World epidemic defies retreat

The HIV/AIDS epidemic continues to grow more than 25 years after the epidemic was identified, despite worldwide efforts to prevent and contain it. According to a recent update on the epidemic jointly issued by UNAIDS (Joint United Nations Program on HIV/AIDS) and WHO (World Health Organization), an estimated 39.5 million people are living with HIV/AIDS. The year 2006 saw 4.3 million new infections and 2.9 million deaths from AIDS-related illness. Of the new infections, 2.8 million or 65 percent occurred in sub-Saharan Africa. WHO says the region represents 70 percent of the world’s unmet need for treatment.

The number of women infected with HIV has been increasing. Of the people infected with HIV, 48 percent are women, with the rate jumping to 59 percent in sub-Saharan Africa. Life expectancy in the region at birth is just 47 years, about 30 years shorter than in developed countries.

WHO warns that some 40 percent of new HIV infections now occur among young people aged 15 to 24 and that East Asia, Central Asia and Eastern Europe saw the most striking increases in the number of HIV-infected people. There were 8.6 million infected people in Asia, 5.7 million in India and 650,000 in China.

The UNAIDS/WHO report says, “In many countries, HIV prevention programs are not reaching the people most at risk of infection, such as young people, women and girls, men who have sex with men, sex workers and their clients, injection-drug users, and ethnic and cultural minorities.”

The report presents a bleak picture. Some 2.3 million children under the age of 15 are living with HIV. Most were infected through their HIV-infected mothers who were unable to receive treatment. Many women in developing countries contract HIV from their husbands. UNICEF (United Nations Children’s Fund) says that 14 million children under 15 have lost one or both parents to AIDS and that by 2010 this number is expected to exceed 25 million. By extending financial and medicinal aid, developed countries can play an important role in protecting children against HIV/AIDS.

The report also says some countries, including Uganda, that had succeeded for a time in reducing new infections are experiencing a resurgence.

The situation in Japan does not warrant complacency. Although the absolute number of HIV/AIDS cases is relatively small, the number of new HIV infections and AIDS cases has been renewing a record high every year recently. In 2004, there were 780 new HIV infections and 385 new AIDS cases for a record combined total of 1,165 cases. In 2005, there were 832 new infections and 367 new AIDS cases for a total of 1,199. In the first three quarters of 2006, there were 679 new infections and 305 new AIDS cases for a total of 984. For the full year, the total number was expected to reach another new high, exceeding the 2005 record. Among developed countries, Japan is rare in that the number of AIDS cases is increasing. From 1989 to 2005, the accumulative total of new HIV infections was 7,392 and of new AIDS cases, 3,644, for a combined total of 11,036.

The big problem is that while HIV infection is spreading among young people, society’s awareness of the danger from HIV/AIDS still seems low. People in their 20s and 30s accounted for about 69 percent of new infections in the third quarter, up from about 66 percent in the second quarter. Tokyo saw 417 new infections and new AIDS cases in 2005. Of the newly infected people, 72 percent were in their 20s and 30s. Six percent were under 20.

Of the newly infected people nationwide in 2005, 34 percent were in their 20s, 38 percent were in their 30s, and 1 percent were teenagers. As for new AIDS cases nationwide the same year, people in their 40s or older accounted for 52 percent of the total while those in their 20s accounted for 13 percent and those in their 30s, 35 percent.

It is also noteworthy that among new AIDS cases nationwide in 2005 the percentage of cases attributable to same-sex contact was the same as that attributable to opposite-sex contact: 37 percent. Causes were unknown for 22 percent of the new AIDS cases. Among new HIV infections nationwide the same year, 64 percent were from same-sex contact, compared with 24 percent from opposite-sex contact. Causes for 10 percent of the new HIV infections were unknown.

The trend in Japan points to the need to educate young people, especially teenagers. Local governments have been reducing their budgets for HIV/AIDS awareness and prevention. They must reverse this downturn, and education authorities should teach children not only the danger of HIV/AIDS but also how to protect both themselves and others. They should heed WHO’s dictum: “Where prevention efforts decline, HIV infections increase.”