trends in the epidemic over time
DESCRIPTION
Trends in the epidemic over time. UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance. A global view of HIV infection 33 million adults living with HIV/AIDS as of end 1999. Adult prevalence rate. 15.0% – 36.0% 5.0% – 15.0% 1.0% – 5.0% 0.5% – 1.0% 0.1% – 0.5% - PowerPoint PPT PresentationTRANSCRIPT
00001-E-1– 27 June 2000
Trends in the epidemic over time
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-2– 27 June 2000
A global view of HIV infectionA global view of HIV infection 33 million adults living with HIV/AIDS as of end 199933 million adults living with HIV/AIDS as of end 1999
Adult prevalence rate
15.0% – 36.0% 5.0% – 15.0% 1.0% – 5.0% 0.5% – 1.0% 0.1% – 0.5% 0.0% – 0.1% not available
00001-E-3– 27 June 2000
Spread of HIV over time in Latin America and Spread of HIV over time in Latin America and the Caribbean, 1984 to 1999the Caribbean, 1984 to 1999
Estimated percentage of adults
(15–49) infected with HIV 2.0% – 6.0%1.0% – 2.0%0.5% – 1.0%0.1% – 0.5%0.0% – 0.1%trend data unavailable
outside region
00001-E-4– 27 June 2000
Spread of HIV over timeSpread of HIV over timein sub-Saharan Africa, 1984 to 1999in sub-Saharan Africa, 1984 to 1999
Estimated percentage of adults
(15–49) infected with HIV 20.0% – 36.0%10.0% – 20.0% 5.0% – 10.0% 1.0% – 5.0% 0.0% – 1.0%trend data unavailable
outside region
00001-E-5– 27 June 2000
Spread of HIV over time in Asia, 1984 to 1999Spread of HIV over time in Asia, 1984 to 1999
2.0% – 5.0% 1.0% – 2.0% 0.5% – 1.0% 0.1% – 0.5% 0.0% – 0.1%trend data unavailable
outside region
00001-E-6– 27 June 2000
New
in
fect
ion
s
-
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
Highly industrialized countries
North Africa & Middle EastEastern Europe & Central asiaSub-Saharan AfricaLatin America & the Caribbean
Southern & Eastern Asia
Estimated annual number of new HIV Estimated annual number of new HIV infections by region, 1980 to 1999infections by region, 1980 to 1999
00001-E-7– 27 June 2000
Peo
ple
liv
ing
wit
h H
IV/A
IDS
Highly industrialized countries
North Africa & Middle East
Eastern Europe & Central Asia
Sub-Saharan AfricaLatin America & the Caribbean
Southern & Eastern Asia
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
Estimated number of people living with Estimated number of people living with HIV/AIDS by region, 1980 to 1999HIV/AIDS by region, 1980 to 1999
00001-E-8– 27 June 2000
Number of diagnosed HIV infections, Number of diagnosed HIV infections, Ukraine, 1993 to 1998Ukraine, 1993 to 1998
5,000 10,000 15,000 20,000 25,000 30,000
1998
1997
1996
1995
1994
1993
Source: National AIDS Programme, Ukraine, 1999
00001-E-9– 27 June 2000
Annual number of newly registered HIV infections, Annual number of newly registered HIV infections, Russia, 1993 to 1999Russia, 1993 to 1999
108 158 196
1,546
4,399 3,947
15,462
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
93 94 95 96 97 98 99
Year of registration
Nu
mb
er o
f H
IV i
nfe
ctio
ns
Source: Russian Federal AIDS Centre, Moscow
00001-E-10– 27 June 2000
The epidemic in sub-Saharan Africa
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-11– 27 June 2000
HIV
pre
vale
nc
e (%
)
Median HIV prevalence among pregnant women Median HIV prevalence among pregnant women in urban areas in Uganda, 1985 to 1998in urban areas in Uganda, 1985 to 1998
Source: STD/AIDS Control Programme, Uganda
0
5
10
15
20
25
30
35
85 86 87 88 89 90 91 92 93 94 95 96 97 98
00001-E-12– 27 June 2000
HIV prevalence among pregnant women HIV prevalence among pregnant women in Botswana, 1998in Botswana, 1998
0
10
20
30
40
50
15-19 20-24 25-29 30-34 35-39 40-44
Age Groups
Source: Ministry of Health, Botswana
HIV
pre
vale
nc
e (%
)
00001-E-13– 27 June 2000
HIV prevalence among pregnant womenHIV prevalence among pregnant womenin South Africa, 1990 to 1999in South Africa, 1990 to 1999
