Every minute, five young people around the globe are infected with HIV.

The HIV/AIDS pandemic poses an incredible health threat to the men, women and children that live in developing countries around the globe. There are more than 30 million people worldwide who live with HIV. An astounding 90% of them live in developing countries.

• Last year, 5.8 million new HIV infections were estimated to have occurred around the globe.

• The large majority of HIV-positive people in developing countries -- an estimated 90% -- are not even aware of their HIV status.

While undoubtedly the health of a country is inextricably linked to the wealth of a country, a myriad of factors contribute to the high numbers HIV infections, reported AIDS cases and AIDS-related deaths in the developing world, particularly in sub-Saharan Africa and South Asia.

Factors Contributing to the Prevalence of HIV/AIDS in the Developing World

The antiretroviral drugs that have significantly contributed to the decrease in both reported AIDS cases and AIDS-related deaths in the United States (commonly called "drug cocktails") are extremely expensive -- roughly US$10,000 per case each year. The price of these medications far exceeds the financial resources available in developing countries, making the "drug cocktails" largely unavailable to those most affected by HIV.

"I've met people of all colors, religions, ethnic backgrounds, gay, straight and they have all impacted my life. They have reinforced in me the fact that none of that matters. All that matters is that we are all human, and we must care for one another."

-- A 16-year-old young woman from El Paso, Texas

Every day, 1,600 children under the age of 15 worldwide are infected with HIV. Last year, 590,000 children were infected with HIV, the majority of whom were exposed to the virus by their mother. The absence of antiretroviral drugs in many developing countries significantly contributes to the prevalence of HIV in children born to women with HIV. If zidovudine (commonly called AZT) was available to HIV-positive pregnant women in developing countries during pregnancy, labor and delivery, and to their newborns for the first six weeks after birth, the risk of mother-to-child HIV transmission (also called vertical transmission) would be reduced by as much as two thirds.

Sexually transmitted diseases (STDs), particularly those that remain untreated, put an individual at increased risk for HIV and facilitate the sexual transmission of HIV. Worldwide, people infected with an STD are five to 10 times more likely to become infected with HIV.

Often in developing countries, STDs remain untreated. This is partially due to an absence of awareness of STD infection on the part of the individual as well as the challenge of finding STD testing and treatment services. Many STDs remain asymptomatic for many years, providing the person infected with the STD with little to no indication that they need to seek medical attention.

Most women in developing countries breast-feed their children. Breastmilk offers a number of advantages to both the mother and the child.

• Breastmilk protects infants from a number of health-threatening infections.

• Breastmilk is convenient, free and socially acceptable in most developing countries.

• Artificial milk requires water as an ingredient. If a woman used unsafe water from a contaminated water supply, then she would run the risk of exposing her child to a myriad of infections.

But HIV can be transmitted through breastmilk, and in developing countries, breastfeeding significantly contributes to the incidence of HIV among children.

• In developing countries, between one third and one half of all HIV infections in young children are acquired through breastmilk.

This is largely due to the fact that an estimated nine out of every 10 HIV-positive women living in developing countries do not know they are infected. For more information on breastfeeding, please visit www.unaids.org on the Internet.

The HIV/AIDS epidemic in...

...sub-Saharan Africa

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), 21 million people living with HIV -- more than two thirds of the worldwide total -- live in sub-Saharan Africa. The majority of HIV-positive African men and women reportedly were exposed through heterosexual contact. An astounding 80% of all women and 87% of all children living with HIV worldwide live in Africa.

African countries along the west coast, in general, have witnessed slower rates of HIV infection than countries in the southern and eastern regions of the continent.

• UNAIDS estimates that one adult in 10 in Côte d'Ivoire lives with HIV. In Nigeria, HIV prevalence in adults is an estimated 4.1%, which is low compared to the prevalence in many other African countries. Because the population of Nigeria is 118 million, however, this prevalence means there are approximately 2.2 million cases in Nigeria alone.

The countries in the southern and eastern regions of Africa have experienced the most dramatic increases in reported cases of HIV infection.

• In 1995, an astounding 70% of the women who visited a prenatal clinic near the Zimbabwe -- South Africa tested HIV positive. In a major commercial farming town in Zimbabwe in 1996, nearly six out of 10 pregnant women were living with HIV. In Zimbabwe in 1997, 25% of adults were believed to be HIV-positive.

• At the beginning of 1998, some 2.9 million people in South Africa were believed to be living with HIV, more than 700,000 of whom were infected in 1997 alone.

• In a major city in Botswana in 1997, 43% of pregnant women reportedly were living with HIV.

Children in this region also are disproportionately affected.

• As of early 1998, 8.2 million children around the globe have been orphaned due to AIDS (lost their mothers or both parents). More than 90% of the 1.6 million orphaned in 1997 live in sub-Saharan Africa.

