AIDS EPIDEMIC EXPLODING IN DEVELOPING WORLDALEXANDRIA, Va. -- The AIDS epidemic in the U.S. and theindustrialized world may actually be declining, but it isexploding in sub-Saharan Africa and Asia.

The current U.S. AIDS toll is 200,000 dead and 334,000 sick,Scott Holmberg of the Centers for Disease Control in Atlantasaid here at the Conference on Advances in AIDS VaccineDevelopment.

By the year 2000, annual new HIV infections will total 6million in Africa, 500,000 in Asia, just more than 100,000 inLatin America and nearly 100,000 in the industrialized world.

"Approximately 90 percent of all deaths will occur indeveloping countries" (the developing world contains about 85percent of the world's population), said Jose Esparza of theGlobal Program on AIDS, part of the World Health Organization.

The epidemiology in the developing world dictates the form anAIDS vaccine must take, said Esparza. It must be affordable,easy to administer and require at the most, several injections,with lasting prophylaxis. An effective vaccine must also be ableto act on the variety of strains worldwide and be heat-stablefor use in countries where refrigeration is rare.

In the U.S., the epidemiology is changing. Homosexual casesdeclined to 52 percent in 1992 from 61 percent three yearsearlier, while intravenous drug-user and heterosexual casesclimbed 4 percent each to 25 percent and 9 percent,respectively.

For sheer numbers of new cases, needle users top the list, saidHolmberg. About one-third of young homosexuals are havingunprotected sex, but incidences in this group are about half thenumber of those in needle users.

Most heterosexual AIDS cases are found in female sex partnersof male drug users, said Holmberg, although he cautioned thatnon-drug-using heterosexual women are "a very difficult groupin which to estimate HIV seroprevelence, and even definingthem is a problem." He added that another emerging group isyoung black and Latino women who do not inject drugs buthave sex with men who do, or "are associated with cracksmoking," he said. -- David C. Holzman

(c) 1997 American Health Consultants. All rights reserved.