HIV in Africa: what is the future?
Berkley, S.
Annals of Internal Medicine 116(4): 339-341
1992
ISSN/ISBN: 0003-4819 PMID: 1733391 Document Number: 321327
In sub-Saharan Africa, the human immunodeficiency virus (HIV) has spread more extensively than in any other region of the world. The infection is transmitted by heterosexuals in this region and has affected both urban and rural areas, with women infected earlier and in disproportionately greater numbers than men. It is currently estimated that almost one African adult in 40 is already infected and that sub-Saharan Africa accounts for over 60% of the estimated 8 to 10 million HIV infections worldwide. For the African continent as a whole, more urban than rural adults are currently infected and, in a few of the most affected countries, such as Rwanda, one in three or four urban women of child-bearing age is already seropositive. However, because Africa is predominantly (over 70%) rural, small rises in seroprevalence in rural areas indicate a shift of the burden of illness away from the cities, as has already occurred in some countries, for example Uganda. This situation is discussed and the possible consequences of the epidemic are estimated. The conclusion stresses that, in the absence of an effective vaccine or treatment that will stop transmission, efforts must be directed towards changing behaviour.