The report, released ahead of the 12th international AIDS conference that begins here on Sunday, paints the gloomiest pictures of the HIV epidemic since it was first recognized in 1981. But where plague and influenza killed in days, death from untreated AIDS takes about a decade, making it a more silent epidemic that officials have too easily ignored, AIDS officials noted. The report contained a glimmer of good news, showing a slowing of infection rates in countries that have adopted strong prevention programs, like Senegal, Tanzania, Thailand and Uganda. But Piot and other officials warned that South Africa, Namibia and other African countries could soon reach a 25 percent adult infection rate unless national leaders undertook similar programs. Infection rates exceed one in three adults in some major African cities and reach 70 percent of women tested in some prenatal clinics.
Many infected women pass the virus on to their babies.
The overwhelming majority of the Africans are doomed to die from AIDS, the officials said, because they live in countries that cannot afford the costly combinations of drugs that have helped keep the virus in check among infected people in developed countries. The African figures compare to a worldwide adult HIV-infection rate of 1 percent for adults and 0.76 percent in the United States. AIDS is now on the verge of moving into the top five leading causes of death in the world, overtaking diarrheal diseases. At first, both Piot and Dr. Bernhard Schwartlander, the U.N. epidemiologist who led the analysis, said they suspected a statistical error. But checking found them accurate and erring on the side of underestimates, they said.