The HIV/AIDS Epidemic © 2000 John B. Pryor Illinois State University.

The The HIV/AIDS HIV/AIDS EpidemicEpidemic

© 2000 John B. Pryor© 2000 John B. Pryor

Illinois State UniversityIllinois State University

AIDS - AIDS - AAcquired cquired IImmune mmune DDeficiency eficiency SSyndromeyndrome

HIV - HIV - HHuman uman

IImmunodeficiencymmunodeficiency VVirusirus

Ways HIV is Transmitted:Ways HIV is Transmitted:1) through unprotected sexual intercourse1) through unprotected sexual intercourse

2) through sharing needles2) through sharing needles

3) through exposure to contaminated 3) through exposure to contaminated bloodblood

4) perinatal exposure4) perinatal exposure

5) mother’s milk5) mother’s milk

Ways you cannot transmit HIV:Ways you cannot transmit HIV:

1) mosquito bites1) mosquito bites

2) casual contact2) casual contact

3) toilet seats3) toilet seats

4) sharing food4) sharing food

Natural History of HIV/AIDSNatural History of HIV/AIDS

HIVHIVInfectionInfection

3-6 Weeks3-6 Weeks

Acute Acute HIVHIVSyndromeSyndrome

6 Months6 Months

PositivePositiveHIV TestHIV Test

9.8 Years9.8 Years 14.8 Years14.8 Years

ClinicalClinicalAIDSAIDS DeathDeath

May be extended by May be extended by new drug therapiesnew drug therapies

Opportunistic Disease -Opportunistic Disease -Karposa SarcomaKarposa Sarcoma

lesionslesions

HIV/AIDSHIV/AIDSGlobal TrendsGlobal Trends

GlobalGlobal AIDS epidemic AIDS epidemic 19901990−−2003 2003

0

10

20

30

40

50

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Mill

ions

Number of people living with HIV and AIDS

0.0

1.0

2.0

3.0

4.0

5.0

Year

% HIVprevalence adult (15-49)

Source: UNAIDS/WHO, 2004


% HIV prevalence, adult (15-49)

2004 Report on the Global AIDS Epidemic (Fig 1)

Adult prevalence %

15.0% − 39.0%5.0% − 15.0%1.0% − 5.0%0.5% − 1.0%0.1% − 0.5%0.0% − 0.1%not available

HIV prevalence in adults, end 2003HIV prevalence in adults, end 2003

38 million people [range: 35-42 million] living with HIV as of end 2003

Epidemic in sub-Saharan Africa Epidemic in sub-Saharan Africa 19851985−−2003 2003

0

5

10

15

20

25

30

1985198619871988198919901991199219931994199519961997199819992000200120022003

Mill

ions


0

5

10

15

20

25

30

% HIVprevalence adult (15-49)


% HIV prevalence, adult (15-49)

Year



North Africa & Middle East1%

High-income countries2%

Latin America & Caribbean7%

Eastern Europe & Central Asia6%

Asia22%

Sub-Saharan Africa62 %

Total: 10 million

Source: UNAIDS/UNICEF/WHO, 2004

Young people (15−24 years old) living Young people (15−24 years old) living with HIV,with HIV,

by region, end 2003 by region, end 2003


400,000 people on treatment: 7% coverage

0

10

20

30

40

50

60

%


Antiretroviral therapy coverage for Antiretroviral therapy coverage for adults, adults,

end 2003 end 2003

Africa Asia Latin America and the Caribbean

Eastern Europe and Central Asia

North Africa and Middle East


0

5,000

10,000

15,000

20,000

2004 2005 2006 2007

Latin America and the Caribbean

Eastern Europe and Central Asia

North Africa and Middle East

East Asia and the Pacific

South and South-East Asia

Sub-Saharan Africa

Source: UNAIDS, 2004

Projected annual HIV and AIDS financing Projected annual HIV and AIDS financing needs needs

by region, 2004by region, 2004−−20072007 (in US$ million) (in US$ million)

US

$ m

illion

s


HIV/AIDSHIV/AIDSGlobal TrendsGlobal Trends

in Childrenin Children

0

1

2

3

4

5

Central Africa

Eastern Africa

Southern Africa

Western Africa

Number of orphans(millions)

REGIONS

Orphans per region Orphans per region within sub-Saharan Africa, within sub-Saharan Africa,

end 2003end 2003

Source: UNAIDS, 2004


Growing role of grandparents Growing role of grandparents Relationships of double orphans and single orphans Relationships of double orphans and single orphans

(not living with surviving parent) to head of household, Namibia, (not living with surviving parent) to head of household, Namibia, 1992 and 20001992 and 2000

2000

Grandchild 61%

Adopted/foster-child 5%

Not related 6%

Son/daughter-in-law 3%

Brother/sister 4%

OtherRelative21%

1992

Adopted/foster-child 1%

Not related 11%

Son/daughter-in-law 3%

Brother/sister 2%

Source: UNICEF-MICS, Measure DHS, 1992 and 2000.

