Record Numbers Infected With HIV

HIV antiretroviral drugs are available to most of the estimated 1.6 million infected people in so-called high-income countries, including the United States. There were 950,000 people with HIV in the United States at the end of last year, 50,000 more than in 2001, the report said.

While the AIDS epidemic initially affected mostly men, the U.N. report said recent surveys showed that nearly half of all people infected between the ages of 15 and 49 were women. In Africa, more than half were women.

The increasing vulnerability of women makes it difficult to impose abstinence and condom use as strategies to prevent AIDS, Kathleen Cravero, the program's deputy executive director, said at a news conference.

"Most of the women and girls, as much in Asia as in Africa, don't have the option to abstain when they want to," she said. "Women who are victims of violence are in no position to negotiate anything, never mind faithfulness and condom use."

In Asia, with 60 percent of the world's population, 7.4 million people are living with HIV. The epidemic is fueled by injected drug use, infected sex workers and sex between men, but it is fast moving into the general population, the report said.

China and India have severe epidemics in a number of provinces, territories and states, the report said. In Indonesia and Vietnam, infections among people who inject drugs have soared.

"There's a window of opportunity to get prevention programs up to scale in Asia," said Cravero. "If we miss it, we will see an epidemic the likes of which we never imagined."

Far from leveling off, infection rates are on the rise in many countries in sub-Saharan Africa. In that region alone last year, 3 million people became newly infected with HIV. In seven African countries -- Botswana, Swaziland, Lesotho, Zimbabwe, South Africa, Namibia and Zambia -- more than 15 percent of the population is infected.

Latin America continued to have low national rates, but there were serious local epidemics, again spurred by people who shoot drugs and by men who have sex with other men, Cravero said.

In the Caribbean, which has the highest incidence of AIDS outside sub-Saharan Africa, the epidemic is spreading most rapidly among heterosexuals.

In high-income countries such as the United States, experts are concerned about the resurgence of sexually transmitted infections and high-risk behaviors, such as having unprotected sex. "People are dropping their guard and that will have its consequences," Cravero said.

More people were also dying from AIDS-related illnesses, the report said. In 2001, 2.5 million people died from AIDS. Last year, 2.9 million died, the result of rising caseloads outstripping countries' abilities to provide treatment, U.N. experts said.

Improved data-gathering methods at the country level have resulted in a revised, lower estimate of the number of people with HIV, Cravero said. Two years ago, the last time the report was issued, the United Nations estimated that 40 million people had HIV.

"Whether it's 38 million or 48 million, it's a catastrophe that has to be dealt with," she said.

The report comes as the world has boosted its commitment and resources, but not enough to meet growing needs, the U.N. report said.

In recent years, countries and donor organizations have stepped up their contributions to combat AIDS, from $300 million in 1996 to about $4.7 billion last year. But this amount was still less than half of the $12 billion required for 2005, the report said.

"AIDS is likely to be with us for a very long time, but how far it spreads and how much damage it does is entirely up to us," said Piot, the program executive director.