Re: PROCAARE: REQUEST FOR INFORMATION--HIV INFECTION--SOUTH AFRICA (fwd)

[Albert Shaw <ashaw@usa.healthnet.org>]

From: jchin <jchin@cdpc.com>

I have been involved with HIV/AIDS estimates for over a decade, and
continue to practice this "art."

In a December/95 issue of the Weekly Epidemiolgical Record (WER) from
WHO, my former unit at GPA in their "swan song" provided HIV prevalence
estimates for all UN member countries.  These estimates were, in my
opinion, reasonably objective and based primarily on the available
HIV/AIDS data (not just on "officially" reported HIV/AIDS data).  Only a
few countries argued strongly to have their HIV estimate reduced (some
middle-eastern and a few Asian countries), and a couple (in Asia)
protested that WHO's initial estimates were too low.  Although these
latter protests were not based on any objective data, GPA/WHO
compromised and raised their HIV prevalence estimates up slightly.

All of the WHO estimates can be considered conservative.  With regards
to the highest number of living adult HIV infections (i.e., HIV
prevalence), India was ranked #1 with 1.75 million and South Africa was
ranked #12 in the world with an estimated HIV prevalence of 650,000. 
With regards to HIV prevalence rates (prevalence of adult HIV infections
divided by the total adult population, India was not in the top 50 and
South Africa was #12.  These data are available as bar figures in the
HIV prevalence section of my homepage <http://www.cdpc.com>.

Since then, there have been rumblings that the HIV prevalence in South
Africa is much higher than the WHO's 1995 estimates.  I have not seen
the "new" or more recent HIV serosurvey data from South Africa, but I
have been to India recently and I know that the current Indian HIV
prevalence estimate is low and needs to be raised. 

The bottom line is that HIV/AIDS is a major, major problem in India and
South Africa regardless of whether any of these countries have the
largest number of HIV infections or not.  I personally think that the
HIV prevalence rate is the more important number and several central
African countries have current adult HIV prevalence rates of close to
20% (i.e., one of every five adults are HIV-positive!).  

I hope my comments are helpful.

Cordially,

Jim Chin

Clinical Professor of Epidemiolgy
School of Public Health
UC Berkeley