REPORT T

REPORT

June 1998

REPOR

the global on theon global HIV/AIDS epidemic HIV/AIDS epidemic HIV/AIDS epidemi June 1998

WHO Joint United Nations Programme on HIV/AIDS

World Health Organization

Report on the global HIV/AIDS epidemic – June 1998

Table of Contents 6

Global estimates of the HIV/AIDS epidemic as of end 1997

7

HIV and AIDS: the global situation

9

10

Orphans

The evolving picture region by region

10 12 14

Sub-Saharan Africa: the epidemic shifts south Asia: low infection rates but rapid spread Latin America and the Caribbean: most infections are in marginalized groups Eastern Europe: drug injection drives HIV The industrialized world: AIDS is falling North Africa and the Middle East: the great unknown

15 18 19

20

Understanding the epidemic

20 23 24

No simple explanations Understanding behaviour Better tracking of the epidemic

26

Prevention works

31

Preventing sexual transmission of HIV among young people

34

Injecting drug use and HIV

36

Making drug-taking safer

40

Finding out one’s HIV status

42

HIV and mortality

44

Life expectancy

46

Treatment reduces AIDS deaths in countries that can afford it

48

Mother-to-child transmission

48 49

51

The breastfeeding dilemma Encouraging developments in prevention

Improving estimates

51 52 55 56 57

59

The 1994 estimates 1997: more data yield better estimates Estimating HIV and AIDS in an age of therapy A changing picture Using Epidemiological Fact Sheets to improve data collection Annex.

59 63

HIV/AIDS estimates and indicators, end 1997 Notes on specific indicators listed in the tables Tables

Map 3

Report on the global HIV/AIDS epidemic – June 1998

Acknowledgements Surveillance of the global epidemic of HIV/AIDS and sexually transmitted diseases is conducted as a joint effort of UNAIDS and WHO. The preparation of this report would not have been possible without the support and valuable contributions of our colleagues in national AIDS programmes around the world and a large number of individuals and organizations. The following persons are among those who supported this work from the beginning and thus deserve our special gratitude: Carlos Avila, Veronique Batter, Beena Varghese, Tim Brown, Laurence Charton, Pedro Chequer, Jim Chin, Monina Klevens, Karl Dehne, Paul Denning, Geoff Garnett, Simon Gregson, Françoise Hamers, Osamah Hamouda, Irena Klavs, Ryuichi Komatsu, Peter Lamptey, Lalit Nath, Denis Pigot, Karen Stanecki, Silvia Titan, Peter Way, Elizabeth Pisani, Lone Simonsen, John Stover, Daniel Tarantola, Tom Zhuwau

5

Report on the global HIV/AIDS epidemic – June 1998

Global estimates of the HIV/AIDS epidemic as of end 1997 People newly infected with HIV in 1997

Total Adults Women Children