1. 2009 AIDS epidemic update Global summary of the AIDS epidemic December 2008 Number of people living with HIV in 2008 People newly infected with HIV in 2008 AIDS-related deaths in 2008 Total33.4 million [31.1 – 35.8 million] Adults31.3 million [29.2 – 33.7 million] Women 15.7 million [14.2 – 17.2 million] Children under 15 years2.1 million [1.2 – 2.9 million] Total2.7 million [2.4 – 3.0 million] Adults2.3 million [2.0 – 2.5 million] Children under 15 years430 000 [240 000 – 610 000] Total2.0 million [1.7 – 2.4 million] Adults1.7 million [1.4 – 2.1 million] Children under 15 years280 000 [150 000 – 410 000] The ranges around the estimates in this table define the boundaries within which the actual numbers lie, based on the best available information.

2. 2009 AIDS epidemic update Global estimates 1990–2008 EstimateHigh and low estimates Number of people living with HIVAdult (15–49) HIV prevalence (%) Number of people newly infected with HIVNumber of adult and child deaths due to AIDS 1990199319961999200220052008 40 30 20 10 0 Number (millions) 1990199319961999200220052008 1.2 0.9 0.6 0.3 0 1990199319961999200220052008 5 3 2 1 0 Number (millions) 1990199319961999200220052008 5 3 2 1 0 Number (millions) 44 Figure I Source: UNAIDS/WHO %

3. 2009 AIDS epidemic update

5. Estimate of the annual number of infant infections averted through the provision of antiretroviral prophylaxis to HIV-positive pregnant women, globally, 1996–2008 1996199820002002200420062008 60 000 50 000 40 000 20 000 0 30 000 10 000 70 000 199719992001200320052007 Infant infections averted Figure II

6. 2009 AIDS epidemic update No prevention of mother-to-child transmission At current levels of antiretroviral prophylaxis Estimated number of new child infections at current levels of antiretroviral prophylaxis and without antiretroviral prophylaxis, globally, 1996–2008 600 000 500 000 400 000 200 000 0 300 000 100 000 1996199820002002200420062008199719992001200320052007 Figure III

7. 2009 AIDS epidemic update

8. Estimated number of AIDS-related deaths with and without antiretroviral therapy, globally, 1996–2008 Figure V 2.5 2.0 1.5 0.5 1.0 3.0 0 Number (millions) Year 1996199820002002200420062008199719992001200320052007 No antiretroviral therapy At current levels of antiretroviral therapy

9. 2009 AIDS epidemic update Estimated number of AIDS-related deaths with and without antiretroviral therapy, by region, 1996–2008 AsiaCaribbeanEastern Europe and Central Asia Latin AmericaMiddle East and North AfricaSub-Saharan Africa 160 120 80 40 0 25 20 10 5 0 2.0 1.6 1.2 0.4 0 (thousands) (millions) 199619982000200220042006200819961998200020022004200620081996199820002002200420062008 15 0.8 20 10 0 120 80 40 20 0 19961998200020022004200620081996199820002002200420062008 25 15 5 100 60 1996199820002002200420062008 500 400 200 0 (thousands) 300 100 Figure VI No antiretroviral therapyAt current levels of antiretroviral therapy

10. 2009 AIDS epidemic update Estimated number of Life-years added due to antiretroviral therapy, by region, 1996–2008 8 7 6 4 5 3 (millions) 2 1 Sub- Saharan Africa AsiaCaribbeanMiddle East and North Africa Western Europe and North America Latin America Eastern Europe and Central Asia Oceania 0 Figure VII 7.2 million 2.3 million 1.4 million 590 000 73 000 40 00049 000 7500

11. 2009 AIDS epidemic update

12. Sub-Saharan Africa Number of people living with HIV 2008 2001 Number of new infections 2008 2001 Number of children newly infected 2008 2001 Number of AIDS-related deaths 2008 2001 22.4 million [20.8 million–24.1 million] 19.7 million [18.3 million–21.2 million] 1.9 million [1.6 million–2.2 million] 2.3 million [2.0 million–2.5 million] 390 000 [210 000–570 000] 460 000 [260 000–640 000] 1.4 million [1.1 million–1.7 million] 1.4 million [1.2 million–1.7 million]

