U.N. Says India Now Has Most AIDS Cases

Actress Naomi Watts, and Mary Fisher, right, both special representatives to the United Nations' program for HIV/AIDS join Peter Piot, center, executive director of the program and United Nations employees, special representatives, tourists and others who took part in an event creating a human red ribbon formed by people holding red umbrellas to symbolize the fight against HIV/AIDS on the North Garden at United Nations headquarters Tuesday, May, 30, 2006. Fisher is HIV-positive and an anti-AIDS activist. (AP Photo/David Karp) (David Karp - AP)

South Africa remains one of the world's most tragic situations with nearly one in three pregnant women testing HIV-positive in public antenatal clinics in 2004. Nearly 19 percent of adults were infected nationwide last year, and the per capita rate is continuing to climb.

"I think in Africa, it is only comparable in demographic terms to the slave trade regarding the impact it has had on the population," Piot said. "In southern Africa, HIV prevalence continues to go up, and they're already the world record."

But Piot said the new numbers do offer a small sliver of hope. Kenya and Zimbabwe, along with some cities in Burkina Faso, reported declines in the overall percentage of adults infected. He said Thailand and Uganda were two of the only previous examples where epidemics were curbed.

In India, officials said there are signs of hope despite the huge number of infections.

Intensive AIDS prevention efforts among prostitutes and the men who frequent them have pushed down HIV infections dramatically in four south Indian states, Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu. The UNAIDS report said the decline in HIV prevalence in those states was in 15- to 24-year-old pregnant women, where the rate fell from 1.7 percent in 2001 to 1.1 percent in 2004.

A recent University of Toronto study in those states credited efforts by authorities and non-governmental groups to educate sex workers. Places like Kamathipura are now scattered with posters and street theater performances and educators, all sharing information about AIDS and HIV. Bombay is in Maharashtra state.

Piot, at a news conference in New York on Tuesday, said that while four Indian states had been investing in HIV prevention, "the rest of the country is a totally different situation. There is an increase in new infections."

"With a huge country like India, what matters is basically work in each and every state," he said.

The Asia-Pacific region, with 8.3 million people infected, is the second-highest after sub-Saharan Africa.

Piot, in the AP interview, said that the sheer population of Asia, home to most of the world's population, makes it a potential problem because even small gains in per capita infections equal huge numbers _ especially in countries like China and India, with over 1 billion people each.

He said Eastern Europe and Central Asia have become a new front where infections have expanded as people have access to more money and started buying injecting drugs _ instead of just shipping them through _ from countries like Afghanistan.

"Absolute numbers are still low, but when you look at the spread of the disease, we know from experience where that leads," Piot said. "The Middle East is the last part of the world where HIV is not spreading rapidly."

Thoraya Ahmed Obeid, executive director of the U.N. Fund for Population Activities, stressed that more action must be taken to empower women and enable them to take control of their sexuality. This is particularly important in southern Africa where sexual violence against women is a factor in the transmission of HIV.

Piot said that there is time to stop AIDS from worsening, but action is needed on a number of fronts. Currently, about 1.3 million people in poor countries have access to antiretroviral treatment, but about 80 percent still are not receiving drugs.

"Intervention is very low ... for many critical populations in many countries. We need to really intensify the response to AIDS," Piot said.

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Associated Press reporter Tarek El-Tablawy contributed to this report from the United Nations.