Report on the global
AIDS epidemic

July 2004

(Download PDF version 15270 KB!)








Overcoming AIDS: the ‘Next Agenda’


A global overview of the AIDS epidemic


The impact of AIDS on people and societies


Focus - AIDS and orphans: a tragedy unfolding


Bringing comprehensive HIV prevention to scale


Focus - HIV and young people: the threat for today’s youth


Treatment, care and support for people living with HIV


Focus - AIDS and human rights: the need for protection


Financing the response to AIDS


National responses to AIDS: more action needed


Focus - AIDS and conflict: a growing problem worldwide


Focus - The essential role of people living with AIDS


Table of country-specific HIV/AIDS estimates and data, as of end 2003


Annex – HIV/AIDS estimates and data, end 2003






Managing Editor/Production Coordinator

Chief Scientific Advisor

Sandra Woods

Catherine Hankins

Principal writers:

Editorial/Research Assistant

Sue Armstrong

Susan Squarey

Chris Fontaine

Project Supervisor

Andrew Wilson

Marika Fahlen

Major editorial contributions:
Michael Bartos, Sandy Beeman, Anindya Chatterjee, Paul De Lay, Julian Fleet,
Robert Greener, Alec Irwin, Mike Isbell, Lesley Lawson, Miriam Maluwa,
Aurorita Mendoza, Lisa Regis

Editorial guidance:
Peter Ghys, Peter Piot, Francoise-Renaud Thery, Michel Sidibe, Karen Stanecki,
Brian Williams

Production team:
Heidi Betts, Alistair Craik, Efren Fadriquela, Nathalie Gouiran, Marie-Laure Granchamp, Lon Rahn, Elena Sannikova, Olga Sheean and Elizabeth Zaniewski

This report would not have been possible without the support and valuable contributions of our colleagues in UNAIDS’ Cosponsor organizations, the UNAIDS Secretariat, national AIDS programmes and research institutions around the world. The following people are among those who made significant contributions and deserve our special gratitude:

Angeline Ackermans, Peter Aggleton, Calle Almedal, Peter Badcock-Walters, Andrew Ball, Heidi Bazarbachi, Julia Benn, Elizabeth Benomar, Alina Bocai, Ties Boerma, Raul Boyle, Don Bundy, Angela Burnett, Alexandra Calmine, Michel Caraël, Pedro Chequer, Mark Connolly, Kieran Daly, Ernest Darkoh, Michel de Groulard, Getachew Demeke, Isabelle de Zoysa, Mandeep Dhaliwal, Neelam Dhingra-Kumar, Rebecca Dodd, Enide Dorvily, Alexandra Draxler, René Ehounou Ekpini, Olavi Elo, José Esparza, Tim Farley, Nina Ferencic, Nathan Ford, Edwige Fortier, Michael Fox, Vidhya Ganesh, Geoffrey Garnett, Amaya Gillespie, Aida Girma, Nick Goodwin, Ian Grubb, Lenin Guzman, Laura Hakokongas, Keith Hansen, Mary Haour-Knipe, Lyn Henderson, Alison Hickey, Wolfgang Hladik, Gillian Holmes, Dagmar Horn, Lee-Nah Hsu, Enida Imamovic, José Antonio Izazola, Jantine Jacobi, Noerine Kaleeba, Pradeep Kakkattil, Mohga Kamal Smith, Carol Kerfoot, Brigitte Khair-Mountain, Robert Kihara, Alexander Kossukhin, Christian Kroll, Amna Kurbegovic, Robin Landis, Susan Leather, Jean-Louis Ledecq, Seung-hee Lee, Ken Legins, Gael Lescornec, Jon Liden, Tony Lisle, Carol Livingston, Ruth Macklin, Bunmi Makinwa, Valerie Manda, Geoff Manthey, Tim Marchant, Hein Marais, William McGreevey, Henning Mikkelsen, David Miller, Jadranka Mimica, Hi-Mom, Roeland Monasch, Erasmus Morah, Rosemeire Munhoz, Elizabeth Mziray, Warren Naamara, Alia Nankoe, Francis Ndowa, Paul Nunn, Philip Onyebujoh, Gorik Ooms, Victor Ortega, Jos Perriens, Eduard Petrescu, Jean-Pierre Poullier, Elizabeth Pisani, Ben Plumley, Joel Rehnstrom, Chen Reis, Sinead Ryan, Marcos Sahlu, Roger Salla Ntounga, Karin Santi, George Schmid, Kristan Schoultz, Geeta Sethi, Ismail Shabbir, Catherine Sozi, Paul Spiegel, Susan Stout, Inge Tack, Miriam Temin, Kate Thomson, Georges Tiendrebeogo, Susan Timberlake, Warren Tiwonge, Stephanie Urdang, Mirjam van Donk, Bob Verbruggen, Anna Vohlonen, Neff Walker, Bruce Waring, Alice Welbourn, Caitlin Wiesen, Alan Whiteside, Desmond Whyms, Brian Williams (WHO), Kenneth Wind-Andersen, Anne Winter, Soumaya Yaakoubi, and Alti Zwandor