Source: Department of Health, South Africa
0.71.7 2.1
4
7.6
10.4
14.2
17
22.8 22.4
0
5
10
15
20
25
90 91 92 93 94 95 96 97 98 99
HIV
pre
vale
nc
e (%
)
00001-E-14– 27 June 2000
Estimated adult HIV prevalence in Kenya, Estimated adult HIV prevalence in Kenya, 1990-19991990-1999
Source: National AIDS and STD Control Programme, 1999 and UNAIDS
0
2
4
6
8
10
12
14
16
90 91 92 93 94 95 96 97 98 99
HIV
pre
vale
nc
e (%
)
00001-E-15– 27 June 2000
The impact of the epidemic on youth
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-16– 27 June 2000
HIV prevalence rate among HIV prevalence rate among 13 to 19-year-olds, Masaka, Uganda, 1989 to 199713 to 19-year-olds, Masaka, Uganda, 1989 to 1997
0
1
2
3
4
5
1989/90 1990/91 1991/92 1992/93 1993/94 1994/95 1995/96 1996/97
girls
boys
Source: Kamali et al. AIDS 2000, 14: 427-434
HIV
pre
vale
nc
e (%
)
00001-E-17– 27 June 2000
HIV prevalence rate among pregnant HIV prevalence rate among pregnant 15 to 19-year-olds, Lusaka, Zambia, 1993 to 199815 to 19-year-olds, Lusaka, Zambia, 1993 to 1998
0
5
10
15
20
25
30
35
Chelstone Chilenje Kalingalinga Matero
Clinic
199319941998
Source: Ministry of Health, Zambia, 1999
HIV
pre
vale
nc
e (%
)
00001-E-18– 27 June 2000
HIV prevalence rate among pregnant 15-24 year-olds HIV prevalence rate among pregnant 15-24 year-olds by educational status, Ugandaby educational status, Uganda
0
5
10
15
20
25
30
1991-1994 1995-1997
HIV
pre
vale
nc
e (%
)
illiterate
primary education
secondary education
Source: Kilian A et al. AIDS 1999, 13: 391-398.
00001-E-19– 27 June 2000
HIV prevalence rate among teenagers HIV prevalence rate among teenagers in Kisumu, Kenya, by agein Kisumu, Kenya, by age
0 0
3.62.2
8.68.3
17.9
29.4
22
33.3
0
5
10
15
20
25
30
35
15 16 17 18 19Age in years
HIV
pre
vale
nc
e (%
)
boys
girls
Source: National AIDS Programme, Kenya, and Population Council, 1999
00001-E-20– 27 June 2000
HIV prevalence rate among women in their teens and HIV prevalence rate among women in their teens and early twenties, various African studies, 1995-1998early twenties, various African studies, 1995-1998
0
10
20
30
40
50
60
70
Carle
tonvi
lle, S
outh A
frica
,
1998
(urb
an)
Muta
sa d
istri
ct, Z
imbab
we,
1998
(rura
l)
Kisum
u, Ken
ya, 1
997
(urb
an)
Lusaka
, Zam
bia, 1
995
(urb
an)
Mposh
i, Zam
bia, 1
996
(rura
l)
Ndola, Z
ambia
199
7 (u
rban
)
Kises
a, T
anza
nia, 1
997
(rura
l)
Yaounde,
Cam
eroon 1
997
(urb
an)
Cotonou, B
enin
199
7 (u
rban
)
Fort Porta
l, Ugan
da 19
95 (u
rban
)
Mas
aka,
Ugan
da 19
96 (r
ural)
women, 15-19
women, 20-24
HIV
pre
vale
nc
e (%
)
00001-E-21– 27 June 2000
Proportion of children testing HIV-positive at aProportion of children testing HIV-positive at asexual abuse clinic, Harare, Zimbabwe, 1998-1999sexual abuse clinic, Harare, Zimbabwe, 1998-1999
0 2 4 6 8 10 12 14
0-4
5-8
9-12
13-16
Ag
e g
rou
p (
year
s)
HIV-infected (%)
tested HIV-positive on arrival
observed to seroconvert after abuse
Source: Family Support Trust, Zimbabwe, 1999.
00001-E-22– 27 June 2000
The impact of the epidemic on other populations and groups
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-23– 27 June 2000
HIV prevalence among people consuming alcoholHIV prevalence among people consuming alcoholand among non-drinkers, Carletonville, South Africa, 1998and among non-drinkers, Carletonville, South Africa, 1998
0
10
20
30
40
50
60
70
men women women in commercial sex areas
HIV
pre
vale
nc
e (%
)
drinkers
non-drinkers
Source: Campbell et al. (unpublished data)
00001-E-24– 27 June 2000
HIV prevalence rate and frequency HIV prevalence rate and frequency of sexually transmitted infection (STI) episodes, of sexually transmitted infection (STI) episodes,
Carletonville miners, South Africa, 1991-1998Carletonville miners, South Africa, 1991-1998
0
10
20
30
40
50
60
70
80
90
1 2-4 5-9 10+
Number of STI episodes
HIV
pre
vale
nc
e (%
)
Source: Ballard R, 2000 (unpublished data).
