unit 1: the global hiv/aids situation #1-1-1. warm up questions: instructions v take five minutes...
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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
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Figure 1.1. HIV Prevalence among Adults in Africa, 2005
#1-1-5Source: UNAIDS, 2006
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Figure 1.2. Trends in HIV Prevalence Among ANC Attendees
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Source: WHO-AFRO, 2003
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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
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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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Current Situation in Ethiopia:
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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
Source: AIDS in Ethiopia, 6th report, September 2006
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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
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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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Current Situation in Ethiopia:
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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
(%
)
Source: AIDS in Ethiopia, 6th report, September 2006
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Current Situation in Ethiopia:
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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)
Source: AIDS in Ethiopia, 6th report, September 2006
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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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Answers to Warm Up Questions, Cont.
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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Answers to Warm Up Questions, Cont.
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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Answers to Warm Up Questions, Cont.
3. What region of Africa has been the most affected by HIV/AIDS?
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Answers to Warm Up Questions, Cont.
3. What region of Africa has been the most affected by HIV/AIDS? Southern Africa
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Answers to Warm Up Questions, Cont.
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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Answers to Warm Up Questions, Cont.
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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