Who’s Winning (and Losing) The Global Fight Against HIV/AIDS

As countries around the globe mark the 24th anniversary of World AIDS Day tomorrow, there are more people than ever living with HIV/AIDS. But fewer people are contracting the virus now than they were a decade ago.

A U.N. report (pdf) on the global spread of the disease, released last week, found that the number of newly infected adults and children in 2011 was 20 percent lower than in 2001.

But not all nations are on the upswing. The U.N. survey, which was voluntarily completed by 186 member countries, found that the rate of infection had decreased in 39 nations by more than 25 percent in the past decade. But in nine others, the rate has increased by at least 25 percent.

Despite the progress, the U.N. sees some concerns ahead. More than 90 percent of funding for HIV programs aimed at high-risk groups — sex workers, men who have sex with men and intravenous drug users — is provided by international donors. But those donors are starting to direct their funding elsewhere, the U.N. said, which will leave the burden to host countries, who may not have the funding or interest in sustaining them.

So who came out on top — and who’s falling behind? Here’s a look around the world.

Caribbean

This region boasts the largest improvement worldwide, spurred by improvements in the Barbados, Bahamas and the Dominican Republic, which have all cut new infections by more than 50 percent. Overall, new infections have declined 42 percent, due in part to one of the highest numbers globally of HIV-positive people in care, including pregnant women. The Caribbean also had a 48 percent decline in AIDS-related deaths between 2005 and 2011 — the largest decline in AIDS-related deaths worldwide.

Sub-Saharan Africa

New infections have declined 25 percent in this hard-hit region since 2001, with several nations slashing their infection rates by 50 percent or more — including Botswana, Ghana and Rwanda.

Still, the region has a long way to go. Sub-Saharan Africa still had 71 percent of new infections last year, and is home to the majority of HIV-positive people on the planet. Nations including Congo, Nigeria and Uganda, which is debating a harsh anti-gay law, reported stable rates of new infections. And though it was the only African nation to do so, Guinea-Bissau reported new infections rising by more than 25 percent.

Oceania

The region, made up of Australia and nearby islands, including New Zealand, Fiji and Papua New Guinea, saw a nearly 22 percent decrease in new infections since 2001. It also boasts the highest percentage of people eligible for antiretroviral therapy in the world, at 69 percent, which means that most people who have HIV/AIDS are getting the treatment they need.

Asia

The U.N. noted an overall 17 percent decrease in new infections for Asia. India, for example, slashed its new infection rate by more than 50 percent. But the improvement didn’t extend across all nations in the region. Four of the nine countries where the rate of new infections rose by more than 25 percent are in Asia: Indonesia, Sri Lanka, Bangladesh and the Philippines. In East Asia, the report said data indicates rising prevalence in HIV among men who have sex with men.

Latin America

New infections have declined nearly 11 percent since 2001, thanks to its high rate of antiretroviral therapy, which slows the rate of deaths from AIDS and lowers the chance that infected people will transmit the virus to others.

North America

The region’s increase in new infections was relatively stable, according to the U.N. In the U.S., the Centers for Disease Control and Prevention recently published its own study showing an alarming uptick in new infections among young people, and in particular young black and Latino men who have sex with other men, while other populations have registered little movement.

Western and Central Europe

The 3 percent increase here is attributable in part due to inconsistent condom use among men who have sex with men, the U.N. found.

Eastern Europe and Central Asia

After years of being relatively stable, new infections have increased nearly 8 percent over the last decade. Four countries in this region registered a spike of more than 25 percent: Kyrgyzstan, Georgia, Kazakhstan and the Republic of Moldova. The U.N. found that epidemics in these countries are usually spread through intravenous drug users, who transmit the disease to their partners. The study also found that people who inject drugs have a lower rate of condom use than sex workers and men who have sex with men.

Middle East and North Africa

New infections have increased in the region by more than 35 percent since 2001. With some of the harshest anti-gay laws in the world, HIV prevention and education programs can’t always reach men who have sex with men, a key demographic. This is also the only region in the world that has not reduced the number of newly infected children, who generally are passed the disease from their mothers.