The AIDS epidemic, caused by HIV, found its way to the United States between the 1970s and 1980s, but was first noticed after doctors discovered clusters of Kaposi's sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981. Treatment of HIV/AIDS is primarily via the use of multiple antiretroviral drugs, and education programs to help people avoid infection.
HIV/AIDS originated in the late 20th century and has become a major public health concern and cause of death in many countries. AIDS rates varies significantly between countries, with the majority of cases are concentrated in Southern Africa. Although the continent is home to about 15.2 percent of the world's population, more than two-thirds of the total population infected worldwide – approximately 35 million people – were Africans, of whom around 1 million have already died. Eastern and Southern Africa alone accounted for an estimate of 60 percent of all people living with HIV and 100 percent of all AIDS deaths in 2011. The countries of Eastern and Southern Africa are most affected, leading to raised death rates and lowered life expectancy among adults between the ages of 20 and 49 by about twenty years. Furthermore, life expectancy in many parts of Africa is declining, largely as a result of the HIV/AIDS epidemic, with life-expectancy in some countries reaching as low as thirty-nine years.
The United States President's Emergency Plan For AIDS Relief (PEPFAR) is a United States governmental initiative to address the global HIV/AIDS epidemic and help save the lives of those suffering from the disease. Launched by U.S. President George W. Bush in 2003, as of May 2020, PEPFAR has provided about $90 billion in cumulative funding for HIV/AIDS treatment, prevention, and research since its inception, making it the largest global health program focused on a single disease in history until the COVID-19 pandemic. PEPFAR is implemented by a combination of U.S. government agencies in over 50 countries and overseen by the Global AIDS Coordinator at the United States Department of State. As of 2023, PEPFAR has saved over 25 million lives, primarily in sub-Saharan Africa.
HIV/AIDS in India is an epidemic. The National AIDS Control Organisation (NACO) estimated that 2.14 million people lived with HIV/AIDS in India in 2017. Despite being home to the world's third-largest population of persons with HIV/AIDS, the AIDS prevalence rate in India is lower than that of many other countries. In 2016, India's AIDS prevalence rate stood at approximately 0.30%—the 80th highest in the world. Treatment of HIV/AIDS is via a combination of antiretroviral drugs and education programs to help people avoid infection.
In 2008, 4.7 million people in Asia were living with human immunodeficiency virus (HIV). Asia's epidemic peaked in the mid-1990s, and annual HIV incidence has declined since then by more than half. Regionally, the epidemic has remained somewhat stable since 2000.
HIV is recognized as a health concern in Pakistan with the number of cases growing. Moderately high drug use and lack of acceptance that non-marital sex is common in the society have allowed the HIV epidemic to take hold in Pakistan, mainly among injecting drug users (IDU), male, female and transvestite sex workers as well as the repatriated migrant workers. HIV infection can lead to AIDS that may become a major health issue.
The history of HIV/AIDS in Australia is distinctive, as Australian government bodies recognised and responded to the AIDS pandemic relatively swiftly, with the implementation of effective disease prevention and public health programs, such as needle and syringe programs (NSPs). As a result, despite significant numbers of at-risk group members contracting the virus in the early period following its discovery, Australia achieved and has maintained a low rate of HIV infection in comparison to the rest of the world.
AIDS Sutra: Untold Stories from India is an anthology of writing telling the human stories behind HIV/AIDS in India. The book has been published in collaboration with Avahan, the India Aids initiative of the Bill and Melinda Gates Foundation. Proceeds from the book go toward educational opportunities for AIDS orphans in India.
Kenya has a severe, generalized HIV epidemic, but in recent years, the country has experienced a notable decline in HIV prevalence, attributed in part to significant behavioral change and increased access to ARV. Adult HIV prevalence is estimated to have fallen from 10 percent in the late 1990s to about 4.8 percent in 2017. Women face considerably higher risk of HIV infection than men but have longer life expectancies than men when on ART. The 7th edition of AIDS in Kenya reports an HIV prevalence rate of eight percent in adult women and four percent in adult men. Populations in Kenya that are especially at risk include injecting drug users and people in prostitution, whose prevalence rates are estimated at 53 percent and 27 percent, respectively. Men who have sex with men (MSM) are also at risk at a prevalence of 18.2%. Other groups also include discordant couples however successful ARV-treatment will prevent transmission. Other groups at risk are prison communities, uniformed forces, and truck drivers.
With less than 0.1 percent of the population estimated to be HIV-positive, Bangladesh is a low HIV-prevalence country.
