Kevin M. De CockI; Paul DelayII
IDepartment of HIV/AIDS, World Health Organization IIDepartment of Evidence, Monitoring and Policy, UNAIDS, Joint UN Programme on HIV/AIDS
Dear Editor:
We wish to clarify misinterpretations concerning World Health Organization (WHO) and UNAIDS – Joint United Nations Programme on HIV/AIDS – positions on the status of the acquired immunodeficiency syndrome (AIDS) epidemic in recent media articles. The story in the Independent on Sunday titled: Threat of world AIDS pandemic among heterosexuals is over, report admits contained a few seriously misleading statements that have led to inferences and conclusions that bear no relation to the highly complex realities of the human immunodeficiency virus (HIV) epidemic.
First and foremost, the global HIV epidemic is by no means over. At the end of 2007, an estimated 33.2 million people were living with HIV. Some 2.5 million people became newly infected that year, and 2.1 million died of AIDS. AIDS remains the leading cause of death in Africa.
Worldwide, HIV is still largely driven by heterosexual transmission. The majority of new infections in Sub-Saharan Africa occur through heterosexual transmission. We have also seen a number of generalized epidemics outside of Africa, such as in Haiti and Papua New Guinea.
Heterosexual transmission continues to drive the epidemic among sex workers, their clients, and their clients’ partners. In addition, prisoners, injecting drug users, as well as men who have sex with men, may also engage in heterosexual relationships. In sub-Saharan Africa almost 60% of adults living with HIV were women, 48% in the Caribbean.
HIV prevention and treatment efforts are showing results. Building on these successes will require improved outreach to populations most at risk with evidence-informed approaches based on local HIV epidemiology — an approach we call knowing your epidemic. In all settings, a supportive environment is required, free from stigma and discrimination, legal barriers or other obstacles that prevent access to services. AIDS awareness campaigns and school-based efforts are essential to promote sexual and reproductive health, ensuring young people have the knowledge and ability to protect themselves against sexually transmitted diseases, and teenage pregnancy.
UNAIDS and WHO remain focused on strengthening monitoring of the epidemic to refine responses further and to recognize changes in transmission patterns should they occur.
To recap: AIDS remains the leading infectious diseases challenge in global health. To suggest otherwise is irresponsible and misleading.
Recebido para publicação em 26/09/2008
Aceito em 26/09/2008
