Unit 1: The Global HIV/AIDS Situation #1-1-1. Warm Up Questions: Instructions v Take five minutes...

Unit 1: The Global HIV/AIDS Situation

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Warm Up Questions: Instructions

Take five minutes now to try the Unit 1 warm up questions in your manual.

Please do not compare answers with other participants.

Your answers will not be collected or graded.

We will review your answers at the end of the unit.

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What You Will Learn

By the end of this unit you should be able to:

describe the overall HIV/AIDS situation in the world

describe the HIV/AIDS situation in sub-Saharan Africa

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Table 1.1. Worldwide Epidemic

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Category NumberWorldwide

Sub-Saharan Africa (% of world total)

Adults and children living with HIV/AIDS in 2004

39 500 000 24 700 000 (63%)

Adults and children newly infected with HIV in 2004

4 300 000 2 800 000 (65%)

Adult and child deaths due to AIDS in 2004

2 900 000 2 100 000 (72%)

Children <15 years old living with HIV in 2004

2 300 000 Not Available

Children <15 years old newly infected with HIV in 2004

530 000 Not Available

Deaths in children <15 years old due to AIDS in 2004

380 000 Not Available

Source: UNAIDS, 2006

Figure 1.1. HIV Prevalence among Adults in Africa, 2005

#1-1-5Source: UNAIDS, 2006

Figure 1.2. Trends in HIV Prevalence Among ANC Attendees

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Source: WHO-AFRO, 2003

Current HIV Situation in Ethiopia:

Based on surveillance results from antenatal clinics (so only includes pregnant women seeking health care services)

Data collected from 36 urban and 43 rural sites throughout the country

Left-over blood from syphilis testing is tested for HIV in unlinked and anonymous fashion

National, regional, urban/rural HIV prevalence estimates are then calculated with an Epidemic Projection Package

Separate computer software used to estimate the various impacts of HIV/AIDS.

Source: AIDS in Ethiopia, 6th report, September 2006 #1-1-7

Current Situation in Ethiopia:

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Figure 4.9: Estimated and Projected HIV Incidence by Age Group, Ethiopia, 1982-2010

0.0

0.2

0.4

0.6

0.8

1.0

1.2

Year

15-19 yrs

20-24 yrs

25-29 yrs

15-19 yrs 0.0 0.0 0.0 0.0 0.0 0.0 0.00.110.1 0.2 0.3 0.4 0.4 0.5 0.5 0.5 0.6 0.6 0.5 0.5 0.5 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.3

20-24 yrs 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.2 0.4 0.6 0.7 0.8 0.8 0.9 0.8 0.7 0.7 0.6 0.510.3 0.2 0.3 0.3 0.2 0.3 0.3 0.3 0.3 0.4

25-29 yrs 0.0 0.0 0.0 0.0 0.0 0.1 0.2 0.3 0.6 0.8 0.9 1.0 1.051.0 0.9 0.8 0.7 0.6 0.5 0.4 0.4 0.4 0.4 0.4 0.4 0.3 0.4 0.4 0.4

82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10

HIV

In

cid

en

ce

(%

)

Source: AIDS in Ethiopia, 6th report, September 2006


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Figure 4.11: Estimated and Projected HIV Prevalence, Adult Population 15 - 49, Ethiopia and Regions, 1982 - 2010

0.0

5.0

10.0

15.0

20.0

25.0

HIV

Pre

va

len

ce

(%

)

Ethiopia 0.0 0.0 0.0 0.0 0.1 0.1 0.3 0.5 0.9 1.5 2.0 2.6 3.2 3.7 4.1 4.4 4.5 4.5 4.5 4.3 4.1 3.9 3.7 3.5 3.3 3.2 3.0 2.9 2.8

Addis Ababa 0.0 0.0 0.1 0.2 0.5 1.1 2.5 5.1 9.3 14.1 18.2 20.6 21.5 21.5 20.9 19.9 18.8 17.5 16.3 15.1 14.0 13.1 12.3 11.7 11.3 11.0 10.8 10.7 10.7

