Care and support for people living with HIV/AIDS

More documents

Recommendations

Info

AIDS in a new millennium: a grim picture with glimmers of hopesentinel surveillance system, depicted in Figure 2, show that the percentage ofpregnant girls aged 15–19 infected with HIV in the capital, Lusaka, has on averagedropped by almost half in the last six years.Comparisons between studies of sexual behaviour conducted in 1990, 1992, 1996and 1998 suggest that these falling HIV rates are due in part to a decrease in theprevalence of some types of risky sexual behaviour in urban areas. For example, farfewer young women in Lusaka were having sex before marriage in 1996 than in 1990,and the percentage of unmarried women who were sexually active fell from 52% to35% over that period. Among young men, according to nationwide studies, thechange came later; in 1998 just over half of unmarried men said they had not had sexin the past year, compared with just over a third two years earlier, and the proportionof men reporting two or more casual partners in the past year also fell. However,there was no evidence at the national level that either girls or boys were postponingthe start of their sex life.Elsewhere in the region too, there are signs that young people are avoiding the patternsof behaviour which led their parents and older siblings to such high levels ofHIV infection. Condom use, for example, is increasing among young people (seepages 59-64) and there are indications that, among the better-educated, sex withcasual partners may start later and be less frequent (see pages 43-44). But thesechanges are taking place against a background of very high infection rates, especiallyin young African women.Figure 3 shows frighteningly high prevalence rates of infection among teenagers andwomen in their early 20s in various urban and rural areas in Africa. The rates amongteenage girls and especially among women under 25 defy belief: in 7 of the 11 studies,more than one woman in five in her early 20s was infected with the virus; a largeproportion of them will not live to see their 30th birthday. Close to 6 out of 10 womenin this age group in the South African town of Carletonville tested positive for HIV.The infection rates in young African women are far higher than those in young men.In the 11 population-based studies presented here, the average rates in teenagegirls were over five times higher than those in teenage boys. Among young peoplein their early 20s, the rates were three times higher in women. In large measure, thisenormous discrepancy is due to age-mixing between young women and older men,who have had much more sexual experience and are much more likely to be exposingthe girls to HIV. It is also because girls are more easily infected during vaginalintercourse with an infected partner than boys are.The fact that, in Africa, women’s peak infection rates occur at earlier ages than men’shelps explain why there are an estimated 12 women living with HIV for every 10 menin this region of the world. Not only do the young age groups account for a biggerproportion of the population, but individuals who are infected at a younger age tendto survive longer and continue to be counted among those living with HIV.11
Report on the global HIV/AIDS epidemic – June 2000Figure 3.HIV prevalence rate among women in their teens and early twenties,various African studies, 1995-199870HIV-infected (%)6050403020women 15-19women 20-24100Mutasa District, Zimbabwe, 1998 (rural)Carletonville, South Africa, 1998 (urban)Kisumu, Kenya, 1997 (urban)Lusaka, Zambia, 1995 (urban)Mposhi, Zambia, 1996 (rural)Ndola, Zambia, 1997 (urban)Kisesa, Tanzania, 1997 (rural)Yaoundé, Cameroon, 1997 (urban)Cotonou, Benin, 1997 (urban)Fort Portal, Uganda, 1995 (urban)Masaka, Uganda 1996 (rural)Asia holds HIV at bay – but for how long?In comparison with the rates of HIV infection in Africa, those in the general populationsof Asia are low. The prevalence among 15–49-year-olds exceeds 1% in onlythree countries – Cambodia, Myanmar and Thailand; in other countries, the prevalencerate is often far lower. In Indonesia, the world’s fourth most populous country,fewer than 5 people in 10 000 are living with HIV. In the Philippines, the rate of HIVinfection is only slightly higher, at 7 per 10 000.These figures do not tell the whole story, however. Within the largest Asian nations,some geographic regions have far more inhabitants than most African countries andhave HIV prevalence rates far greater than the national average. In Asian countriesin which the epidemic is concentrated in certain groups, such as injecting drugusers, it is misleading to focus solely on the prevalence in the general population.China and India between them account for around 36% of the world’s population.With such huge populations, even low HIV prevalence rates mean that huge numbersof people live with the virus. Indeed, in India, where only 7 adults in 1000 areinfected with HIV, 3.7 million people were living with HIV/AIDS at the beginning of themillennium – more than in any other country in the world except South Africa. India’sepidemic is highly diverse: while some states show almost no HIV infection, othershave reached adult HIV prevalence rates of 2% and above.12
Page 2 and 3: UNAIDS/00.13E (English original, Ju
Page 4 and 5: Report on the global HIV/AIDS epide
Page 10 and 11: AIDS in a new millennium: a grim pi
Page 22 and 23: Waking up to devastationWaking up t
Page 24 and 25: Waking up to devastationgreatly ove
Page 26 and 27: Waking up to devastationThere is no
Page 28 and 29: Waking up to devastationHousehold i
Page 30 and 31: Waking up to devastationThe toll on
Page 32 and 33: Waking up to devastationfishing) wh
Page 34 and 35: Waking up to devastationally lose t
Page 36 and 37: Waking up to devastationvide counse
Page 38 and 39: What makes people vulnerable?What m
Page 40 and 41: What makes people vulnerable?“For
Page 42 and 43: What makes people vulnerable?Figure
Page 50 and 51: What makes people vulnerable?knowin
Page 52 and 53: What makes people vulnerable?becaus
Page 56 and 57: Prevention: daunting challenges ahe
Page 62 and 63:
Prevention: daunting challenges ahe
Page 64 and 65:
Page 66 and 67:
Page 68 and 69:
Page 70 and 71:
Page 72 and 73:
Page 74 and 75:
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Opening new doors with counselling
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Care and support for people living
Page 88 and 89:
Page 90 and 91:
Page 92 and 93:
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
Page 106 and 107:
Page 108 and 109:
National responses to the epidemic:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
Page 116 and 117:
Page 118 and 119:
Annex 1.How reliable are estimates
Page 120 and 121:
Annex 2. HIV/AIDS estimates and dat
Page 122 and 123:
Annex 2. HIV/AIDS estimates and dat
Page 124 and 125:
Table of country-specific HIV/AIDS
Page 126 and 127:
Page 128 and 129:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
show all

Care and support for people living with HIV/AIDS

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?