2009 AIDS epidemic update Global summary of the AIDS epidemic December 2008 Number of people living with HIV in 2008 People newly infected with HIV in 2008 AIDS-related deaths in 2008 Total33.4 million [31.1 – 35.8 million] Adults31.3 million [29.2 – 33.7 million] Women 15.7 million [14.2 – 17.2 million] Children under 15 years2.1 million [1.2 – 2.9 million] Total2.7 million [2.4 – 3.0 million] Adults2.3 million [2.0 – 2.5 million] Children under 15 years [ – ] Total2.0 million [1.7 – 2.4 million] Adults1.7 million [1.4 – 2.1 million] Children under 15 years [ – ] The ranges around the estimates in this table define the boundaries within which the actual numbers lie, based on the best available information.

2009 AIDS epidemic update Global estimates 1990–2008 EstimateHigh and low estimates Number of people living with HIVAdult (15–49) HIV prevalence (%) Number of people newly infected with HIVNumber of adult and child deaths due to AIDS Number (millions) Number (millions) Number (millions) 44 Figure I Source: UNAIDS/WHO %

2009 AIDS epidemic update

Estimate of the annual number of infant infections averted through the provision of antiretroviral prophylaxis to HIV-positive pregnant women, globally, 1996– Infant infections averted Figure II

2009 AIDS epidemic update No prevention of mother-to-child transmission At current levels of antiretroviral prophylaxis Estimated number of new child infections at current levels of antiretroviral prophylaxis and without antiretroviral prophylaxis, globally, 1996– Figure III

2009 AIDS epidemic update

Estimated number of AIDS-related deaths with and without antiretroviral therapy, globally, 1996–2008 Figure V Number (millions) Year No antiretroviral therapy At current levels of antiretroviral therapy

2009 AIDS epidemic update Estimated number of AIDS-related deaths with and without antiretroviral therapy, by region, 1996–2008 AsiaCaribbeanEastern Europe and Central Asia Latin AmericaMiddle East and North AfricaSub-Saharan Africa (thousands) (millions) (thousands) Figure VI No antiretroviral therapyAt current levels of antiretroviral therapy

2009 AIDS epidemic update Estimated number of Life-years added due to antiretroviral therapy, by region, 1996– (millions) 2 1 Sub- Saharan Africa AsiaCaribbeanMiddle East and North Africa Western Europe and North America Latin America Eastern Europe and Central Asia Oceania 0 Figure VII 7.2 million 2.3 million 1.4 million

2009 AIDS epidemic update

Sub-Saharan Africa Number of people living with HIV Number of new infections Number of children newly infected Number of AIDS-related deaths million [20.8 million–24.1 million] 19.7 million [18.3 million–21.2 million] 1.9 million [1.6 million–2.2 million] 2.3 million [2.0 million–2.5 million] [ – ] [ – ] 1.4 million [1.1 million–1.7 million] 1.4 million [1.2 million–1.7 million]

2009 AIDS epidemic update Sub-Saharan Africa estimates 1990–2008 Number of people living with HIVAdult (15–49) HIV prevalence (%) Number of people newly infected with HIVNumber of adult and child deaths due to AIDS Figure 1 EstimateHigh and low estimates Number (millions) % Number (millions) Number(millions) Source: UNAIDS/WHO

2009 AIDS epidemic update

Distribution of new infections by mode of exposure in Ghana and Swaziland, 2008 Sources: Bosu et al. (2009) and Mngadi et al. (2009). Figure No risk Medical injections Blood transfusions Injecting drug use (IDU) Partners IDU Sex workers Clients Partners of Clients Men who have sex with men (MSM) Female partners of MSM Engaged in casual sex (CS) Partners of CS Low-risk heterosexual % GhanaSwaziland 1Swaziland 2 Note: sensitivity analysis for Swaziland used different data sources.