00001-E-25– 27 June 2000
HIV prevalence in military personnel in AfricaHIV prevalence in military personnel in Africa
Nigeria: 11% among peacekeepers returning from
Sierra Leone and Liberia vs 5% in adult
population
South Africa: 60-70% in military vs 20% in adult
population
Source: Nigeria AIDS bulletin No 15, May 20, 2000; The Mail & Guardian, Pretoria, March 31, 2000; UNAIDS/WHO 1999 estimate
00001-E-26– 27 June 2000
The demographic impact of the epidemic
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-27– 27 June 2000
Projected population structure with and Projected population structure with and without the AIDS epidemic, Botswana, 2020without the AIDS epidemic, Botswana, 2020
80757065605550454035302520151050
020406080100120140 0 20 40 60 80 100 120 140
Males Females Deficits due to AIDS
Projected population structure in 2020
Population (thousands)
Ag
e in
yea
rs
Source: US Census Bureau, World Population Profile 2000
00001-E-28– 27 June 2000
Increase in mortality among men between 15 and 60, selected African countries, 1986-1997
0
10
20
30
40
50
60
70
80
Tanzania, 1996 Malawi, 1992 Zimbabwe, 1994 Uganda, 1995 Zambia, 1996-97
Pro
ba
bil
ity
of
dy
ing
fro
m a
ll c
au
se
s estimated for 6 years before survey estimated for year of survey
Source: Timaeus I, AIDS 1998, 12 (suppl): S15-S27
00001-E-29– 27 June 2000
Adult mortality attributable to HIV, Adult mortality attributable to HIV, community-based studies in Africa, 1990-1996 community-based studies in Africa, 1990-1996
0 5 10 15 20 25 30 35 40
Rakai, Uganda (21% HIV)
Masaka, Uganda (8% HIV)
Kisesa, Tanzania (7% HIV)
Mwanza, Tanzania (4% HIV)
Mortality per 1,000 person - years
Mortality among HIV-negatives
Excess mortality due to HIV
Source: Boerma JT et al, AIDS 1998, 12 (suppl 1): S3-S14
00001-E-30– 27 June 2000
Trends in mortality among children under five yearsTrends in mortality among children under five yearsold and end-1999 adult HIV prevalence rate, old and end-1999 adult HIV prevalence rate,
selected African countries, 1981-1996selected African countries, 1981-1996
KenyaHIV prevalence 14.1%
ZambiaHIV prevalence 19.9%
CameroonHIV prevalence 7.7%
80 %
85 %
90 %
95 %
100 %
105 %
110 %
80 82 84 86 88 90 92 94 96 98
Rel
ati
ve
un
der
-5 m
ort
alit
y (
198
1 =
10
0%)
Source: Demographic and Health Surveys, Macro International, USA
00001-E-31– 27 June 2000
Probability of a Zimbabwean boy Probability of a Zimbabwean boy aged 15 dying before age 50, aged 15 dying before age 50,
trends over time, various national surveystrends over time, various national surveys
0
5
10
15
20
25
30
35
40
45
50
55
60
1980 1985 1990 1995 2000
Pro
bab
ilit
y o
f d
yin
g b
efo
re a
ge
50 (
%)
reports from surviving siblings
death registration
household reports of death
Source: Feeney G, 1999 (unpublished data).