13. 2009 AIDS epidemic update Sub-Saharan Africa estimates 1990–2008 Number of people living with HIVAdult (15–49) HIV prevalence (%) Number of people newly infected with HIVNumber of adult and child deaths due to AIDS Figure 1 EstimateHigh and low estimates 1990199319961999200220052008 25 20 15 10 5 0 Number (millions) 1990199319961999200220052008 10 8 6 4 2 0 % 1990199319961999200220052008 4 3 2 1 0 Number (millions) 1990199319961999200220052008 4 3 2 1 0 Number(millions) Source: UNAIDS/WHO

14. 2009 AIDS epidemic update

15. Distribution of new infections by mode of exposure in Ghana and Swaziland, 2008 Sources: Bosu et al. (2009) and Mngadi et al. (2009). Figure 3 0 20 40 60 80 100 No risk Medical injections Blood transfusions Injecting drug use (IDU) Partners IDU Sex workers Clients Partners of Clients Men who have sex with men (MSM) Female partners of MSM Engaged in casual sex (CS) Partners of CS Low-risk heterosexual % GhanaSwaziland 1Swaziland 2 Note: sensitivity analysis for Swaziland used different data sources.

16. 2009 AIDS epidemic update HIV prevalence among antenatal clinic clients in Swaziland, 1992–2008 Source: Ministry of Health and Social Welfare (2009). Figure 4 10 20 30 40 50 199219941996199820002002200420062008 HIV prevalence (%) 0

17. 2009 AIDS epidemic update Age at first sexual intercourse by education status in Swaziland, 2007 Sources: Central Statistical Office & Macro International (2008). Figure 5 0 20 40 60 80 100 Women < 15 yrs Women < 18 yrs Men < 15 yrs Men < 18 yrs No education Lower primary Higher primary Secondary High School Tertiary %

18. 2009 AIDS epidemic update Source: Smith et al. (2009), Baral et al. (2009), and Sanders et al. (2007) HIV prevalence among men who have sex with men in countries in sub-Saharan Africa, 2002–2008 Figure 6 BotswanaMalawiNamibiaSouth Africa 1 ZambiaKenya 2UR Tanzania NigeriaSenegal 0 10 20 30 40 50 HIV prevalence (%) Southern AfricaEast AfricaWest Africa South Africa 2 Kenya 1

19. 2009 AIDS epidemic update Asia Number of people living with HIV 2008 2001 Number of new infections 2008 2001 Number of children newly infected 2008 2001 Number of AIDS-related deaths 2008 2001 4.7 million [3.8 million–5.5 million] 4.5 million [3.8 million–5.2 million] 350 000 [270 000–410 000] 400 000 [310 000–480 000] 21 000 [13 000–29 000] 33 000 [18 000–49 000] 330 000 [260 000–400 000] 280 000 [230 000–340 000]

20. 2009 AIDS epidemic update

22. Vulnerability to sexual HIV transmission in commercial sex in Karachi and Lahore, Pakistan Source: Bokhari et al. (2007). Figure 9 Has never heard of HIV/AIDS Does not know that condoms can prevent transmission of HIV No perceived HIV risk 020406080100 55 63 61 82 51 57 45 60 31 42 20 28 Per cent Female sex workers (FSWs) Male clients of FSWs Male sex workers Hijras

23. 2009 AIDS epidemic update Saturating prevention coverage through complementary programming. Avahan has achieved a high coverage of target populations (routine programme monitoring data) Source: Avahan and State AIDS Control Society programme data (2008). Figure 10 Tamil Nadu* 21 000 est. Maharashtra 27 000 est. Andhra Pradesh 46 000 est. Karnataka 26 000 est. Injecting drug users Nagaland 28 000 est. Manipur 35 000 est. 49%26%24% 36%64% 76%5%19% 70%14%15% 26%22%53% 26%12%62% 36%26%38% 74%26% 61%11%29% 58%20%22% Tamil Nadu* 84 000 est. Maharashtra 72 000 est. Andhra Pradesh 115 000 est. Karnataka 89 000 est. Female sex workers High Risk – Men who have sex with men Percent of Mapped Urban Key Population covered** Government of India and OthersAvahanUncovered Percentages indicate intended coverage through establishment of services in specific geographic areas. * Includes districts with no intended coverage. ** Mapping and size estimation quality varies by state. Does not include rural areas

