Explore the vast range of titles available.

Introduction Over the past 20 years, the response to the HIV epidemic has achieved remarkable results. These results have often been motivated by targets adopted by countries through United Nations (UN) Political Declarations on HIV. The 2016 political declaration included two impact targets, to achieve a 75% decline in new HIV infections and AIDS‐related deaths between 2010 and 2020, and to reach the 90‐90‐90 testing and treatment targets by 2020. Our objective is to summarize progress towards these targets using robust and comparable HIV estimates released by UNAIDS in July 2021. In addition, we comment on the importance of targets and the modelled estimates required to quantify those targets. Discussion The UNAIDS estimates indicate that at the global and regional levels, the 2020 targets were missed: new infections declined by 31% and AIDS‐related deaths declined by 47% between 2010 and 2020, compared to a target of 75% decline for both indicators. Similarly, no region achieved the 90‐90‐90 testing and treatment targets. Some countries, in diverse settings, achieved these targets showing that the targets were not overly ambitious if the right funding, policies and evidence‐informed interventions at the right scale were in place. The 2021 UN Political Declaration on HIV, adopted on 8 June 2021, has set out a new set of ambitious but achievable targets for 2025. The 2025 targets and the required actions to reach those targets are described in the Global AIDS Strategy 2021–2026, which provides a framework to reprioritize HIV responses by reducing inequalities and building on the achievements of multiple Sustainable Development Goals. The Strategy encourages countries to monitor progress against targets for different geographic areas and populations to maximize equitable services and ensure accountability and also to understand why targets are being missed. Conclusions The UNAIDS epidemiological estimates provide information that promote accountability and estimate progress towards global targets at the national level. Additional strategic information and analyses are required to identify the populations that are furthest from the targets and the programmes and policies that are keeping countries from meeting their targets.

This first-person account by one of the pioneers of HIV/AIDS research chronicles the interaction among the pediatric HIV/AIDS community, regulatory bodies, governments, and activists over more than three decades. After the discovery of AIDS in a handful of infants in 1981, the next fifteen years showed remarkable scientific progress in prevention and treatment, although blood banks, drug companies, and bureaucrats were often slow to act. 1996 was a watershed year when scientific and clinical HIV experts called for treating all HIV-infected individuals with potent triple combinations of antiretroviral drugs that had been proven effective. Aggressive implementation of prevention and treatment in the United States led to marked declines in the number of HIV-related deaths, fewer new infections and hospital visits, and fewer than one hundred infants born infected each year. Inexplicably, the World Health Organization recommended withholding treatment for the majority of HIV-infected individuals in poor countries, and clinical researchers embarked on studies to evaluate inferior treatment approaches even while the pandemic continued to claim the lives of millions of women and children. Why did it take an additional twenty years for international health organizations to recommend the treatment and prevention measures that had had such a profound impact on the pandemic in wealthy countries? The surprising answers are likely to be debated by medical historians and ethicists. At last, in 2015, came a universal call for treating all HIV-infected individuals with triple-combination antiretroviral drugs. But this can only be accomplished if the mistakes of the past are rectified. The book ends with recommendations on how the pediatric HIV/AIDS epidemic can finally be brought to an end.

Background & objectives: The National AIDS Control Organisation (NACO) and the ICMR-National Institute of Medical Statistics, the nodal agency for conducting HIV estimations in India, have been generating HIV estimates regularly since 2003. The objective of this study was to describe India's biennial HIV estimation 2017 process, data inputs, tool, methodology and epidemiological assumptions used to generate the HIV estimates and trends of key indicators for 2010-2017 at national and State/Union Territory levels. Methods: Demographic Projection (DemProj) and AIDS Impact Modules (AIM) of Spectrum 5.63 software recommended by the United Nations Programme on HIV and AIDS Global Reference Group on HIV Estimates, Modelling and Projections, were used for generating HIV estimations on key indicators. HIV sentinel surveillance, epidemiological and programme data were entered into Estimation Projection Package (EPP), and curve fitting was done using EPP classic model. Finally, calibration was done using the State HIV prevalence of two rounds of National Family Health Survey (NFHS) -3 and -4 and Integrated Biological and Behavioural Surveillance (IBBS), 2014-2015. Results: The national adult prevalence of HIV was estimated to be 0.22 per cent in 2017. Mizoram, Manipur and Nagaland had the highest prevalence over one per cent. An estimated 2.1 million people were living with HIV in 2017, with Maharashtra estimated to have the highest number. Of the 88 thousand annual new HIV infections estimated nationally in 2017, Telangana accounted for the largest share. HIV incidence was found to be higher among key population groups, especially people who inject drugs. The annual AIDS-related deaths were estimated to be 69 thousand nationally. For all indicators, geographic variation in levels and trends between States existed. Interpretation & conclusions: With a slow decline in annual new HIV infections by only 27 per cent from 2010 to 2017 against the national target of 75 per cent by 2020, the national target to end AIDS by 2030 may be missed; although at the sub-national level some States have made better progress to reduce new HIV infection. It calls for reinforcement of HIV prevention, diagnosis and treatment efforts by geographical regions and population groups.

This publication addresses research questions related to an increase in the levels of access and utilization for four key interventions that have the potential to significantly reduce HIV infections among People Who Inject Drugs (PWID) and their sexual and injecting partners, and hence morbidity and mortality in low and middle-income countries (LMIC). These interventions are drawn from nine consensus interventions that comprise a 'comprehensive package' for PWID. The four interventions are: Needle and Syringe Programs (NSP), Medically Assisted Therapy (MAT), HIV Counseling and Testing (HCT), and Antiretroviral Therapy (ART). The book summarizes the results from several recent reviews of studies related to the effectiveness of the four key interventions in reducing risky behaviors in the context of transmitting or acquiring HIV infection. Overall, the four key interventions have strong effects on the risk of HIV infection among PWID via different pathways, and this determination is included in the documents proposing the comprehensive package of interventions. In order to attain the greatest effect from these interventions, structural issues must be addressed, especially the removal of punitive policies targeting PWID in many countries. The scientific evidence presented here, the public health rationale, and the human rights imperatives are all in accord: we can and must do better for PWID. The available tools are evidence-based, right affirming, and cost effective. What are required now are political will and a global consensus that this critical component of global HIV can no longer be ignored and under-resourced.