00001-E-32– 27 June 2000
Estimated impact of AIDS on under-5 child Estimated impact of AIDS on under-5 child mortality rates, selected African countries, 2010mortality rates, selected African countries, 2010
Botswana Kenya Malawi Tanzania Zambia Zimbabwe
0
50
100
150
200
250Deaths per 1000 live births
Without AIDS
With AIDS
Source: US Census Bureau
00001-E-33– 27 June 2000
Changes in life expectancy in selected African countries with high HIV prevalence, 1950 to 2000
South-Africa
35
40
45
50
55
60
65
1950-55 1955-60 1960-65 1965-70 1970-75 1975-80 1980-85 1985-90 1990-95 1995-00
Lif
e e
xp
ecta
ncy
at
bir
th,
in y
ears
Botswana
Uganda
Zambia
Zimbabwe
Source: United Nations Population Division, 1998
00001-E-34– 27 June 2000
0 10 20 30 40 50 60 70
Cambodia
Haiti
Mozambique
Rwanda
Côte d'Ivoire
Zambia
Kenya
South Africa
Zimbabwe
Botswana
Life expectancy at birth (years)
Predicted life expectancy Loss in life expectancy due to HIV/AIDS
Source: U.S. Census Bureau, 2000
Predicted loss in life expectancy Predicted loss in life expectancy due to HIV/AIDS in children born in 2000due to HIV/AIDS in children born in 2000
00001-E-35– 27 June 2000
Lifetime risk of AIDS death for 15-year-old boys, Lifetime risk of AIDS death for 15-year-old boys, assuming unchanged or halved risk of becoming assuming unchanged or halved risk of becoming
infected with HIV, selected countriesinfected with HIV, selected countries
Source: Zaba B, 2000 (unpublished data)
Current adult HIV prevalence rate
Burkina Faso
Cambodia
Côte d’Ivoire
Kenya
South AfricaZambia
Zimbabwe
Botswana
Burkina FasoCambodia
Côte d’Ivoire
Kenya
South AfricaZambia
Zimbabwe
Botswana
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0% 5% 10% 15% 20% 25% 30% 35% 40%
Ris
k o
f d
yin
g o
f A
IDS
current level of risk maintained
risk halved over next 15 years
00001-E-36– 27 June 2000
Leading causes of death in Africa, 1999Leading causes of death in Africa, 1999
1 HIV/AIDS 2 Acute lower respiratory infections 3 Malaria 4 Diarrhoeal diseases 5 Perinatal conditions 6 Measles 7 Tuberculosis 8 Cerebrovascular disease 9 Ischaemic heart disease 10 Maternal conditions
20.6
10.3
9.1
7.3
5.9
4.9
3.4
3.2
3.0
2.4
Source: The World Health Report 2000, WHO
Rank % of total
00001-E-37– 27 June 2000
Leading causes of death globally, 1999Leading causes of death globally, 1999
1 Ischaemic heart disease 2 Cerebrovascular disease 3 Acute lower respiratory infections 4 HIV/AIDS 5 Chronic obstructive pulmonary disease 6 Perinatal conditions 7 Diarrhoeal diseases 8 Tuberculosis
11 Malaria
12.7
9.9
7.1
4.8
4.8
4.2
4.0
3.0
1.9
Source: The World Health Report 2000, WHO
Rank % of total
00001-E-38– 27 June 2000
Leading causes of disease burden Leading causes of disease burden in Africa, 1999in Africa, 1999
1 HIV/AIDS 2 Malaria 3 Acute lower respiratory infections 4 Diarrhoeal diseases 5 Perinatal conditions 6 Measles 7 Maternal conditions 8 Tuberculosis 9 Congenital abnormalities 10 Road traffic accidents
19.9
9.9
8.5
6.5
6.5
4.7
3.4
2.3
1.7
1.7
Source: The World Health Report 2000, WHO
Rank % of total
00001-E-39– 27 June 2000
Leading causes of disease burden Leading causes of disease burden globally, 1999globally, 1999
1 Acute lower respiratory infections 2 HIV/AIDS 3 Perinatal conditions 4 Diarrhoeal diseases 5 Ischaemic heart disease 6 Unipolar major depression 7 Cerebrovascular disease 8 Malaria
12 Tuberculosis
6.7
6.2
6.2
5.0
4.1
4.1
3.5
3.1
2.3
Source: The World Health Report 2000, WHO
Rank % of total
00001-E-40– 27 June 2000
The economic impact of the epidemic
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-41– 27 June 2000
Newly diagnosed AIDS cases and medical expenditure Newly diagnosed AIDS cases and medical expenditure on an agricultural estate in Kenya, 1989 to 1997on an agricultural estate in Kenya, 1989 to 1997
0
20
40
60
80
100
120
89 90 91 92 93 94 95 96 97
Nu
mb
er o
f n
ewly
dia
gn
ose
d A
IDS
cas
es
0
5
10
15
20
25
Med
ical
exp
end
itu
re (
KS
h m
illi
on
s)new AIDS cases
medical spending
Source: Rugalema et al. HIV/AIDS and the commercial agricultural sector of Ken UNDP/FAO, 1999
00001-E-42– 27 June 2000
Impact of HIV/AIDS on urban households, Côte d’Ivoire
Impact of HIV/AIDS on urban households, Côte d’Ivoire
General populationGeneral population Families living with AIDSFamilies living with AIDS
Source: Simulation-based on data from Bechu, Delcroix and Guillaume, 1997
Monthly income per capitaMonthly income per capita
Monthly consumptionper capitaMonthly consumptionper capita
00
5 0005 000
10 00010 000
15 00015 000
20 00020 000
25 00025 000
– 5 000– 5 000
30 000 Francs CFA30 000 Francs CFA
Savings/DisavingsSavings/Disavings
00001-E-43– 27 June 2000
Reduction in production in a household with an AIDS death, Zimbabwe
Crops
Maize
Cotton
Vegetables
Groundnuts
Cattle owned
Reduction in output
61%
47%
49%
37%
29%
Source: Stover & Bollinger, 1999
00001-E-44– 27 June 2000
Factors that determine the spread of the epidemic: Knowledge and behaviour
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-45– 27 June 2000
Percentage of 15-19 girlsPercentage of 15-19 girlswho do not know that a HIV-infected person who do not know that a HIV-infected person
may look healthy, 1994-1999may look healthy, 1994-1999
Sources: UNICEF, DHS surveys and other nationwide surveys, 1994-99.