24. 2009 AIDS epidemic update Comparison of the incidence of syphilis in China reported from 26 sentinel sites and from the nationwide sexually transmitted disease surveillance system Source: Chen et al. (2007). Figure 11 Reported incidence of total syphilis from sentinel sites Reported incidence of total syphilis from the nationwide sexually transmitted disease surveillance system 0 5 10 15 20 25 30 35 1993199419951996199719981999200020012002200320042005 Incidence (per 100 000)

25. 2009 AIDS epidemic update Trends in HIV, hepatitis B, hepatitis C and syphilis in men who have sex with men in Beijing in 2004, 2005 and 2006 Source: Ma et al. (2007). Figure 12 0 2 4 6 8 10 12 14 HIV Hepatitis B Hepatitis C Prevalence (%) Syphilis 200420052006

26. 2009 AIDS epidemic update Eastern Europe and Central Asia Number of people living with HIV 2008 2001 Number of new infections 2008 2001 Number of children newly infected 2008 2001 Number of AIDS-related deaths 2008 2001 1.5 million [1.4 million–1.7 million] 900 000 [800 000–1.1 million] 110 000 [100 000–130 000] 280 000 [240 000–320 000] 3700 [1700–6000] 3000 [1600–4300] 87 000 [72 000–110 000] 26 000 [22 000–30 000]

27. 2009 AIDS epidemic update

28. HIV cases per million population in the WHO Eastern Europe region by year of notification, 2000–2007 Source: Van de Laar et al. (2008). Figure 14 0 20 40 60 80 100 120 140 160 180 20002001200220032004200520062007 HIV cases per million population Note: Data from Russian Federation not included.

29. 2009 AIDS epidemic update Caribbean Number of people living with HIV 2008 2001 Number of new infections 2008 2001 Number of children newly infected 2008 2001 Number of AIDS-related deaths 2008 2001 240 000 [220 000–260 000] 220 000 [200 000–240 000] 20 000 16 000–24 000 21 000 [17 000–24 000] 2300 [1400–3400] 2800 [1700–4000] 12 000 [9300–14 000] 20 000 [17 000–23 000]

30. 2009 AIDS epidemic update

31. HIV prevalence trends among young people (aged 15–24) in the Dominican Republic, 1991–2007 Source: Halperin, et al (2009). Figure 16 0.0 0.5 1.0 1.5 2.0 2.5 19911992199319941995199619971998199920002001200220032004200520062007 HIV prevalence (%) Women in population-based survey Pregnant women at La Altagracia Hospital, Santo Domingo Men in population-based survey

32. 2009 AIDS epidemic update Latin America Number of people living with HIV 2008 2001 Number of new infections 2008 2001 Number of children newly infected 2008 2001 Number of AIDS-related deaths 2008 2001 2.0 million [1.8 million–2.2 million] 1.6 million [1.5 million–1.8 million] 170 000 [150 000–200 000] 150 000 [140 000–170 000] 6900 [4200–9700] 6200 [3800–9100] 77 000 [66 000–89 000] 66 000 [56 000–77 000]

33. 2009 AIDS epidemic update

34. Distribution of HIV incidence by mode of exposure in Peru: estimate for 2010 Source: Alarcón Villaverde (2009). Figure 18 6.36% 6.30% 6.22% 5.54% 1.98% 1.33% 0.89% 0.23% 0.22% 0.0% 54.97% 0102030405060 Without risk Blood transfusions Partners (injecting drug users) Medical injections Female sex workers Clients of female sex workers Injecting drug users Partners (casual heterosexual sex) Female partners of men who have sex with men Casual heterosexual sex Partners of clients of female sex workers Low-risk heterosexual Men who have sex with men % Risk groups

35. 2009 AIDS epidemic update Estimated HIV-1 seroprevalence and 95% confidence interval for HIV among men who have sex with men and female sex workers by country Source: Soto et al. (2007). Figure 19 0 El SalvadorGuatemalaHondurasNicaraguaPanamaAll countries HIV seroprevalence (%) n: 28148415751126749314546023541810852366 5 10 15 20 25 Men who have sex with men Female sex workers 15.3 3.2 12.1 4.3 12.4 9.6 7.6 0.2 8.9 0.2 11.7 3.6

36. 2009 AIDS epidemic update Condom use among female sex workers who attend VICITS (Vigilancia Centinela de ITS) in Tegucigalpa, San Pedro Sula and La Ceiba, Honduras, in 2008 Source: Secretaria de Salud Honduras (2008). Figure 20 100 10.6% 40.7% 96.7% With clientsWith casual partners With regular partners Condom use % 80 60 40 20 0 (n= 463)

