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Doing the Right Thing. Karen A. Stanecki XV International AIDS Conference. Global Report 2002. Global Report 2004. Trends in global adult HIV prevalence. 50. Millions. 40. 30. Estimated number of people living with HIV. 20. 10. 0. 1991. 1993. 1995. 1997. 1999. 2001. 2003.

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Doing the Right Thing

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Doing the right thing

Doing the Right Thing

Karen A. Stanecki

XV International AIDS Conference


Doing the right thing

Global Report 2002

Global Report 2004

Trends in global adult HIV prevalence

50

Millions

40

30

Estimated number

of people

living with HIV

20

10

0

1991

1993

1995

1997

1999

2001

2003


Doing the right thing

Deaths due to AIDS

New infections

Global

Global

Sub-Saharan Africa

Sub-Saharan Africa

Steadily rising annual HIV infections

and AIDS deaths

5

Millions

4

3

2

1

0

1991

1993

1995

1997

1999

2001

2003


Rising hiv infection among injecting drug users followed by rising infection among sex workers

IDU (Guangxi, China)

IDU (Jakarta, Indonesia)

IDU (Hanoi, Vietnam)

Sex workers (Guangxi, China)

Sex workers (Hanoi, Vietnam)

Sex workers (Jakarta, Indonesia)

Rising HIV infection among injecting drug users, followed by rising infection among sex workers

100

90

80

70

60

% HIV

positive

50

40

30

20

10

0

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003


Doing the right thing

High proportions of men who inject drugs are also clients of sex workers

Hanoi, Vietnam

Bangkok, Thailand**

Katmandhu Valley, Nepal

Surabaya, Indonesia

Delhi, India

Sichuan, China*

Central Bangladesh

0

10

20

30

40

50

60

70

80

90

100

%

Unprotected commercial sex

Commercial sex with a condom

Source: Behavioural surveillance reports


Doing the right thing

100

80

60

%

40

Condom use,

Female sex workers

20

HIV prevalence,

female sex workers

0

1995

1997

1999

2001

2003

Increasing condom use and

decreasing HIV infections in Cambodia

Source: Cambodia National Center for HIV/AIDS Dermatology and STDs, Ministry of Health


Doing the right thing

Needle-exchange programmes promote healthy sexual behaviour and safe injection

Bangladesh

100

Participated in needle exchange

90

90

Did not participate

80

72

70

59

60

51

50

Percent

38

40

30

21

17

20

16

10

0

Sought medical

treatment for STI**

Used needle

after other injector

last time

Used needle

after other injector

in the last week

Reported STI symptom

past year*

* of sexually active respondents; ** of respondents reporting STIs

Source: National behavioural surveillance data


Asia s hiv prevention successes have three features in common

Asia’s HIV prevention successes have three features in common

  • They recognize and target the behaviors that are causing most new infections

  • They use the most effective interventions that directly reduce the risk of HIV transmission

  • They provide the services to the population at greatest risk of HIV exposure


Doing the right thing

Treatment is critical, and HIV prevention services remain a major priority

in Indonesia

Sex workers needing

condoms and STI services

200 000

Drug injectors needing

needles and condoms

115 000

High-risk MSM needing

condoms and lubricant

63 000

Prisoners needing

prevention services

110 000

Men and women

needing antiretrovirals

8 500

0

50 000

100 000

150 000

200 000

250 000

Source: Based on national estimates of people at risk for HIV, Ministry of Health , Indonesia


Doing the right thing

HIV prevalence in adults, end 2003

38 million people [range: 35-42 million] living with HIV as of end 2003

Adult prevalence %

15.0% − 39.0%

5.0% − 15.0%

1.0% − 5.0%

0.5% − 1.0%

0.1%− 0.5%

0.0% − 0.1%

not available


Doing the right thing

HIV prevalence among 15−24-year-olds

in selected sub-Saharan African countries, 2001−2003

20

Men

Women

15

10

% HIV prevalence

5

0

Niger

(2002)

Mali

(2001)

Burundi

(2002)

Kenya

(2003)

Zambia

(2001-2002)

South

Africa

(2003)

Zimbabwe

(2001-2002)

2004 Report on the Global AIDS Epidemic (Fig 7)


It s about human rights

It’s about human rights

Every person in need must have

access to HIV treatment.

And the more people have access

to effective prevention,

the fewer people will be

in need of treatment.


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