According to estimates from the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO), 36.1 million adults and 1.4 million children were living with HIV at the end of 2000. This is more than 50% higher than the figures projected by WHO in 1991 on the basis of the data then available.

Number of people infected during 2000, and the number of deaths

During 2000, some 5.3 million people became infected with the human immunodeficiency virus (HIV), which causes AIDS. The year also saw 3 million deaths from HIV/AIDS - a higher global total than in any year since the beginning of the epidemic, despite antiretroviral therapy which staved off AIDS and AIDS deaths in the richer countries.

Deaths among those already infected will continue to increase for some years even if prevention programmes manage to cut the number of new infections to zero. However, with the HIV-positive population still expanding the annual number of AIDS deaths can be expected to increase for many years

Young people and children with HIV/AIDS and the AIDS orphans

Around half of all people who acquire HIV become infected before they turn 25 and typically die of the life-threatening illnesses called "AIDS" before their 35th birthday. This age factor makes AIDS uniquely threatening to children. By the end of 1999, the epidemic had left behind a cumulative total of 13.2 million AIDS orphans, defined as those having lost their mother or both parents before reaching the age of 15.

In 2000, an estimated 600,000 children aged 14 or younger became infected with HIV. Over 90% were babies born to HIV-positive women, who acquired the virus at birth or through their mother's breast milk. Of these, almost nine-tenths were in sub-Saharan Africa. Africa's lead in mother-to-child transmission of HIV was firmer than ever despite new evidence that HIV ultimately impairs women's fertility: once infected, a woman can be expected to bear 20% fewer children than she otherwise would.

Men and AIDS

In all parts of the world except sub-Saharan Africa, there are more men infected with HIV and dying of AIDS than women. Altogether, an estimated 2.5 million men aged 15-49 became infected during 2000, bringing the number of adult males living with HIV or AIDS by the end of the year to 18.2 million. Men & AIDS will again be the theme for World AIDS DayWorld AIDS Day in 2001.

HIV/AIDS around the world

The overwhelming majority of people with HIV, some 95% of the global total, live in the developing world. That proportion is set to grow even further as infection rates continue to rise in countries where poverty, poor health systems and limited resources for prevention and care fuel the spread of the virus.

High-income Countries

During the year 2000, 30,000 adults and children are estimated to have acquired HIV in Western Europe, and 45,000 in North America. Overall HIV prevalence has risen slightly in both regions, mainly because anti retroviral therapy is keeping HIV positive people alive longer.

Sub-Saharan Africa

In Africa south of the Sahara desert, an estimated 3.8 million adults and children became infected with HIV during the year 2000, bringing the total number of people in the region living with HIV/AIDS to 25.3 million by the end of the year. The number of people who became infected during the year was slightly less than the 1999 total of 4.0 million. However, this trend will not continue if countries such as Nigeria begin experiencing a rapid expansion.

For the moment, overall HIV prevalence, the regional total of people living with HIV or AIDS continues to rise because there are still more newly infected individuals joining it each year than there are people leaving it through death. However, as people infected years ago succumb to HIV related illnesses (average survival in the absence of anti retroviral therapy is estimated at around 8-10years), mortality from AIDS is increasing. AIDS deaths in 2000 totalled 2.4 million, as compared with 2.2 million in 1999. In the coming years, unless there is far broader access to life prolonging therapy, and providing that new infections do not start rising again, the number of surviving HIV positive Africans can be expected to stabilise and finally shrink, as AIDS increasingly claims the lives of those infected long ago.

It is estimated that between 12 and 13 African women are currently infected for every 10 African men. There are a number of reasons why female prevalence is higher than male in this region, including the greater efficiency of male-to-female HIV transmission through sex and the younger age at initial infection for women.

Eastern Europe and Central Asia

The estimated number of adults and children living with HIV or AIDS in Eastern Europe and the countries of the former Soviet Union was 420,000 at the end of 1999. Just one year later, a conservative estimate puts the figure at 700,000. Most of the quarter million adults who became infected during 2000 are men, the majority of them injecting drug users. During the year new epidemics in drug injectors emerged in Uzbekistan and in Estonia, a country which reported far more HIV cases in 2000 than in any previous year.

HIV shows no sign of curbing its exponential growth in the Russian Federation. Judging from the number of cases reported during the first nine months of the year, registered new infections during the year 2000 may well reach 50,000. This is far more than the total of 29,000 infections registered in the country between 1987 and 1999. However, even this massive rise understates the real growth in the epidemic: by Russian estimates, the national registration system captures just a fraction of the infections. Unsafe drug-injecting practices are still the major spur to HIV transmission in this huge nation.

Asia

An estimated 700,000 adults, 450,000 of them men, have become infected in South and South-East Asia in the course of the year 2000. Overall, as of end 2000, the region is estimated to have 5.8 million adults and children living with HIV or AIDS.

The region of East Asia and the Pacific is still keeping HIV at bay in most of its huge population. Some 130,000 adults and children became infected in the course of the year. This brings the number of people living with HIV or AIDS at the end of the year 2000 to 640,000, representing just 0.07% of the region's adult population, as compared with the prevalence rate of 0.56% in South and South-East Asia.

North Africa and the Middle East

Few new country estimates of HIV infection were produced for this region between 1994 and 1999. Recent evidence, however, suggests that new infections are on the rise. With an estimated 80,000 new infections in the region during 2000, the number of adults and children living with HIV or AIDS had reached 400,000 by the end of the year 2000.

Latin America and the Caribbean

In Latin America an estimated 150,000 adults and children became infected during 2000. By the end of the year some 1.4 million adults and children in the region were estimated to be living with HIV or AIDS, as compared with 1.3 million at the end of 1999

The Future

What is needed on a massive national and international level is to:

end the stifling silence that continues to surround HIV in many countries,
explode myths and misconceptions that translate into dangerous sexual practices,
expand prevention initiatives such as condom promotion that can reduce sexual transmission,
create conditions in which young children have the knowledge and the emotional and financial support to grow up free of HIV,
devote real money to providing care for those infected with HIV and support to their families.
A trail of successful responses has already been blazed by a small number of dedicated communities and governments. The challenge for everyone is to adapt and massively expand successful approaches that make it harder for the virus to spread, and that make it easier for those affected to live full and rewarding lives.

Source: UNAIDS Joint United Nations Programme on HIV/AIDS, "AIDS Epidemic Update December 2000" and "Report on the global HIV/AIDS epidemic June 2000".