Grandchild 44%

OtherRelative39%


HIV/AIDSHIV/AIDSTrends in Trends in

AfricaAfrica

Spread of HIV in sub-Saharan Africa, 1987Spread of HIV in sub-Saharan Africa, 1987

Estimated percentage of Estimated percentage of adults adults

(15–49) infected with HIV(15–49) infected with HIV


(15–49) infected with HIV(15–49) infected with HIV 16.0% – 32.0%16.0% – 32.0%

8.0% – 16.0%8.0% – 16.0%

2.0% – 8.0%2.0% – 8.0%

0.5% – 2.0%0.5% – 2.0%

0% – 0.5%0% – 0.5%

trend data trend data

unavailableunavailable

outside regionoutside region

16.0% – 32.0%16.0% – 32.0%

8.0% – 16.0%8.0% – 16.0%

2.0% – 8.0%2.0% – 8.0%

0.5% – 2.0%0.5% – 2.0%

0% – 0.5%0% – 0.5%



outside regionoutside region World HealthOrganizationWorld HealthOrganization UNAIDS–Addis–May 1999UNAIDS–Addis–May 1999

Spread of HIV in sub-Saharan Africa, 1997Spread of HIV in sub-Saharan Africa, 1997


(15–49) infected with HIV(15–49) infected with HIV


(15–49) infected with HIV(15–49) infected with HIV 16.0% – 32.0%16.0% – 32.0%

8.0% – 16.0%8.0% – 16.0%

2.0% – 8.0%2.0% – 8.0%

0.5% – 2.0%0.5% – 2.0%

0% – 0.5%0% – 0.5%



outside regionoutside region

16.0% – 32.0%16.0% – 32.0%

8.0% – 16.0%8.0% – 16.0%

2.0% – 8.0%2.0% – 8.0%

0.5% – 2.0%0.5% – 2.0%

0% – 0.5%0% – 0.5%



outside regionoutside region World HealthOrganizationWorld HealthOrganization UNAIDS–Addis–May 1999UNAIDS–Addis–May 1999

Life expectancy at birth in selected most Life expectancy at birth in selected most affected countries, 1980affected countries, 1980−−1985 to 1985 to

20052005−−20102010

Source: UN Population Division, World Population Prospects: the 2002 Revision


20

30

40

50

60

70

1980-1985 1985-1990 1990-1995 1995-2000 2000-2005 2005-2010

Years

Botswana

South Africa

Swaziland

Zambia

Zimbabwe

Population size with and without AIDS, Population size with and without AIDS, South Africa, 2000 & 2025South Africa, 2000 & 2025

Source: UN Population Division

0

Males Females

2000 2025

0-45-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-8485-8990-9495-99100+

03 2 1 1 2 3 3 2 1 1 2 3

Males Females

Age-group

Hypothetical size of the population in the absence of AIDSActual estimated and projected population


(in millions) (in millions)

HIV/AIDSHIV/AIDSTrends Trends

inin

Newly diagnosed HIV infections per million Newly diagnosed HIV infections per million population population

in Eastern European and Central Asian in Eastern European and Central Asian countries, countries, 1996—20031996—2003

Source: (1) HIV /AIDS Surveillance in Europe, EuroHIV mid-year report 2003, no. 69. (2) AIDS Foundation East West

0

200

400

600

800

1,000

1,200

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

New HIV infection

per million population

EstoniaRussian Federation

UkraineBelarus

Moldova, Republic of

Latvia

KazakhstanUzbekistanKyrgyzstan


0.0 0.0 0.00.1 0.2

0.4

1.6

3.4

4.24.3

0.0

1.0

2.0

3.0

4.0

5.0

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

%

Number of HIV+ inmates 7 13 239 1,460 2,319 4,100 15,100 33,000 36,850 36,000

Number of inmates 929,000 1,018,0001,048,0001,018,3001,014,5001,060,400 925,100 980,200 877,400 830,400

HIV-positive inmates in the penal system HIV-positive inmates in the penal system of the Ministry of Justice in the Russian Federation, of the Ministry of Justice in the Russian Federation,

1994 through 2003 1994 through 2003

Source: Based on GUIN (Department of Penalty Execution) data - Main Directorate of Corrections of the Ministry of Justice


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