0
83 81 80
7368 67 66 66
62 6257 56 54
51 5047 47 45 45
41 40 39 39 37 35 33 32 31 3128 26
23 22
14
10
20
30
40
50
60
70
80
90
100
Benin
Domin
ican
Rep
ublic
Camer
oonChad
Comoro
s
Côte d
'Ivoire
Brazil
Kenya
Mad
agas
car
Mal
awi
Mal
i
Moza
mbiq
ueHai
ti
Niger
Tanza
nia
Uganda
Zambia
Zimbab
we
Nepal
Lesoto
Bangla
desh
Cambodia
Guatem
ala
Papua
New G
uinea
Mongolia
South A
frica
Viet N
am
Cape
Verde
Centra
l Afri
can R
epublic
Eritre
a
Roman
ia
Turkey
TogoPer
u
Pe
rce
nta
ge
wh
o d
o n
ot
kn
ow
00001-E-46– 27 June 2000
Knowledge of condoms among Knowledge of condoms among adolescent boysadolescent boys
Do not know condomsDo not know condoms
Know condoms but Know condoms but not where to get themnot where to get them
Know condoms and Know condoms and where to get themwhere to get them
0%
25%
50%
75%
100%Bra
zil
Brazi
l
Domin
ican
Rep
ublic
Domin
ican
Rep
ublic
Haiti
Haiti
Peru
Peru
Boliv
ia
Boliv
iaM
alaw
i
Mal
awi
Nicar
agua
Nicar
agua
Zam
bia
Zam
bia
Zim
babw
e
Zim
babw
eTa
nzan
ia
Tanz
ania
Kenya
Kenya
Ugand
a
Ugand
a
Mal
iM
ali
Niger
Niger
Moz
ambi
que
Moz
ambi
que
Chad
Chad
Sources: UNICEF, DHS surveys, 1994-1999
Per
cen
tag
e o
f 15
-19
year
old
bo
ys
00001-E-47– 27 June 2000
Percentage of 15-49 year old women Percentage of 15-49 year old women who are aware that HIV can be transmitted who are aware that HIV can be transmitted
from a mother to her child, 1994-1999from a mother to her child, 1994-1999
Sources: UNICEF, DHS and other nationwide surveys, 1994-1999
96%
Niger
Chad
Mali
Madagascar
Benin
Cameroon
Cote d'Ivoire
CAR
Tanzania
Haiti
Peru
South Africa
Kenya
Uganda
Zambia
Zimbabwe
Dominican Rep.
0% 10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
26%
36%
41%
58%
62%
65%
66%
70%
73%
74%
79%
84%
85%
85%
88%
92%
00001-E-48– 27 June 2000
Risk perceptionRisk perception percentage of sexually active women (15-19) percentage of sexually active women (15-19)
that perceive not to be at risk at all of getting AIDSthat perceive not to be at risk at all of getting AIDS
HIV Prevalence (at time of survey *)
*HIV prevalence in women attending antenatal care clinics in major urban areas
Zimbabwe
Zambia
UgandaKenya
CARHaiti
Togo
CameroonMali
Chad
BeninNiger
Dominican Rep.
