AIDS around world - Africa

It is in Africa, in some of the poorest countries in the world, that the impact of the virus has been most severe. Altogether, there are now 16 countries in Africa in which more than one-tenth of the adult population aged 15-49 is infected with HIV. In seven countries, all in the southern cone of the continent, at least one adult in five is living with the virus. In Botswana, a shocking 37.3% of adults are now infected with HIV, while in South Africa, 21.5% are infected. With a total of 5.3 million infected people, South Africa has the largest number of people living with HIV/AIDS in the world.

A first step in publicly admitting the AIDS crisis, a road sign in Botswana.

Rates of HIV infection are still increasing in many countries in Sub-Saharan Africa, and an estimated 3.1 million people in this region were infected in 2004, the most recent year for which data is available. This means that there are now an estimated 25.4 million people here living with HIV/AIDS. In this part of the world, particularly, women are disproportionately at risk. As the rate of HIV infection in the general population rises, the same patterns of sexual risk result in more new infections simply because the chances of encountering an infected partner become higher. Sub-Saharan Africa has, relative to its population, by far the most severe HIV epidemic anywhere in the world, and has become the focal point of a number of initiatives to prevent the onward transmission of HIV and to provide antiretroviral medication to infected people, but these initiatives have yet to have a significant impact on death rates.

Whilst West Africa is relatively less affected by HIV infection, the prevalence rates in some large countries are creeping up. Côte d'Ivoire is already among the 15 worst affected countries in the world; in Nigeria over 5% of adults have HIV but the prevalence rate in other West African countries remains below 3%. In Western Africa the epidemic displays a diversity not seen to such an extent in other parts of Africa. National prevalence rates can remain low, while infection rates in certain populations can be very high indeed.

Infection rates in East Africa, once the highest on the continent, hover above those in the West of the continent but have been exceeded by the rates now being seen in the southern cone. The prevalence rate among adults in Ethiopia and Kenya has reached double-digit figures and continues to rise.

These rises are not inevitable. Uganda has brought its estimated prevalence rate down to around 5% from a peak of close to 14% in the early 1990s with strong prevention campaigns, and there are encouraging signs that Zambia's epidemic may be following the course charted by Uganda. Yet, even in these countries, the suffering generated by HIV infections acquired years ago continues to grow, and a falling prevalence rate usually indicates that a high number of deaths have already occurred.