Two decades after AIDS first became noticed, as a disease of homosexual men, women now account for half of the 37 million adults infected with HIV, according to a new UN report.
The finding is one of the key findings published yesterday in the AIDS Epidemic Update, a report on the evolution of the global HIV status produced twice a year by two UN agencies, the WHO and UNAIDS.
It found that the AIDS epidemic has claimed more than 3 million lives this year and that an estimated 5 million people became infected this year, bringing to 42 million the number of people living with the virus.
"This year, for the first time in the epidemic's history, the number of women living with HIV has risen to 50 percent of the global total," said Dr. Peter Piot, executive director of UNAIDS.
"The face of AIDS has changed," he said.
"You could say there's been a feminization of AIDS."
In Africa, women already make up 70 percent of the HIV infected population and that is gradually increasing, Piot said, and elsewhere around the world, women make up a growing proportion of people living with HIV because sex between men and women has taken over as the primary way the disease spreads in many regions.
Sub-Saharan Africa is still by far the worst affected region. About twice as many young women as men are infected there, the report found.
Last year, between 6 percent and 11 percent of young women aged between 15 and 24 had HIV, compared with between 3 percent and 6 percent of young men in the same age group.
It is particularly difficult for women there to follow prevention recommendations because of their subordinate position in society in many regions.
A recent study found that in Zimbabwe, rape is common and that negotiating for safe sex to prevent HIV infection is almost impossible for many adolescent girls because involvement with older men in return for such benefits as clothes and school fees is widespread.
The phenomenon of intergenerational sex is driving much of the epidemic in Southern Africa, where between one-quarter and one-third of older men are HIV positive.
The shift toward women will ultimately exacerbate the spread of HIV, Piot said, because from women it can be spread not only through sex, but through breast feeding.
The fastest growing HIV problem is in Eastern Europe and Central Asia, where the number of people with HIV this year stands at 1.2 million.
The epidemic is expanding rapidly in the Baltic States, in Russia and several Central Asian countries.
One million people in the Asia Pacific region became infected with HIV this year, while an estimated half a million others died from the disease, the UN said yesterday.
In its end of year report, the UNAIDS agency said that in the face of an epidemic which continued to spread there was a "vital need" for prevention programs focusing on people most at risk of infection.
"We have a narrow window of opportunity to prevent the epidemic from becoming much worse in Asia ... but many governments in the region still don't see the epidemic as one which needs to be addressed with urgency," said UNAIDS regional team leader Tony Lisle.
"Around 11 million people in Asia will become HIV infected in the next five years, and unless the response to the epidemic is greatly increased and expanded in scale we will really have a major problem," he said.
The UNAIDS report said infection rates in most Asian nations, with the exception of Thailand, Myanmar and Cambodia, remained low. But these figures masked serious epidemics localized in certain communities and districts.
"India's national adult HIV prevalence rate of less than one percent offers little indication of the serious situation it faces," it said, noting that a massive 3.97 million people in the country were infected by the end of last year.
In China, epidemics have broken out among groups including blood donors, IV drug users and sex workers in the southern provinces of Yunnan, Guangxi and Guangdong, it said.
"Unless effective responses rapidly take hold a total 10 million Chinese will have acquired HIV by the end of this decade -- a number equivalent to the entire population of Belgium."
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