Brazil
Guatemala
BoliviaColombia
Nepal
Nicaragua
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
50%
52%21%
36%
41%
63%45%
43%
46%
60%54%
87%
76%52%
87%54%
58%93%
68%
30%
27%
19%16%
10%
10%7%
6%
3%
2%2%
1%1%1%
1%
1%1%
0%
0%
Sources: UNICEF, DHS surveys, 1994-1999
Percentage of 15-19 year old girls who think they are not at risk of AIDS
00001-E-49– 27 June 2000
Knowledge and beliefs concerning AIDS Knowledge and beliefs concerning AIDS among AIDS orphans, Rusinga Island, Kenyaamong AIDS orphans, Rusinga Island, Kenya
Source: Source: Johnston T et al. Population Communication Africa, Kenya, 1999Johnston T et al. Population Communication Africa, Kenya, 1999
99.699.6
39.339.3
18.318.3
0000
1010
2020
3030
4040
5050
6060
7070
8080
9090
100100
Know aboutKnow aboutAIDSAIDS
Believe people in Believe people in extended family extended family
died of AIDS died of AIDS
Believe parents Believe parents died of AIDS died of AIDS
Orp
han
s h
old
ing
th
e b
elie
f (%
)O
rph
ans
ho
ldin
g t
he
bel
ief
(%)
Believe many people in their community have died of AIDS
00001-E-50– 27 June 2000
Casual sex and condom use Casual sex and condom use by educational status, Mozambiqueby educational status, Mozambique
Number of years respondent spent in school
Res
po
nd
ents
rep
ort
ing
th
e b
eh
avio
ur
(%)
0
10
20
30
40
50
60
0-2 3-6 7-9 10+
casual sex in the past year
condom use at last casual sex
Source: Agha S, et al. The promotion of safer sex among high-risk individuals in Mozambique, Population Services International, USA, 1999
00001-E-51– 27 June 2000
Number of reported rapes and convictions Number of reported rapes and convictions in Botswana, 1984 to 1997in Botswana, 1984 to 1997
0
200
400
600
800
1000
1200
1400
84 85 86 87 88 89 90 91 92 93 94 95 96 97
reported rapes
convictions
Source: Emang Basadi Women’s Association, Botswana, 1998
Nu
mb
er
00001-E-52– 27 June 2000
Reported incidence of syphilis and gonorrhoea Reported incidence of syphilis and gonorrhoea in China, 1989 to 1998in China, 1989 to 1998
0
5
10
15
20
25
30
89 90 91 92 93 94 95 96 97 98
Rep
ort
ed c
ase
s p
er 1
00,0
00R
epo
rted
ca
ses
per
100
,000
Gonorrhoea
Syphilis
Source: Chen X-S et al. Sex Transm Dis 2000, 27:138-142
00001-E-53– 27 June 2000
Prevalence of syphilis among pregnant women Prevalence of syphilis among pregnant women attending antenatal clinics in the Moscow region, attending antenatal clinics in the Moscow region,
1993 to 19971993 to 1997
0
100
200
300
400
500
600
700
800
1993 1994 1995 1996 1997
Pre
vale
nce
pe
r 10
0,0
00
Source: Borisenko KK et al. Int J STD & AIDS, 1999, 10:665-668
00001-E-54– 27 June 2000
Proportion of all new HIV infections that are inProportion of all new HIV infections that are ininjecting drug users, selected countries, 1998-1999injecting drug users, selected countries, 1998-1999
0
10
20
30
40
50
60
70
80
90
100
Canada China Latvia Malaysia Moldova RussianFederation
Ukraine Viet Nam
Source: National AIDS Programmes
Per
cen
tag
e
00001-E-55– 27 June 2000
Rectal gonorrhoea and sexual risk behaviour among men Rectal gonorrhoea and sexual risk behaviour among men who have sex with men, San Francisco, USA, 1994 to 1998 who have sex with men, San Francisco, USA, 1994 to 1998
Pro
po
rtio
n r
epo
rtin
g r
isk
be
hav
iou
r (%
)
multiple partners in the past six months
unprotected anal sex in the past six months
42
33
23
2021
27
38 38
44
0
20
40
60
80
100
90 91 92 93 94 95 96 97 98
rectal gonorrhoea rate
Cases of rectal gonorrhoeaCases of rectal gonorrhoeaper 100,000 populationper 100,000 population
Source: San Francisco Department of Public Health (California), USA, 1999
00001-E-56– 27 June 2000
Proportion of newly reported AIDS cases by Proportion of newly reported AIDS cases by race/ethnicity, 1985-1999, United Statesrace/ethnicity, 1985-1999, United States
0
10
20
30
40
50
60
70
85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
Per
cen
tag
e o
f A
IDS
cas
es
White, not HispanicBlack, not HispanicHispanicAsian / Pacific IslanderAmerican Indian / Alaska native
Source: U.S. Centers for Disease Control and Prevention, 2000
00001-E-57– 27 June 2000
Increase in proportion Increase in proportion of ethnic minority members among newly diagnosed of ethnic minority members among newly diagnosed
AIDS cases, Canada, 1990 to 1999AIDS cases, Canada, 1990 to 1999
Source: Health Canada, HIV and AIDS in Canada. Surveillance Report to December 31, 1999.
