Aids pandemic gains renewed strength
Pastor Dale Morgan
Aids pandemic gains renewed strength*
· Report highlights reversal of prevention in Uganda
· Improvement in Europe and US 'not sustained'
Sarah Boseley, health editor
Wednesday November 22, 2006
The Guardian
The spread of the HIV/Aids pandemic continues unabated, with the number
of people infected rising once more in some countries which had been
thought to be beating the disease, according to the UN.
There are now 39.5 million living with HIV infection, according to the
annual UNAIDS report, released ahead of World Aids Day on December 1,
and 4.3 million of those were infected in 2006. That is 400,000 more
than were infected in 2004.
Most alarming is the increased prevalence in Uganda, long held up as a
showcase to the world of what could be achieved in Africa with
campaigning, education and widespread condom use. The report shows a
rise from a low of 5.6% infection among men and 6.9% among women in 2000
to 6.5% in men and 8.8% in women in 2004.
The reasons for the increase are not clear, but there has been a shift
in the message from Uganda's leadership. Between the early 1990s and
early 2000s, HIV prevalence fell sharply in major cities among pregnant
women - the group most commonly monitored because they have contact with
health services - as President Yoweri Museveni worked to raise awareness
of the dangers of HIV and put the authority of his office behind condom use.
But in recent years the message on condoms has been diluted in favour of
greater emphasis on sexual abstinence until marriage - in line with the
thinking of the Bush administration, which is spending millions of
dollars on HIV prevention and treatment. Critics say many women are not
in a position to abstain from sex and that many are infected by their
husbands.
The report says further research is needed to validate the apparent
trend "but the current findings do hint at the possible erosion of the
gains Uganda made against Aids in the 1990s". There is evidence of
erratic condom use and more men having sex with multiple partners.
In Mali also the epidemic could be growing after remaining stable for
some years, with HIV prevalence among pregnant women rising from 3.3% in
2002 to 4.1% in 2005. While Kenya's epidemic is in decline, the report
says there are suggestions that this could be because of the high death
rate and "the saturation of infection among people most at risk".
In North America and western Europe also, the gains made by programmes
aimed at preventing infection have not been maintained. The number of
infections in the US, with a far greater proportion in African-Americans
and Hispanics, is stable but not declining. In the UK, there is a steady
rise.
In western Europe, says the report, "the largest increases have been
reported in the UK, where HIV remains one of the principal communicable
disease threats". New diagnoses are increasing in areas other than
London, which has the most cases. Most of those with HIV were infected
in sub-Saharan Africa. Fear of stigma and discrimination is discouraging
Africans in the UK from being tested, says the UN.
Peter Piot, UNAIDS's executive director, was concerned by the trends.
"This is worrying - as we know increased HIV prevention programmes in
these countries have shown progress in the past, Uganda being a prime
example ... Countries are not moving at the same speed as their epidemics."