New Reports Chart Devastating Path of AIDS in Asia
October 2004—Half a million Asians died of AIDS in 2003 and more than twice as many became newly infected with HIV, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS), which released its biennial report on the state of the global epidemic in July. The epidemic appears to be advancing throughout much of Asia, according to the report—indeed the fastest growing incidence of HIV in the world is in East Asia and Eastern Europe.
Along with the UNAIDS report, an extensive study focusing on recent AIDS data provides a critical look exclusively at the epidemic in Asia, including the spread of HIV and sexually transmitted infections and the behaviors fueling that spread. Published by the MAP (Monitoring the AIDS Pandemic) network, the study draws lessons that can help guide the response to HIV/AIDS across the continent.
Notable points in the two studies include:
- An estimated 7.4 million people are living with HIV in Asia, including 1.1 million new infections in 2003—higher than any previous year.
- The epidemic in Asia is concentrated among key population segments, chief among them intravenous (IV) drug users, sex workers and their clients (and their clients’ partners), and men who have sex with men. Involvement with the commercial sex industry, combined with an unwillingness to use condoms, remains the most common risk behavior in Asia, but the steepest recent rises in HIV infection are now seen among IV drug users.
- Asia has had greater success with HIV prevention than any other continent in the developing world. By putting judgment aside and focusing on massive education and prevention campaigns, the reports note that countries such as Thailand and Cambodia have been able to slow the epidemic’s expansion. In Thailand, the number of new infections among sex workers and their customers has dropped from a high of 140,000 in 1991 to 21,000 in 2003.
- HIV prevention programs remain the overwhelming need throughout much of Asia. In most countries, current efforts often fail to provide people with counseling, condoms, clean needles, and effective treatment of sexually transmitted disease.
Asian nations have been in China, Indonesia, Nepal, and Viet Nam.
- India has the largest number of people with HIV outside South Africa—4.6 million in 2002. Most often, infections are acquired sexually, but the epidemic is highly diverse. Awareness of the disease and its prevention remains low.
- China’s low overall prevalence of HIV is being challenged by simultaneous HIV epidemics developing in different populations and at different rates across the country.
- In Pakistan, infections rates are low, but scant or no education about HIV/AIDS and high levels of risky behaviors suggest that conditions are ripe for HIV to spread.
- Cambodia still has the highest prevalence of AIDS in Asia, but infections among sex workers and their clients have dropped from 43% in 1998 to 29% in 2002.
Both the UNAIDS and MAP reports focus on the particular character of AIDS in Asia and the efforts of underfunded programs throughout this vast and diverse region to grapple with a quickly unfolding disaster. Although striking successes have been registered, the challenges for healthcare and policy advocates remain tremendous.
At a Glance: AIDS in Asia, 2003
- Half a million AIDS deaths
- More than one million newly infected with HIV
- 7.4 million living with HIV/AIDS
- One in four of the world’s new HIV infections