1. HIV/AIDS Weakens the Immune System
Opportunistic infections:
Pneumonia
Meningitis
Some cancers
Tuberculosis (TB)
Other parasitic, viral and fungal infections that weaken the immune system
[Note: This is a collection of slides highlighting global and regional HIV/AIDS statistics, as of July Feel free to use any number of these slides when discussing AIDS with your students.]
HIV kills by weakening the body’s immune system until it can no longer fight infection.
((Meningitis - Inflammation of the meninges of the brain and the spinal cord, most often caused by a bacterial or viral infection and characterized by fever, vomiting, intense headache, and stiff neck. (according to dictionary.com))

2. Global Estimates – HIV/AIDS
People now living with HIV
New HIV infections in 2005
Deaths due to AIDS by the end of 2005
40 million
4.9 million
25 million
The total number of people living with the human immunodeficiency virus (HIV) rose in 2005 to reach its highest level ever: an estimated 40 million.
An estimated 4.9 million people were newly infected in 2005
95% in sub-Saharan Africa, Eastern Europe, or Asia
25 million people had died of AIDS by the end of 2005

3. Growth of the AIDS Epidemic
People With HIV/AIDS, Cumulative Regional Totals
Millions
Sixty-three percent of the world’s HIV population lives in sub-Saharan Africa.
The first published report of AIDS was in the United States on June 5, Source: CDC, accessed July 7, 2006.
*Western and Central Europe & North America.
Source: UNAIDS/WHO, 2005.

4. Map of HIV Prevalence Worldwide
2005
The greatest prevalence is in sub-Saharan Africa.
[FYI: This map is based on more recent data than the map in PRB’s recent Population Bulletin on this subject. A few countries (such as, Brazil and Peru swapped status; Mozambique is in a higher status), have a different prevalence than the 2004 data determined. Even though the status has changed from one year’s report to another, it is recommended that these changes are not interpreted as a trend.]
Adults Ages with HIV
15.01% %
5.01% %
1.01% - 5.0%
0.51% - 1.0%
0.0% - 0.5%
Not available
Source: UNAIDS, 2006 Report on the Global AIDS Epidemic, 2006.

5. People Now Living with HIV
Western & Central Europe
720,000
Eastern Europe & Central Asia
1.5 million
North America
1.3 million
East Asia
Caribbean
330,000
North Africa & Middle East
440,000
South & South-East Asia
7.6 million
Sub-Saharan Africa
24.5 million
Latin America
1.6 million
Oceania
78,000
Sub-Saharan Africa remains by far the worst-affected region, with 24.5 million people living with HIV at the end of 2005, compared to 23.5 million in Just under two-thirds (63%) of all people living with HIV are in sub-Saharan Africa, as are more than three-quarters (76%) of all women living with HIV.
HIV prevalence in the Caribbean is the second-highest in the world, with 1.6% of adults infected with HIV (in comparison with 6.1% in Sub-Saharan Africa). Haiti has the highest HIV prevalence in the Caribbean, with 190,000 people living with HIV and the adult prevalence estimated at 3.8% in Cuba, as an exception for the region, has very low HIV prevalence (0.1% among adults). The country’s program to prevent mother-to-child transmission of HIV is among the most effective in the world and Cuba offers free, universal access to antiretroviral therapy. Expanding access to antiretroviral treatment is helping a handful of Caribbean island countries make small yet significant progress in fighting the epidemic.
Total: 40 million
Source: UNAIDS, 2006 Report on the Global AIDS Epidemic, 2006.

6. HIV Demographics, Worldwide
Composition of the Population Living with HIV, 2005
Another pattern of HIV infection is the distribution between genders.
Worldwide, the percentage of women and men living with HIV is relatively equal.
Source: UNAIDS, 2006 Report on the Global AIDS Epidemic, 2006.

7. HIV Demographics, Africa
Composition of the Population Living with HIV, 2005
Sub-Saharan Africa
Rest of the World
The proportion of people living with HIV who are adult women (ages 15 to 49) is 1.9 times higher in sub-Saharan Africa than in other regions.
In sub-Saharan Africa, women account for more than half of the 24.5 million people living with HIV. In other regions, the proportion of people living with HIV who are women drops to an average of around one-third.
Source: UNAIDS, 2006 Report on the Global AIDS Epidemic, 2006.

