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There is new evidence that adult HIV infection rates have decreased in certain countries and that changes in behaviour to prevent infection—such as increased use of condoms, delay of first sexual experience and fewer sexual partners—have played a key part in these declines. The new UN report also indicates, however, that overall trends in HIV transmission are still increasing, and that far greater HIV prevention efforts are needed to slow the epidemic.

Kenya, Zimbabwe and some countries in the Caribbean region all show declines in HIV prevalence over the past few years with overall adult infection rates decreasing in Kenya from a peak of 10% in the late 1990s to 7% in 2003 and evidence of drops in HIV rates among pregnant women in Zimbabwe from 26% in 2003 to 21% in 2004. In urban areas of Burkina Faso prevalence among young pregnant women declined from around 4% in 2001 to just under 2% in 2003.

These latest findings were published in AIDS Epidemic Update 2005, the annual report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO). The joint report, which this year focuses on HIV prevention, was released today in advance of World AIDS Day, marked worldwide on the first of December.

Several recent developments in the Caribbean region (in Bahamas, Barbados, Bermuda, Dominican Republic and Haiti) give cause for guarded optimism—with some HIV prevalence declines evident among pregnant women, signs of increased condom use among sex workers and expansion of voluntary HIV testing and counselling.

Despite decreases in the rate of infection in certain countries, the overall number of people living with HIV has continued to increase in all regions of the world except the Caribbean. There were an additional five million new in
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