Since HIV was discovered, it has taken 20 million lives and every year there are nearly 3 million new infections. However the yearly rate of new infections fell by 21% between 1997 and 2010 according to UNAIDS (the Joint United Nations Programme on HIV/AIDS). Paradoxically, the number of people living with HIV has never been higher, mainly because of better access to treatment.
In the world in 2011 (data from UNAIDS)
• People living with HIV: 34 million
• New infections: 2,7 million
• AIDS related deaths: 1,8 million
According to UNAIDS, we are closer to ending this epidemic than we have ever been before: “science, political support and the community-based response have started to produce tangible results”. The benefits of improvements in access to treatment which now concern 6.6 million people throughout the world are nevertheless outweighed by the spread of the epidemic in some areas.
Thus, in Eastern Europe and central Asia, the number of people living with HIV increased by 250% between 2001 and 2010, whereas in Botswana access to treatment for 80% of patients helped to decrease new infections by two thirds compared to the late 1990s.
UNAIDS, calls for stronger strategies to curb the epidemic, in six main areas :
• Interventions targeted towards the most vulnerable populations, in particular sex workers and their clients, men who have sex with men, and injecting drug users.
• Prevention of mother-to-child transmission
• Behavior change programs
• Promotion and distribution of condoms
• Treatment, care and help for people living with HIV.
• Voluntary circumcision in countries where HIV prevalence is high and circumcision rates are low
To reach this objective by 2015, it is crucial to maintain investment as there are still 7 million people in the world who do not have access to treatment. According to UNAIDS, international aid went from 8.7 billion dollars in 2009 to 7.6 billion in 2010.
With an objective by member states of at least 22 to 24 billion US dollars per year for the fight against AIDS by 2014, UNAIDS requests that strategic investments be maintained.
The epidemic in France (Data from “The French Institute for public health surveillance” 2010)
According to figures of the French Institute for public health surveillance, there were 6,265 new HIV infections in 2010. The number of new infections has been stable since 2008, while it had significantly dropped between 2004 and 2007.
Men who have sex with men (MSM) is the population at highest risk of HIV and other STIs (sexually transmitted infections).
In 2010, 2,500 men who have sex with men discovered their HIV positive status which corresponds to 40% of all infections. It is the only group where the number of new infections has gone up since 2003. These men are often diagnosed after taking a risk. Their average age is 37 but the proportion of under 25s has been steadily increasing since 2003.
STI transmission is also high among MSM; more than three quarters of syphilis cases affect this group and the number of gonorrhea cases rose by 50% between 2008 and 2010 among MSM.
People infected through heterosexual intercourse.
In 2010, 3,600 people were infected through heterosexual intercourse, accounting for 57% of all new infections. This number has been decreasing since 2007 especially among people who were born abroad. The 2,500 heterosexuals who were born abroad represent the majority of new cases among this group (69%). This group is mainly made up of people from sub-Saharan Africa (76%) and women (60%).
Late diagnosis.
In 2010, the average age of those newly diagnosed was 37.9.
15% of people who discover their HIV positive status are at the AIDS stage; more than one person out of four is diagnosed when their CD4 count is less than 200 copies even though it is recommended to initiate treatment at a CD4 count of 500 copies. Consequently, the number of AIDS cases (1,500 yearly) and the number of AIDS related deaths (300) has not decreased since 2007.
Even though gay people usually get tested earlier than other groups (50% have a CD4 count of 500 copies) the number of people diagnosed HIV positive at primary infection stage is still too low. Diagnoses at primary infection stage increased until 2007 but have stagnated at 20% since then.
During the weeks following infection, the amount of virus produced is extremely high, with a viral load of 100,000 or even one million copies/ml. If people are not aware of their HIV status then it is very difficult to have appropriate prevention strategies. Many researchers estimate that this short period could account for half of all new infections.
According to Doctor François Dabis from Bordeaux university, the author of the weekly epidemiological journal which published these data, we urgently need to reduce new infections: “We need to commit ourselves to eliminating new infections rather than trying to eradicate HIV/AIDS. Reducing new infections by 80 or 90%, which could be done in 5 years, should be on the health agenda of all electoral programs proposed by our politicians”.