DireDawa 0.0 0.0 0.0 0.1 0.1 0.3 0.5 0.9 1.7 2.8 4.5 6.3 8.1 9.4 10.1 10.4 10.2 9.9 9.5 8.9 8.3 7.8 7.3 6.8 6.4 6.2 5.9 5.8 5.7

Harari 0.0 0.0 0.0 0.1 0.1 0.3 0.5 1.0 1.7 3.0 4.5 6.1 7.4 8.2 8.5 8.5 8.2 7.9 7.4 6.9 6.4 6.0 5.6 5.2 4.9 4.7 4.6 4.5 4.4

Amhara 0.0 0.0 0.0 0.0 0.1 0.1 0.2 0.3 0.6 1.0 1.6 2.4 3.4 4.3 5.2 5.8 6.1 6.1 6.0 5.8 5.5 5.2 4.8 4.5 4.2 3.9 3.7 3.5 3.4

Tigray 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.2 0.4 0.6 1.0 1.4 2.0 2.5 3.0 3.4 3.7 3.9 4.1 4.2 4.3 4.3 4.2 4.2 4.1 4.0 3.8 3.7 3.6

Gambella 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.2 0.2 0.4 0.6 0.9 1.3 1.9 2.5 3.1 3.7 4.2 4.4 4.6 4.6 4.4 4.3 4.0 3.8 3.5 3.2 3.0 2.8

Afar 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.2 0.4 0.6 1.0 1.5 2.2 2.8 3.3 3.6 3.8 3.9 3.8 3.7 3.6 3.4 3.2 3.1 2.9 2.8 2.7 2.7 2.6

Benishangul Gumuz 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.2 0.3 0.4 0.6 0.9 1.2 1.5 1.8 2.1 2.4 2.6 2.8 2.8 2.9 2.9 2.8 2.8 2.7 2.6 2.6 2.5

Oromia 0.0 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.2 0.4 0.6 0.9 1.3 1.6 2.0 2.3 2.6 2.7 2.8 2.8 2.8 2.7 2.6 2.4 2.3 2.2 2.1 1.9 1.9

SNNPR 0.0 0.0 0.0 0.0 0.0 0.1 0.1 0.2 0.3 0.5 0.8 1.2 1.6 2.1 2.4 2.7 2.9 2.9 2.9 2.8 2.7 2.6 2.4 2.3 2.2 2.1 2.1 2.0 2.0

Somali 0.0 0.0 0.0 0.0 0.0 0.1 0.2 0.4 0.7 1.1 1.4 1.7 1.8 1.8 1.8 1.7 1.7 1.6 1.6 1.5 1.5 1.4 1.3 1.2 1.2 1.1 1.1 1.1 1.0

82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10

year and HIV Prevalence Level


Table 1.2. Comparing 1994 and 1997 Prevalence Rates

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1994 1997 Most recent

West Africa

Accra, Ghana 1.7% 2.2% 4.2% (2003)

Cotonou, Benin 0.9% 4.4% 3.9% (2003)

Southern Africa

Francistown, Botswana 29.7% 42.9% 45.6% (2003)

KwaZulu-Natal, South Africa 13.5% 26.9% 37.5% (2003)

Harare, Zimbabwe 25.8% 30.4% 20.3% (2002)

East Africa

Addis Ababa, Ethiopia 20.3% 16.7% 11% (2003)

Kampala, Uganda 22.3% 14.3% 10% (2002)

Central Africa

Yaounde, Cameroon ---- 5.6% 7.2% (2002)

Source: WHO-AFRO, 2003

Some Increase, Some Decrease

In southern Africa, HIV prevalence at ANCs in major urban areas has dramatically increased since the early 1990s, although rates appear to be levelling off now.

In some West African urban areas prevalence rates have remained low and stable (< 5%).

Uganda and a few other areas have experienced declines.

