Report: India Tops In AIDS Infections

The global battle against HIV/AIDS shows no sign of letting up a quarter-century into an epidemic that has claimed 25 million lives, the head of the U.N.'s HIV/AIDS joint program said, while a report Tuesday showed that India now has the largest number of infections.

"I think we will see a further globalization of the epidemic spreading to every single corner of the planet," UNAIDS head Dr. Peter Piot told The Associated Press.

Data released Tuesday shows that India now has the largest number of people living with HIV/AIDS. With an estimated 5.7 million infections, it has surpassed South Africa's 5.5 million.

But the epidemic still remains at its worst in sub-Saharan Africa, where per capita rates in several countries continue to climb — a third of adults were infected in Swaziland in 2005.

UNAIDS on Tuesday launched a 630-page report that takes stock of where the world currently stands, with nearly 40 million people living with HIV/AIDS.

It documents countries' progress and failures, and projects what must happen to keep some regions from experiencing disaster. The report was released a day before a High Level Meeting on AIDS in New York, a week prior to the 25th anniversary of the first documented AIDS cases on June 5, 1981.

"It won't go away one fine day, and then we wake up and say, 'Oh, AIDS is gone,"' Piot told The AP in a recent telephone interview from Geneva. "I think we have to start thinking about looking at the next generations. There's an increasing diversity in how the epidemic looks."

Piot said one of the most disturbing findings was how few babies are being protected against infection. Only 9 percent of pregnant women in poor countries are receiving services, such as access to drugs, to help prevent mother-to-child transmission, despite a UNAIDS goal of 80 percent coverage.

"The thing I'm most disappointed with and surprised about is prevention of mother-to-child transmission," Piot said. "For HIV, the coverage is still very low and we didn't meet the target. Here we have something that is non-controversial; it's about saving the babies."

Women's vulnerability to the disease continues to increase, with more than 17 million women infected worldwide — nearly half the global total — and more than three-quarters of them living in sub-Saharan Africa, the report found.

Stigma and discrimination also still plague those infected with the virus worldwide, and young people's knowledge about HIV/AIDS remains low with less than 50 percent having adequate information about the disease — a far cry from the 90 percent target UNAIDS set for 2005.

Piot said the situation in sub-Saharan Africa remains dismal, where 24.5 million people were infected and home to nearly 90 percent of the world's children living with the virus.

South Africa remains one of the world's most tragic situations with nearly one in three pregnant women testing HIV-positive in public antenatal clinics in 2004. Nearly 19 percent of adults were infected nationwide last year and the per capita rate is continuing to climb.

"I think in Africa, it is only comparable in demographic terms to the slave trade regarding the impact it has had on the population," Piot said. "In southern Africa, HIV prevalence continues to go up, and they're already the world record."

But Piot said the new numbers do offer a small sliver of hope. Kenya and Zimbabwe, along with some cities in Burkina Faso, reported declines in the overall percentage of adults infected. He said Thailand and Uganda were two of the only previous examples where exploding epidemics were curbed.

"We still have a long way to go, but it's the first time since we published this report that we have more than just Uganda," he said of the rate decline in sub-Saharan Africa.

The Asia-Pacific region is also a concern with 8.3 million people infected, the second-highest after sub-Saharan Africa.

Piot said that the sheer population of Asia makes it a potential problem because even small gains in overall per capita infections equal huge numbers — especially in countries like China and India, each of which have more than 1 billion people.

Piot said Eastern Europe and Central Asia have become a new front where infections have expanded as people have access to more money and have started buying injecting drugs — instead of just shipping them through — from countries like Afghanistan.

"Absolute numbers are still low, but when you look at the spread of the disease, we know from experience where that leads," Piot said. "The Middle East is the last part of the world where HIV is not spreading rapidly."

Piot said that there is still time to stop AIDS from worsening, but action is needed now on a number of fronts. Currently, about 1.3 million people in poor countries have access to antiretroviral treatment, but about 80 percent still are not receiving drugs.

"Ultimately, it depends on how the leadership reacts, how the international community will continue to respond and how ready communities are to face the problem," Piot said. "Intervention is very low ... for many critical populations in many countries. We need to really intensify the response to AIDS."