Business Day (Johannesburg)

24 November 2004

African Women Most Vulnerable to HIV

London — Young women are almost an endangered species in southern Africa from AIDS, says UNAIDS deputy director

Women make up nearly half of the 37,2-million adults living with HIV, and the proportion rises to almost 60% in sub-Saharan Africa, according to an annual United Nations (UN) report released yesterday.

But the epidemic appears to have stabilised in the region , where 25,4-million people are infected with the virus the worst-affected area of the world. Stabilising means an equal number of people are being newly infected with and dying of AIDS.

"In the countries of southern Africa, overall, there is a 25% prevalence rate," said Kathleen Cravero, deputy executive director of the Joint UN Programme on HIV/AIDS (UNAIDS), which released the report.

"Increasingly, the face of AIDS is young and female."

About 64% of all HIV-positive people worldwide and 76% of all women with the virus are in subSaharan Africa.

In every region , the number of women infected rose during the past two years: east Asia had the highest jump with 56%, and eastern Europe and central Asia had 48%. In sub-Saharan Africa, three-quarters of all 15- to 24year-olds with HIV are female.

"Young women are almost an endangered species in southern Africa from AIDS for several reasons," Cravero said.

Many are illiterate or jobless, and often depend on men and have no powers to resist sex or ask partners to use condoms.

"In some places, the main HIV risk factor for a woman is the fact that she is faithful to a husband with previous or current sex partners," the report says. Teenage girls acquire the virus at a younger age and from older men. Violence against women makes them more vulnerable .

The UNAIDS and World Health Organisation (WHO) report, released ahead of World AIDS Day on December 1, shows the number of adults and children with HIV reached its highest level this year at an estimated 39,4-million, compared with about 36,6-million two years ago.

More than 3-million people died of the illness this year. New infections climbed nearly 50% since 2002 in east Asia, mainly because of growing epidemics in China, Indonesia and Vietnam.

In eastern Europe and central Asia, there has been a 40% jump in the past two years, fuelled by the growing number of infections in the Russian Federation and Ukraine. The Caribbean is the second most affected region in the world.

"The epidemic is obviously still ahead of us because we are seeing 39,4-million people (living with HIV)," Cravero said.

Although spending to fight HIV/AIDS has almost tripled from $2,1bn in 2001 to $6,1bn this year, fewer than one in five people in low- and middle-income countries have access to HIV prevention services. As many as 6million need HIV treatment.

"Universal access to treatment for everyone who needs it is a goal, a legitimate goal that everyone can push for," Cravero said.

The WHO launched a "3 by 5" programme to get 3-million people on treatment by the end of next year. About 440000 people in the developing world accessed life-prolonging antiretroviral drugs by June this year.

"We are working with the WHO to go for that goal with as much gusto as we can possibly get," she said.

Women in east Asia are contracting HIV at a faster rate than in the rest of the world. There is a worrying new trend in Thailand: men who visit prostitutes increasingly pass on the infection to their wives, the UN report says.

In many parts of the world, particularly in Asia, more women than men get HIV because it has spread beyond brothels, where most infections occurred 12 years ago, said the latest global HIV status report, published yesterday.

Women have seen higher rates of infection than men because it is easier for them to get HIV the virus that causes AIDS through heterosexual intercourse.

About 2,3-million out of the 8,2-million people living with HIV in Asia are women an increase of 56% since 2002. The epidemic has claimed about 540000 lives in Asia so far this year .

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