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AIDS (Acquired Immunodeficiency Syndrome) about AIDS (Acquired Immunodeficiency Syndrome) - Since the start of the AIDS epidemic in the 1980s, the disease has claimed over 20 million lives worldwide. Today, the number of people with HIV continues to increase in every part of the world. The World Health Organization estimates that about 39.4 million people were living with HIV at the end of 2004. Of this number, about 4.9 million—one of eight—had contracted the virus within the last year. Globally, 3.1 million people died of AIDS in 2004. Although sub-Saharan Africa remains the area hardest hit by HIV and AIDS, the virus is now spreading most rapidly in East Asia, Eastern Europe, and Central Asia.

In many countries, the impact of AIDS goes far beyond the death toll. AIDS has always hit young adults particularly hard about half the new adult HIV infections occur in people between the ages of 15 and 24, with young women becoming infected more often than young men. The loss of large numbers of people in the prime of life means that fewer adults are available to take care of children and the elderly. About 15 million children have already been orphaned by AIDS, most of them in sub-Saharan Africa. The loss of working-age adults also affects the workforce, with important economic consequences in countries where HIV and AIDS are most prevalent. Recent surveys have also found that women are increasingly affected by HIV and AIDS. Women now make up almost half the total cases of HIV and AIDS worldwide and represent well over half the cases in some of the hardest-hit areas, such as sub-Saharan Africa.

Gender inequality is one underlying cause. In many places, women have less access than men to education, testing, counseling, and treatment. A UNICEF study showed that as many as half the women in countries where HIV and AIDS present the greatest danger lack basic information about the disease, such as how it is transmitted and what they can do to protect themselves. In addition, many women contract HIV not through their own high-risk behavior, but through the high-risk behavior of their partners. 

In the past few years, increased international funding has helped to address some aspects of the global HIV epidemic. Education, testing, and counseling are now more widely available in some parts of the world, as are anti-HIV medications. Anti-HIV drugs are crucial both for decreasing the incidence of mother-to-child HIV transmission during childbirth and for allowing those with HIV to live longer, more productive lives. Nonetheless, international funding for AIDS still falls far short of what is required. Overall, it is estimated that prevention programs reach less than 20 percent of the people most at risk and that only 7 percent of individuals who need anti-HIV drugs have access to them. The “3 by 5” AIDS initiative, begun in 2003 by the World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS), was an ambitious venture with the goal of providing the infrastructure and drugs necessary to treat 3 million people in developing countries with life-prolonging anti-HIV therapy by the end of 2005. Although this goal ultimately was not met, there were many local success stories. In addition, the initiative succeeded in bringing global attention to the need to expand HIV treatment access and helped to mobilize support. WHO and UNAIDS continue to work towards their goal of universal access to treatment by 2010. 

In the United States, testing HIV-positive is not the death sentence it was two decades ago, largely because of the anti-HIV drugs now available. Although this is certainly good news, it has unfortunately also led to complacency and the return of high-risk behaviors in some quarters. No current anti-HIV therapy is a cure—treatments can only delay the onset of illness. Inevitably, drug-resistant strains of HIV have evolved in some people receiving treatment. Drug-resistant strains can then be transmitted to other individuals. In 2005, public health officials were alarmed to find in a New York City patient an aggressive strain of HIV that was resistant to 19 of the 20 licensed anti-HIV medications. It is almost inevitable that eventually, a transmissible strain of HIV will appear that can’t be treated with current drugs.