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More adults are dying of AIDS despite better access to drugs, U.N. reports
  David Perlman, SF Chronicle Science Editor
Wednesday, May 31, 2006
A record number of adults worldwide are dying of AIDS today, even as infection rates appear to be slowing and drugs to fight the disease are becoming available to more people around the globe, United Nations officials reported Tuesday.
The annual report from UNAIDS also noted that women in greater numbers than ever are being infected with HIV, the virus that causes AIDS, or dying of illnesses related to the disease.
Still, in an otherwise gloomy assessment of the status of AIDS around the world, the agency that coordinates the international battle against the epidemic instilled a touch of optimism into its report.
"The epidemic appears to be leveling off," said Paul De Lay, the UNAIDS official in charge of evaluating the mountains of data reported by health officials in the 191 nations that are U.N. members. "The rate of HIV infections is still increasing, but not in as massive a scale as we've seen in the past ten or fifteen years."
During the past year, the report said:
-- There is a "measurable decline" in the rate of HIV infection among many nations, although the number of infections continues to rise unacceptably as populations and poverty both increase -- particularly in sub-Saharan Africa.
-- HIV infections are declining among young people in many sub-Saharan countries, primarily due to increased condom use, delays in the age of starting sexual activity and reductions in the numbers of partners among sexually active individuals.
-- Antiretroviral drugs are becoming more available in many regions, although costs are still far higher than most poor nations can afford.
-- Funds to fight the epidemic have risen sharply in the past decade -- from a worldwide total of $300 million in 1996 to $8.3 billion last year, with the heaviest contributions coming from the United States and the World Bank.
But against that picture were these distressing numbers from UNAIDS, the semi-independent U.N. agency that was founded 10 years ago to mobilize the world against the epidemic's ravages:
-- By the beginning of this year, an estimated 38.6 million people in the world were living with HIV infections or were ill with AIDS.
-- An estimated 4.1 million people were infected with HIV last year alone, and nearly 3 million people died of AIDS-related causes.
-- Despite a declining number of HIV infections among young people, those under the age of 25 accounted for half of all new infections last year, and nearly half of all the people living with HIV/AIDS were women.
-- Although access to antiretroviral drugs tripled during the past two years in countries marked by low- or middle-income status -- including those in southern Africa, the Caribbean and Southeast Asia -- only 20 percent of people living with HIV/AIDS were receiving the treatment this past year. And access to AIDS prevention services was even more severely limited in those countries.
-- Despite the $8.3 billion donated for international AIDS-fighting work last year, current needs will reach $15 billion this year and $22 billion by 2008 -- just to keep pace with increasing needs for prevention, education and treatment.
De Lay said work still needs to be done in underdeveloped nations, where only 9 percent of mothers receive antiretroviral drugs designed to reduce transmission of HIV from pregnant women to their unborn infants. By contrast, the drugs are available to 60 percent of mothers in more affluent countries. Even that, he noted, is short of the goal set five years ago to make the drugs accessible to 8o percent of all the world's mothers.
A major problem preventing access to treatment, De Lay said, is the stigma and shame that exists in poor countries for women who become infected with HIV. The social obstacles keep them from seeking the drugs or, all too often, they become exiles from their homes, making any kind of care unavailable.
The stigmatization also prevents widespread education about the dangers of HIV/AIDS, he said. Fewer than 50 percent of young people worldwide have any accurate understanding of the disease, although UNAIDS had a goal to educate 90 percent of people 25 years old or younger by this year, according to the U.N. data.
It was 25 years ago this summer that the disease now called AIDS was first detected and recorded in the United States. Since then at least 25 million people around the world have died, and more than 15 million youngsters under the age of 18 have been orphaned by the AIDS death of one or more parents.
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