February 25, 2011 Updated
Today's HIV/AIDS
Ichikawa Seiichi
Nagoya City University, Graduate School of Nursing
1-Kawasumi, Mizuho-cho, Mizuho-ku, Naogoya City, 467-8601, Japan
e-mail：yaichisei@ybb.ne.jp
It has been 30 years since HIV emerged, and still the numbers of people with HIV and AIDS continues to increase, now reaching 33.3 million people in the world today. This situation indicates that efforts to date have not been adequate in providing HIV prevention and medical treatment to those who need them. Even in Japan, HIV infections are increasing among gay and bisexual men and foreigners, indicating the necessity to increase programs which provide information about HIV, counseling and support for those who are worried they might have HIV, accessible HIV testing services and medical treatment and support for people with HIV and AIDS. HIV/AIDS is still a pressing and important concern that our society needs to respond to.
HIV/AIDS in the world.
HIn the 1980’s, HIV（Human Immunodeficiency Virus） spread through Saharan and southern Africa, escalating rapidly to a global pandemic. According to UNAIDS (the Joint United Nations programme on HIV/AIDS), the number of people living with HIV/AIDS (PLWH/A) as of 2009 was estimated to be 33.3 million in the world, with equal numbers of infections among men and women.（1） While the number of people living with HIV and AIDS soared from 1990 to the beginning of the 2000’s, this increase has slowed somewhat in recent years. Countries where new HIV infections have decreased by more than 25% between the years 2001 and 2009 include 33 countries, 22 of which are located in southern Saharan Africa. HIV infection rates in Ethiopia, Nigeria, South Africa, Zambia and Zimbabwe have also mostly remained stable or indicate decreasing trends. On the other hand, the numbers of people living with HIV and AIDS have increased by more than 25% in some countries in Eastern Europe and Central Asia in the years 2001 to 2009.
Infection with HIV has become, even after progression to AIDS (Acquired Immunodeficiency Syndrome）, no longer a fatal disease due to the development of Highly Active Anti-Retroviral Therapy (HAART）treatment in the middle of 1990’s. This treatment, which prescribes several anti-retroviral drugs, has proven to be extremely effective. However, for people in developed nations where the greatest numbers of people living with HIV and AIDS live, access to treatment is hampered by inadequate money for health budgets . Southern Saharan African nations, where approximately 22.5 million PLWHA lived in 2009, need extensive time and money to establish treatment access based on present inadequacies in their economic and medical infrastructures. Therefore, extensive global support is needed for the countries most affected to support prevention and treatment efforts to respond to HIV/AIDS.（2）
HIV/AIDS in Japan
According to AIDS Surveillance Committee Reports published by the Ministry of Health, Labour and Welfare, the number of cumulative reports at the end of December 2009 was 11,573 HIV and AIDS 5,330 reports, excluding infections caused by infected blood products.（3） Since 2004, the number of yearly HIV/AIDS reports has continuously been above 1,000 cases. In Japan, several anti-HIV drugs have been available for more than a decade, and the numbers of HIV infected people developing AIDS have been significantly decreased. However, the number of people diagnosed when they have already developed AIDS still continues to grow, indicating the need to promote HIV testing, particularly among patients with sexual transmitted infections coming for treatment at clinics and hospitals.
Among 1,021 HIV and 431 AIDS reports in 2009, 91.3% (932 HIV cases) and 93.0% (401 AIDS cases) are Japanese. Furthermore, among Japanese HIV and AIDS reports, 70.7% (659 HIV cases) and 51.1% (205 AIDS cases) are gay and bisexual men. While the numbers of heterosexual infection reports among Japanese have remained constant since 2000, the number of gay and bisexual men among HIV and AIDS reports continue to increase.
The number of annual HIV/AIDS reports among foreigners in Japan peaked at 332 cases in the year 1992, but this number dropped to half in the following year. The most recent annual report indicates there were 100 HIV and 50 to 70 AIDS cases among foreigners. Surveillance data also indicates that more and more foreigners are infected within Japan, and this indicates the need to provide HIV prevention information, support and medical treatment services for foreigners living in Japan.
In our country, gay and bisexual men and foreigners are among the groups who are most vulnerable to HIV infection, and this indicates the necessity to increase support systems that provide easy access to information about HIV and sexual transmitted infections, as well counseling and HIV testing services, and medical treatment.
The HIV/AIDS response
In the near future, the numbers of people with HIV and AIDS will continue to increase due to the continuing trend of increasing HIV reports and the prolonging of the lives of people living with HIV and AIDS through HAART. As well as this, gay and bisexual men, sex workers, and drug users who face the highest burden of HIV infections are groups that need to be targeted by prevention programs in order to arrest the increasing high infections among these groups. Moreover, in countries where social disparity between men and women exists, HIV risk for women is higher than that among men.
The future response to HIV/AIDS globally and within Japan must work toward eradicating discrimination and prejudice toward people with HIV and AIDS, and increase effective and accessible HIV related information and support services. HIV preventive activities must be accompanied by support and medical care for people with HIV and AIDS in order create a supportive environment. A long-term vision and response is needed to arrest increasing HIV infection rates globally, and within Japan.
References
- Joint United Nations Programme on HIV/AIDS(UNAIDS)：AIDS SCORECARDS, OVERVIEW：UNAIDS Report on The Global AIDS Epidemic 2010, November 2010
- Joint United Nations Programme on HIV/AIDS(UNAIDS)：AIDS epidemic update 2009, December 2009
- MHLW AIDS trend committee ：Yr.2009 AIDS Trend History 27 May 2010
