HIV / AIDS in Africa: the second decade and beyond.

The epidemic spread of HIV infection began silently in the mid- to late 1970s but the major implications of HIV/AIDS for the continent were recognized only a decade later. Now 16 years after the first AIDS cases were documented in the US HIV/AIDS is Africas most serious public health problem. The epidemic is growing affecting both children and adults and with an epidemiology which combines the features of an acute infection with those of a chronic disease. However despite considerable understanding of the biology epidemiology and social determinants of HIV/AIDS regionally and internationally no country has been able to control the epidemic. The authors describe the current status of the epidemic in Africa the response and challenges for the future. For some time HIV/AIDS will remain the dominant public health problem for most sub-Saharan African countries and the major impact of HIV disease has yet to be felt.