Over half the HIV infected people globally do not know their positive status: UN

A new report released by UNAIDS reveals that as many as 19 million (54 per cent) of the 35 million people in the world living with HIV do not know their HIV-positive status. The UNAIDS Gap Report deals with two aspects of the AIDS epidemic—the hope that ending the disease is possible and the gaps between the people moving forward and the people left behind.

In his foreword to the report, Michel Sidibé, executive director, UNAIDS, emphasises that ending AIDS is not possible without putting the people first. “Too often people at higher risk of HIV infection face multiple issues—such as being a young woman displaced from home and living with HIV. Ensuring that no one is left behind means closing the gap between people who can get services and people who can’t, the people who are protected and the people who are punished,” he writes.

Gaps are many and wide

The report says that although new HIV infections have dropped by 38 per cent since 2001, there were 2.1 million people newly infected in 2013. Fifteen countries accounted for more than 75 per cent of these cases. South Africa accounted for 18 per cent of HIV cases in 2013.

Of the 35 million people living with HIV globally, some 2 to 4 million also suffer from hepatitis B infection and 4 to 5 million from hepatitis C infection, making treatment crucial and complicated. Prisoners are more vulnerable to HIV, tuberculosis and hepatitis B and C than the general public, the report mentions.

In sub-Saharan Africa, only eight male condoms were available per year for each sexually active individual. Among young people, condom access was even less. Adolescent girls and young women in the region account for one in four new HIV infections. Globally, 15 per cent of all women living with HIV are aged 15-24 years old. Of these, 80 per cent live in sub-Saharan Africa. In this region, women acquire HIV infection at least 5-7 years earlier than men, the report says.

Millions lack access to treatment

Sidibé says 22 million HIV-positive people in the world do not have access to life-saving treatment; this translates to three of five HIV-positive persons not getting access to antiretroviral therapy. The proportion is alarming in South Africa (58 per cent), India (64 per cent) and Nigeria (80 per cent).

South Africa has announced a bold target of providing 4.5 million HIV-positive people with access to antiretroviral drugs, the report says. In India, HIV treatment coverage is only 36 per cent, while it is even lesser (20 per cent) in Nigeria. Of all AIDS-related deaths in the sub-Saharan Africa region, 19 per cent occur in Nigeria, while 51 per cent of AIDS-related deaths in Asia happen in India alone.

There is still hope

Although the Gap Report highlights some disappointing statistics about the effort to fight AIDS, it is also a ray of hope. The report says the number of people newly infected with HIV continues to decline in most parts of the world—a decline of 38 per cent from 2001. New HIV infections have declined by more than 75 per cent in 10 countries and by more than 50 per cent in 27 countries.

In countries with the highest burden of HIV infection, knowledge of HIV status among people living with HIV is higher than before. More than 85 per cent of people in sub-Saharan Africa living with HIV who know their status now receive antiretroviral therapy. The percentage of people living with HIV without access to treatment has been reduced from 90 per cent in 2006 to 63 per cent in 2013.

Since 1995, antiretroviral therapy has averted 7.6 million deaths globally, including 4.8 million deaths in sub-Saharan Africa. Access to antiretroviral medicines for HIV-positive pregnant women has averted more than 900,000 new HIV infections among children since 2009.

AIDS-related deaths have fallen by 35 per cent since 2005, when the highest number of deaths was recorded. In sub-Saharan Africa, the number fell by 39 per cent between 2005 and 2013. Between 2009 and 2013, the number of deaths decreased significantly in several countries, including South Africa (51 per cent), Dominican Republic (37 per cent), Ukraine (32 per cent), Kenya (32 per cent), Ethiopia (37 per cent) and Cambodia (45 per cent).

Sidibé says that to fight the AIDS epidemic, it is crucial to focus on location and population—to be at the right place for the right people. “If part of the success we have seen comes from ‘what gets counted gets done’, then it is time for everyone to be counted and reached,” he concludes.

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