In East Asia there was a 56 per cent increase followed by a 48 per cent rise in both the other two regions, according to AIDS Epidemic Update 2004, the annual report by the Joint UN Programme on HIV/AIDS (UNAIDS) and the UN World Health Organization (WHO). The number of people living with HIV globally has also reached its highest level with an estimated 39.4 million people, up from an estimated 36.6 million in 2002. “We do not yet have a vaccine, but we do know that prevention and treatment work and we have the tools to deliver them. Government leaders, civil society and the private sector are all affected and we must all mobilize to save lives,” WHO Director-General Lee Jong-wook said. “These latest trends firmly establish AIDS as a unique development challenge,” UNAIDS Executive Director Peter Piot added of the report’s indication that there is no single AIDS epidemic worldwide, with many regions and countries experiencing diverse epidemics, some still in the early stages. “The time of quick fixes and emergency responses is over. We have to balance the emergency nature of the crisis with the need for sustainable solutions,” he added. Women are increasingly affected, now making up nearly half of the 37.2 million adults aged 15 to 49 living with HIV worldwide. In sub-Saharan Africa, the worst-affected region, close to 60 per cent of adults living with HIV are women – or 13.3 million. The steepest increases in overall HIV infections also occurred in East Asia, Eastern Europe and Central Asia, with a 50 per cent rise in East Asia largely attributable to growing epidemics in China, Indonesia and Viet Nam. The 40 per cent increase in Eastern Europe and Central Asia is mainly due to Ukraine’s expanding epidemic and the growing number of people living with HIV in the Russian Federation. With an estimated 860,000 people living with HIV at the end of 2003, Russia has the largest epidemic in Europe. As the numbers of people becoming infected and living with HIV increases, so does the number of those needing antiretroviral treatment, as well as care for opportunistic infections. Women are more physically susceptible to HIV infection than men. Male-to-female HIV transmission during sex is about twice as likely to occur as female-to-male transmission. For many women in developing countries, the “ABC” prevention approach (Abstinence, Being faithful and reducing number of sexual partners, and Condom use) is insufficient. “Strategies to address gender inequalities are urgently needed if we want a realistic chance at turning back the epidemic,” Dr. Piot said. “Concrete action is necessary to prevent violence against women, and ensure access to property and inheritance rights, basic education and employment opportunities for women and girls.” According to the report, millions of young people are becoming sexually active each day with no access to prevention services. In sub-Saharan Africa, three quarters of all 15 to 24 year-olds living with HIV are female. Young women there are three times more vulnerable to HIV infection than their male counterparts. In addition to being biologically more vulnerable to infection, many women and girls, particularly in southern Africa, find themselves using sex as a commodity in exchange for goods, services, money or basic necessities – often with older men. In other regions where the epidemic is spread largely by intravenous drug users and female prostitutes with male clients, women made up between 25 per cent and 40 per cent of reported cases. In North America, HIV/AIDS is the leading cause of death among African-American women ages 35 to 44, apparently the result of undisclosed high-risk sexual behaviour of their male partners.Speaking at a press briefing, Desmond Johns, Director of the UNAIDS New York Office, said such facts “demonstrates eloquently the paradox that many women face, where they are at heightened vulnerability in the face of low risk.” Quite often – because of societal norms, gender imbalance and violence against women – “women are placed at risk for who they are and not so much for what they do,” he said.

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