At the end of 2011, the world had 34.2 million HIV-infected people, a slight increase from 33.5 million the year before, says a new update on the epidemic put out by the Joint United Nations Programme on HIV/AIDS (UNAIDS). The increase is good news in a sense because it reflects that fact that more infected people are receiving antiretroviral (ARV) drugs, leading to fewer deaths from AIDS.
The slick, 135-page report, "Together We Will End AIDS," explains that 8 million people now receive ARVs, an increase of 20% from 2010. All told, 54% of the 14.8 million who need ARVs now receive them. But ARV coverage is below 25% in Eastern Europe, Central Asia, Northern Africa, and the Middle East. And worldwide, only 4% of HIV-infected injecting drug users are on ARVs.
Young people, 15 to 24 years old, now account for 40% of new adult infections. Women in that age bracket have twice the number of new infections as similarly aged men; the report notes that many of the HIV-infected women are subject to sexual violence, and they begin sexual activities and marry at a younger age. The number of children infected by their mothers has dropped to 330,000 from a peak of 570,000 in 2003.
The world now spends $16.8 billion each year on HIV/AIDS, with an increasing amount of the investment—more than 50%—coming from low- and middle-income countries. The report points to a $7.2 billion funding gap, which it says the world must address by 2015 to treat everyone in need and to offer effective prevention interventions more widely. Although generic ARV prices have plummeted to as little as $100 per person for a year's treatment, the report also notes that when people develop drug-resistant viruses and need "second-line treatments," it's much more expensive; in high-income countries, the cost can run up to $6000 per month.
In his introduction to the report, UNAIDS Executive Director Michel Sidibé says there is a growing optimism that the world can end the HIV/AIDS epidemic by applying proven treatment and prevention tools that now exist. "Many prominent leaders are now speaking openly about the beginning of the end of AIDS, getting to zero and the start of an AIDS-free generation," writes Sidibé. "The world is investing in this vision, and the investment is paying off."