HIV/AIDS: What do the numbers mean?


HIV and AIDS: What do the decreased numbers mean?

World AIDS Day comes on the eve of efforts by leaders in the U.S. Congress to make much-needed changes in U.S. global AIDS policy. In the last few months, news stories have focused on dramatic new evidence regarding the numbers of those infected with or affected by HIV and AIDS.

Fighting the spread of HIV and meeting the needs of those living with or affected by HIV/AIDS has been a central priority for AJWS for many years, through our grantmaking, our public education and our advocacy on U.S. and global policies. AJWS is also taking leadership to shape effective changes in U.S. and international AIDS policy.

What do the numbers say?

In the last month, estimates by the Joint UN Programme on HIV/AIDS (UNAIDS) indicated a marked downward shift in the numbers of those affected by HIV and AIDS worldwide. The latest estimates, for example, put the number of those infected with HIV at 33 million worldwide, down from an estimated 40 million in previous data.

Similarly, new data indicate that there are roughly 2.5 million new HIV infections worldwide each year, down from the previous estimate of 4.5 million new infections annually. Large shifts in the global data were affected by far more accurate data collection in countries with large populations, such as India, Nigeria, and South Africa.

Is the problem solved?

No. Reduced numbers are not a reason to lessen the focus on HIV/AIDS as one of the most devastating pandemics in the 21st century. Sub-Saharan Africa remains deeply affected by HIV and AIDS. It is the region with the single largest number of cases of those suffering from AIDS-related illnesses. Moreover, AIDS is closely related to vulnerability to tuberculosis and malaria, two other leading killers, especially in sub-Saharan Africa.

HIV is spreading most rapidly among those who are socially, economically and politically most vulnerable, including intravenous drug users, sex workers, women and girls, and other vulnerable populations. Unprotected sexual intercourse is now the single biggest cause of the spread of HIV worldwide and is responsible for 80 percent of new infections in sub-Saharan Africa. Women often have little power to determine when and whom they marry, or when and with whom they have sex.

Declining global investments in, and low rates of access to, basic reproductive and sexual health services leave women at risk of unprotected sex, unplanned pregnancies, unsafe abortions and sexually transmitted infections. Increasingly, poverty drives women to exchange sex for food, clothing, school fees or money for rent.

Not surprisingly, the highest rates of new infections in many countries are among women and adolescent girls. In Kenya, for example, one study found that older adolescent girls ages 15 to 18 were four times more likely than their male counterparts to be infected with HIV.

These and other concerns—such as the continued gap between those who need access to antiretroviral therapy to survive AIDS-related illnesses and those who have it—mean that the work to combat AIDS worldwide is far from over.

What should we do?

The U.S. Congress will soon begin considering necessary changes in the U.S. Global Leadership on AIDS, Tuberculosis and Malaria Act of 2003, and may consider authorizing as much as $50 billion on global AIDS programs.

AJWS is working strenuously to ensure that any and all U.S. funds allocated for global AIDS programs are spent on efforts that are evidenced-based, promote human rights, prevent the greatest number of new infections possible and ensure universal access to prevention, treatment and care.

For example, AJWS is seeking to remove restrictions, such as those that require that at least a third of all US funds spent on prevention go to abstinence-until-marriage programs, because such programs have now been shown to be ineffective by several large-scale studies and by analyses conducted by the U.S. Government Accountability Office and the Institute of Medicine. Similarly, AJWS is seeking to remove restrictions on safe needle exchange, remove the so-called "prostitution pledge," and ensure purchase of generic drugs to treat the greatest number possible of those in need.

But we need your help. When Congress reconvenes in January, these and other needed changes in U.S. global AIDS policies will require the support of constituents throughout the United States. We hope you will partner with us in this effort.