AIDS virus infections worldwide have risen 10 percent over the past year, showing a disturbing lack of progress in prevention, the United Nations AIDS Program in Geneva said in a report issued yesterday. The document, released as a prelude to World AIDS Day on Dec. 1, also reported that the spread is largest among young people and more women are becoming infected.
Overall, the number of people infected with H.I.V., the AIDS virus, rose by 5.8 million, to 33.4 million from 27.6 million. All but 5 percent of the infections occurred in Asia, Africa and Eastern Europe.
Half of the new infections -- nearly 3 million -- were among those 15 to 24 years old, the age when most people become sexually active. Because it is also a time when they are at their peak productive and reproductive years, AIDS is causing economic devastation in many countries. The number of children orphaned by AIDS is also rising significantly. ''This is gloomy news,'' said Dr. Peter Piot, the head of the United Nations AIDS Program.
Women are reaching an unwelcome equality with men in H.I.V. infections, the report said. Women now account for 43 percent of all H.I.V. infected people over 15 years, a rise of 2 percent over the preceding year.
''There are no indications that this trend will reverse,'' Dr. Piot said.
One in 10 new infections among people under 15 years resulted from infection in utero, at birth, or through breast-feeding.
In Africa, where AIDS continues to run rampant, Namibia and Swaziland have been added to the list of countries where from 20 to 26 percent of people 15 to 39 are infected. They join Botswana and Zimbabwe as the countries with the highest infection rates. Despite the staggering rates, many people in those countries refuse to discuss AIDS or say someone died of it. ''The silence needs to be broken,'' Dr. Piot said.
H.I.V. trends in India, where 930 million people live, are also alarming. Only two years ago, H.I.V. was thought to be concentrated in prostitutes and their clients, Dr. Piot said in an interview. Now in five Indian states, more than 1 percent of pregnant women in urban areas are infected. Similarly, rural areas, where 73 percent of Indians live, were thought to be spared from H.I.V. Now, the virus is common in some villages.
A random survey of households in the Indian state of Tamil Nadu with 25 million people indicates that 500,000 are infected. Infection rates are 2.1 percent in rural areas compared with 0.7 percent in cities. The rates are expected to soar because 10 percent of the population had gonorrhea, syphilis or other sexually transmitted diseases, which increase the risk of H.I.V. infection.
Many women who say they are monogamous are at high risk of becoming infected. In one study of 400 women attending a clinic for sexually transmitted diseases in the city of Pune, 93 percent were married and 91 percent said they had been monogamous.
During 1998, the United States and Western Europe recorded little progress in reducing the number of new H.I.V. infections, and while the disease is not out of control in these areas, it has not been stopped, the United Nations said. ''The epidemic has not been overcome anywhere,'' Dr. Piot said.
World AIDS Day will focus on ways to harness the power of youth to prevent H.I.V. infections. The United Nations report said that young people were more likely to practice abstinence or safer sex than adults if they had the information to do so.
In Senegal, 40 percent of women under 25 and 65 percent of men used condoms in non-monogamous sexual relations in 1997, compared with fewer than 5 percent for both sexes at the start of the decade. The shift was attributed to educational programs.
In Western Europe, 60 percent of young people now use condoms the first time they ever have sex, up from 10 percent since the early 1990's. Nevertheless, in the United States 3 million adolescents a year contract a sexually transmitted disease, a clear indicator of unsafe sex that also increases the risk of transmitting H.I.V.
Since 1981, when AIDS was first recognized, 47 million people have become infected and 14 million have died. Of these, 2.5 million will have occurred in 1998. AIDS now kills more people worldwide than any other infection, ahead of malaria, which caused 1 million deaths. Tuberculosis is third. Because tuberculosis is common among H.I.V.-infected people, and accounts for 30 percent of all AIDS deaths, stronger programs are needed to combat tuberculosis and AIDS, the United Nations said.