amfAR, The Foundation for AIDS Research

New Data on HIV/AIDS in Asia

Published September 16, 2014

UNAIDS and the World Health Organization (WHO) have both released new reports detailing progress on HIV in Asia and the many challenges that remain. Some important highlights are excerpted below.

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Regional Overview:

In 2013, there were 4.8 million HIV-positive people living in the Asia-Pacific region, and an estimated 350,000 new infections.

  • Of the new HIV infections, 22,000 were among children and adolescents under the age of 15.

New HIV infections declined by 8% in South and Southeast Asia and by 16% in the Pacific between 2005 and 2013.

  • Countries with the largest declines included: Myanmar (58%), Thailand (56%), and Vietnam (46%).
  • New HIV infections in India declined by 19%, but still accounted for 38% of all new infections in the region.
  • China had approximately 20% of all new HIV infections in the region, and reported a 4% increase in 2013.
  • who-82714-3.jpgIn Indonesia, new HIV infections rose by 48% between 2005 and 2013.

An estimated 250,000 people died of AIDS-related causes in Asia in 2013—a 37% decline since 2005.  However, in 2013, HIV infection was the number two cause of death among adolescents globally and the number one cause of death in sub-Saharan Africa.

  • India accounted for 62% of all AIDS-related deaths in the region.
  • Cambodia reported a 72% decline in AIDS-related deaths since 2005, the largest in the region, followed by Thailand (56%) and Myanmar (29%).
  • In Indonesia, AIDS-related deaths increased by 427% from 2005 to 2013 and by 352% in Pakistan.
  • The WHO reports that not enough data are collected on children and adolescents to fully assess and respond to their HIV-related needs. However, we do know that the number of AIDS-related deaths among adolescents has increased substantially, despite having fallen in all other age groups. 

About US$ 2.2 billion was invested in the AIDS response in the Asia-Pacific in 2012.

Treatment Access:

  • In 2013, 33% of adults in the Asia-Pacific were accessing antiretroviral therapy (ART). 
  • In addition, 29% of children and adolescents under 15 in Southeast Asia and 61% in Western Pacific were on ART.
  • Thailand and Cambodia were the only two low- or middle-income countries in the region where more than 50% of HIV-positive people were receiving ART.
  • Median CD4 cell counts at ART initiation rose from 115 cells/mm3 in 2008 to 302 cells/mm3 in 2011, according to cohort data from 13 TREAT Asia network centers. Although these are primarily urban referral hospitals, this increase reflects the general improvement in regional treatment scale-up.

Key Populations:

In many parts of the Asia-Pacific, the HIV epidemic is concentrated among key populations.  However, in the 16 countries in the region reporting HIV prevention funding data to the WHO, only 36% of funding went to programs targeting men who have sex with men (MSM), transgender individuals, people who inject drugs (PWID), or sex workers.

MSM:

  • 15% of MSM in South and Southeast Asia were HIV positive in 2012, but in certain areas the rate was much higher. For instance, 25% of MSM in Bangkok were HIV positive in 2013.
  • Condom use among MSM in Southeast Asia ranged from 31% in Bangladesh to 86% in Thailand.
  • Less than 50% of MSM had been tested for HIV in the majority of countries in the region.
  • In China, more than one-third of new HIV infections were among MSM.

PWID:

  • Of the estimated 3.8 million people in Asia and the Pacific who injected drugs in 2013, approximately 2.5 million were living in China.
  • 12% of PWID in Asia were HIV positive in 2013, but in certain areas the rate was much higher. For instance, 56% of PWID in Jakarta were HIV positive.
  • In Kathmandu, where harm reduction services are widely available, HIV prevalence among PWID declined from 68% in 2002 to 6.3% by 2011.
  • 15 countries in the region still impose a maximum sentence of death for drug use.

Sex Workers:

  • Sex work or aspects of sex work, such as solicitation, are criminalized in all countries in the region except Indonesia.
  • 5% of female sex workers (FSW) in Asia were HIV positive in 2013, but in certain areas the rate was much higher—22% in Mumbai, for instance.
  • The HIV rate has declined among FSWs in many countries in the region over the past decade. In Cambodia, for example, prevalence declined from 27% to 4% between 2002 and 2012.
  • The rate of self-reported condom use among FSWs in the region is 80%. Among transgender sex workers, who often have less access to HIV services than FSWs, the rate is 50% or less.

Transgender individuals:

  • Limited data exists regarding HIV in transgender individuals in most countries, but globally they are nearly 40 times more likely to be HIV positive than the general population.
  • Approximately 44% of transgender individuals in India and 26% in Indonesia are HIV positive.
  • In most areas, transgender individuals have limited access to HIV services, but India developed a targeted strategy that has greatly expanded this population’s access to HIV testing and services.

Women:

  • In 2013, 26% of HIV-positive pregnant women in Southeast Asia and 58% in the Pacific received the antiretroviral medicines needed to prevent mother-to-child transmission of HIV.
  • The majority of HIV infections among women in Asia occurred among those whose long-term sexual partners are PWID, clients of sex workers, or MSM.
  • In India, 75% of women who tested HIV positive reported having a husband who migrates for work and is away from home for extended periods of time.
  • Too often, stigma and discriminatory social and cultural norms create barriers that prevent women from accessing HIV prevention and care services. In addition, 9% of countries reporting to UNAIDS had laws—including coercive HIV testing and age-of-consent requirements—that reduced women’s and girls’ access to HIV services.

 

You can download the full reports here: UNAIDS and WHO.