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In sub-Saharan Africa, the worst-affected region, close to 60% of adults living with HIV are women -- or 13.3 million. These latest findings were published in AIDS Epidemic Update 2004, the annual report by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO).

The joint report was released today in advance of World AIDS Day, commemorated worldwide on the first of December.

The report indicates that there is no single AIDS epidemic worldwide. Many regions and countries are experiencing diverse epidemics, some still in the early stages.

"These latest trends firmly establish AIDS as a unique development challenge," said Dr. Peter Piot, UNAIDS Executive Director. "The time of quick fixes and emergency responses is over. We have to balance the emergency nature of the crisis with the need for sustainable solutions."

According to the report, the number of people living with HIV globally has also reached its highest level with an estimated 39.4 million people, up from an estimated 36.6 million in 2002. The steepest increases in HIV infections occurred in East Asia, Eastern Europe,and Central Asia over the past two years.

In East Asia, the 50% increase in HIV infections from 2002-2004 is largely attributable to growing epidemics in China, Indonesia and Viet Nam. The 40% increase in Eastern Europe and Central Asia is mainly due to Ukraine's expanding epidemic and the growing number of people living with HIV in the Russian Federation. With an estimated 860,000 people living with HIV at the end of 2003, Russia has the largest epidemic in Europe.

As the numbers of people becoming infected and living with HIV increases, so does the number of those needing antiretroviral treatment, as well as care for opportunistic infections.

"We do not yet have a vaccine, but we do know that prevention and treatment work and we have the tools to deliver them. Government leaders, civil society and the private sector are all affected and we must all mobilise to save lives," said Dr. LEE Jong-wook, Director- General of the World Health Organization.

Women and AIDS - A Growing Challenge

Women are more physically susceptible to HIV infection than men. Male-to-female HIV transmission during sex is about twice as likely to occur as female-to-male transmission. For many women in developing countries, the "ABC" prevention approach (Abstinence, Being faithful and reducing number of sexual partners, and Condom use) is insufficient.

"Strategies to address gender inequalities are urgently needed if we want a realistic chance at turning back the epidemic," said Dr Piot. "Concrete action is necessary to prevent violence against women, and ensure access to property and inheritance rights, basic education and employment opportunities for women and girls."

According to the report, millions of young people are becoming sexually active each day with no access to prevention services. In sub-Saharan Africa, three quarters of all 15-24 year olds living with HIV are female.

Young women are three times more vulnerable to HIV infection than their male counterparts. In addition to being biologically more vulnerable to infection, many women and girls, particularly in Southern Africa, find themselves using sex as a commodity in exchange for goods, services, money, or basic necessities -- often with older men. This "transactional sex" is mainly driven by poverty and the desire for a better life.