2008 Report on the global AIDS epidemic 06/06 e Lépidémiologie du VIH en Afrique Un exemple dépidémie généralisée

06/06 e 2008 Report on the

global AIDS epidemic

L’épidémiologie du VIH en Afrique

Un exemple d’épidémie généralisée



HIV prevalence (%) in adults (15–49) in Africa, 2007

2.8



HIV prevalence (%) among pregnant women attending antenatal clinics in sub-Saharan Africa, 1997–2007

NOTE: Analysis restricted to consistent surveillance sites for all countries except South Africa (by province) and Swaziland (by region)

Southern Africa

0

10

20

30

40M

edia

n H

IV p

reva

len

ce (

%) 50 Botswana

LesothoMozambiqueNamibiaSouth AfricaSwazilandZimbabwe

1997–1998

1999–2000

2001 2002 2003 2004 2005 2006 2007

West Africa

0

5

10

15

20

Med

ian

HIV

pre

vale

nce

(%

)

0

5

10

15

20

Med

ian

HIV

pre

vale

nce

(%

)

Eastern Africa

1997–1998

1999–2000

2001 2002 2003 2004 2005 2006 2007 1997–1998

1999–2000

2001 2002 2003 2004 2005 2006 2007

Ethiopia

Kenya

Burkina FasoCôte d'IvoireGhanaSenegal

2.9 Source: National surveillance reports and UNAIDS/WHO/UNICEF, Epidemiological Fact Sheets on HIV and AIDS. July 2008.



HIV prevalence (%) among 15–24 years old, by sex, selected countries, 2005–2007

0 5 10 15 20 25% HIV prevalence

SwazilandSouth Africa

ZimbabweCentral African Republic

Côte d'IvoireSierra Leone

RwandaHaiti

GuineaEthiopia

Benin

DR CongoNiger

SenegalCambodia

India

UgandaChad

Dominican Republic

Mali

Female

Male

2.10 Source: Demographic and Health Surveys and other national population-based surveys with HIV testing.





Impact of AIDS on life expectancy in five African countries, 1970–2010Impact of AIDS on life expectancy in five African countries, 1970–2010

Life expectancy at birth (years)

Source: United Nations Population Division (2004). World Population Prospects: The 2004 Revision, database.

Botswana

South Africa

Swaziland

Zambia

Zimbabwe

1970–1975 1975–1980

1980–19851985–1990

1990–19951995–2000

2000–20052005–2010

70

65

60

55

50

45

40

35

30

25

20

4.1



Changes in population structure: Ghana and Lesotho

2.12

1950 2007Ghana

1950 2007Lesotho

10 5 0 5 10 10 5 0 5 10Percentage Percentage

Age

Male Female Male Female100+

80

60

40

20

0

Age

10 5 0 5 10 10 5 0 5 10Percentage Percentage

Male Female Male Female100+

80

60

40

20

0

Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2006 Revision, http://esa.un.org/unpp



Estimated number of children under 18 orphaned by AIDS in sub-Saharan Africa (1990–2007)

6.2 Source: UNAIDS/WHO unpublished estimates, 2007.

Mill

ion

s

1990 20062003 20051995 2000 200420020

2

4

6

8

10

12

14

2007



Relationship between tuberculosis notification rate and HIV prevalence in Zimbabwe, 1990–2006

5.6 Source: WHO Global TB control report 2008 (WHO, 2008a); UNAIDS HIV prevalence estimates.

50

100

150

200

250

300

350

400

450

500

1985 1990 1995 2000 2005 2010

TB notification rate (per 100 000 population)

% HIV prevalence in all ages

TB notification rate (new and relapse),rate per 100 000 population

HIV prevalence in all (%)

10

12

14

16

18

0

2

4

6

8



Intérêt de la modélisation pour évaluer l’impact des programmes

Integrating HIV Prevention and Treatment: From Slogans to ImpactJoshua A Salomon,1* Daniel R Hogan,1 John Stover,2 Karen A Stanecki,3 Neff Walker,3,4 Peter D Ghys,

