HIV/AIDS in Africa

HIV/AIDS originated in the early 20th century and has become a major public health concern and cause of death in many countries. AIDS rates vary significantly between countries, with the majority of cases concentrated in Southern Africa. Although the continent is home to about 15.2 percent of the world's population, more than two-thirds of the total population infected worldwide – approximately 35 million people – were Africans, of whom around 1 million have already died. Eastern and Southern Africa alone accounted for an estimate of 60 percent of all people living with HIV and 100 percent of all AIDS deaths in 2011. The countries of Eastern and Southern Africa are most affected, leading to raised death rates and lowered life expectancy among adults between the ages of 20 and 49 by about twenty years. Furthermore, life expectancy in many parts of Africa is declining, largely as a result of the HIV/AIDS epidemic, with life-expectancy in some countries reaching as low as thirty-nine years.

Countries in North Africa, West Africa and the Horn of Africa have significantly low prevalence rates, as their populations typically engage in fewer high-risk cultural patterns that promote the spread of the virus in other parts of Africa. Southern Africa is the worst affected region on the continent. As of 2011, HIV has infected at least 10 percent of the population in Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Eswatini, Zambia, and Zimbabwe.

In response, a number of initiatives have been launched in various parts of the continent to educate the public on HIV/AIDS. Among these are combination prevention programs, considered to be the most effective initiative, such as the abstinence, be faithful, use a condom campaign or the Desmond Tutu HIV Foundation's outreach programs.

The number of HIV positive people in Africa receiving anti-retroviral treatment in 2012 were over seven times the number receiving treatment in 2005, with nearly 1 million added in the previous year. Between 2000 and 2018, new HIV infections fell by 37%, and HIV-related deaths fell by 45% with 13.6 million lives saved due to ART in the same period. This achievement was the result of great efforts by national HIV programmes supported by civil society and a range of development partners. It reported that 1.1 million people have been newly infected with HIV in 2018. An estimated 420,000 [340,000−530,000] people died in the African Region from HIV-related causes from 1985-2021, implying that mortality has dropped by approximately 55% since 2010.

Overview

In a 2019 research article titled "The Impact of HIV & AIDS in Africa", the charitable organization AVERT wrote:

+Regional comparisons of HIV in 2011 World region Adult HIV prevalence(ages 15–49) Persons livingwith HIV AIDS deaths, annual New HIVinfections, annual Worldwide 0.8% 34,000,000 1,700,000 2,500,000 Sub-Saharan Africa 4.9% 23,500,000 1,200,000 1,800,000 South and Southeast Asia 0.3% 4,000,000 250,000 280,000 Eastern Europe and Central Asia 1.0% 1,400,000 92,000 140,000 East Asia 0.1% 830,000 59,000 89,000 Latin America 0.4% 1,400,000 54,000 83,000 Middle East and North Africa 0.2% 300,000 23,000 37,000 North America 0.6% 1,400,000 21,000 51,000 Caribbean 1.0% 230,000 10,000 13,000 Western and Central Europe 0.2% 900,000 7,000 30,000 Oceania 0.3% 53,000 1,300 2,900

Regional prevalence

In contrast to Arab North Africa and the Horn of Africa, traditional cultures and religions in Sub-Saharan Africa have generally exhibited a more liberal attitude to female out-of-marriage sexual activity. The latter includes practices such as multiple sexual partners and unprotected sex, high-risk cultural patterns that have been implicated in the much greater spread of HIV in the subcontinent.

North Africa

Country Adult prevalenceages 15–49, 2021 Number of peopleliving with HIV, 2021 AIDS deaths, 2021 New HIV infections, 2021 Algeria <0.1% 21,000 <500 2000 Egypt <0.1% 30,000 <1000 not available Libya 0.2% 8,300 <200 <500 Morocco <0.1% 23,000 <500 <1000 Sudan 0.1% 41,000 1,900 3,100 Tunisia <0.1% 5,400 <500 <500

Horn of Africa

As with North Africa, the HIV infection rates in the Horn of Africa are quite low. This has been attributed to the Muslim nature of many of the local communities and adherence to Muslim norms regarding sexuality.

Ethiopia's HIV prevalence rate decreased from 3.6 percent in 2001 to 1.4 percent in 2011. The number of new infections per year decreased from 130,000 in 2001, to 24,000 in 2011.

Central Africa

In 2010, HIV infection rates in central Africa were moderate to high.

Country Adult prevalenceages 15–49, 2011 Adult prevalenceages 15–49, 2001 Number of peopleliving with HIV, 2011 Number of peopleliving with HIV, 2001 AIDS deaths, 2011 AIDS deaths, 2001 New HIV infections, 2011 New HIV infections, 2001 Angola 2.1% 1.7% 230,000 130,000 12,000 8,200 23,000 20,000 Cameroon 4.6% 5.1% 550,000 450,000 34,000 28,000 43,000 57,000 Central African Republic 4.6% 8.1% 130,000 170,000 10,000 16,000 8,200 15,000 Chad 3.1% 3.7% 210,000 170,000 12,000 13,000 not available not available Congo 3.3% 3.8% 83,000 74,000 4,600 6,900 7,900 7,200 Democratic Republic of the Congo 1.2–1.6% not available 430,000–560,000 not available 26,000–40,000 (2009) not available not available not available Equatorial Guinea 4.7% 2.5% 20,000 7,900 <1,000 <500 not available not available Gabon 5.0% 5.2% 46,000 35,000 2,500 2,100 3,000 4,900 São Tomé and Príncipe 1.0% 0.9% <1,000 <1,000 <100 <100 not available not available

Eastern Africa

HIV infection rates in eastern Africa are moderate to high.

