The Global Challenge of HIV and AIDS

By Lamptey, Peter R.; Johnson, Jami L. et al. | Population Bulletin, March 2006 | Go to article overview

The Global Challenge of HIV and AIDS


Lamptey, Peter R., Johnson, Jami L., Khan, Marya, Population Bulletin


The AIDS epidemic may be the most devastating health disaster in human history. The disease continues to ravage families and communities throughout the world. In addition to the 25 million people who had died of AIDS by the end of 2005, at least 40 million people are now living with HIV. An estimated 4.9 million people were newly infected with HIV in 2005-95 percent of them in sub-Saharan Africa, Eastern Europe, or Asia. While some areas have successfully slowed the epidemic, it is surging in others.1

In the most-affected regions, hard-earned improvements in health over the last 50 years have been overwhelmed by death and disability from AIDS. The disease is crippling progress at the personal, family, community, and national levels. In severely affected nations, economic growth and political stability are also threatened.2

Sub-Saharan Africa is the hardest hit region in the world (see Table 1). More Africans die of AIDS-related illness than of any other cause. South Africa has the largest number of people living with HIV-between 4.5 million and 6.2 million. Swaziland has the highest adult HIV prevalence rate: More than 38 percent of adults are infected with HIV.

While the scale and force of the epidemic have hit Africa hardest, other regions also face serious AIDS epidemics (see Figure 1, page 4). HIV prevalence is spreading fastest in Eastern Europe and the former Soviet republics because of increases in injecting drug use and a breakdown in the health care system.

HIV prevalence is also rising rapidly in many parts of eastern and southern Asia. China and India will see millions of additional infections unless they launch effective, large-scale prevention programs.

Countries throughout the industrialized world face serious challenges from AIDS. Infection rates have not declined significantly in Western Europe or North America, where the epidemic has spread from the gay male population to ethnic minorities, the poor, and other marginalized groups.

Globally, the AIDS pandemic shows no sign of slowing, despite concerted efforts to control it and a few success stories. The difficulties in reducing the number of new infections are also compounded by poor access to lifesaving treatment. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that only about 15 percent of the 6.5 million people in developing countries who need treatment have access to antiretroviral drugs.

HIV and AIDS

AIDS, or acquired immunodeficiency syndrome, is caused by the human immunodeficiency virus (HIV), which is spread through blood, semen, vaginal secretions, and breast milk. The most common method of transmission is unprotected sexual intercourse with an HIV-positive partner. Other routes include transfusions of HIV-infected blood or blood products; tissue or organ transplants; use of contaminated needles, syringes, or other skin-piercing equipment; and mother-to-child transmission during pregnancy, birth, or breastfeeding. HIV is extremely fragile. It cannot survive long outside the body's fluids or tissue and it cannot penetrate unbroken skin.3

HIV kills by weakening the body's immune system until it can no longer fight infection. Opportunistic infections are illnesses such as pneumonia, meningitis, some cancers, tuberculosis (TB), or other parasitic, viral, and fungal infections that occur when the immune system is weakened.

HIV generally progresses over a decade before developing into AIDS, but there is a long delay after infection before symptoms become evident. Early HIV-related symptoms include chronic fatigue, diarrhea, fever, weight loss, persistent cough, skin rashes, herpes and other oral infections, swelling of the lymph nodes, and memory loss or other mental changes.

AIDS is almost always fatal without treatment, although a few individuals have survived with AIDS untreated for up to 20 years. Current drug regimens, such as highly active antiretroviral therapy (HAART), slow the virus' replication in the body. …

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