Female HIV rates now reach male levels

For the first time in the 20-year history of the global Aids epidemic, the number of women infected with HIV has equalled the number of men, according to figures released yesterday by the United Nations Aids programme.

Scientists at UNAids estimate that there are now 42 million people in the world with HIV or Aids, of whom 5 million became infected this year. Of the 38.6 million infected adults, about 19.2 million are women.

Although Aids first became known in the West as an epidemic of homosexual men, it has increasingly become focused on sub-Saharan Africa, where more than 60 per cent of those infected are women. "It's once more a sad story," said Peter Piot, executive director of UNAids. "The face of the epidemic is continually changing. The face of the epidemic is increasingly a female face, especially in Africa."

About 2 million women and some 800,000 children became infected with HIV in 2002, the vast majority of them in the famine-ravaged countries of southern Africa where Aids is exacerbating food shortages, partly because of the increasing impact on the women who work in the fields. "With millions killed by Aids, and millions more left ill, whole communities have been left defenceless when drought arrives," Dr Piot said.

"We must act now, on a much larger scale than anything we have done before, not only to assist those nations already hard-hit, but also to stop the explosive growth of Aids in the parts of the world where the epidemic is newly emerging."

Professor Alan Whiteside, a UN adviser at the University of Natal, said about 15 million people were now at risk of starvation in Lesotho, Malawi, Mozambique, Swaziland, Zambia and Zimbabwe. More than 5 million adults were infected, most of them women.

People sick with HIV were less able to go into the fields to plant crops when the rains come, said Professor Whiteside. The economic collapse was also forcing women into unsafe sexual liaisons.

Girls in Africa are at higher risk of HIV than boys of the same age. Scientists estimate that between 6 and 11 per cent of young women in sub-Saharan Africa are infected with the virus, compared with between 3 and 6 per cent of young men.

The UNAids report says: "Studies have shown that young women tend to marry men several years older, and that their risk of infection increases if a husband is three or more years older than they are. This, combined with the fact that young women and girls are biologically prone to infection (the cervix being susceptible to lesions), helps explain the large differences in HIV prevalance between girls and boys."

Scientists at UNAids believe the worst of the Aids epidemic is not over in southern Africa, where the spread of HIV is described as "rampant", but there are promising signs of a change in sexual behaviour among the young. The rate of increase in HIV prevalence among South African women attending antenatal clinics, for instance, has begun to fall among those under 20, indicating that health education campaigns are beginning to work.

The UNAids report paints a bleaker picture in other parts of the world, such as eastern Europe, Russia and central Asia.

Dr Piot said the only way of containing such an explosive growth was through health education. "The Aids epidemic does yield, in some cases dramatically, to determined human intervention. We can prevent 29 million new HIV infections this decade if we implement a full prevention package globally by 2005," he said.