2009 AIDS epidemic update HIV prevalence among antenatal clinic clients in Swaziland, 1992–2008 Source: Ministry of Health and Social Welfare (2009). Figure HIV prevalence (%) 0

2009 AIDS epidemic update Age at first sexual intercourse by education status in Swaziland, 2007 Sources: Central Statistical Office & Macro International (2008). Figure Women < 15 yrs Women < 18 yrs Men < 15 yrs Men < 18 yrs No education Lower primary Higher primary Secondary High School Tertiary %

2009 AIDS epidemic update Source: Smith et al. (2009), Baral et al. (2009), and Sanders et al. (2007) HIV prevalence among men who have sex with men in countries in sub-Saharan Africa, 2002–2008 Figure 6 BotswanaMalawiNamibiaSouth Africa 1 ZambiaKenya 2UR Tanzania NigeriaSenegal HIV prevalence (%) Southern AfricaEast AfricaWest Africa South Africa 2 Kenya 1

2009 AIDS epidemic update Asia Number of people living with HIV Number of new infections Number of children newly infected Number of AIDS-related deaths million [3.8 million–5.5 million] 4.5 million [3.8 million–5.2 million] [ – ] [ – ] [13 000–29 000] [18 000–49 000] [ – ] [ – ]

2009 AIDS epidemic update

Vulnerability to sexual HIV transmission in commercial sex in Karachi and Lahore, Pakistan Source: Bokhari et al. (2007). Figure 9 Has never heard of HIV/AIDS Does not know that condoms can prevent transmission of HIV No perceived HIV risk Per cent Female sex workers (FSWs) Male clients of FSWs Male sex workers Hijras

2009 AIDS epidemic update Saturating prevention coverage through complementary programming. Avahan has achieved a high coverage of target populations (routine programme monitoring data) Source: Avahan and State AIDS Control Society programme data (2008). Figure 10 Tamil Nadu* est. Maharashtra est. Andhra Pradesh est. Karnataka est. Injecting drug users Nagaland est. Manipur est. 49%26%24% 36%64% 76%5%19% 70%14%15% 26%22%53% 26%12%62% 36%26%38% 74%26% 61%11%29% 58%20%22% Tamil Nadu* est. Maharashtra est. Andhra Pradesh est. Karnataka est. Female sex workers High Risk – Men who have sex with men Percent of Mapped Urban Key Population covered** Government of India and OthersAvahanUncovered Percentages indicate intended coverage through establishment of services in specific geographic areas. * Includes districts with no intended coverage. ** Mapping and size estimation quality varies by state. Does not include rural areas

2009 AIDS epidemic update Comparison of the incidence of syphilis in China reported from 26 sentinel sites and from the nationwide sexually transmitted disease surveillance system Source: Chen et al. (2007). Figure 11 Reported incidence of total syphilis from sentinel sites Reported incidence of total syphilis from the nationwide sexually transmitted disease surveillance system Incidence (per )

2009 AIDS epidemic update Trends in HIV, hepatitis B, hepatitis C and syphilis in men who have sex with men in Beijing in 2004, 2005 and 2006 Source: Ma et al. (2007). Figure HIV Hepatitis B Hepatitis C Prevalence (%) Syphilis

2009 AIDS epidemic update Eastern Europe and Central Asia Number of people living with HIV Number of new infections Number of children newly infected Number of AIDS-related deaths million [1.4 million–1.7 million] [ –1.1 million] [ – ] [ – ] 3700 [1700–6000] 3000 [1600–4300] [72 000– ] [22 000–30 000]

2009 AIDS epidemic update

HIV cases per million population in the WHO Eastern Europe region by year of notification, 2000–2007 Source: Van de Laar et al. (2008). Figure HIV cases per million population Note: Data from Russian Federation not included.

2009 AIDS epidemic update Caribbean Number of people living with HIV Number of new infections Number of children newly infected Number of AIDS-related deaths [ – ] [ – ] – [17 000–24 000] 2300 [1400–3400] 2800 [1700–4000] [9300–14 000] [17 000–23 000]

2009 AIDS epidemic update

HIV prevalence trends among young people (aged 15–24) in the Dominican Republic, 1991–2007 Source: Halperin, et al (2009). Figure HIV prevalence (%) Women in population-based survey Pregnant women at La Altagracia Hospital, Santo Domingo Men in population-based survey

2009 AIDS epidemic update Latin America Number of people living with HIV Number of new infections Number of children newly infected Number of AIDS-related deaths million [1.8 million–2.2 million] 1.6 million [1.5 million–1.8 million] [ – ] [ – ] 6900 [4200–9700] 6200 [3800–9100] [66 000–89 000] [56 000–77 000]

