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U.N. to Cut Estimate Of AIDS Epidemic
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Newer studies commissioned by governments and relying on random, census-style sampling techniques found consistently lower infection rates in dozens of countries. For example, the United Nations has cut its estimate of HIV cases in India by more than half because of a study completed this year. This week's report also includes major cuts to U.N. estimates for Nigeria, Mozambique and Zimbabwe.
The revisions affect not just current numbers but past ones as well. A UNAIDS report from December 2002, for example, put the total number of HIV cases at 42 million. The real number at that time was 30 million, the new report says.
The downward revisions also affect estimated numbers of orphans, AIDS deaths and patients in need of costly antiretroviral drugs -- all major factors in setting funding levels for the world's response to the epidemic.
James Chin, a former World Health Organization AIDS expert who has long been critical of UNAIDS, said that even these revisions may not go far enough. He estimated the number of cases worldwide at 25 million.
"If they're coming out with 33 million, they're getting closer. It's a little high, but it's not outrageous anymore," Chin, author of "The AIDS Pandemic: The Collision of Epidemiology With Political Correctness," said from Berkeley, Calif.
The picture of the AIDS epidemic portrayed by the newer studies, and set to be endorsed by U.N. scientists, shows a massive concentration of infections in the southern third of Africa, with nations such as Swaziland and Botswana reporting as many as one in four adults infected with HIV.
Rates are lower in East Africa and much lower in West Africa. Researchers say that the prevalence of circumcision, which slows the spread of HIV, and regional variations in sexual behavior are the biggest factors determining the severity of the AIDS epidemic in different countries and even within countries.
Beyond Africa, AIDS is more likely to be concentrated among high-risk groups, such as users of injectable drugs, sex workers and gay men. More precise measurements of infection rates should allow for better targeting of prevention measures, researchers say.
