The HIV/AIDS pandemic has been halted and is beginning to reverse, at least by some measures, according to a report from the Joint United Nations Programme on HIV/AIDS (UNAIDS).

New HIV infections in 2012 were down slightly from 2011 and by 33% since 2001, while AIDS-related deaths continued to fall from their peak in 2005, the report said.

And about 9.7 million people in low and middle-income countries are now on antiretroviral medication, up by about 20% since 2011, the report said.

The news is "all really good," commented Carlos del Rio, MD, of Emory University in Atlanta, and a spokesman for the HIV Medicine Association.

"The massive investments in prevention and in care and treatment are beginning to pay off," he told MedPage Today.

Del Rio cautioned against too much optimism. "My concern is that people will say we've won the battle and we can move on," he said.

But if global investment to combat the pandemic, by such programs as the President's Emergency Plan for AIDS Relief (PEPFAR), is cut markedly, Del Rio said, the progress "will immediately reverse."

Indeed, the report, released as the UN General Assembly is set this week to debate progress on its so-called Millennium Development Goals, also notes that funding, in real terms, is flat.

Total resources available in 2012 were $18.9 billion (U.S.), up only slightly from $17.1 billion a year earlier.

But many countries have increased their domestic financial outlays for HIV/AIDS, although the low- and middle-income countries most affected by the pandemic remain in need of international help, the report says.

The key findings, based on data from 171 of the 193 member UN states, are:

There were 2.3 million new HIV infections worldwide, down from 2.5 million in 2011 and down 33% from the 3.4 million in 2001.
The drop in new infections was observed in both adults and children but was more marked in children -- 260 000 in 2012, down 52% from the 550,000 in 2001.
The number of AIDS-related deaths was 1.6 million in 2012, down slightly from 1.7 million in 2011 and from the 2005 peak of 2.3 million.
Tuberculosis-related deaths in people living with HIV have fallen by 36% since 2004, although TB still remains the leading killer of people with HIV.

The approximately 9.7 million people living with HIV who had access to antiretroviral therapy represent 61% of people eligible for treatment under the 2010 WHO guidelines and 34% of those eligible under the 2013 WHO guidelines, which expanded access because of mounting evidence that treatment prevents transmission.

The 2015 UN development goals call for 50% reductions in both sexual and drug-related HIV transmission, eliminating new HIV infections among children, reaching 15 million people with HIV treatment, and mobilizing $22 billion to $24 billion a year for HIV programs.

The UNAIDS report notes that 26 states saw the annual number of new HIV infections among adults and adolescents fall by 50% or more between 2001 and 2012, but many others have not had similar success, underscoring "the importance of intensifying prevention efforts."

But there is no evidence to suggest that new infections among injection drugs users are declining, meaning the "world is not on track" to meet the target of a 50% cut in transmission, the report said.

On the other hand, the world is "within reach" of getting therapy to 15 million people who need it by 2015, the report said.




http://www.medpagetoday.com/HIVAIDS/HIVAIDS/41790