According to estimates from the UNAIDS 2009 AIDS Epidemic Update, approximately 31.3 million adults and 2.1 million children worldwide were living with HIV at the end of 2008. During 2008 alone, some 2.7 million people became infected with the virus, and another 2 million died from AIDS. The number of AIDS-related deaths across the globe peaked around 2004 and has declined slightly since then. Below is an overview of the current incidence and death toll of HIV/AIDS in various regions around the world.
It is in Africa, in some of the poorest countries on earth, that the impact of HIV has been most severe. At the end of 2007, there were nine nations on the African continent where more than one-tenth of the adult population aged 15-49 was infected with HIV. In three countries, all situated in the southern cone of the continent, at least one adult in five is currently living with the virus. In Botswana, for instance, the infection rate among adults is 23.9%; in South Africa, 18.1%. With a total of approximately 5.7 million infected, South Africa has more people living with HIV than any other country in the world.
Throughout sub-Saharan Africa, an estimated 1.9 million people became newly infected with HIV in 2007, bringing the region's total infected population to an estimated 22 million. In this part of the world, women are disproportionately at risk.
Although West Africa is less affected by HIV infection, the prevalence in some large countries is gradually rising. The Ivory Coast, for instance, is already among the fourteen most-affected countries in the world, and in Nigeria some 2.6 million adults and children are living with HIV.
Infection rates in East Africa, once the highest on the continent, hover above those in the West but have been exceeded by the rates now seen in the southern cone. In 2007, HIV prevalence among adults in Kenya, Tanzania, and Uganda topped 5%.
Not all African countries have experienced an increase in the incidence of HIV in recent years. In Uganda, for example, the estimated prevalence of infection fell to around 5% from a peak of about 15% in the early 1990s. This trend is thought to have resulted, at least in part, from strong prevention campaigns. There are encouraging signs of the same trend taking place in parts of Zambia, Kenya and Zimbabwe.
North Africa and the Middle East:
The latest UNAIDS estimates indicate that 35,000 people in North Africa and the Middle East acquired HIV in 2008, bringing the total number of infected people living in the region to an estimated 310,000.
Half of the world's population lives in Asia, so even small differences in the infection rates can mean huge increases in the absolute number of people infected. The total number of people living with HIV across the continent is thought to be approximately 4.7 million. Approximately half (2.4 million) of these cases are in India. Other large epidemics exist in China (700,000), Thailand (610,000) and Myanmar (240,000).
In most Asian countries the AIDS epidemic is centred among particular high-risk groups, particularly men who have sex with men, injecting drug users, and sex workers and their partners. However, the epidemic has recently begun to spread beyond these groups and into the wider population.
Some Asian countries, such as Thailand, have responded rapidly to the epidemic with extensive campaigns to educate the public and prevent the spread of HIV -- and have succeeded in cutting infection rates. Other very populous regions, such as China, have only recently admitted that the spread of HIV threatens their populations, and as a result their prevention work is lagging behind the spread of the virus.
The epidemic in Asia has ample room for growth. The sex trade and the use of illicit drugs are extensive, as are migration and mobility within and across borders. The fluidity in international markets and especially the lack of economic stability on the continent has spawned a great deal of migration, both within individual countries and across national borders, facilitating the spread of HIV. India, China, Thailand and Cambodia, to name only a few, have highly mobile populations within their borders, with people moving from state to state and from rural to urban areas. In China, permanent and temporary migrants may total as many as 120 million people.
Eastern Europe and Central Asia:
The AIDS epidemic in Eastern Europe and Central Asia is rapidly increasing, due largely to high rates of injecting drug use and needle sharing. In 2008, some 1.5 million people in these regions were living with HIV, compared to 900,000 in 2001. In addition, AIDS claimed an estimated 87,000 lives there during 2008, more than three times the corresponding figure for 2001. The Russian Federation (with 940,000 HIV-infected people as of 2007), Ukraine, and the Baltic states (Estonia, Latvia, and Lithuania) have been the worst-affected areas. HIV also continues to spread in Belarus, Moldova and Kazakhstan, and more recent epidemics are emerging in Kyrgyzstan and Uzbekistan.
HIV is ravaging the populations of several Caribbean island states. Indeed, some have worse epidemics than any other country in the world outside of sub-Saharan Africa. In the most affected countries of the Caribbean, the spread of HIV infection is driven chiefly by unprotected sex between men and women, although infections associated with injecting drug use are common in some places, such as Puerto Rico.
The Bahamas is the worst-affected nation in the region, with an HIV infection rate among adults of 3%. Haiti has also been hard hit, with an infection rate of 2.2%. HIV transmission in Haiti is overwhelmingly heterosexual, and both infection and death are concentrated in young adults. Many tens of thousands of Haitian children have lost one or both of their parents to AIDS.
On the Caribbean coast of South America, Suriname and Guyana had an adult HIV prevalence of 2.4% and 2.5%, respectively, at the end of 2007.
The heterosexual epidemics of HIV infection in the Caribbean are driven by the combination of early sexual activity and frequent partner exchange by young people. A study conducted in Barbados found that one quarter of 15-29 year old women said they had been sexually active by the age of 15, and almost one in three men aged 15-29 years reported having had multiple sexual partnerships during the previous year.
Approximately 2 million people were living with HIV in Latin America at the end of 2008. During that year, some 77,000 people in the region died of AIDS, while an estimated 170,000 were newly infected. The HIV epidemics in Latin America are fueled by varying combinations of unsafe sex (both heterosexual and homosexual) and injecting drug use. In nearly all countries, the highest rates of HIV infection are found among men who have sex with men, and the second highest rates are found among female sex workers.
The Central American nation of Belize has a well-established HIV epidemic, with the infection rate among adults exceeding 2%. The virus is mainly spread through unprotected sex, particularly commercial sex, as well as sex between men.
Brazil has an adult HIV prevalence of 0.6%. Because of its large overall population, this country accounts for nearly half of all people living with HIV in Latin America. Heterosexual transmission, injecting drug use, and sex between men account for roughly equal numbers of infections nationwide.
In Argentina, HIV was initially seen as a disease of male injecting drug users and men who have sex with men. Now the virus is spread mostly through heterosexual intercourse and is affecting a rising number of women. The other Andean countries are currently among those least affected by HIV.
Adapted from "AIDS & HIV Around the World," by Avert.org