37. 2009 AIDS epidemic update North America and Western and Central Europe Number of people living with HIV 2008 2001 Number of new infections 2008 2001 Number of children newly infected 2008 2001 Number of AIDS-related deaths 2008 2001 2.3 million [1.9 million–2.6 million] 1.9 million [1.7 million–2.1 million] 75 000 [49 000–97 000] 93 000 [76 000–110 000] <500 [<200–<500] <500 [<200–<500] 38 000 [27 000–61 000] 27 000 [18 000–42 000]

38. 2009 AIDS epidemic update North America and Western and Central Europe estimates 1990–2008 Number of people living with HIVAdult (15–49) HIV prevalence (%) Number (millions) 1990199319961999200220052008 3 2 1 0 1990199319961999200220052008 0.6 0.4 0.2 0 Figure 21 EstimateHigh and low estimates Source: UNAIDS/WHO %

39. 2009 AIDS epidemic update Yearly number of new HIV and AIDS cases and related deaths in Switzerland, 1995–2008 Source: Federal Office of Public Health (2009). Figure 22 19951996199719981999200020012002200320042005200620072008 HIVDeath with AIDS AIDS casesDeath without AIDS Number of people 1200 1000 800 600 400 200 0

40. 2009 AIDS epidemic update Estimated new HIV infections by transmission category, extended back calculation model, 50 US states and the District of Columbia, 1977–2006 Source: Hall et al. (2008a). 80 000 70 000 60 000 50 000 40 000 30 000 20 000 10 000 0 1977- 1979 1980- 1981 1982- 1983 1984- 1985 1986- 1987 1988- 1990 1991- 1993 1994- 1996 1997- 1999 2000- 2002 2003- 2006 Infections Period Men who have sex with men (MSM) Injecting drug use (IDU) MSM / IDU Heterosexual Figure 23 Tick marks denote the beginning and end of a year. The model specified periods within which the number of HIV infections was assumed to be approximately constant.

41. 2009 AIDS epidemic update Middle East and North Africa Number of people living with HIV 2008 2001 Number of new infections 2008 2001 Number of children newly infected 2008 2001 Number of AIDS-related deaths 2008 2001 310 000 [250 000–380 000] 200 000 [150 000–250 000] 35 000 24 000–46 000 30 000 [23 000–40 000] 4600 [2300–7500] 3800 [1900–6400] 20 000 [15 000–25 000] 11 000 [7800–14 000]

42. 2009 AIDS epidemic update

43. Percentage of condom use as reported by street children, male injecting drug users, female sex workers and men who have sex with men in Egypt Source: Shawky et al. (2009). Figure 25 9.2% 6.8% 11.8% 13.0% 12.0% 0 5 10 15 Street boysStreet girlsMale injecting drug users Female sex workers Men who have sex with men % At least once in 12 months prior to surveyLast practice

44. 2009 AIDS epidemic update Oceania Number of people living with HIV 2008 2001 Number of new infections 2008 2001 Number of children newly infected 2008 2001 Number of AIDS-related deaths 2008 2001 59 000 [51 000–68 000] 36 000 [29 000–45 000] 3900 2900–5100 5900 [4800–7300] <500 [<500–<1000] <500 [<200–<500] 2000 [1100–3100] <1000 [<5000–1200]

45. 2009 AIDS epidemic update

46. Proportion of all HIV and AIDS cases in different Pacific island countries and territories, 1984–2007 Sources: The Secretariat of the Pacific Community and the Papua New Guinea Department of Health. French Polynesia 1.1% New Caledonia 1.2% All others 0.8% Guam 0.8% Fiji 1.1% Papua New Guinea 95.0% Figure 27

47. 2009 AIDS epidemic update Annual newly diagnosed HIV infections in Australia, 1999–2008 Source: National Centre in HIV Epidemiology and Clinical Research (2009). Figure 28 0 200 400 600 800 1000 1200 200820002001200220032004200520062007 Number of people 1999

48. 2009 AIDS epidemic update HIV infections detected in Papua New Guinea, by age, 1987–2006 Source: Papua New Guinea National AIDS Council and Department of Health. Figure 29 0 500 1000 1500 2000 2500 3000 0-45-910-1415-1920-2425-2930-3435-3940-4445-4950-5455-59 Over 60Unknown MaleFemaleSex not Stated Number Age group