UNAIDS has said that HIV/AIDS in Indonesia is one of Asia's fastest growing epidemics. In 2010, it is expected that 5 million Indonesians will have HIV/AIDS. In 2007, Indonesia was ranked 99th in the world by prevalence rate, but because of low understanding of the symptoms of the disease and high social stigma attached to it, only 5-10% of HIV/AIDS sufferers actually get diagnosed and treated. According to the a census conducted in 2019, it is counted that 640,443 people in the country are living with HIV. The adult prevalence for HIV/ AIDS in the country is 0.4%. Indonesia is the country is Southeast Asia to have the most number of recorded people living with HIV while Thailand has the highest adult prevalence.
The first HIV/AIDS cases in Nepal were reported in 1988. The HIV epidemic is largely attributed to sexual transmissions and account for more than 85% of the total new HIV infections. Coinciding with the outbreak of civil unrest, there was a drastic increase in the new cases in 1996. The infection rate of HIV/AIDS in Nepal among the adult population is estimated to be below the 1 percent threshold which is considered "generalized and severe". However, the prevalence rate masks a concentrated epidemic among at-risk populations such as female sex workers (FSWs), male sex workers (MSWs), injecting drug users (IDUs), men who have sex with men (MSM), Transgender Groups (TG), migrants and male labor migrants (MLMs) as well as their spouses. Socio-Cultural taboos and stigmas that pose an issue for open discussion concerning sex education and sex habits to practice has manifest crucial role in spread of HIV/AIDS in Nepal. With this, factors such as poverty, illiteracy, political instability combined with gender inequality make the tasks challenging.
Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. In 2009 the adult prevalence of HIV was 1.3%. As of 2016, Thailand had the highest prevalence of HIV in Southeast Asia at 1.1 percent, the 40th highest prevalence of 109 nations.
HIV/AIDS in Bolivia has a less than 1 percent prevalence of Bolivia's adult population estimated to be HIV-positive. Bolivia has one of the lowest HIV prevalence rates in the Latin America and Caribbean region.
Nicaragua has 0.2 percent of the adult population estimated to be HIV-positive. Nicaragua has one of the lowest HIV prevalence rates in Central America.
Avahan is an initiative sponsored by the Bill & Melinda Gates Foundation to reduce the spread of HIV in India. It began in 2003. As of 2009 the Gates Foundation had pledged US$338 million to the programme, whose aim was to reduce HIV transmission and the prevalence of STIs in vulnerable high-risk populations, notably female sex workers, MSM, and injecting drug users (IDU), through prevention education and services such as condom promotion, STI management, behaviour change communication, community mobilisation, and advocacy. Avahan worked in six high-prevalence states. All the states in India who had a HIV prevalence of more than 1 per cent in the year 2002, were considered as HIV high-prevalent states. All the states had a lead partner and other NGOs and CBOs at the district-level who implemented the prevention programme. India HIV/AIDS Alliance is the state lead partner in Andhra Pradesh, Karnataka Health Promotion Trust in Karnataka, Path Finder in Maharashtra, Tamil Nadu AIDS Initiative and Voluntary Health Services (VHS) in Tamil Nadu. The other two states are Nagaland and Manipur in the North-East of India had Emmanuel Hospital Association and Australian International Health Institute as lead partner. Apart from the State Lead Partners, Avahan had cross-cutting partners for advocacy in Centre for Advocacy and Research, for Police Advocacy in Constella Futures, care and support in CARE. By 2013, control of the programme transitioned to the Government of India in phases. After Avahan, BMGF shifted its focus on TB, maternal and child health and other areas like polio.
Sema K. Sgaier is a scientist, global health expert, and documentary photographer. Sgaier’s expertise includes molecular biology, genetics, genomics, neuroscience, epidemiology, disease surveillance, monitoring & evaluation of programs and policy development.
Founded in 1999, Alliance India is a non-governmental organisation operating in partnership with civil society, government and communities to support sustained responses to HIV in India that protect rights and improve health. Complementing the Indian national programme, we build capacity, provide technical support and advocate to strengthen the delivery of effective, innovative, community-based HIV programmes to vulnerable populations: sex workers, men who have sex with men (MSM), transgender people, hijras, people who inject drugs (PWID), and people living with HIV.
Michel Alary is a Canadian academic, doctor of preventive medicine and a health researcher. He is a Professor of Social and Preventive Medicine at Université Laval and the director of population health research at the Research Centre of the CHU de Quebec – Université Laval. He also serves as a Medical Consultant at the Institut national de santé publique du Québec. Alary has published over 260 research papers and has produced major reports for the World Bank and UNAIDS about HIV in sub-Saharan Africa. He also evaluated the Bill & Melinda Gates Foundation's India AIDS Initiative for which his project received the Avahan Recognition Award. He has conducted epidemiological and preventive research on blood-borne infections, HIV and other Sexually Transmitted Diseases (STD) among the most vulnerable populations in developed and developing countries.