2009 AIDS epidemic update

Distribution of HIV incidence by mode of exposure in Peru: estimate for 2010 Source: Alarcón Villaverde (2009). Figure % 6.30% 6.22% 5.54% 1.98% 1.33% 0.89% 0.23% 0.22% 0.0% 54.97% Without risk Blood transfusions Partners (injecting drug users) Medical injections Female sex workers Clients of female sex workers Injecting drug users Partners (casual heterosexual sex) Female partners of men who have sex with men Casual heterosexual sex Partners of clients of female sex workers Low-risk heterosexual Men who have sex with men % Risk groups

2009 AIDS epidemic update Estimated HIV-1 seroprevalence and 95% confidence interval for HIV among men who have sex with men and female sex workers by country Source: Soto et al. (2007). Figure 19 0 El SalvadorGuatemalaHondurasNicaraguaPanamaAll countries HIV seroprevalence (%) n: Men who have sex with men Female sex workers

2009 AIDS epidemic update Condom use among female sex workers who attend VICITS (Vigilancia Centinela de ITS) in Tegucigalpa, San Pedro Sula and La Ceiba, Honduras, in 2008 Source: Secretaria de Salud Honduras (2008). Figure % 40.7% 96.7% With clientsWith casual partners With regular partners Condom use % (n= 463)

2009 AIDS epidemic update North America and Western and Central Europe Number of people living with HIV Number of new infections Number of children newly infected Number of AIDS-related deaths million [1.9 million–2.6 million] 1.9 million [1.7 million–2.1 million] [49 000–97 000] [76 000– ] <500 [<200–<500] <500 [<200–<500] [27 000–61 000] [18 000–42 000]

2009 AIDS epidemic update North America and Western and Central Europe estimates 1990–2008 Number of people living with HIVAdult (15–49) HIV prevalence (%) Number (millions) Figure 21 EstimateHigh and low estimates Source: UNAIDS/WHO %

2009 AIDS epidemic update Yearly number of new HIV and AIDS cases and related deaths in Switzerland, 1995–2008 Source: Federal Office of Public Health (2009). Figure HIVDeath with AIDS AIDS casesDeath without AIDS Number of people

2009 AIDS epidemic update Estimated new HIV infections by transmission category, extended back calculation model, 50 US states and the District of Columbia, 1977–2006 Source: Hall et al. (2008a) Infections Period Men who have sex with men (MSM) Injecting drug use (IDU) MSM / IDU Heterosexual Figure 23 Tick marks denote the beginning and end of a year. The model specified periods within which the number of HIV infections was assumed to be approximately constant.

2009 AIDS epidemic update Middle East and North Africa Number of people living with HIV Number of new infections Number of children newly infected Number of AIDS-related deaths [ – ] [ – ] – [23 000–40 000] 4600 [2300–7500] 3800 [1900–6400] [15 000–25 000] [7800–14 000]

2009 AIDS epidemic update

Percentage of condom use as reported by street children, male injecting drug users, female sex workers and men who have sex with men in Egypt Source: Shawky et al. (2009). Figure % 6.8% 11.8% 13.0% 12.0% Street boysStreet girlsMale injecting drug users Female sex workers Men who have sex with men % At least once in 12 months prior to surveyLast practice

2009 AIDS epidemic update Oceania Number of people living with HIV Number of new infections Number of children newly infected Number of AIDS-related deaths [51 000–68 000] [29 000–45 000] – [4800–7300] <500 [<500–<1000] <500 [<200–<500] 2000 [1100–3100] <1000 [<5000–1200]

2009 AIDS epidemic update

Proportion of all HIV and AIDS cases in different Pacific island countries and territories, 1984–2007 Sources: The Secretariat of the Pacific Community and the Papua New Guinea Department of Health. French Polynesia 1.1% New Caledonia 1.2% All others 0.8% Guam 0.8% Fiji 1.1% Papua New Guinea 95.0% Figure 27

2009 AIDS epidemic update Annual newly diagnosed HIV infections in Australia, 1999–2008 Source: National Centre in HIV Epidemiology and Clinical Research (2009). Figure Number of people 1999

2009 AIDS epidemic update HIV infections detected in Papua New Guinea, by age, 1987–2006 Source: Papua New Guinea National AIDS Council and Department of Health. Figure Over 60Unknown MaleFemaleSex not Stated Number Age group