HIV, AIDS, and Drug Abuse in the International Sector

Abstract

AIDS has become the leading cause of death among people under age 45 in many major cities throughout the United States and Western Europe, and the projected mortality rate for those infected with HIV is virtually 100%. As of July 5, 1996, the World Health Organization (WHO) Global Programme on AIDS reported a cumulative 1,393,649 AIDS cases from 193 countries (WHO 1996). This represented a 19% increase in actual cases reported a year earlier. However, the WHO estimates that allowing for incomplete reporting and under-diagnosis, there were probably some 7.7 million cumulative AIDS cases by mid-1996. In terms of HIV, the WHO estimates that there has been a cumulative distribution of almost 30 million HIV-infected individuals as of mid-1996 (WHO 1996). The joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that some 20.1 million adults were living with HIV infection or AIDS at the close of 1995. By the year 2000, UNAIDS estimates project that 30 to 40 million people will have been infected with HIV worldwide (UNAIDS 1996). With more than 19 million HIV-infected adults, Sub-Saharan Africa remains the most affected region of the world (WHO 1996). The predominant mode of transmission since the beginning of the epidemic has been through heterosexual contact. The reuse of unsterilized hypodermic needles in transfusions and inoculations is also relatively common in many African nations. In a number of countries in that part of the world, furthermore, HIV infection has been spread through population movements due to situations of conflict or poverty (Decosas et al. 1995). The lower status of women in a number of African nations has also contributed to the rapid spread of the epidemic (UNAIDS 1996). HIV infections in African women outnumber men by a ratio of 6 to 5. More than 6 million women of childbearing age have been affected, and UNAIDS believes that as many as I million children may already have been infected either prior to or during birth, or during breast feeding (UNAIDS 1996). Another contributing factor has been the full range of sexually transmitted diseases, which increase the risk of HIV infection if left untreated (UNAIDS 1996).