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WORLD HEALTH FORUM. 1991; 12(4):496-7.WHO estimates that the number of AIDS cases worldwide will grow from about 1.5 million to 12-18 million by 2000--a 10 fold increase. Further it expects the cumulative number of HIV infected individuals to increase from 9-11 million to 30-40 million by 2000--a 3-4 fold increase. Dr. Hiroshi Nakajima, the Director-General of WHO, points out that despite the rise in AIDS, there is something for which to be thankful--neither air, nor water, nor insects disseminate HIV and causal social contact does not transmit it. Further since AIDS is basically a sexually transmitted disease, health education can inform people of the need to make life style changes which in turn prevents its spread. In addition, Dr. Nakajima illustrates how frank health education and information campaigns in the homosexual community in developed countries have resulted in reduced infection rates. In fact, many of the people disseminating the safer sex message in the homosexual community were people living with HIV and AIDS. HIV has infected >7 million adults and children in Sub-Saharan Africa since the AIDS pandemic began. It is now spreading quickly in south and southeast Asia where at least 1 million people carry HIV. In fact, WHO believes that by the mid to late 1990s HIV will infect more Asians than Africans. Further Latin America is not HIV free and it can be easily spread there too. Heterosexual intercourse has replaced homosexual intercourse and needle sharing by intravenous drug users as the leading route of HIV transmission.
ANTIBIOTICS AND CHEMOTHERAPY. 1991; 43:1-13.Delphi techniques used by the World Health Organization predict more than 6 million cases of AIDS and millions more to be infected with HIV by the year 2000. In the absence of quick solutions to the epidemic, one must prepare to work against and survive it. The modes of HIV transmission are constant and seen widely throughout the world. Transmission may occur through sexual intercourse and the receipt of donated semen; transfusion or surgically-related exposure to blood, blood products, or donated organs; and perinatally from an infected mother to child. There are, however, 3 patterns of transmission. Pattern I transmission is characterized by most cases occurring among homosexual or bisexual males and urban IV-drug users. Pattern II transmission is predominantly through heterosexual intercourse, while pattern III of only few reported cases is observed where HIV was introduced in the early to mid-1980s. Both homosexual and heterosexual transmission have been documented in the latter populations. Significant case underreporting exists in some countries. Investigators are therefore working to find incidence rates of both infection and AIDS cases to better estimate actual present and future needs in the fight against the epidemic. Surveillance data does reveal a rapidly rising and marked number of reported AIDS cases. The cumulative number reported to the World Health Organization increased over 15-fold over the past 4 years to reach 141,894 cases by March 1, 1989. Large, increasing numbers of cases are reported from North and Latin America, Oceania, Western Europe, and areas of central, eastern and southern Africa. 70% of all reported cases were from 42 countries in the Americas. 85% of these are within the United States. Increases in the proportion of IV-drug users who are infected with HIV are noteworthy especially in Western Europe and the U.S. The epidemic in Italy is also specifically discussed.