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Prevention efforts and treatment are helping to stabilize the global HIV/AIDS epidemic. But progress is uneven. Infection rates are still unacceptably high, and women in many parts of the world are increasingly becoming infected with HIV/AIDS. Women accounted for almost half (47 percent) of people living with the disease as of the end of 2007. And only about one-third of pregnant women with HIV received medicines to prevent passing HIV to their babies.
In many countries, women and girls are at greater risk of HIV/AIDS due to gender inequality, discrimination, and stigma. Women and girls often are unable to talk with their sexual partners about abstinence, faithfulness, and condom use. Many face sexual or physical violence, or the threat of violence. They are often blamed for causing AIDS and other sexually transmitted infections (STIs) and shunned once they do have the disease. Many women and girls also lack access to prevention and health care services. Pregnant women may be unable to get the treatment they need to prevent passing HIV to their babies.
This disease has many effects on women, including:
The global HIV/AIDS epidemic has received greater attention by the international community over the past several years. This has led to numerous initiatives by governments and organizations to promote prevention and treatment efforts worldwide. In 33 countries, HIV incidence has dropped by more than 25 percent between 2001 and 2009; 22 of those countries are in sub-Saharan Africa.
Sub-Saharan Africa is the hardest-hit region in the world. In 2009, an estimated 1.8 million people became infected with HIV, totaling in 22.5 million people in sub-Saharan Africa living with HIV. Globally, 68 percent of all people who have HIV live in this region. About 76 percent of all HIV-positive women in the world live in this region. Sixty percent of people living with HIV in sub-Saharan Africa are women and girls. Most women with HIV here have been infected by their husbands or sexual partners. Nearly 12 million children under the age of 18 living in sub-Saharan Africa have lost one or both parents to AIDS. Many grandparents, who have lost all of their adult children to the disease, are left raising their grandchildren, many of whom also are HIV-positive. Fortunately, in most sub-Saharan African countries, HIV rates are stable or showing signs of decline. Prevention efforts appear to be having an impact in some countries. Coinfection with tuberculosis (TB), which is a major cause of illness and death in people with HIV, also is a big problem in this region. People living with HIV are more vulnerable to getting drug-resistant TB. In South Africa, 44 percent of people with TB also have HIV. Addressing both infections is an urgent need.
About 4.9 million people were living with HIV in Asia in 2009. Trends vary by region and country. Southeast Asia is the most affected, with the epidemic growing at especially high rates in Indonesia. In many parts of Asia, HIV is found mainly in high-risk groups, such as sex workers and injection drug users. But in India, HIV has spread to the wider population, including women thought to be at low risk of infection. About 360,000 people were newly infected with HIV in 2009; a 20 percent drop from the number of new infections in 2001. Throughout most of the region, HIV numbers have stabilized. However, HIV actually increased in some countries with a relatively low rate of HIV. In Bangladesh, the Philippines, and in Pakistan, where the main mode of transmission is IV drug use, HIV rates went up. Also, the proportion of HIV infections in women has gone up. Women accounted for 21 percent of HIV infections in Asia in 1990, and in 2009 they accounted for 35 percent.
The Caribbean is the only other region, besides sub-Saharan Africa, where the percent of women and girls living with HIV (53 percent) is higher than that of men and boys. There were 240,000 people living with HIV in the Caribbean at the end of 2009. Unprotected sex between sex workers and clients is a main cause of HIV spread in the region. Female sex workers in the Dominican Republic, Jamaica, and Guyana have the highest rates of HIV. In Bermuda and Puerto Rico, unsafe injection drug use is a major mode of transmission. The rate of HIV varies throughout this region — for example, only 0.1 percent of the Cuban population has HIV. That's one person out of 1,000. In the Bahamas, the rate is 3.1 percent — more than three people out of 100.
The number of people living with HIV in this region tripled from 2000 to 2009, reaching a total of 1.4 million people. Nearly 90 percent of new HIV cases were in the Russian Federation and Ukraine. Injection drug use has fueled the spread of HIV in this region, followed by unprotected sex between men and women. About 25 percent of the 3.7 million people in this region who inject drugs (most of whom are men) are HIV-positive. But increases in HIV in men who inject drugs have resulted in higher rates of HIV in women as well. For example, by 2009, an estimated 45 percent of HIV-positive Ukranians were women, as opposed to 41 percent in 2004. AIDS-related death has also jumped, from 18,000 AIDS-related deaths in 2001 to about 76,000 in 2009.
In 2009, about 1.4 million people were living with HIV in this region, where HIV rates are stable. Unprotected sex between men is a main cause of HIV spread in many Latin American countries. HIV transmission between female sex workers and their clients is another major factor in the spread of HIV in this region. Widespread stigma, discrimination, and cultural issues keep prevention and treatment efforts from reaching at-risk populations in this region. This also affects Latin American women, whose partners may have sex with men without their knowledge.
About 2.3 million people in North America and Western and Central Europe were living with HIV in 2009. Access to treatment has helped the numbers of AIDS-related deaths in this region stay low compared to those in other parts of the world. Still, the United States has one of the largest HIV epidemics in the world, and certain populations are more affected. HIV is the third leading cause of death among African-American women ages 35-44 in the United States, and the fourth leading cause of death among African-American women ages 25-34. In 2009, the rate of HIV diagnosis in African-American women was 20 times higher than in white females. In Western and Central Europe, the number of new HIV diagnoses has climbed, especially in men who have sex with men. In 23 European countries, the new cases of HIV in men who have sex with men rose 86 percent between 2000 and 2006.
In 2009, there were an estimated 460,000 people living with HIV in the Middle East and North Africa. Limited data here makes it hard to see patterns and trends related to the HIV epidemic. We do know that unprotected paid sex is the main way HIV is passed in some counties, while injection drug use is the way HIV is passed in other counties. Most HIV cases are found in men. But in some countries, more and more women are getting HIV as it is passed to them from men who pay for sex or use injection drugs. Also, men who have sex with men are heavily stigmatized in these countries. It is hard to find HIV/AIDS services for men who have sex with men, which is fueling the spread of the virus.
Content last updated: July 01, 2011.
Resources last updated: September 25, 2013.