Worldwide Growth and size of the epidemic

Even though North America and Europe experienced the first impact of the epidemic, infections with HIV are now seen throughout the world, and the major focus of the epidemic is in developing/resource-poor countries.

The joint United Nations programme on AIDS (UNAIDS) has estimated that by the end of 2000 there were 36.1 million people living with HIV/AIDS (34.7 million adults and 1.4 million children <15 years). The new infections during that year were 5.3 million, approximately 16,000 new infections per day.

Currently, 95% of all infections occur in developing countries and continents, the major brunt of the epidemic being seen in sub- Saharan Africa and south-east Asia. It is now recognised that cases of AIDS were first seen in Central Africa in the 1970s even though at that time it was not recognised as such. Current surveys from some
African countries show that the prevalence of infection is high amongst certain groups – 50–90% of prostitutes, up to 60–70% of those attending departments for sexually transmitted diseases and antenatal clinics. In the developing world, HIV is spread mainly by heterosexual intercourse.

At a family level, UNAIDS estimated that by the end of 1999 the epidemic had left behind a cumulative total of 13.2 million AIDS orphans (defined as those having lost their mother or both parents to AIDS before reaching the age of 15 years).

Many of these maternal orphans have also lost their father. Orphans in Zimbabwe are expected to total 1 million by 2005 and 2 million in South Africa by 2010. Traditional family structures and extended families are breaking down under the strain of HIV. Population growth and death rates are increasingly affected. Life expectancy in countries with adult prevalences of over 10% (for example Botswana, Kenya, Zimbabwe, South Africa, Zambia, Rwanda) are expected to see an average reduction in life expectancy of 17 years by 2010–2015. Young, highly productive adults die at the peak of their output, which has a considerable impact on a country’s economy.