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Figure 1.3. Urban versus Rural HIV Prevalence

#1-1-12Source: WHO-AFRO, 2003


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Figure 3.1: Unadjusted HIV Prevalence by Age Group and Site Setting , 2005

9.1

10.6

7.1

9.5

2.42.2

1.6

2.2

5.6 5.4

3.3

5.3

0

2

4

6

8

10

12

15-24 25-34 35-49 Total

Age Group (years)

Urban Rural Total

HIV

Pre

va

len

ce

(%

)



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Figure 4.3: Annual Estimated and Projected New AIDS Cases, 1990-2010

0

20

40

60

80

100

120

140

160

Year

Urban

Rural

National

Urban 3 6 10 16 23 30 38 46 53 59 64 67 70 71 71 70 68 67 66 65 65

Rural 1 2 4 7 10 15 21 28 35 42 49 55 60 64 66 68 67 66 64 62 59

National 5 9 15 23 33 45 59 73 88 101 113 122 129 134 137 137 136 133 129 126 125

90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10

No

. P

roje

cted

AID

S C

ases

(th

ou

san

ds)


High Prevalence Factors

High prevalence of other STIs increase the risk of acquiring and transmitting HIV

Limited access to STI management

Limited access to, or social non-acceptance of, condoms

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High Prevalence Factors, Cont.

War or civil disturbance

Cultural or ethnic practices, such as polygamy and wife inheritance

Women’s low status and inability to influence their partner’s behaviour

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High Prevalence Factors, Cont.

Low literacy rates

Increasing urbanisation, migration, mobilisation and separation of families as a result of poverty or other social circumstances

Low level of political commitment to the prevention and control of HIV/AIDS

Exposure to blood from unsafe medical practices and traditional practices

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In Summary

By the end of 2004, there were almost 40 million people living with HIV/AIDS worldwide, including more than 2 million children.

The situation is especially serious in sub-Saharan Africa, which accounts for 64% of these infections.

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Warm Up Review

Take a few minutes now to look back at your answers to the warm up questions at the beginning of the unit.

Make any changes you want to.

We will discuss the questions and answers in a few minutes.

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Answers to Warm Up Questions

1. True or false? Almost 40 million people are infected with HIV worldwide.

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Answers to Warm Up Questions, Cont.

1. True or false? Almost 40 million people are infected with HIV worldwide. True

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2. What region of the world has been affected the most by HIV/AIDS, with an infection prevalence rate of over 30% in some countries?

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2. What region of the world has been affected the most by HIV/AIDS, with an infection prevalence rate of over 30% in some countries? Sub-Saharan Africa

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3. What region of Africa has been the most affected by HIV/AIDS?

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3. What region of Africa has been the most affected by HIV/AIDS? Southern Africa

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4. Some of the factors that account for the high prevalence of HIV/AIDS in sub-Saharan Africa include

a. extensive population mobility

b. women’s status and inability to influence partner’s behavior

c. war and civil disturbance

d. blood exposure from unsafe medical practices

e. all of the above

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4. Some of the factors that account for the high prevalence of HIV/AIDS in sub-Saharan Africa include

a. extensive population mobility

b. women’s status and inability to influence partner’s behavior

c. war and civil disturbance

d. blood exposure from unsafe medical practices

e. all of the above

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Small Group Discussion: Instructions

Get into small groups to discuss these questions.

Choose a speaker for your group who will report back to the class.

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Small Group Reports

Select one member from your group to present your answers.

Discuss with the rest of the class.

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Case Study: Instructions

Try this case study individually.

We’ll discuss the answers in class.

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Case Study Review

Follow along as we go over the case study in class.

Discuss your answers with the rest of the class.

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Questions, Process Check

Do you have any questions on the information we just covered?

Are you happy with how we worked on Unit 1?

Do you want to try something different that will help the group?

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Unit 1: The Global HIV/AIDS Situation #1-1-1. Warm Up Questions: Instructions v Take five minutes...

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