HIV/AIDS IN AFRICA

 

More than 90 percent of adults infected with HIV live in developing countries. Two-thirds of the total number of people in the world living with HIV are in Sub-Saharan Africa. While Central and Western Africa remain the hardest hit by HIV/AIDS, Sub-Saharan Africa is the region in which the epidemic is growing fastest. Nearly all (over 97 percent) of infected Africans do not know they are infected, mainly because they lack awareness of or access to HIV testing. Contrary to conventional wisdom, heterosexual transmission accounts for most infections and at least 43 percent of all infected adults in developing countries are women.

The consequences of this epidemic are far-reaching. As AIDS mortality rises, a growing number of children will be orphaned. This will exacerbate poverty and inequality. By the year 2010, AIDS will have made orphans of almost 40 million children in Sub-Saharan Africa. Very young orphans whose mothers are infected or die of AIDS have higher mortality rates than other orphans because roughly one-third of them are themselves infected with HIV at or around the time of birth. Also, AIDS orphans are more likely to become two-parent orphans because HIV is transmitted sexually.

In Sub-Saharan Africa, 7.4 percent of all those aged 15-49 are believed to be infected with HIV (this contrasts with 0.5 percent of adults infected in the United States). The potential for political and economic instability is tremendous. Only a small number of individuals with HIV-related disease can afford effective new drug regimens and most will die within 5-7 years of becoming infected. Further, HIV/AIDS causes illness and death among adults in the most productive age groups, resulting in significantly slower growth of the labor force and heightening educational needs among a population which is losing the well-educated as well as the under-educated. Most Sub-Saharan African countries face the dual challenge of lowering HIV prevalence and of coping with the impact of existing high prevalence on their health systems and societies.

Early government commitment and intervention can slow the spread of AIDS decisively. While incidence is still high, recent trend data in Uganda show that government efforts can be extremely effective. In 1997, 5-9 percent of Ugandan adults were infected, compared to 7-12 percent in 1996. This decrease is most pronounced among Ugandan youth, concurring with studies which have shown that they are adopting safer sexual behavior (including later sexual initiation, fewer partners and increased condom use).

To combat and contain the spread of HIV/AIDS, there remains continued need for heightened public awareness and government intervention. The U.S. Government has focused its efforts on prevention of heterosexual transmission of HIV in approximately 30 countries via programs that: change risky behavior through education, motivation and innovation; promote condom use; reduce sexually transmitted infections that increase the risk for HIV; improve the policy environment to reduce the transmission of HIV; conduct research to improve program cost-effectiveness; and increase commitment through advocacy, voluntary counseling and testing programs.