About 3 million people will die from AIDS this year and five million more will become infected with HIV worldwide, UNAIDS said in its annual report on the plague.
The epidemic continues unabated in large sections of sub-Saharan Africa and is poised for an explosive outbreak in parts of Asia and the former Soviet Union. Even in the United States and Western Europe where therapy is readily available, new infections are on the rise.
In the U.S., the number of people diagnosed with HIV infection began to fall dramatically with the introduction of protease inhibitors in 1996. That trend leveled off in 1999 and over the ensuing three years the number of new HIV diagnoses have increased by 5.1%, the Centers for Disease Control and Prevention (CDC) said in releasing data from 2002, in the Nov. 28 issue of Morbidity and Mortality Weekly Report.
New diagnoses surged 17% among gay and bisexual men and African Americans accounted for 55% of all new cases. Close to a million Americans are believed to carry the virus and perhaps a third don't know it. Estimates are that 40,000 new infections occur each year.
The CDC analysis is based upon data reported by 29 states. However, it does not include data from many major centers of infection—including New York, California, and Texas—and it totals significantly less than half of the national HIV caseload. It also represents infections that were newly diagnosed but likely were transmitted several months or perhaps even more than a decade earlier.
'Stigma and discrimination—themes for this year's World AIDS Day—help perpetuate the HIV epidemic around the world and here in this country,' said Harold Jaffe, director of CDC's HIV prevention programs. 'These obstacles deter people from getting tested and prevent HIV-infected people from receiving treatment. They also increase the already heavy burden of HIV in communities of color.'
In the United Kingdom, the Health Protection Agency announced that newly diagnosed cases of HIV increased about 20% in 2002, to 6,400 persons. About 70% of those infections were acquired elsewhere and the person then immigrated to England.
Among gay and bi men, gonorrhea nearly doubled to 3,363 cases and syphilis jumped from 52 to 607 cases. The government has committed additional resources to prevention and testing activities that are targeted to groups at high risk for HIV and STDs.
In Russia, the number of people infected with HIV has increased ten-fold in just the last three years, and may be has high as 1.5 million people.
One of the brightest spots continues to be Uganda where committed political leadership has made remarkable progress at stemming new infections at the epicenter of the epidemic. For the 12th consecutive year, the HIV prevalence rate was lower than the preceding year.
Another encouraging sign is that the government of South Africa recently reversed its long-standing resistance to providing antiretroviral therapy for people with advanced HIV disease. The use of generic drugs and further reductions in the cost of drugs helped, but it will be an enormous task to implement treatment on a wide scale.
