[HARMRED] U.N. Reports Decrease in New H.I.V. Infections

[Richard Lake]

Newshawk: Richard Lake
Pubdate: Wed, 24 Nov 2010
Source: New York Times (NY)
Page: A4
Copyright: 2010 The New York Times Company
Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Donald G. McNeil Jr.
Referenced: The report http://www.unaids.org/globalreport/Global_report.htm

U.N. REPORTS DECREASE IN NEW H.I.V. INFECTIONS

Fewer people are being infected with the virus that causes AIDS than 
at the epidemic's peak, but progress against the disease is still 
halting and fragile, the United Nations' AIDS-fighting agency reported Tuesday.

In its new report on the epidemic, Unaids said 2.6 million people 
became newly infected with H.I.V., the virus that causes AIDS, in 
2009 -- almost 20 percent fewer than in the late 1990s.

But progress is spotty. About 25 countries are doing better at 
prevention, including several in southern Africa with sky-high AIDS rates.

South Africa, which has the world's worst epidemic, has benefited 
from the changeover from the presidency of Thabo Mbeki, which was 
hostile to the distribution of AIDS drugs, to that of Jacob Zuma, who 
has publicly taken an AIDS test and urged citizens to do the same. 
Still, it faces an estimated 350,000 to 500,000 new infections annually.

In one area, progress has been heartening: giving mothers drugs to 
prevent the infection of their babies at birth or through breastfeeding.

"We've had a 50 percent reduction of infections among young people in 
South Africa, which is a huge reservoir," Michel Sidibe, executive 
director of Unaids, said in an interview in Manhattan last week.

Mr. Sidibe gave several reasons for the change.

"Relations between parents and children over discussing sexuality are 
changing," he said. "Previously, no one would talk about it. Now, 
more people are willing to talk to their children."

Also, he said, people are sleeping around somewhat less. "In 59 
countries we surveyed, only 25 percent said they had had more than 
one partner in the last year," he said. "That is a big shift."

And, he said, while posters urging everyone to use condoms are not 
particularly effective, government health agencies have gotten better 
at "concentrating on hot spots" like sex workers and long-haul truckers.

In countries like Senegal and Malawi, Mr. Sidibe said, "there has 
been a sea change in attitudes toward men who have sex with men."

In countries that jailed homosexuals or simply denied that there were 
any, gay men have been released from prison. Instead of driving gay 
men underground, some governments are trying to reach them with 
safe-sex education and condoms.

At the same time, some countries are becoming worse, especially those 
in Eastern Europe and Central Asia, where the epidemic is 
concentrated among heroin-injectors and their sexual partners. As 
Afghan and southeast Asian heroin spreads along new distribution 
routes, more addicts are created, increasing AIDS infections in 
countries with little history of dealing with them.

There are exceptions. In Iran, Mr. Sidibe said, he accompanied a 
woman in a chador who was handing out condoms in prison.

"I was shocked," he said. "In Iran, the prisons had one of the most 
progressive programs. There was methadone maintenance; there was 
condom distribution. They even had conjugal visits for prisoners -- 
five hours in a private room every three months with your wife. With condoms."

There is also both good and bad news on the treatment front. About 
5.2 million people are getting antiretroviral drugs -- more than ever 
before, thanks to the multinational Global Fund to Fight AIDS, 
Tuberculosis and Malaria and its strictly American counterpart, the 
President's Emergency Plan for AIDS Relief. But 10 million more still 
need the treatment immediately, and it seems unlikely that donors 
will give enough money to keep them all alive.

Also, some people have developed resistance to first-line drugs, but 
the money for more expensive second- and third-line drugs is not there.

It is now nearly 30 years since the epidemic began, and an estimated 
33.3 million people are living with H.I.V. That number has never been 
higher, and its growth is due to a combination of new infections and 
the receipt of life-prolonging treatment by more of the sick.

But a comparison illustrates how much progress still needs to be made 
before it can be said that the world is winning the war on AIDS: in 
its previous report, Unaids estimated that for every 100 people put 
on treatment each year, 250 became newly infected. Now, it estimates 
that for every 100 on treatment, 200 become infected.