8. Adults with HIV Who are Women
2005
Percent
Women make up almost one-half of HIV infections worldwide and 59 percent of infections in sub-Saharan Africa, where the virus is spread predominantly through heterosexual transmission and has reached the general population. In a generalized epidemic, women’s low status and inability to negotiate with men puts them at great risk of contracting the disease.
Women account for smaller percentages of infected people where the AIDS epidemic is limited to high-risk populations such as injecting drug users or men having sex with men.
Source: UNAIDS, 2006 Report on the Global AIDS Epidemic, 2006.

9. Effect of AIDS on Life Expectancy 2015-2020
Projections for Selected Countries
Life expectancy at birth, in years
AIDS has reduced life expectancy in several countries around the world.
[Definition:
Life Expectancy The average number of additional years a person could expect to live if current mortality trends were to continue for the rest of that person's life. Most commonly cited as life expectancy at birth.
Provides a sense of the distribution of health services, the level of infant mortality rates, and general well-being of the population.]
In Lesotho, for example, without accounting for the impact of AIDS, life expectancy would have been 69 years; however, with AIDS, life expectancy has dropped to 39 years.
Because life expectancy says so much about a country’s well-being, It is a key indicator of social and economic development
All of these countries have lower life expectancies than industrialized nations. This is in large part the result of high infant mortality rates.
Source: United Nations, World Population Prospects: The 2004 Revision, 2005.

10. Effect of AIDS on Child Mortality
Selected Countries in Sub-Saharan Africa,
Deaths of children under age 5 per 1,000 live births
Another key indicator of social and economic development can be traced by looking at child mortality. The child mortality rate is defined as the death rate for children under age 5. So far, the epidemic has stalled or reversed progress in child survival in highly affected countries.
For example:
In South Africa and Swaziland, child mortality rose between the late 1990s and early 2000s. If not for AIDS mortality, the rate would have dropped (the right bar) to 43 in South Africa and 73 in Swaziland today. Instead, the rate in South Africa went from 62 in the late 1990s to 74 in the early 2000s; for Swaziland, the rate went from 109 to 143 during the same time period.
Children infected with HIV through their mothers (mother-to-child transmission) have a difficult chance surviving. One-third die before reaching age 1 and approximately 60% die by age 5.
[The Millennium Development Goal #4 – Reduce child mortality:
Reduce by two thirds, between 1990 and 2015, the under-five mortality rate.]
Source: UNAIDS and UNICEF, A Call to Action: Children, The Missing Face of AIDS, 2005; and United Nations, World Population Prospects: The 2004 Revision, 2005.

11. AIDS’ Toll on Population Structure, South Africa
Population Structure in 2020
Millions
Age
80+ 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5
Females
Males
An unique aspect of this disease is the effect it is having on the adult population.
[As the outer bars show….]
If we use South Africa as an example, between now and 2020, the adult population will shrink, with especially high losses among women in their 30s and 40s, and men over 40.
(Largest number of AIDS deaths tends to occur approximately 10 years after HIV prevalence rates peak).
By the year 2020, fewer children will be born because of deaths and lower fertility among HIV-positive women.
South Africa embodies many of the changes projected for populations severely affected by AIDS.
With AIDS
Without AIDS
Source: United Nations, World Population Prospects: The 2004 Revision (CD-ROM Edition—Extended Dataset), 2005.

12. Slower Population Growth
Populations continue to grow in many
heavily affected countries,
although the growth is less than it
would be in the absence of AIDS.

13. South Africa’s Population With and Without AIDS
Millions
In South Africa, deaths from AIDS will nearly halt population growth in the next 15 years despite high fertility. (The fertility rate of South Africa is: 2.8 children per woman, according to PRB’s 2005 World Population Data Sheet)
Source: United Nations, World Population Prospects: The 2004 Revision (CD-ROM Edition—Extended Dataset), 2005.

14. HIV – Only Health Problem or a Development Issue?
Public Health Burden
Overwhelms health systems in many countries
Labor, Business, and Agriculture
Losses in skilled labor
Decreases productivity; having an economic impact
Threatens agricultural production and food security
Governance and Public Service
Country losses of political leaders and civil servants
Revenues decline and costs rise
Demand for social services increases
This slide provides a few possible answers to Question #6 from Handout 1:
The Food and Agricultural Organization, when speaking about HIV/AIDS, said, “The disease is no longer just a health problem but has become a development issue as well.”
The possible answers are in more detail on the slide and generally noted as follows:
AIDS affects people in their prime working ages.
Business level – having a high turn over rate among employees can lead to decreased productivity. On the national level, this can lead to fewer exports, reducing the country’s Gross Domestic Product.
The disease is crippling progress at the personal, family, community, and national levels.

