The HIV/AIDS Epidemic © 2000 John B. Pryor Illinois State University

AIDS -  Acquired  Immune  Deficiency  Syndrome HIV -  Human  Immunodeficiency  Virus

Ways HIV is Transmitted: 1) through unprotected sexual intercourse 2) through sharing needles 3) through exposure to contaminated blood 4) perinatal exposure 5) mother’s milk

Ways you cannot transmit HIV: 1) mosquito bites 2) casual contact 3) toilet seats 4) sharing food

Natural History of HIV/AIDS HIVInfection 3-6 Weeks AcuteHIVSyndrome 6 Months Positive HIV Test 9.8 Years 14.8 Years ClinicalAIDS Death May be extended by new drug therapies

Opportunistic Disease - Karposa Sarcoma lesions

HIV/AIDS Global Trends

Adult prevalence % 15.0% − 39.0% 5.0% − 15.0% 1.0% − 5.0% 0.5% − 1.0% 0.1%− 0.5% 0.0% − 0.1% not available HIV prevalence in adults, end million people [range: million] living with HIV as of end 2003

North Africa & Middle East 1% High-income countries 2% Latin America & Caribbean 7% Eastern Europe & Central Asia 6% Asia 22% Sub-Saharan Africa 62 % Total: 10 million Source: UNAIDS/UNICEF/WHO, 2004 Young people (15−24 years old) living with HIV, by region, end Report on the Global AIDS Epidemic (Fig 30)

400,000 people on treatment: 7% coverage % Source: UNAIDS/WHO, 2004 Antiretroviral therapy coverage for adults, end 2003 AfricaAsiaLatin America and the Caribbean Eastern Europe and Central Asia North Africa and Middle East 2004 Report on the Global AIDS Epidemic (Fig 33)

0 5,000 10,000 15,000 20, Latin America and the Caribbean Eastern Europe and Central Asia North Africa and Middle East East Asia and the Pacific South and South-East Asia Sub-Saharan Africa Source: UNAIDS, 2004 Projected annual HIV and AIDS financing needs by region, 2004 − 2007 (in US$ million) US$ millions 2004 Report on the Global AIDS Epidemic (Fig 35)

HIV/AIDS Global Trends in Children

Central Africa Eastern Africa Southern Africa Western Africa Number of orphans (millions) REGIONS Orphans per region within sub-Saharan Africa, end 2003 Source: UNAIDS, Report on the Global AIDS Epidemic (Fig 15)

Growing role of grandparents Relationships of double orphans and single orphans (not living with surviving parent) to head of household, Namibia, 1992 and Grandchild 61% Adopted/foster-child 5% Not related 6% Son/daughter-in-law 3% Brother/sister 4% Other Relative 21% 1992 Adopted/foster-child 1% Not related 11% Son/daughter-in-law 3% Brother/sister 2% Source: UNICEF-MICS, Measure DHS, 1992 and Grandchild 44% Other Relative 39% 2004 Report on the Global AIDS Epidemic (Fig 16)

HIV/AIDS Trends in Africa

Spread of HIV in sub-Saharan Africa, 1987 Estimated percentage of adults (15–49) infected with HIV Estimated percentage of adults (15–49) infected with HIV 16.0% – 32.0% 8.0% – 16.0% 8.0% – 16.0% 2.0% – 8.0% 2.0% – 8.0% 0.5% – 2.0% 0.5% – 2.0% 0% – 0.5% 0% – 0.5% trend data unavailable outside region 16.0% – 32.0% 8.0% – 16.0% 8.0% – 16.0% 2.0% – 8.0% 2.0% – 8.0% 0.5% – 2.0% 0.5% – 2.0% 0% – 0.5% 0% – 0.5% trend data unavailable outside region World Health Organization World Health Organization UNAIDS–Addis–May 1999

Spread of HIV in sub-Saharan Africa, 1997 Estimated percentage of adults (15–49) infected with HIV Estimated percentage of adults (15–49) infected with HIV 16.0% – 32.0% 8.0% – 16.0% 8.0% – 16.0% 2.0% – 8.0% 2.0% – 8.0% 0.5% – 2.0% 0.5% – 2.0% 0% – 0.5% 0% – 0.5% trend data unavailable outside region 16.0% – 32.0% 8.0% – 16.0% 8.0% – 16.0% 2.0% – 8.0% 2.0% – 8.0% 0.5% – 2.0% 0.5% – 2.0% 0% – 0.5% 0% – 0.5% trend data unavailable outside region World Health Organization World Health Organization UNAIDS–Addis–May 1999

Life expectancy at birth in selected most affected countries, 1980 − 1985 to 2005 − 2010 Source: UN Population Division, World Population Prospects: the 2002 Revision 2004 Report on the Global AIDS Epidemic (Fig 12) Years Botswana South Africa Swaziland Zambia Zimbabwe

HIV/AIDS Trends in

Newly diagnosed HIV infections per million population in Eastern European and Central Asian countries, 1996—2003 Source: (1) HIV /AIDS Surveillance in Europe, EuroHIV mid-year report 2003, no. 69. (2) AIDS Foundation East West ,000 1, New HIV infection per million population Estonia Russian Federation Ukraine Belarus Moldova, Republic of Latvia Kazakhstan Uzbekistan Kyrgyzstan 2004 Report on the Global AIDS Epidemic (Fig 9)