A 17-year-old young woman from Voorhees, New Jersey, became an HIV/AIDS peer educator, raised money for HIV/AIDS charities at church and recruited her family members in the fight against HIV/AIDS. "I decided to do this because it is an epidemic that can be prevented. I got involved to stop HIV/AIDS from spreading. I used to think of this epidemic as just statistics, but now the numbers have names and faces. I am now fighting for my friends."

Since the beginning of the HIV/AIDS pandemic, 11.7 million people around the globe have died of an AIDS-related illness, with 83% of these deaths occurring in sub-Saharan Africa. Emerging and re-emerging infectious diseases, poor quality of and access to medical treatment, and untreated STDs contribute to the high number of AIDS cases and AIDS-related deaths in this region. However, the lack of available antiretroviral drugs significantly contributes to the high numbers of AIDS cases and deaths in sub-Saharan Africa.

The lack of HIV education, awareness, prevention and testing services inhibits the ability of people in this vulnerable region to protect themselves, each other and the children they someday may have.

...in Asia

The HIV/AIDS pandemic was not a serious health threat in Asia until the early 1990s. People in India and certain countries in South and Southeast Asia -- Thailand, Myanmar (Burma), Viet Nam and Cambodia -- reportedly are affected by HIV more than people in other regions of Asia. Today, there are 5.8 million people living with HIV in South and Southeast Asia.

• India is the largest country with HIV-infected people in the world.

The sex industry in South and Southeast Asia significantly facilitates the rampant spread of HIV.

• In Myanmar, HIV infections among sex workers increased from 4% to more than 20% between 1992 and 1996.

• In Cambodia, one in two sex workers tested positive for HIV in recent surveillance.

• About 30% of sex workers aged 13 to 19 in Cambodia are infected with HIV.

The high rates of HIV infection among female sex workers exposes not only the client, but also other women to HIV.

• In a recent survey of Thai women, more than half of those who were HIV positive were infected by their one and only lifetime sex partner.

• Thai women living with HIV reported that their partners were more likely to have visited a female sex worker and to have had one or more sexually transmitted diseases than HIV-negative women.

Injection drug use accounts for a substantial number HIV infections in Asia.

• In Bangkok, the capital of Thailand, HIV rates among injection drug users increased from 2% to 40% in less than two years.

• Until 1997, injection drug users accounted for 70% of HIV infections in Viet Nam.

• Nine out of 10 injection drug users in Kachin, Myanmar, are estimated to be infected with HIV.

Two 13-year-old Latino boys, one in El Paso, Texas, and the other in Juarez, Mexico, work together to promote HIV/AIDS education and awareness through a cross-border initiative, often reaching the poorest areas in the region. The young, HIV/AIDS advocate in Mexico explained, "I'm just an honest guy. I tell people this is their life. AIDS is a part of their life. Their lives are worth protecting. Simple as that."

In South and Southeast Asia, HIV transmission among injection drug users is exacerbated by a system of communal drug injections, known in Viet Nam as "shooting galleries," where clients pay for shots of opium or heroin. The dealer, using one syringe, withdraws the drug solution from a pot, injects the client, and without cleaning the syringe, provides the next client with the same service. One pot holds roughly 50 injections. In Myanmar, the system of communal drug injections is similar to that in Viet Nam and the prevalence of HIV/AIDS is just as startling.

While HIV/AIDS has not affected Asia as quickly as it has sub-Saharan Africa, the pandemic is expected to grow. UNAIDS expects that by the end of the year 2000, one out of every four HIV infections worldwide will be in Asia and the Pacific.

...in Latin America and the Caribbean

According to UNAIDS, 1.6 million people in Latin America and the Caribbean are living with HIV. The HIV/AIDS epidemic in this region of the world parallels that in the United States, disproportionately affecting men who have sex with men (MSM), injection drug users, and women.

• Up to 30% of MSM in Mexico are believed to be living with HIV.

• In Brazil, one out of every four AIDS cases and HIV infections is among women.

According to UNAIDS, surveillance of the HIV/AIDS epidemic in Latin America and the Caribbean is limited, and access to care, although better than in other areas of the developing world, remains patchy overall.

...in Eastern Europe

Until 1994, the number of people living with HIV in Eastern Europe was extraordinarily low. However, in the last four years, several countries of the former socialist economies of Eastern Europe have seen six-fold increases in HIV infections.

• In the Ukraine in 1994, 44 people were reportedly living with HIV, although UNAIDS believes the number was actually closer to 1,500. Now, the number of people living with HIV is estimated to be 110,000.

• In the Russian Federation, the number of reported new HIV infections in 1996 was 1,546. One year later, that number had increased nearly three-fold -- 4,399 new reported HIV infections.

• The bulk of new HIV infections in the Russian Federation are in injection drug users, accounting for approximately 80% of new diagnoses.

...in North Africa and in the Middle East

Less than 1% of all HIV infections throughout the world are believed to be among people living in North Africa and the Middle East. Unfortunately, little is known about the HIV/AIDS pandemic in this region of the world. However, the generally conservative social and political attitudes and traditions in many countries in North Africa and the Middle East present challenges to HIV/AIDS awareness and prevention efforts in these areas.

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