In Tunisia, the WHO World Health Report (2004) indicates an adult mortality⁸ rate per 1000 population of 167 for males and 115 for females. Life expectancy for males is 69.5 for females 73.9. Healthy life expectancy is 61.3 for males; 63.6 for females.⁹

HIV/AIDS is a huge burden for sub-Saharan Africa. Throughout the region in 2003, an estimated 23-27 million people were thought to be living with the disease which also caused up to 2.5 million deaths. This represents a huge loss and impacts significantly on health systems and social and family structures.

Tunisia is a country in Northern Africa that has been affected by the HIV/AIDS epidemic. Estimates suggest that in Tunisia, between 400 and 2,400 adults were living with HIV/AIDS at the end of 2003. In the same year, up to 400 adults and children are thought to have died from the disease (Table 2).

Table 2 Tunisia HIV and AIDS estimates, end 2003

Source: 2004 Report of the global AIDS epidemic

UNAIDS reports:

No evidence of HIV infection was found among women attending prenatal clinics tested for HIV during 1989-1992, or in 1999. In 2001, however, one of 458 pregnant women (0.2%) was infected. HIV seroprevalence among blood donors has been relatively stable from 1989; for the past 3 years around 0.003%. Rates among high risk groups are low. In 1989 and 1992, a group of bar girls tested revealed HIV prevalence rates of 1.3% and 2.3% respectively. Men who have sex with men were screened in 1989; there were no HIV positive cases among 72 individuals tested. Although about one-third of reported AIDS cases have been among injection drug users (IDUs), it is believed that the majority acquired their infection outside of Tunisia. However, the prevalence of HIV infection among IDUs was 1.6% in 1992 and 0.3% in 1997 indicating that, no matter where the infection was acquired, the risk for transmission within the country exists. In 1993, 0.4% of TB patients were HIV positive and 0.25% in 1996. Surveillance for STI patients is sporadic. The rate of HIV infection among this group was 2.3%, 0.8% and 0.0% in 1991, 1992 and 1999, respectively. The seroprevalence for syphilis among blood donors has been consistently less than 1%.¹⁰