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1 April 2007

Volume 44, Number 7
Clinical Infectious Diseases 2007;44:981–987
© 2007 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2007/4407-0018$15.00
DOI: 10.1086/512371
HIV/AIDS INVITED ARTICLE

HIV Epidemiology Update and Transmission Factors: Risks and Risk Contexts—16th International AIDS Conference Epidemiology Plenary

Chris Beyrer

Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

The contexts in which the human immunodeficiency virus (HIV) pandemic is occurring are increasingly diverse. Individual‐level risks for HIV infection are at the core of these epidemics and are powerfully impacted by social, structural, and population‐level risks and protections. The emerging epidemics among injection drug users across Eurasia are largely the result of needle sharing, but the drivers of disease spread include increases in opiate availability, limited HIV infection prevention and programs for drug users, and undermining policy environments. An emerging epidemic of HIV infection among men who have sex with men in developing countries is primarily spread through unprotected anal intercourse but is also driven by limited HIV infection prevention services, social stigma, and the lack of human rights protection. The epidemic in southern Africa, which is spreading largely through heterosexual exposure, is driven by high rates of labor migration, concurrent sexual partnerships, gender inequalities, and the limited availability of male condoms. We need to do much more to control HIV infection, and social and structural risks are crucial intervention targets.

Received 28 September 2006; accepted 12 December 2006; electronically published 26 February 2007.

Reprints or correspondence: Dr. Chris Beyrer, Dept. of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., E 7152, Baltimore, MD 21210 ().

Kenneth H. Mayer, Section Editor

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