HIV rate plummets by 26%

The number of children in the world infected with HIV decreased by more than a quarter (26 percent) between 2009 and 2011, but more than 90 percent of the 3.4 million children living with HIV are in sub-Saharan Africa.

Released yesterday, the annual UNAIDS report revealed that there were 34.2m people living with HIV in 2011, more than ever before, which they ascribed to the life-prolonging effects of antiretroviral (ART) therapy. An estimated 23.5m of these people were living in sub-Saharan Africa, including 3.1m children. UNAIDS reported other achievements, including:

• An increase of 20 percent in just one year of people accessing ART (8 million);
• A 20 percent reduction in the number of people newly infected with HIV (2.5m);
• A 24 percent decline since the peak in 2005 in the number of people who died from Aids related causes in 2011 (1.7m).
• Tuberculosis remained the leading cause of death among people living with HIV, despite it being preventable and curable.
• Young people aged 15-24 accounted for almost half (40 percent) of new infections. 
• Globally, infection rates in young women 15 to 24 years old are twice as high as among men of the same age, with a young woman acquiring HIV infection every minute.

There is agreement that this is mainly due to their lower economic and sociocultural status in many countries, where women and girls are disadvantaged in negotiating safer sex and accessing HIV-prevention information and services. A failure by many countries to implement and scale up some of the basic programmes that aim to reduce HIV transmission was cited for the high rates of infection among those 15 to 24.

 These programmes include voluntary medical male circumcision, behavioural change programmes, condom promotion, and key programmes for those populations at higher risk of HIV infection such as teenagers, men who have sex with men and injecting drug users. Some achievements were also reported in sub-Saharan Africa, where nearly 6.2 million people are receiving ART, up from just 100,000 in 2003.

The most dramatic progress was in SA, Zimbabwe and Kenya. In 2011, at least 300,000 people in SA enrolled in treatment. The report cautions that as more people start ART, concerns are growing about the possible increase in HIV drug resistance. Low to moderate levels of transmitted drug resistance have been observed - increasing from one percent in 2005 to three percent in 2010. Recent surveys reported that among those initiating treatment in low- and middle-income countries, about five percent had drug resistance.

SA is listed in the report as one of eight countries showing a rapid decline in new HIV infections among children - 49 percent. Most adult HIV infections in sub-Saharan Africa resulted from unprotected sexual intercourse, including paid sex and sex between men. The report also makes a case for treatment interventions to become increasingly community-based. A systematic review of treatment programmes in sub-Saharan Africa reported that on average 70 percent of people receiving ART from specialist clinics were still receiving treatment after two years. On the other hand, a Community ART Group model initiated by people receiving ART in Mozambique resulted in 97.5 percent still receiving treatment after 26 months.

Anso Thom: Health-e News Service, 18 July 2012