[The HIV-pandemic in the third world--worse than anticipated?].

BACKGROUND

The first AIDS cases were discovered 25 years ago in the United States. We describe how the epidemic evolved in the Third World, with emphasis on the current situation and on the African continent, which is most affected.

METHODS

The present review article is based on a literature review and own working experience.

RESULTS AND INTERPRETATION

In 2005, more than 90 % of HIV-infected persons lived in Third World countries, mainly Africa and Asia. Transmission in Africa is mainly heterosexual and approximately 60 % of the infected are women. Asia has epidemics among intravenous drug users and men who have sex with men, and among sex workers and their customers. Several Asian countries now have generalized epidemics. Urban populations are more affected than rural ones in all geographical areas of the world, with only a few exceptions. Modern HIV treatment saves many lives, but only an increase of preventive measures can reverse the current trends. To obtain a reversal, it is adamant with broad mobilization of affected populations, clear political leadership and prioritisation and a considerable increase in help from developed countries.