Primary gaseous air pollutants have been associated with death from multiple causes, however, it remains unknown if they play a role in premature mortality among individuals living with HIV/AIDS. Data on HIV/AIDS patients were collected from the Hubei Provincial Center for Disease Control and Prevention, with a total of 1,467 AIDS-related deaths (ARD) between 2013 and 2020. Daily mean sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were generated by artificial intelligence algorithms combined with big data. We employed a time-stratified case-crossover approach and conditional logistical regression models to investigate the acute effects of primary gaseous air pollutants on ARD. Per interquartile range increase in the concentrations of SO2 was significantly linked with ARD, with a corresponding odds ratio (OR) of 1.17 [95% confidence intervals (CIs): 1.01, 1.35] at lag 4 day. Furthermore, our findings indicated that males exhibited a heightened vulnerability to the adverse effects of SO2 and NO2, for example, the ORs were 1.24 (95% CIs: 1.05, 1.47) and 1.16 (95% CIs: 1.01, 1.34), respectively. Moreover, individuals aged over 65 years were more susceptible to SO2 and CO. Additionally, we identified the warm season as a sensitive period for mortality associated with SO2 and NO2. Our study furnished fresh evidence regarding the detrimental effects of primary gaseous air pollutants on ARD.

In recent years, Europe and Central Asia has experienced the world’s fastest growing HIV/AIDS epidemic. Yet, in the Western Balkan countries the HIV prevalence rate is under 0.1 percent, which ranks among the lowest. This may be due to a low level of infection among the population—or partly due to inadequate surveillance systems. All major contributing factors for the breakout of an HIV/AIDS epidemic are present in the Western Balkans. HIV/AIDS disproportionably affects youth (80 percent of HIV-infected people are 30 years old or younger). Most of the Western Balkan countries have very young populations, which have been affected by the process of social transition, wars, unemployment and other factors. Among youth, there is generalized use of drugs and sexual risk behavior. Therefore, the number of cases of HIV has been increasing, especially in Serbia, and the incidence of Hepatitis C has clearly increased, which suggests that sharing of infected needles is practiced by injecting drug users. Apart from human suffering, an HIV/AIDS epidemic can have a significant impact on costs of care for individuals, households, health services and society as a whole. This study has found weak public health systems and gaps in financing and institutional capacity necessary to implement evidence-based and cost-effective HIV/AIDS Strategies. Political commitment must increase for action to occur promptly. Prevention interventions are cost effective and, in the short term, affordable with own-country resources. Medium- and long-term interventions would require donor assistance. Longer-term interventions would aim at preventing poverty, exclusion and unemployment, for example, by empowering young people to participate in the regional and global labor market.

A critical analysis of the World Bank's strategy to combat HIV/AIDS in Africa. The World Bank's Commitment to HIV/AIDS in Africa examines the development challenges posed by HIV/AIDS in Sub-Saharan Africa and outlines a comprehensive agenda for action. This report reaffirms the World Bank's dedication to supporting African countries in achieving their Universal Access targets, integrating AIDS into national development plans, and strengthening national systems. This agenda provides a roadmap for policymakers, development practitioners, and researchers seeking to understand and address the complexities of the HIV/AIDS epidemic in Africa. Discover how the World Bank is working with partners to: * Provide sustainable funding for HIV/AIDS programs * Promote evidence-based strategies for prevention and treatment * Strengthen governance and accountability * Build capacity in key sectors This report is essential reading for anyone committed to global health and development in Africa.

The HIV/AIDS epidemic has the potential to impede and even reverse development if not addressed early enough. Poverty and income inequality have been shown to facilitate the diffusion of HIV epidemics. While abject poverty in the Middle East and North Africa region remains low, a significant proportion of the population (23.2%) live under 2 per day and are extremely vulnerable in their ability to cope with shocks.In order to preserve the benefits of national and regional development investments put in place by governments, and donor agencies, greater investments to improve HIV/AIDS advocacy, information and prevention strategies are needed now to maintain the current low prevalence levels. This title outlines the role of the Bank in confronting the HIV/AIDS epidemic in the region based on a review of needs and gaps at the regional and country level.

Recent evidence suggests that the prevalence of HIV/AIDS is increasing in the Middle East, North Africa, and Eastern Mediterranean (MENA/EM) region, and that the total number of AIDS-related deaths has risen almost sixfold since the early 1990s. Although this figure is low compared with those for Africa, South Asia, and the Caribbean, low prevalence does not equal low risk. The situation can change rapidly, and even conservative estimates indicate that AIDS poses a real threat to the region’s long-term growth.This book reviews the current knowledge available on the prevalence of HIV/AIDS in the MENA/EM region with the goal of stimulating discussion among policy- and decisionmakers. In other regions, early investments in good surveillance and effective prevention programs have proved to be relative bargains, compared with the costs of a full-blown epidemic. As the authors argue, the time to act is now, while prevalence levels are still low. To that end, they make specific recommendations and offer best practices and case studies from around the world.This volume is the product of the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organization (Eastern Mediterranean Regional Office), and the World Bank. It will be of particular interest to those in the fields of public health, social policy, and economic development, as well as to students and scholars of the region.