3 and Bernhard Schwartländer5

1Harvard Center for Population and Development Studies, Department of Population and International Health, Harvard School of Public Health, Boston, Massachusetts, United States of America

2The Futures Group International, Glastonbury, Connecticut, United States of America3Joint United Nations Programme on HIV/AIDS, Geneva, Switzerland

4United Nations Children's Fund, New York, New York, United States of America5Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland

Joep Lange, Academic EditorUniversity of Amsterdam, the Netherlands



Impact of three scenarios on HIV infection Impact of three scenarios on HIV infection in sub-Saharan Africa, 2003–2020in sub-Saharan Africa, 2003–2020

0.0

1.0

2.0

3.0

4.0

5.0

2003 2005 2010 2015 2020

Year

Treatment-centered

Prevention-centered

Baseline

Comprehensive response

Number of new HIV infections (millions)

Source: Salomon JA et al. (2005). Integrating HIV prevention and treatment: from slogans to impact6.1



Impact of AIDS-related deaths in sub-Saharan Africa, 2003–2020Impact of AIDS-related deaths in sub-Saharan Africa, 2003–2020

2003 2005 2010 2015 2020

Year

Treatment-centered

Prevention-centered

Baseline

Comprehensive response

0.0

0.5

1.0

1.5

2.0

2.5

3.0

Number of AIDS- relateddeaths (millions)

Source: Salomon JA et al. (2005). Integrating HIV prevention and treatment: from slogans to impact6.2







HIV prevalence (%) in adults (15–49) in Middle East and North Africa, 2007

2.21



L’épidémiologie du VIH en Asie



HIV prevalence (%) in adults (15–49) in Asia, 2007

2.13



1985

< 5 % High Risk Group

> 5 % High Risk Group

> 1 % Antenatal Women



>1%Antenatal Women

1993

<5% High Risk Group

> 5% High Risk Group



1998

< 5 % High Risk Group

> 5 % High Risk Group

> 1 % Antenatal Women



2004

<5% High Risk Group

> 5% High Risk Group

>1%Antenatal Women

8 M HIV+ I M new Infections 8 M HIV+ I M new Infections 0.5 M deaths0.5 M deaths



HIV prevalence (%) trends in India among injecting drug users HIV prevalence (%) trends in India among injecting drug users and pregnant women, selected areas, India, 1998–2004*and pregnant women, selected areas, India, 1998–2004*

AntenatalClinic attendees

Antenatalclinicattendees

Injectingdrugusers

1998 1999 2000 2001 2002 2003 2004

%

0.0

1.0

2.0

3.0

4.0

5.0

1998 1999 2000 2001 2002 2003 2004

%

0.0

0.3

0.6

0.9

1.2

1.5

1998 1999 2000 2001 2002 2003 2004

%

0.0

3.0

6.0

9.0

12.0

15.0

Andhra Pradesh

Karnataka

Maharashtra

Tamil Nadu

Madhya Pradesh

Mizoram

Uttar Prahesh

West Bengal

Delhi

Mizoram

West Bengal

2.9

*Data from consistent surveillance sites only.



HIV prevalence trends among pregnant women in major cities HIV prevalence trends among pregnant women in major cities in Cambodia, Myanmar and Thailand, 1990–2004in Cambodia, Myanmar and Thailand, 1990–2004

Phnom Penh Mandalay and Yangon Bangkok

Sources: Cambodia National Center for HIV/AIDS, Dermatology and STDs (Phnom Penh); Myanmar Ministry of Health (Mandalay and Yangon); Thailand Ministry of Public Health (Bangkok), 2005.

19901999 2003

20040.0

1.0

2.0

3.0

4.0

5.0

19931994

19951996

19971998 2000

20012002

19911992

% HIV prevalence

2.10

Documents

2008 Report on the global AIDS epidemic 06/06 e Lépidémiologie du VIH en Afrique Un exemple dépidémie généralisée