AIDS epidemic growing worldwide

The AIDS epidemic has continued to grow in all regions of the world this year and surged back in some areas where there had been declines, according to the annual AIDS report issued Tuesday by the United Nations and World Health Organization.

Although the rate of growth has slowed since the early years of the epidemic, the AIDS toll for 2006 is expected to be 2.9 million people dead and 4.3 million infected with HIV, the virus that causes AIDS. Officials said 39.5 million people are living with HIV.

Acquired immune deficiency syndrome has killed more than 25 million people since the first case was reported in 1981, making it one of the most destructive diseases in history.

“In a short quarter of a century, AIDS has drastically changed our world,” U.N. Secretary-General Kofi Annan said.

Health officials were particularly concerned about rebounds in the infection rate in regions where they thought they were making headway against the virus.

In Uganda, significant declines in the prevalence of the human immunodeficiency virus during the 1990s have leveled off, the report says, and infection rates in rural areas and among pregnant women appeared to be rising.

“In Uganda, which has been previously recorded as a success story, the latest national behavioral data show increasing erratic condom use and rising numbers of men who have had sex with more than one sexual partner in the previous year,” said Dr. Paul De Lay, director of evaluation for UNAIDS.

He attributed the increase in risky behavior to complacency and a decline in the intensity of prevention programs, funding and political commitment.

Heath officials also were discouraged by a change in the shape of the epidemic in Thailand. Although the number of new infections in the country is still dropping, a group previously thought to be low-risk -- married women -- now accounts for one-third of new infections, De Lay said.

Sub-Saharan Africa continues to struggle with the largest number of people living with HIV, but the “most striking” overall increases in new infections occurred in Eastern Europe and Central Asia, a trend that has been apparent for several years, the report says.

In that region, 270,000 new infections are expected by the end of the year, a 70% jump from two years ago. One-third of the new cases have been appearing among 15- to 24-year-olds, almost all in Russia and Ukraine.

“Some of the most brisk epidemics that we’re seeing, such as in Eastern Europe and in Central and East Asia, are the results of injecting drug use,” said Dr. Kevin De Cock, director of the HIV/AIDS department at the WHO.

Western Europe, particularly Britain, also saw a rise in HIV rates, driven by increases among gay men, said Karen Stanecki, UNAIDS senior advisor on demographics.

Encouraging signs, however, emerged among young people in eight African countries, officials said.

The decrease in HIV rates among 15- to 24-year-olds has been most significant in Kenya, where a drop of more than 25% in rural and urban areas fueled a national decline, officials said. Urban areas of Zimbabwe, Ivory Coast and Malawi and rural areas of Botswana saw similar declines.

In Latin America, the Caribbean and North America, the rate of new infections remained steady. About 43,000 people in North America have been diagnosed this year.

But Stanecki was not satisfied with this stabilization.

“We still think the fact that new infections are remaining stable in the U.S. is not good news,” Stanecki said. “We feel this is a place where prevention programs should be more focused.”

De Cock also encouraged establishing more targeted programs for intravenous drug users, saying scientific evidence has shown that they can corral infections.

In Portugal, for instance, prevention programs aimed at intravenous drug users led to a 31% decline in new diagnoses from 2001 through 2005.

jia-rui.chong@latimes.com