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[procaare] Has the HIV Epidemic Peaked?
- From: "Debra Warn" <DWARN@popcouncil.org>
- Date: Thu, 26 Jun 2008 10:15:59 -0400
Has the HIV Epidemic Peaked?
NEW YORK (26 June 2008)-The HIV epidemic appears to have stabilized
around the world, according to "Has the HIV epidemic peaked?" published
in the June issue of the Population Council's peer-reviewed journal
Population and Development Review. The authors are Population Council
Vice President and Distinguished Scholar John Bongaarts and three
colleagues affiliated with the United Nations Population Division.
Although the rate of new infections has probably peaked in all world
regions, the absolute number of HIV-positive individuals is expected to
continue to grow in sub-Saharan Africa and remain near current levels
worldwide-posing an ongoing challenge to public health programs. As a
result of continued high rates of population growth and only moderate
success of prevention programs in reducing HIV incidence, a large number
of adolescents and adults are still likely to become infected.
Most of the world's 33.2 million HIV-positive individuals are likely to
die of AIDS-related illnesses eventually. Further, with 2.5 million
people being newly infected every year, the death toll from AIDS will
remain high over the coming years.
The findings in "Has the HIV epidemic peaked?" also indicate that the
percent of the population infected with HIV has stabilized everywhere in
the world over the past decade except in Eastern Europe-where prevalence
rates are expected to reach their highest point this year.
Worldwide approximately 0.8 percent of adults-ages 15-49-are infected
with HIV. HIV prevalence is 1 percent or lower in all major world
regions except in sub-Saharan Africa, where it is 5 percent. In this
region, prevalence levels range from a fraction of 1 percent in several
countries in Western Africa to above 15 percent in some Eastern and
Southern Africa nations. The spread of infection among populations in
this region has been more widespread because multiple and concurrent
sexual partnerships are relatively common, male circumcision and condom
use are relatively rare, and other sexually transmitted infections-which
raise the risk of HIV transmission-are more prevalent.
Although trends vary, a general pattern in the past growth of the
epidemic has been identified: a slow spread of the AIDS virus in the
early 1980s or 1990s, followed by a period of rapid expansion, before
reaching a relatively stable level. The appearance of plateaus implies
that HIV is present in a small proportion of the population but that it
does not generally spread beyond one or more subgroups.
The main explanation for this finding is that population subgroups have
widely varying risks for infection. Sex workers and their clients,
needle-sharing intravenous drug users, and men who have sex with men are
the most vulnerable. Men and women living in monogamous unions or
without sexual partners are at the opposite end of the spectrum. At
first, the virus spreads quickly among the groups at highest risk, but
then transmission slows when the individuals in those groups become
infected or die, and the lower-risk groups remain uninfected. An
epidemic reaches a plateau when the virus has achieved maximum
penetration of the vulnerable groups. This point was reached in most
countries by the early 2000s.
Declining prevalence rates in several countries are consistent with the
view that current prevention efforts have had an impact. Despite these
encouraging trends, high-risk behavior remains pervasive, and HIV
continues to spread in much of the world.
"These findings indicate a continuing need to develop new prevention
technologies and for prevention and treatment programs especially in the
countries with substantial epidemics," Bongaarts concludes.
Bongaarts, John, Thomas Buettner, Gerhard Heilig, and Francois
Pelletier. "Has the HIV epidemic peaked?" Population and Development
Review 34(2): 199-224 (June 2008).
Population and Development Review seeks to advance knowledge of the
interrelationships between population and socioeconomic development and
provides a forum for discussion of related issues of public policy.
Melissa May, APR: firstname.lastname@example.org +1 212 339 0525
Diane Rubino: email@example.com +1 212 339 0617
Findings from Population Council research will be presented at the XVII
International AIDS Conference, 3-8 August 2008, in Mexico. (more:
The Population Council (www.popcouncil.org) is an international,
nonprofit, nongovernmental research organization that seeks to improve
the well-being and reproductive health of current and future generations
around the world and to help achieve a humane, equitable, and
sustainable balance between people and resources. The Council conducts
biomedical, social science, and public health research and helps build
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