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The United Nations and the World Health Organization released an update today on the global AIDS epidemic. There are alarming reports of HIV continuing to spread in southern Africa. More than 30 percent of the pregnant women who came to the clinics tested positive for the virus. HIV did decline in some countries, and overall anti-AIDS drugs slowed the death rate. NPR's Brenda Wilson has more.

BRENDA WILSON reporting:

The number of people with HIV increased in every region of the world, except the Caribbean, and that includes the United States and Europe, where rates of infection were up among women and gay men. It's estimated that 40 million people worldwide are infected with HIV, an increase of two million since 2004. Dr. Jim Kim, the director of WHO's AIDS division, says the most worrisome news came from southern Africa.

Dr. JIM KIM (Director, AIDS Division, World Health Organization): There are six countries in southern Africa in which more than 20 percent of the pregnant women have been shown to be HIV-positive. There are two countries in which the percentages are greater than 30 percent: Swaziland and Botswana. Swaziland's a small country, but 43 percent of the women in the clinics are positive--the pregnant women are positive. These are just horrendous, horrific numbers.

WILSON: In Swaziland, more than half, 56 percent, of pregnant women between the ages of 25 and 29 years old were HIV-positive. Kim says that the reason is that in the push for treatment, prevention has often been forgotten. But many countries, he says, see the scale up of treatment as an opportunity to encourage people to be tested. The southern African country of Lesotho will ask everyone in the country to get tested.

Dr. KIM: This country now is going to scale it up to everyone in the entire country by the end of 2007. In order to do that, they have to provide HIV counseling, which is prevention, to every person in Lesotho. This is the kind of dramatic, extraordinary effort that we're going to have to make if we're going to save countries like Swaziland, Lesotho, Botswana, Namibia and others that have very high rates of HIV infection.

WILSON: There were bright spots in the report. Kenya, Uganda and Zimbabwe in 2004 showed a decline in overall rates of infection. An epidemiologist for WHO, George Lott(ph), says surveys show that in Zimbabwe people are limiting the number of partners and using condoms.

Mr. GEORGE LOTT (Epidemiologist, World Health Organization): We are always very suspicious about what is happening in Zimbabwe because of the political background, so we check that. And it has confirmed this other kind of survey, Democratic Health Survey, but always with surveys in factories. It all leads to the same conclusion that it is realistic; we can assume that the decline is a real decline.

WILSON: The region with the next largest epidemic is Asia, the countries of India, Indonesia, China and Vietnam. More than eight million people are infected, with epidemics concentrated among injection drug users and sex workers. WHO's Jim Kim says Chinese health officials saw the damage an epidemic could do to a country's economy and reputation after SARS, so it's setting up over a thousand centers to help injection drug users.

Dr. KIM: And I asked them point blank, `How did you get the government and all the people to agree to needle exchange and methadone maintenance when it's so controversial?' And the head of the program looked at me and said, `Well, we looked at the data, we looked at the information, and we know that this is one of the best HIV-prevention measures that we have ever discovered. And so we simply told everybody in China that we must do this to stop HIV infections, so we're doing it.'

WILSON: Russia and the Ukraine, which have the fastest-growing epidemics in the world, haven't caught on to any of these ideas. Brenda Wilson, NPR News, Washington.

NORRIS: You can read the UN's report on the new AIDS numbers at npr.org.

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