amfAR, The Foundation for AIDS Research

UNAIDS Report Shows Epidemic Continuing to Spread in Asia


January 2004—There are 7.4 million people living with HIV/AIDS in Asia, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS). In its annual report on the state of AIDS worldwide, released on November 25, the organization reported that one million people in Asia became infected with HIV last year and 500,000 died from AIDS.

While Asia has a lower percentage of the population living with HIV than areas such as sub-Saharan Africa, the region’s population density turns a prevalence of one percent into a significant number of infected individuals. Additionally, some areas in Asia, including certain districts in India and provinces in China, have prevalence rates as great as five percent. The report focused on methods of transmission in Asian countries and high-risk populations.

In India, between 3.82 and 4.58 million people are living with HIV/AIDS, and at least 300,000 became infected in 2003. Several states are experiencing serious epidemics, including Maharashtra and Tamil Nadu, where sex workers in some cities have infection rates of 50 percent. Though the epidemic is currently concentrated in at-risk populations, India’s National AIDS Control Organization reports that the virus is traveling from urban centers to rural areas and from at-risk groups into the general population.

Though China has a low national prevalence, concentrated epidemics continue to worsen in certain regions, with others beginning to follow. HIV prevalence rates of between 20 and 80 percent have been found among injection drug users (IDUs) in Xinjiang and Guangdong provinces, and intravenous drug use is on the rise nationwide while condom use remains low.

Cambodia’s epidemic continues to hover around three percent, a prevalence that has remained steady for six years. Infection rates appear to have dropped among brothel-based sex workers, thanks to a condom campaign sponsored by NGOs and the government. The 100 percent condom program implemented in the sex industry in Thailand helped reduce HIV prevalence from four to two percent, where it remains. However, there is evidence in both countries of increasing transmission between spouses and a rising rate of HIV infections among the general population.

HIV prevalence in Vietnam remains below one percent, but the report cited “outbreaks” in IDUs, who represent 65 percent of the country’s infections. Infection rates are on the rise among commercial sex workers in urban areas.

Myanmar is experiencing infection rates of between one and two percent among 15- to 24-year-olds. While the majority of the country’s infections are concentrated among commercial sex workers and IDUs, there is evidence that migrant workers are contributing to the spread of HIV among the general population.

In Indonesia, where condom use is very low in the sex industry, HIV infections are on the rise among sex workers. But it is IDUs who are fueling the epidemic, according to UNAIDS. Unclean equipment is used by more than 90 percent of IDUs in the country’s major cities.

Bangladesh and Nepal both have prevalence rates of below one percent, but the report noted that widespread unsafe behavior, particularly among at-risk populations and youth, is sowing the seeds for epidemics in both countries.