Marking the arrival of a milestone experts had predicted for years, the UN and the World Health Organization announced Wednesday that about half the HIV-infected people worldwide are women. The continued spread of AIDS in sub-Saharan Africa, where the majority of new infections have occurred in women for several years, is the main engine behind the "feminization" of the epidemic, although the number of infected women is rising elsewhere as well.

Heterosexual transmission is now the main cause of new infections in Western Europe and is of growing importance in Eastern Europe. "We are far away from the gay white male disease it was in the 1980s," said UNAIDS Executive Director Peter Piot. In all, 42 million people are living with HIV, according to the report.

African girls are at higher risk because their partners tend to be older and are more likely to be infected. Many African girls and married women find it difficult to demand safe sex practices. Male-to-female transmission is more efficient than female-to-male, and the genital tract of teenage girls is more vulnerable to infection than that of older girls.

The report cites numerous social and economic consequences of the rising numbers of infected women. Women in Africa do most of the work on subsistence farms and most of the food preparation, are more involved in the education of children, and are the chief caregivers for ill family members. Experts believe the effects of the drought and famine in southern Africa are much worse because of AIDS, and they warn of the risk of the poor socialization of the 11 million children who have lost one or both parents to AIDS. The worsening African food shortage "is the first sign of the larger societywide destabilizing impact of AIDS, as was predicted several years ago, but which I frankly didn't think would happen so quickly," Piot said.

There was also good news, however. The report cites early evidence that the prevention campaigns that helped reduce new infections in Uganda and Thailand are working elsewhere. HIV prevalence has fallen among pregnant women in South Africa (from 21 percent in 1998 to 15 percent last year), in Addis Ababa, Ethiopia (from 24 percent in 1995 to 15 percent last year) and in the Dominican Republic.

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