HIV prevention for young people in Sub-Saharan Africa: effectiveness of interventions and areas for improvement. Evidence from Rwanda

Abstract

Following the explosion of the HIV epidemic at the beginning of the 1980s, the number of people living with HIV increased at a staggering rate. The peak of new in- fections occurred in the mid-nineties with 3.5 million [3.2 million – 3.8 million] new infections. Since then, the number of newly infected people has been decreasing slowly. Since the peak in HIV deaths in 2004 (2.2 million [1.9 million – 2.6 million]), due to the widespread introduction of anti-retroviral treatment, also the number of AIDS-related deaths started to decrease.[1] The continued large number of infections and a longer life expectancy of HIV-positive people, have resulted in an ever increasing number of HIV-positive persons worldwide. Re- cent UNAIDS data show that an estimated 34.2 million people were living with HIV world- wide in 2010. This means that about 1% of the adult world population is infected with the virus. In 2011, an estimated 1.7 million people died of an AIDS-related cause and 2.5 million new infections occurred. Seven thousand people get infected with HIV every day. [1] With 12% of the world population and almost 70% of HIV infections, sub-Saharan Africa is carrying the greatest burden. Within this region, we find large differences between countries, e.g. Mauritania with an HIV prevalence of the adult population (15 to 49 years) of 0.7% [0.6% – 0.9%], Cameroon with 5.3% [4.9% – 5.8%] and Swaziland with 25.9% [24.9% – 27.0%] [2]. While these data might be subject to reporting or measurement bi- ases, the large differences between the countries indicate the existence of important differ- ences within the sub-Saharan African region.