Kenya

In 2008, Kenya had the third largest number of individuals in Sub-Saharan Africa living with HIV. Kenya had the highest prevalence rate of any country outside of Southern Africa. Kenya's HIV infection rate dropped from around 14 percent in the mid-1990s to 5 percent in 2006. It rose again to 6.2 percent by 2011. The number of newly infected people per year decreased by almost 30 percent, from 140,000 in 2001 to 100,000 in 2011.

In 2012, Nyanza Province had the highest HIV prevalence rate at 13.9 percent, with the North Eastern Province having the lowest rate at 0.9 percent.

Christian men and women had a higher infection rate than their Muslim counterparts. This discrepancy was especially visible among women, with Muslim women having a rate of 2.8 percent versus 8.4 percent among Protestant women and 8 percent among Catholic women. HIV detection was more common among the wealthiest than among the poorest, at 7.2 percent versus 4.6 percent.

Historically, HIV had been more prevalent in urban than rural areas, although the gap is closing rapidly. In 2013, men in rural areas were more likely to be HIV-infected, at 4.5 percent, than those in urban areas, at 3.7 percent.

Tanzania

Between 2004 and 2008, the HIV incidence rate in Tanzania for people aged 15–44 slowed to 3.37 per 1,000 person-years. The rate was 4.42 for women, and 2.36 for men. The number of newly infected people per year increased slightly, from 140,000 in 2001 to 150,000 in 2011. There were significantly fewer HIV infections in Zanzibar, which in 2011 had a prevalence rate of 1.0 percent compared to 5.3 percent in mainland Tanzania.Tanzania HIV/AIDS and Malaria Indicator Survey 2011-12, authorized by the Tanzania Commission for AIDS (TACAIDS) and the Zanzibar Commission for AIDS; implemented by the Tanzania National Bureau of Statistics in collaboration with the Office of the Chief Government Statistician (Zanzibar); funded by the United States Agency for International Development, TACAIDS, and the Ministry of Health and Social Welfare, with support provided by ICF International; data collected 16 December 2011 to 24 May 2012; report published in Dar es Salaam in March 2013

Uganda

Uganda has registered a gradual decrease in its HIV rates from 10.6 percent in 1997, to a stabilized 6.5–7.2 percent since 2001. This has been attributed to changing local behavioral patterns, with more respondents reporting greater use of contraceptives and a two-year delay in first sexual activity, as well as fewer people reporting casual sexual encounters and multiple partners.

The number of newly infected people per year increased by over 50 percent, from 99,000 in 2001 to 150,000 in 2011. More than 40 percent of new infections are among married couples, indicating widespread and increasing infidelity. This increase has caused alarm. The director of the Centre for Disease Control – Uganda, Wuhib Tadesse, said in 2011 that,

Country Adult prevalenceages 15–49, 2011 Adult prevalenceages 15–49, 2001 Number of people livingwith HIV, 2011 Number of people livingwith HIV, 2001 AIDS deaths, 2011 AIDS deaths, 2001 New HIV infections, 2011 New HIV infections, 2001 Burundi 1.3% 3.5% 80,000 130,000 5,800 13,000 3,000 6,900 Comoros 0.1% <0.1% <500 <100 <100 <100 not available not available Kenya 6.2% 8.5% 1,600,000 1,600,000 62,000 130,000 100,000 140,000 Madagascar 0.3% 0.3% 34,000 22,000 2,600 1,500 not available not available Mauritius 1.0% 0.9% 7,400 6,600 <1,000 <500 not available not available Mayotte not available not available not available not available not available not available not available not available Réunion not available not available not available not available not available not available not available not available Rwanda 2.9% 4.1% 210,000 220,000 6,400 21,000 10,000 19,000 Seychelles not available not available not available not available not available not available not available not available South Sudan 3.1% not available 150,000 not available 11,000 not available not available not available Tanzania 5.1% 7.2% 1,600,000 1,400,000 84,000 130,000 150,000 140,000 Uganda 7.2% 6.9% 1,400,000 990,000 62,000 100,000 150,000 99,000

Western Africa

Western Africa has moderate levels of infection of both HIV-1 and HIV-2. The onset of the HIV epidemic in the region began in 1985, with reported cases in Senegal, Benin, and Nigeria. These were followed in 1986 by Côte d'Ivoire. The first identification of HIV-2 occurred in Senegal by microbiologist Souleymane Mboup and his collaborators.

HIV prevalence in western Africa is lowest in Senegal and highest in Nigeria, which has the third largest number of people living with HIV in Africa after South Africa and Mozambique. Nigeria's infection rate, of the number of patients relative to the entire population, is much lower, at 3.7 percent, compared to South Africa's 17.3 percent.

In Niger in 2011, the national HIV prevalence rate for ages 15–49 was 0.8 percent. For sex workers, it was 36 percent.

HIV/AIDS in Africa

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