The global picture: by the end of 2002, 42 million people were living with HIV/AIDS, including more than three million children under the age of 15. For the first time since the start of the epidemic, half the number of people living with HIV/AIDS were women and girls. In 2002 alone, AIDS killed more than 2.5 million adults and 610,000 children.
Young people, especially girls, have been hardest hit. Half of all new HIV infections – around 6,000 every day – are among young people between the ages of 15 and 25. In sub-Saharan Africa, two girls (aged 15 to 24) are infected for every new infection among boys in the same age group; in the most affected countries, the ratio is five or six girls (aged 15 to 19) for every boy infected in that age group.
Young people offer the greatest hope for defeating the epidemic. In countries like Ethiopia, Uganda, Cambodia, Brazil and Zambia, responses that involved and treated young people as a priority have paid off, with drops of up to a third in prevalence rates.
The impact of HIV/AIDS has been most devastating in sub-Saharan Africa, where nearly 30 million people are infected. In Botswana, South Africa and Zimbabwe, more than 60 per cent of 15-year-old boys today can expect to become infected during their lifetimes. Nine out of ten children living with HIV/AIDS are African.
The Caribbean is the second worst-affected region, with 420,000 infections. The Bahamas, Guyana and Haiti have been hardest hit. Most new infections are being reported among women aged 15 to 24.
Eastern Europe and Central Asia have the fastest growing HIV/AIDS epidemic, fuelled largely by injecting drug use. Almost 80 per cent of new infections registered in the Commonwealth of Independent States between 1997 and 2000 were among people under age 29. Sharing infected needles appears to be the main mode of transmission in these regions, as well as in several countries in the Middle East and North Africa.
In parts of Asia and the Pacific, HIV infections concentrated among injecting drug users and sex workers have moved into the general population. Reported HIV prevalence rates are still relatively low, but both China and India are experiencing serious, localized epidemics that affect millions.
Sexual activity begins in adolescence for the majority of people, many of whom don’t have the facts on prevention. In sub-Saharan Africa, where two girls are infected for every boy, half the teenage girls surveyed did not realize that a healthy looking person could be HIV-positive. In the Ukraine, 39 per cent of teenagers had never heard of AIDS or still believe HIV can be transferred through supernatural means.
Every day, almost 2,000 babies are infected with HIV during pregnancy, at birth or through breastfeeding. Without effective interventions, about one third of infants born to HIV-positive mothers contract the virus. Most of these infants will die before their fifth birthday.
In 2001, at least 15 per cent of children in 10 sub-Saharan countries had lost one or both parents to AIDS or other causes. Children orphaned by HIV/AIDS are more likely to suffer from abuse and exploitation, and are more likely to become infected themselves. Because of the 10-year time lag between infection and death, the number of orphans will continue to rise for at least the next decade.
Increased HIV prevention could save 29 million people from infection by 2010 and bring down HIV infection rates among young people by a quarter. Comprehensive prevention and care programmes in low- and middle-income countries will require US $10.5 billion a year by 2005, rising to US $15 billion a year in 2007. In 2002, they received only US $3 billion.