HIV prevention working in some countries but big picture bleak

Despite new evidence suggesting that prevention efforts are having a positive effect in a small but growing group of countries, the big picture remains bleak, a joint UNAIDS and World Health Organisation report revealed on Monday. The 'AIDS Epidemic Update 2005' showed that worldwide the number of people living with HIV rose to an estimated 40.3 million during the year, an extra five million new infections had occurred, and more than 500,000 children were among the estimated three million who died from AIDS related illnesses. These startling figures are forcing senior UN officials to reiterate the need for greater prevention efforts to slow the pandemic. "It is true that some prevention campaigns are hitting the point and others are missing it altogether. These campaigns should be more intensive in addressing the various information needs of people, while also being sustained over longer periods of time," Mark Stirling, director of the UNAIDS Regional Support Team for Eastern and Southern Africa, told PlusNews. Although all countries were doing their best to ensure universal access to treatment, prevention, and care for orphans, Stirling stressed that they had be much more aggressive in tackling the pandemic by reconsidering their current strategies, goals and targets. The report recognised that access to antiretrovirals (ARVs) had improved over the past two years, with more than one million people in low- and middle-income countries now living longer and more productive lives. Between 250,000 and 350,000 deaths were averted in the current year as a result of expanded access to ARVs. "Yes, there is guarded optimism over the progress that has been made in terms of access to life-prolonging treatment, but we could definitely be doing more along the lines of prevention to get ahead of this pandemic," Stirling noted. UNAIDS said although there was ample evidence that HIV/AIDS did yield to determined and concerted intervention, Sub-Saharan Africa remained the region hardest-hit and was presently home to an estimated 25.8 million HIV-positive people - almost a million more than in 2003 - and some 77 percent of the women living with HIV across the world. "The epidemic continues to intensify in southern Africa. HIV infection levels among pregnant women are 20 percent or higher in six southern African countries, including Botswana, Lesotho and South Africa," the report noted. Dean Peacock, the South African programme manager for EngenderHealth's Men As Partners (MAP) project, which encourages the role of men in HIV prevention and speaking out against domestic and sexual violence, told PlusNews that gender-based violence also helped exacerbate the impact of HIV on women. "We can always do more, and we certainly should do more to engage men as firm proponents of gender equality, and who could help end sexual violence and alleviate the affect of AIDS on women," said Peacock. He noted that the response of South African men to MAP had thus far been phenomenal, with most men steering away from living up to "ridiculous" notions of manhood and masculinity. "The response has proved that contemporary gender roles do not work for men, and very often finds them living dangerously, be it driving in the fast lane on public roads, drug abuse, or taking multiple sex partners. It is definitely in our best interest, as men, to challenge these rules," he said. In a statement released ahead of the agency's epidemic update, UNAIDS Executive Director Peter Piot said it was clear that a rapid increase in the scale and scope of HIV prevention was urgently needed. "We must move from small projects with short-term horizons to long-term, comprehensive strategies," he stressed. The full UNAIDS/WHO AIDS Epidemic Update 2005 can be accessed at UNAIDS