(May 2000) More people died of AIDS in 1999 than in any previous year. The 2.6 million deaths in 1999 brought the estimated total number of deaths since the beginning of the epidemic to 16.3 million.

The annual number of deaths from AIDS is not expected to peak for many years because of the large number of people already infected. The Joint United Nations Programme on HIV/AIDS and the World Health Organization estimate that in 1999, 5.6 million people became infected with the human immunodeficiency virus (HIV), which causes the life-threatening illness AIDS. Nearly 34 million people currently live with HIV/AIDS.

The AIDS epidemic affects people of all ages. About half of all people who contract AIDS are under age 25. Over 90 percent of the children under age 15 who contract HIV are born to mothers with HIV. Women can pass HIV to their children during pregnancy or delivery and through breastfeeding. Over the course of the epidemic, AIDS has left over 11.2 million children under age 15 without their mothers and many of those same children without a father. While some therapies can lengthen the life of someone with AIDS, there is still no cure for AIDS.

The elderly population is affected indirectly by HIV/AIDS, as older people become the primary caretakers of their own children who are dying of AIDS and also may become caretakers of grandchildren orphaned by AIDS.

Africa Dealt Worst Blow

Infection rates are not equally distributed around the globe. Ninety-five percent of people who are infected with HIV live in developing countries. The highest concentration of people with the HIV infection is in Africa, which accounts for 13 percent of the world’s population but 69 percent of the cases of HIV infection. By contrast, Asia contains 61 percent of world population and 20 percent of HIV cases. The Americas have 14 percent of world population and 8 percent of HIV cases. Europe contributes 12 percent of world population and 2 percent of its population lives with an HIV infection. Half of 1 percent of world population lives in Oceania and those countries have an even lower percent of HIV cases worldwide — 0.1 percent.

In sub-Saharan Africa about one in every 30 people is infected with HIV. Just over half of these people live in the countries of Eastern Africa. Over 8 million people live with the HIV infection in five Eastern African countries: 1.2 million in Mozambique, 1.4 million in Tanzania, 1.5 million in Zimbabwe, 1.6 million in Kenya, and 2.6 million in Ethiopia.

In Western Africa, Nigeria has the largest population of people living with HIV — 2.3 million. Nearly 3 million people in South Africa are infected with HIV — the highest number of any country in Africa.

New evidence in Africa indicates that more women than men are infected with HIV on that continent — perhaps 12 or 13 women are infected for every 10 men who are infected. One reason for this difference by gender is that women contract the disease at younger ages and may be more likely to become infected during any single exposure.

HIV/AIDS is having a devastating effect on life expectancy in some countries. A child born in Southern Africa in the early 1950s could expect to live to age 44. By the early 1990s, life expectancy in this region had risen to nearly 60 years. But because of AIDS, that gain is expected to be lost. A child born in Southern Africa between 2005 and 2010 is expected to live just 45 years.

Uganda Provides Hope for Africa

However, there is a glimmer of hope in Africa. In Uganda the rate of new HIV infections has declined since the early 1990s when three in 10 pregnant women in the capital city of Kampala had HIV. President Yoweri Museveni has openly discussed the problem since 1986. People at all levels of society — political, community, and religious leaders — have been involved in the campaign to halt AIDS in Uganda, and it has made a major impact on the epidemic in this country. Still, it took several years to begin to see declines in the rate of new infections. It is not clear whether other African countries will repeat this experience. There have been recent signs of government leadership in halting the spread of HIV in Kenya and Tanzania; the presidents of these two countries have stated that the countries need to deal with HIV in order to curb the epidemics in sub-Saharan Africa.

Thai Effort Successful

In Asia, Thailand’s experience shows even more dramatically the effects that concerted action by the government, nongovernmental organizations, the media, and communities can have on the prevalence of HIV infection. The effort there to halt risky behaviors and promote safe behaviors, such as condom use, produced results in just a few years. In 1988, rapid growth of HIV infections among intravenous drug users alerted Thai authorities to a growing problem. Thailand quickly set up a national system to monitor the epidemic. Beginning in 1990, it conducted three rounds of a national survey on sexual risk behaviors. The level of risk behavior among some populations was strikingly high. This knowledge helped reinforce an effort for intensive and extensive prevention efforts in multiple sectors of society. The nationwide prevention program of the 1990s included strong support from the prime minister, key ministries, provincial governors, the business community, religious and other community leaders, and people living with HIV/AIDS. Data indicate that risk behaviors decreased and the prevalence of HIV infection dropped as the campaign continued. Thailand’s experience demonstrates that adopting safe behaviors can change the course of the epidemic for an entire nation.


References

Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO), AIDS Epidemic Update: December 1999.

Carl Haub and Diana Cornelius, 2000 World Population Data Sheet (Washington, DC: Population Reference Bureau, 2000).

Werasit Sittitrai, associate director, Department of Policy, Strategy and Research, UNAIDS, “HIV Prevention Needs and Successes: A Tale of Three Countries,” unpublished paper based on a speech at the Office of AIDS Research Advisory Council, National Institutes of Health, Bethesda, Maryland, April 28, 1999. Available online at: www.unaids.org.

Karen Stanecki, U.S. Census Bureau presentation at population seminar, National Press Club, Washington, DC, Jan. 18, 2000.

UNAIDS, Report on the Global HIV/AIDS Epidemic: June 1998.

Note: The regional figures were calculated by PRB using country level data from the 1998 UNAIDS report cited here. The 1999 UNAIDS report provides updated regional prevalence data. Those data are not reported here because the regions differ from those used on the Data Sheet. For these latest data and future updates, go to www.unaids.org.