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close this bookAIDS in Africa (UNAIDS, 1999, 11 p.)
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View the documentHot-spots of infection
View the documentYoung people in danger
View the documentHIV and AIDS -making themselves felt
View the documentChildren on the brink
View the documentThe challenge to business
View the documentA hard-to-break silence
View the documentAct before it is too late

Hot-spots of infection

No country in Africa has escaped the virus, and yet some are far worse affected than others. The bulk of new infections continue to be concentrated in East Africa and especially in the southern part of the continent.

The southern African region in fact holds the majority of the world’s hard-hit countries:

· In Botswana, Namibia, Swaziland and Zimbabwe, current estimates show that over one person in five between the ages of 15 and 49 is living with HIV or AIDS.

· Zimbabwe is especially hard-hit. There are 25 surveillance sites in the country where blood taken from pregnant women is tested anonymously as a way of tracking HIV infection. The most recent data, from 1997, show that HIV prevalence remained below 10% in just two of these sites. In the remaining 23 sites, between a fifth and half of all pregnant women were found to be infected with HIV. At least a third are likely to pass the infection on to their baby.

· South Africa trailed behind some of its neighbours in HIV infection levels at the start of the 1990s. Unfortunately, it is catching up fast. This year, just over 50% of all new infections in southern Africa occurred in this one country.

· In South Africa, as in Malawi, Mozambique, Rwanda and Zambia, between one in seven and one in nine adults live with HIV infection.

· In Central African Republic, Cd’Ivoire, Djibouti and Kenya, at least one in ten adults are HIV-infected.


(Source: Department of Health, South Africa)

In general, West Africa is less affected by HIV than southern or East Africa. Some countries in central Africa have also seen HIV remain relatively stable, while in neighbouring countries rates have continued to climb.

Early and sustained prevention efforts can be credited with these lower rates in some places- Senegal provides a good example. But elsewhere, where far less has been done to encourage safer sex, the reasons for the relative stability remain obscure. Research is under way to explain differences between epidemics in various countries. Factors that may play a role include patterns of sexual networking, levels of condom use with different partners, and promptness in diagnosing and curing other sexually transmitted diseases (which if left untreated can magnify the risk of HIV transmission through sex as much as 20-fold).