Released yesterday (WED), the annual UNAIDS report revealed that there were 34,2-million people living with HIV in 2011, more than ever before, which they ascribed to the life-prolonging effects of antiretroviral therapy. An estimated 23,5-million of these people were living in sub-Saharan Africa, including 3,1-million children.

UNAIDS reported a number of other achievements including:

–               An increase of 20 percent in just one year of people accessing ART (8-million);

–               A 20 percent reduction in the number of people newly infected with HIV (2,5-million);

–               A 24 percent decline since the peak in 2005 in the number of people who died from AIDS-related causes in 2011 (1,7-million).

Tuberculosis remained the leading cause of death among people living with HIV, despite it being a preventable and curable disease.

Young people aged 15 to 24 years accounted for almost half (40%) of all new adult HIV infections.

Globally, infection rates in young women 15 to 24 years old are twice as high as among men of the same age with a young woman acquiring HIV infection every minute.

There is agreement that this is mainly due to their lower economic and sociocultural status in many countries where women and girls are disadvantaged in negotiating safer sex and accessing HIV prevention information and services.

The statistics are:

–               HIV is the leading cause of death for women of reproductive age worldwide;

–               Only one female condom is available for every 36 women in sub-Saharan Africa;

–               More than one third of women aged 20-24 years in low- and middle-income countries marry before they are 18 years old;

–               Approximately 40 percent of pregnancies worldwide are unintended;

–               Globally, less than 30 percent of young women have comprehensive and correct knowledge on HIV;

–               Two thirds of the world’€™s 796-million illiterate adults are women;

–               Between 11 and 45 percent of adolescent girls reported that their first sexual experience was forced.

A failure by many countries to implement and scale up some of the basic programmes that aim to reduce HIV transmission, was cited as a reason for the high rates of infection among those 15 to 24 years. These programmes include voluntary medical male circumcision, behavioural change programmes, condom promotion and key programmes for those populations at higher risk of HIV infection such as teenagers, men who have sex with men and injecting drug users.

Some achievements were also reported in sub-Saharan Africa where nearly 6,2-million people are receiving ART, up from just 100 000 in 2003. The most dramatic progress was in South Africa, Zimbabwe and Kenya. In 2011, at least 300 000 people in South Africa were newly enrolled in treatment.

The report cautions that as more people start ART, concerns are growing about the possible increase in HIV drug resistance.

Low to moderate levels of transmitted drug resistance have been observed ‘€“ increasing from one percent in 2005 to three percent in 2010. Recent surveys reported that among those initiating treatment in low- and middle-income countries, about five percent had drug resistance.

South Africa is listed in the report as one of eight countries showing a rapid decline in new HIV infections among children ‘€“ 49 percent.

The majority of adult HIV infections in sub-Saharan Africa resulted from unprotected sexual intercourse, including paid sex and sex between men.

The report also makes a case for treatment interventions to become increasingly community based. A systematic review of treatment programmes in sub-Saharan Africa reported that, on average, 70 percent of people receiving ART from specialist clinics were still receiving treatment after two years.

On the other hand, a Community ART Group model initiated by people receiving ART in Mozambique, to improve access and retention on treatment and decongest health services, resulted in 97,5 percent of people still receiving treatment after 26 months.