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Global Aspects of the HIV Pandemic 

Global Aspects of the HIV Pandemic
Chapter:
Global Aspects of the HIV Pandemic
Author(s):

Emilio Letang

, Francine Cournos

, Dimitri Prybylski

, Donn Colby

, E. Kainne Dokubo

, Chuan-Mei Lee

, Julia del Amo

, Jordi Blanch

, Esteban Martínez

, Gaddy Noy

, Farah Ahmad-Stout

, Marshall Forstein

, and Sara Gorman

DOI:
10.1093/med/9780199392742.003.0004
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date: 22 August 2019

This chapter presents the complex and diverse nature of the HIV/AIDS epidemic on a global scale, as well as a global epidemiology of HIV. The hardest-hit region of the world is sub-Saharan Africa, where heterosexual transmission dominates. Here the overall rate of new HIV infections has decreased in 25 countries by 50% between 2001 and 2011, coupled with scale-up of antiretroviral therapy and prevention of mother-to-child transmission. The Asia-Pacific region has the second highest burden of HIV in the world and, despite a decline in the annual number of new infections, is also seeing increasing HIV prevalence in high-risk groups. In Europe there is a clear division between the epidemics in eastern and western countries. Although antiretroviral therapy has led to great advances in health in this region, late identification of illness and barriers to care for stigmatized populations are a ubiquitous problem in the European Union. In the United States, despite reasonably good access to care, the incidence of HIV has not declined significantly since the advent of effective treatment. Substantial efforts and new strategies in the United States and the Americas have been developed to meet the goals of prevention and care engagement. The chapter also identifies the work needed to address the nuanced challenges to HIV prevention and treatment in different subpopulations across the world.

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