1Global AIDS epidemic 1990–2003
2 Median HIV prevalence in antenatal clinic population in Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu, India, 1998–2003*
3 Trends in HIV prevalence among various groups, Cambodia, 1998–2002
4 Estimated number of new HIV infections in Thailand by year and changing mode of transmission
5 Epidemic in sub-Saharan Africa, 1985–2003
6 HIV prevalence among 15–49-year-olds in urban and rural areas, selected sub-Saharan African countries, 2001–2003
7 HIV prevalence among 15–24-year-olds in selected sub-Saharan African countries, 2001–2003
8 Median HIV prevalence (%) in antenatal clinics in urban areas, by subregion, in sub-Saharan Africa, 1990–2002
9Newly diagnosed HIV infections per million population in Eastern European and Central Asian countries, 1996–2003
10 HIV prevalence among men having sex with men in Latin America, 1999–2002
11 Condom use with a non-cohabiting partner, Dominican Republic, 2002
12 Life expectancy at birth in selected most-affected countries, 1980–1985 to 2005–2010
13 Population size with and without AIDS, South Africa, 2000 and 2025
14 Examples of estimates of the impact of AIDS on economic growth, 1992–2000
15 Orphans per region within sub-Saharan Africa, end 2003
15a Problems among children and families affected by HIV and AIDS
16 Growing role of grandparents—Relationships of double orphans and single orphans (not living with surviving parent) to head of household, Namibia, 1992 and 2000
17 Projected new adult infections given current degree of intervention and a timely scale up of the comprehensive interventions package
18 Reinforcing strategies of risk, vulnerability and impact reduction
19 Proportion of respondents stating that HIV can be transmitted through sexual contact, selected states in India
20 Trends in sexual behaviour among young people in selected sub-Saharan African countries, 1994–2001—Percentage of young people (15–24-year-olds) who report using a condom at last sex with a non-marital non-cohabiting partner, of those who have had sex with such a partner in the last 12 months
21 Trends in sexual behaviour among young people in selected sub-Saharan African countries, 1994–2001—Percentage of young people (15–24-year-olds) who had sex with a non-marital, non-cohabiting partner in the 12 months prior to the survey
22 Annual prevalence of HIV and other sexually transmitted diseases at the Clinique de Confiance, Abidjan, Côte d’Ivoire (1992–2002)
23 HIV-positive inmates in the penal system of the Ministry of Justice in the Russian Federation, 1994 through 2003
24 Participating countries in the joint subregional HIV prevention and care programme along the Abidjan-Lagos migration corridor
25 Proportion of 15–24-year-old injecting drug users infected with HIV, various studies
26 Changes in voluntary counselling and testing in South Africa: more sites = more tested
27 Khayelitsha: Availability of decentralized antiretroviral therapy access, advocacy, and multi-disciplinary support services dramatically increases demand for testing and counselling
28 Pregnant women attending antenatal clinics, served by ‘Call to Action’ programme in Africa*, 2000–2003** (N = 416 498)
29 Pregnant women attending antenatal clinics, served by ‘Call to Action’ programme outside Africa*, 2000–2003** (N = 243 103)
30 Young people (15–24 years old) living with HIV, by region, end 2003
31 Sexual and reproductive health status of 15–19-year-old girls in 2000 and 2001
32 Percentage of young women (15–24 years old) with comprehensive HIV and AIDS knowledge, by region, by 2003
33 Antiretroviral therapy coverage for adults, end 2003—400 000 people on treatment: 7% coverage
34 Prices (US$/year) of a first-line antiretroviral regimen in Uganda: 1998–2003
35 Projected annual HIV and AIDS financing needs by region, 2004–2007 (in US$ million)
36 Global resources needed for prevention, orphan care, care and treatment and administration and research 2004–2007 (in US$ million)
37 Institutional spending for HIV and AIDS 1996–2002 (US$ disbursements in millions)
38 Percentage that out-of-pocket AIDS expenditure constitutes of total AIDS expenditure, selected countries, 2002
39 Projected disbursements on HIV and AIDS by top bilateral donors (US$ in millions) for 2003
40 Net Official Development Assistance (ODA) as percentage of gross national income (GNI): 2003
41 HIV/AIDS/STI ODA, 2002—Total amount obligated in US$ million and obligations per US$ million GNI
42 The Global Fund to Fight AIDS, Tuberculosis and Malaria Pledges and contributions received, as of December 31, 2003
43 Funds committed by top 15 US grantmakers in 2002 (US$ millions)
44 Funding for microbicide research, in US$
45 Changes in AIDS Programme Effort Index scores 2000, 2001 and 2003
46 Relations between National AIDS Committees and bilaterals—Percentage of responding countries where UNAIDS Secretariat representatives indicated that a formal relationship existed between the NAC and bilateral donors
47 Level of mainstreaming in 63 low- and middle-income countries
48 Health and human resource constraints—Percentage of countries where the UNAIDS Secretariat representative indicated that a lack of health personnel was a major barrier to the national AIDS response
49 HIV prevalence by country of asylum and country of origin, by region, 2003
50HIV risk factors for conflict and displaced persons camps
51Participation in partnership forums by people living with HIV, 2003




UNAIDS/04.16E (English original, June 2004)




Cover design: Lewis Evans



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