BARCELONA (Reuters) - Different strategies are needed to curb the spread of HIV/AIDS, which is not one but many epidemics throughout the world, a leading AIDS expert said on Saturday.

"There is no country which has controlled HIV/AIDS and different parts of the world face their own special challenges," Doctor Kevin De Cock, of the Centers for Disease Control and Prevention (CDC) program in Kenya, told a news conference.

Whether it is through intravenous drug use in southern and eastern Europe, commercial sex workers in Asia, heterosexual sex in Africa or risky behavior in the United States, the spread of the virus is insidious and must be tackled on various fronts.

In the United States, which is the most heavily affected country in the industrialized world with almost one million people living with HIV, De Cock said public health priorities must focus on reinvigorating prevention efforts because there has been no drop in the incidence of the disease.

"Despite some advances, HIV incidence in the United States has not declined significantly over the past decade, with approximately 40,000 new infections occurring annually," he added on the eve of the 14th International AIDS Conference.

Doctors in the United States are already seeing newly infected individuals who have multi-drug resistant strains of the virus.

"Some people are going to become infected with a virus that might not be impossible, but will be more difficult to treat," warned Doctor Frederick Hecht, of San Francisco General Hospital.

In Eastern Europe, where the epidemic is spreading at the most rapid pace and mostly among men, De Cock called for needle exchange programs, testing for HIV and interventions to reduce drug use and secondary sexual transmission.

What happens next in Asia will depend largely on the spread of HIV through India and China, the two most populous countries in the region.

De Cock said curtailing intravenous drug use, improving the safety of blood supplies, particularly in China, and targeting the prevention message to commercial sex workers and their clients are needed to limit the spread of the virus in Asia.

The situation in Africa, which bears the highest burden of AIDS, is compounded by eroding health infrastructure and threats from other disease such as malaria and tuberculosis.

"Health in general has gone backwards in sub-Saharan Africa over the past 20 years," according to De Cock whose comments on the epidemic are published in the latest issue of the Journal of the American Medical Association.

Sub-Saharan Africa represents 77% of AIDS deaths, 70% of HIV-infected people, 68% of new infections and 90% of children infected with the virus. De Cock questioned the extent to which public health strategies could reverse the epidemic without long-term economic development or an HIV vaccine.

"Despite the obstacles, the increased attention to and resources for global health, the moral challenge of this era, offer hope and opportunities not seen before in the history of the HIV/AIDS pandemic," he added.

Reference Source 89

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