, paid or otherwise. However, sex between men is believed to be a factor in transmission, particularly in Cuba, Dominica, the Dominican Republic, Guyana, and Trinidad & Tobago. |
| Eastern Europe & Central Asia |
The HIV epidemic in the Russian Federation (already the largest in the region) continues to grow, although apparently at a slower pace than in Ukraine, where annual new HIV diagnoses have more than doubled since 2001. The annual number of new HIV diagnoses is also rising in Central Asian countries. Injecting drug-use and the overlap with sex work account for the majority of HIV infections. However, as the epidemics in the region evolve, the proportion of women infected with HIV is growing. About 40% of newly registered cases of HIV in the region in 2006 were among women. |
| Western & Central Europe |
New HIV diagnoses in this region are increasing (particularly among men who have sex with men), as is the total number of people living with HIV (the latter likely because of increased access to anti-retroviral treatment). In the region overall, unprotected heterosexual sex accounted for the largest share (42%) of new HIV diagnoses in 2006 (compared with the 29% that were attributed to unprotected sex among men). Unprotected heterosexual sex is the main reported mode of transmission in most countries of Central Europe, except for Estonia, Latvia, Lithuania, and Poland, where the mode is injecting drug use, and Croatia, the Czech Republic, Hungary, and Slovenia, where it is unprotected sex between men. |
| North America |
Annual numbers of new HIV diagnoses have remained relatively stable over recent years, but access to life-prolonging anti-retroviral therapy has led to an increase in the number of people living with HIV. In 2005, about one third (32%) of newly diagnosed HIV infections and AIDS cases in the United States were attributable to high-risk heterosexual sex, as were 33% of new infections in 2006 in Canada. However, a substantial proportion of infections in Canada were among people born in countries with high HIV prevalence (mainly sub-Saharan Africa and the Caribbean). Transmission through use of contaminated injecting equipment accounts for 18% of new HIV diagnoses in the United states and 19% in Canada. A closer look at U.S. Centers for Disease Control and Prevention (CDC) data makes apparent that a significant area of concern in the United States is equitable access to HIV/AIDS prevention, care, and treatment services given that people of color and individuals with lower incomes are disproportionately impacted. Of 38,000 HIV diagnoses made in the United States during 2008, 72% were among people of color. More specifically, 50% were among African Americans and 19% among Latinos; these two segments of the population make up 12% and 15% respectively of the populace overall. |
| Oceania |
Most of the regions epidemics are small, except in Papua New Guinea, where the annual number of new HIV diagnoses more than doubled 2002 and 2006, when 4,017 new HIV cases were reported. Unprotected sex between men is the primary cause of HIV infection in Australia and New Zealand. After declining sharply in the 1990s, new HIV diagnoses in Australia have increased, from 763 reported in 2000 to 998 reported in 2006. |