15. Poverty and HIV/AIDS
Inadequate access to accurate information or prevention services
Seeing no alternative besides sex work, for some women
Labor migration – leads to increased vulnerability and spread of HIV
Once infected, inadequate access to health care and treatment
Vicious cycle of poverty, such as children orphaned because of AIDS
This slide provides a few possible answers to Question #7 on Handout 1: “How might poverty exacerbate the HIV/AIDS problem and increase individual vulnerabilities?”
“Inadequate nutrition, health care, education, and economic activities all contribute to the spread of the epidemic, and shorten the life span of those infected.” (according to The Hunger Project)
Poverty could mean little access to accurate information or prevention services.
Poverty drives some women into the sex industry.
Labor migration is another trade that leads to increased vulnerability and spread of HIV. (Without family and community support systems, migrants are more likely to engage in risky behaviors.)
Once infected:
The poor tend to have less access to health care and treatment.
AIDS often takes the primary wage earner, leaving children to assume responsibility for younger siblings and seek work to help support the family. Instead of staying in school to seek better employment opportunities later, these children usually become trapped in the vicious cycle of poverty.
(At the end of 2003, 15 million children had lost at least one parent to AIDS, according to “The Global Challenge of HIV and AIDS,” Population Bulletin, March 2006, Population Reference Bureau.)

16. Poverty and HIV/AIDS
The Hunger Project, A Vicious Cycle – Poverty exacerbates HIV/AIDS, and HIV/AIDS exacerbates poverty, October 2001.
United Nations (Population Division), Population, Development and HIV/AIDS with Particular Emphasis on Poverty, 2005.
ILO and UNAIDS, Women, girls, HIV/AIDS and the world of work, December 2004.
The previous suggested answers came from a variety of sources:
The vulnerability section of “The Global Challenge of HIV and AIDS,” Population Bulletin, March 2006, Population Reference Bureau.
The other sources listed on the slide.
Also useful:
Cohen, Desmond, United Nations Development Programme, Poverty and HIV/AIDS in Sub-Saharan Africa, 1998.

17. About 11,000 New HIV Infections a Day in 2005
More than 95% are in low and middle income countries
About 1,500 are in children under age 15
About 10,000 are adults age 15 and older, of whom:
almost 50% are women
about 40% are ages 15–24
Given the number of new infections, the need for continued prevention efforts is clear. Virtually every region, including sub-Saharan Africa, has several countries where the epidemic is still at a low level or at an early enough stage to be held in check by effective action.
As women are increasingly affected, strategies are needed to address the structural dynamics of the AIDS epidemic—particularly the wide-ranging gender inequalities that help power the spread of HIV. It is important that women are more closely involved in designing and guiding programs that are meant to serve them.
Source: UNAIDS, 2006 Report on the Global AIDS Epidemic, 2006.

18. Children Estimated to be Living with HIV
Children are defined as under age 15
Western & Central Europe
4,000
Eastern Europe & Central Asia
6,900
North America
11,000
East Asia
6,400
Caribbean
22,000
North Africa & Middle East
31,000
South & South-East Asia
170,000
Sub-Saharan Africa
2.0 million
Latin America
32,000
Oceania
3,000
The overwhelming majority of children with HIV contract the infection from their mothers, during pregnancy, delivery, or through breastfeeding. In sub-Saharan Africa, about 2 million children (younger than age 15) were living with HIV at the end of 2005—8% of the total number of people living with HIV in the region.
Total: 2.3 million
Source: UNAIDS, 2006 Report on the Global AIDS Epidemic, 2006.

19. Global HIV and AIDS Estimates for Children
Children are defined as under age 15
Children living with HIV
New HIV infections in 2005
Deaths due to AIDS in 2005
2.3 million
540,000
380,000
It is estimated that:
2.3 million children (under the age of 15) worldwide are living with HIV.
540,000 were newly infected during 2005.
380,000 children died from AIDS during 2005.
Source: UNAIDS, 2006 Report on the Global AIDS Epidemic, 2006.

20. In Summary HIV / AIDS - global epidemic
Obvious impacts on demographic trends, especially population projections
Visual patterns of mortality and health ….
Therefore, the AIDS epidemic is an important and useful topic to cover in AP Human Geography.