0
2
4
6
8
10
12
14
16
90 91 92 93 94 95 96 97 98 99
Per
cen
tag
e et
hn
ic m
ino
rity
me
mb
ers
Aboriginal
Black
Latin American
00001-E-58– 27 June 2000
Percentage of women who are mothers Percentage of women who are mothers or pregnant by the end of their teens, 1990-1998 or pregnant by the end of their teens, 1990-1998
0
10
20
30
40
50
60
70
80
Benin
Camer
oon
CAR
Comoro
s
Côte d
'Ivoire
Ghana
Kenya
Mad
agas
car
Mal
i
Moza
mbiq
ue
Namib
ia
Niger
Niger
ia
Rwanda
Seneg
al
Togo
Uganda
Zambia
Zimbab
we
Source: Demographic and Health Surveys, various countries
Per
cen
tag
e o
f w
om
en
00001-E-59– 27 June 2000
Proportion of children aged 10-14 who are still Proportion of children aged 10-14 who are still in school according to whether their parents are alive, in school according to whether their parents are alive,
surveys in various countries, 1994-1998surveys in various countries, 1994-1998
0
10
20
30
40
50
60
70
80
90
100
Benin
Cameroon
Chad
Côte d'Ivoire
Mali
Niger
Tanzania
TogoHaiti
Bolivia
Guatem
alaPeru
living with one or both parents both parents dead
Source: Demographic and Health Surveys, Macro International, USA, and UNICEF, 2000
Pro
po
rtio
n o
f c
hil
dre
n i
n s
ch
oo
l (%
)
00001-E-60– 27 June 2000
Proportion of girls and boys aged 15-19 Proportion of girls and boys aged 15-19 who do not know how to protect themselves fromwho do not know how to protect themselves from
HIV, surveys in selected countries, 1994-1998HIV, surveys in selected countries, 1994-1998
0
10
20
30
40
50
60
70
80
90
100
Bangla
desh
Moza
mbiq
ue
Niger
Chad
Tanza
nia
Comoro
s
Mal
i
Bolivia
Peru
Camer
oon
Nicar
agua
Kenya
Zambia
Cote d
'Ivoire
Zimbab
we
Uganda
Brazil
Pro
po
rtio
n w
ho
do
no
t kn
ow
girls
boys
Source: Demographic and Health Surveys, Macro International, USA, and UNICEF
00001-E-61– 27 June 2000
Proportion of 15 to 19 year-old girls married, proportion Proportion of 15 to 19 year-old girls married, proportion reporting ever having had sex, and adult HIV prevalence reporting ever having had sex, and adult HIV prevalence
rate, surveys in selected countries, 1996-1998rate, surveys in selected countries, 1996-1998
0
10
20
30
40
50
60
70
80
Philippin
es 1
998
Indones
ia 1
997
Bolivia
199
8
Sénég
al 1
997
Nicar
agua
1998
Kenya
199
8
Chad 1
996-
97
Zambia
199
6
Togo 199
8
Niger
199
8
Camer
oon 199
8
Moza
mbiq
ue 19
97
married
ever had sex
adult HIV prevalence rate
Source: Demographic and Health Surveys, Macro International, USA
Per
cen
tag
e
00001-E-62– 27 June 2000
HIV prevalence rates among pregnant women andHIV prevalence rates among pregnant women andamong all adults aged 15-49among all adults aged 15-49
Source: Sentinel surveillance data from antenatal clinics and population-based studies, selected African countries, 1990-1998
0
5
10
15
20
25
30
35
Lusaka,Zambia
94-96
Mposhi,Zambia
94-96
Mwanza,Tanzania 90-91
Rakai,Uganda 90
Rakai,Uganda
91
Rakai,Uganda 92
Kisumu,Kenya 98
pregnant women all adults
HIV
pre
vale
nc
e (%
)
00001-E-63– 27 June 2000
Learning from success stories: Programmes that work
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-64– 27 June 2000
Prevalence of sexually transmitted diseasesamong sex workers, Dakar, Senegal,
1991 and 1996
0
10
20
30
40
50
Trichomonas vaginalis
Chlamydia trachomatis
Neisseria gonorrhoeae
Syphilis
STD prevalence (%) 1991
1996
Source: National AIDS Programme, Senegal
00001-E-65– 27 June 2000
Proportion of men reporting casual sex in the Proportion of men reporting casual sex in the past year and condom use with their last non-regular past year and condom use with their last non-regular
partner, Tamil Nadu, India, 1996 to 1998partner, Tamil Nadu, India, 1996 to 1998
0
10
20
30
40
50
60
70
1996 1997 1998
%
casual sex, truckers
casual sex, factory workers
condom use, truckers
condom use, factory workers
Source: AIDS Prevention and Control Project, Tamil Nadu, India, 1999
00001-E-66– 27 June 2000
Trend in HIV prevalence in 21 year old military Trend in HIV prevalence in 21 year old military conscripts in Thailandconscripts in Thailand
Source: Armed Forces Research Institute of Medical Sciences, Thailand
1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999
