CMEonHIV.com is dedicated to providing online CME presentations (slides with voiceover) on HIV/AIDS for healthcare professionals given by local and international experts to keep you up-to-date on the ongoing developments in the field.
Conference
"The Global HIV/AIDS Epidemic : CURRENT CHALLENGES" Dr. Helene Gayle (biography) English - 2002-04-13 - 55 minutes
Summary : HIV is the most devastating disease humankind has ever faced. Since the beginning of the HIV epidemic more than 60 million people have been infected with HIV. Today, it is estimated that 40 million people are living with HIV/AIDS. Although, HIV continues to affect people throughout the world, 95% of new HIV infections are among people in developing countries. HIV/AIDS is now the 4th leading cause of death and the leading infectious cause. In 2001, 5 million people were newly infected with HIV and 3 million people died.
Sub Saharan Africa, has been the region of the world where HIV has had the greatest impact. There it is the leading cause of death. Africa accounts for 70% of all people living with HIV. Life expectancy has declined 15-20 years in the most heavily impacted countries going from an average of 62 to 47 years. Southern Africa has been the hardest hit, with South Africa the country with the largest number of people living with HIV in the world. Nigeria, the most populous country in sub Saharan Africa, has had a steadily escalating rate of HIV infection, with an estimated 5% infection rate among adults.
The transmission of HIV infection in Asia began more recently than in Africa, with Thailand, the first country experiencing major spread. However, India and China, the world's most populous countries are experiencing rapid growth of HIV in certain subpopulations and geographic areas. Although overall national rates of infection are relatively low, even small increases in infection rates translates into large number of people infected with HIV.
The Caribbean is the second-most affected region in the world; several countries have adult prevalence rates of at least 1%. There has been a major increase in HIV infection in Eastern Europe and the nations of the former Soviet Union. This region currently has the fastest rate of new infection in the world, with 250,000 new infections in 2001. The Russian Federation has reported a near doubling of new diagnoses annually since 1998 with 10,993 individuals with reported infection in 1998 and 129,000 individuals in 2001.
Though data suggests a trend towards increasing infection rates in North Africa and the Middle East, the rates remain at relatively low levels.
HIV prevention strategies can reduce the incidence of new infections and be cost-effective in developing countries. The most highly cost-effective strategies for prevention include condom promotion, STD control, voluntary counseling & testing, female condom promotion, injection drug user interventions, screening blood supply, and antiretroviral drugs to prevent mother-to-child transmission. These steps range in cost-effectiveness from actually saving funds to US$19 per disability-adjusted life year, or US$506 per HIV infection averted. Countries like Uganda, Thailand and Senegal have demonstrated that these efforts can be successful in reducing the transmission of HIV.
Although effective treatment, though not a cure, for HIV is widely available in rich countries, they are not in widespread use in poor countries where the problem is greatest. Major impediments to access to anti-HIV or antiretroviral drugs are the cost and the lack of stable health care infrastructures to administer and monitor what are rather complex treatment regiments. Many efforts are underway to explore affordable and appropriate use of antiretroviral therapies in resource poor setting. Absent antiretroviral drugs, treatment of associated infections can have a substantial impact of improving the health of people with HIV infection. For example, tuberculosis, a treatable infectious disease, is the leading cause of death for people with HIV in developing countries.
Most experts estimate that $7-10 billion is needed to effectively fight the global HIV/AIDS epidemic.
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