HIV infection remains persistently high, UN says

While the world’s attention was focused on the Covid pandemic and the war in Ukraine, the fight against an older enemy has lost its decisive role: last year more than 1.5 million people became infected with HIV, about three times the global target, the UN said. . Wednesday.

According to UNAIDS, the organization’s HIV and AIDS program, about 650,000 people died of AIDS in 2021, at about one per minute. Progress against the disease has slowed and global infections have remained stable since 2018.

The losses in 2021 have been uneven, with people aged 15 to 24 – and especially young women – bearing a disproportionate share of the burden. The program says that every two minutes there is one new infection of a teenage girl or young woman.

In sub-Saharan Africa, young people account for 31 percent of new infections, and almost four out of five cases occur in girls and young women. In El Salvador, HIV prevalence has almost doubled among men who have sex with men and has increased by about eight times among transgender people.

In the Asia-Pacific region, the number of new HIV infections is rising where it has been declining before. And about 160,000 children worldwide have become infected, despite the existence of prevention methods.

“These numbers should represent more than just an alarm—they should represent a point,” said Stephan Wallace, an epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle.

In most countries, including the US, only privileged groups tend to have continued access to HIV prevention and treatment. Wallace said. “Groups that are oppressed in different parts of the world or substantially lower in the social hierarchy do not have the same access,” he said.

There are an estimated 40 million people living with HIV worldwide. About 10 million of them, including about half of the infected children, do not have access to treatment.

Fortunately, many of those already on treatment continued to do so in 2021, thanks in part to innovative HIV programs in some countries. But the past two years have brought relentless waves of hardship, especially in low- and middle-income countries, that have undermined HIV prevention and diagnosis.

Millions of girls have been out of school due to the spread of the coronavirus, a surge in teenage pregnancies and gender-based violence. The pandemic has caused poverty rates and fuel costs to skyrocket.

The war in Ukraine has led to further spikes in food prices and restrictions on supply chains.

“During the economic crisis, women – especially young women – will more dependent on paid sex as a source of income,” said Harsha Tirumurthy, an economist at the University of Pennsylvania. “It’s not exclusively, but in general economic history.”

In 2021, debt repayments in low-income countries accounted for 171% of spending on health, education and social protection combined. According to the report, donor countries have tightened their budgets, and HIV funding from countries other than the United States has fallen by 57 percent over the past decade.

Low- and middle-income countries will need an estimated $29 billion to fight HIV by 2025, but will face an estimated $8 billion shortfall.

“These numbers reflect political will,” said UNAIDS Executive Director Winnie Byanyima.

“Do we care about empowering and protecting our girls?” she added. “Do we want to stop AIDS deaths among children? Do we prioritize saving lives over criminalization? If we do this, we must bring back the AIDS response.”

The reaction in some countries has been colored by the fact that people from marginalized communities are at highest risk.

In Australia, Canada and the United States, new HIV infections are higher among blacks and indigenous people than among whites. Men who have sex with men, drug users and sex workers, who collectively account for about 70 percent of global infections, are at about 30 times the risk of infection compared to the general population.

An effective global policy must take these realities into account; it’s about “more than giving people condoms and lube,” says the doctor. Wallace said.

In an ideal world, for example, young women would have unhindered access to reproductive health services without stigmatization or judgment from their families, communities, or houses of worship. Dr. Tirumurti suggested that money transfer programs can be just as important as medical instruments in slowing the spread of new infections among girls.

At a meeting in 2016, UN member countries set new targets for 2020 of fewer than 500,000 new HIV infections annually, fewer than 500,000 AIDS-related deaths, and the elimination of HIV-related discrimination. Countries have not achieved these targets.

The world is also unlikely to hit another target: cutting up to 370,000 new infections annually by 2025. The real number is likely to be three times higher, the new report estimates.