HIV
pre
vale
nc
e (%
)H
IV p
reva
len
ce
(%)
00
55
00001-E-67– 27 June 2000
Annual number of deaths due to AIDS, Annual number of deaths due to AIDS, Canada, 1990 to 1999Canada, 1990 to 1999
0
200
400
600
800
1000
1200
1400
1600
90 91 92 93 94 95 96 97 98 99
Nu
mb
er o
f A
IDS
de
ath
s
Source: Health Canada, HIV and AIDS in Canada. Surveillance Report to December 31, 1999
00001-E-68– 27 June 2000
Proportion of sex workers and sex workers’ clients Proportion of sex workers and sex workers’ clients always using condoms with commercialalways using condoms with commercial
partners, Cambodia, 1997 to 1999partners, Cambodia, 1997 to 1999
0
10
20
30
40
50
60
70
80
90
1997 1998 1999
Pro
po
rtio
n r
epo
rtin
g c
on
sist
ent
con
do
m u
se (
%)
brothel-based sex workers
military/police
motorbike taxi drivers
beer promotion women
Source: National AIDS Programme, Cambodia, and Family Health International, 2000
00001-E-69– 27 June 2000Source: National STD/AIDS Control Programmes, Senegal and Uganda Armed Forces Research Institute of Medical Sciences, Thailand
00
55
1010
1515
2020
2525
3030
89 90 91 92 93 94 95 96 97 98 99
HIV
pre
vale
nc
e (%
)H
IV p
reva
len
ce
(%)
Kampala, <20 year old ANC
Thailand, 21 year old military conscripts
Dakar, all ages ANC
Trends in HIV prevalence in selected populations Trends in HIV prevalence in selected populations in Kampala, Uganda; Dakar, Senegal; and Thailand;in Kampala, Uganda; Dakar, Senegal; and Thailand;
1989 to 19991989 to 1999
00001-E-70– 27 June 2000
Condom use for casual sex in the past six months,Condom use for casual sex in the past six months,17 to 30 year-olds, Switzerland, 1987 to 199717 to 30 year-olds, Switzerland, 1987 to 1997
0
20
40
60
80
100
never sometimes always
Source: University Institute of Social and Preventive Medicine, Lausanne, Switzerland, 1999
87 88 89 90 91 92 93 94 95 96 97
Per
cen
tag
e
00001-E-71– 27 June 2000
Condom use for casual sex, by age, selectedCondom use for casual sex, by age, selectedLatin American and Caribbean countries, 1996-1997Latin American and Caribbean countries, 1996-1997
0
10
20
30
40
50
60
70
80
15-19 20-29 30-39 40-49
Age group (years)
Pro
po
rtio
n r
epo
rtin
g c
on
do
m u
se
wit
hth
eir
mo
st r
ecen
t n
on
-reg
ula
r p
artn
er (
%)
Chile
Costa Rica
Cuba
Dominican Republic
Source: National AIDS Programmes
00001-E-72– 27 June 2000
EXTRA SLIDES
UNAIDS/WHO Working Group on Global HIV/AIDS
and STI Surveillance
00001-E-73– 27 June 2000
Annual number of reported HIV infections in the Annual number of reported HIV infections in the UK, by mode of transmission, 1983 to 1999UK, by mode of transmission, 1983 to 1999
0
500
1000
1500
2000
2500
83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99
Nu
mb
er o
f d
iag
no
ses
Heterosexual MSM + MSM/IDU
Source: PHLS Communicable Disease Surveillance Centre UK, July 2000
00001-E-74– 27 June 2000
Number of AIDS patients, AIDS deaths and patients Number of AIDS patients, AIDS deaths and patients on antiretroviral therapy among men who have sex with on antiretroviral therapy among men who have sex with
men (MSM), San Francisco, USA, 1980 to 1998men (MSM), San Francisco, USA, 1980 to 1998
0
1000
2000
3000
4000
5000
6000
7000
8000
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98
MSM taking antiretroviral drugsMSM taking antiretroviral drugs
AIDS deaths among MSMAIDS deaths among MSM
MSM with AIDSMSM with AIDS
Source: San Francisco Department of Public Health (California), USA, 1999
00001-E-75– 27 June 2000
35
21
26
46
12
7
4
117
57
103
69
7
19
17
14.8
7.8
1.5
15.0
14.0
2.0
21.5
14.9
15.2
2.1
26.3
147.3
5.2
12.2
150.0 100.0 50.0 0.0 50.0 100.0 150.0
AustraliaAustralia
BelgiumBelgium
CanadaCanada
DenmarkDenmark
FinlandFinland
GermanyGermany
JapanJapan
LuxembourgLuxembourg
NetherlandsNetherlands
NorwayNorway
SwedenSweden
SwitzerlandSwitzerland
UKUK
USAUSA
1998 HIV/AIDS ODA in US$ million HIV/AIDS ODA in US$ per US$ million 1998 GNP
HIV/AIDS ODA in 1998: HIV/AIDS ODA in 1998: Total amount obligated, in US$ million Total amount obligated, in US$ million
and per US$ million of donor country’s GNPand per US$ million of donor country’s GNP