AT least 19 million of the 35 million people living with HIV globally do not know that they have the virus, a report from the United Nations
AIDS agency said.
But the UNAIDS said there is a chance that the HIV epidemic will end in 2030 if life-saving treatment is scaled up.
“Whether you live or die should not depend on access to an HIV test,” Michel Sidibé, executive director of UNAIDS, said. “Smarter scale-up is needed to close the gap between people who know their HIV status and people who don’t, people who can get services and people who can’t and people who are protected and people who are punished.”
The UNAIDS Gap Report showed that people who discover that they are HIV-positive seek treatment. In sub-Saharan Africa, almost 90 percent of people who tested positive for HIV had access to anti-retroviral therapy.
Research showed that in sub-Saharan Africa, 76 percent of people on anti-retroviral therapy achieved viral suppression, which means that they are unlikely to transmit the virus to their sexual partners. New data analysis demonstrates that for every 10 percent increase in treatment coverage, there is a one percent decline in the percentage of new infections among people living with HIV.
In 2013, an additional 2.3 million people gained access to life-saving medicines that could bring the global number of people accessing anti-retroviral therapy to nearly 13 million by the end of 2013, the report said.
“If we accelerate all HIV scale-up by 2020, we will be on track to end the epidemic by 2030,” Sidibé said. “If not, we risk significantly increasing the time it would take, adding a decade, if not more.”
By ending the epidemic in 2030, the world would avert 18 million new HIV infections and 11.2 million AIDS-related deaths between 2013 and 2030.
The report revealed that 15 countries account for more than 75 percent of the 2.1 million new HIV infections that occurred in 2013. In every region of the world, there are three or four countries that bear the burden of the epidemic. In sub-Saharan Africa, just three countries–Nigeria, South Africa and Uganda–account for 48 percent of all new HIV infections, the report said.
It added that entire countries are being left behind. For example, six nations–Central African Republic, Democratic Republic of the Congo, Indonesia, Nigeria, Russian Federation and South Sudan–face the triple threat of high HIV burden, low treatment coverage and no or little decline in new HIV infections.
HIV prevalence is estimated to be 28 times higher among people who inject drugs, 12 times higher among sex workers and up to 49 times higher among transgender women than among the rest of the adult population. In sub-Saharan Africa, adolescent girls and young women account for one in four new HIV infections.
“There will be no ending AIDS without putting people first, without ensuring that people living with and affected by the epidemic are part of a new movement,” Sidibé said. “Without a people-centered approach, we will not go far in the post-2015 era.”
The report showed that it is both essential and possible to go deeper than a country-wide approach. Because countries and regions have multiple and varying epidemics, having country targets and sound policies in place creates space to address complex micro-epidemics with tailored, bite-sized solutions that will help reach people faster with better HIV services.
But the report also showed that a lack of data on people most affected by HIV, coupled with widespread stigma and discrimination, punitive legal environments, barriers to civil society engagement and lack of investment in tailored programs are holding back results. It confirms that countries that ignore discrimination and condone inequalities will not reach their full potential, and face serious public health and financial consequences of inaction.
The report emphasized the need for equal access to quality HIV services as both a human right and public health imperative. Hope and gaps UNAIDS is reporting the lowest levels of new HIV infections this century, at 2.1 million (9 million–2.4 million). In the last three years alone. new HIV infections have fallen by 13 percent.
It is estimated that 35 million people were living with HIV in the world at the end of 2013. AIDS-related deaths are at their lowest since the peak in 2005, having declined by 35 percent.
Tuberculosis continues to be the leading cause of death among people living with HIV. New HIV infections among children have fallen by 58 percent since 2001 and dropped below 200,000 for the first time in the 21 most affected countries in Africa. The highest number of people living with HIV was in sub-Saharan Africa–24.7 million people. Asia and the Pacific are second at an estimated 4.8 million people.
The percentage of people living with HIV who were receiving treatment was found to be highest in Western Europe and North America, at 51 percent (39–60 percent), and in Latin America, at 45 percent (33–51 percent). However, coverage was lowest in the Middle East and North Africa, at just 11 percent (8–16 percent).
Meanwhile, new HIV infections declined by 40 percent in the Caribbean but new HIV infections have risen by eight percent in Western Europe and North America, by seven percent in the Middle East and North Africa and by five percent in Eastern Europe and Central Asia since 2005.
AIDS-related deaths were seen to be rising steeply in the Middle East and North Africa, by 66 percent. The only other region where AIDS-related deaths are increasing is Eastern Europe and Central Asia, where deaths rose by five percent between 2005 and 2013.