south and south east asia

trends

Abstracted from Fact Sheet 2003: Asia and the Pacific

At the end of 2003, approximately 4.6 to 8.2 million people were living with HIV/AIDS on South and Southeast Asia. This figure accounts for approximately, 610,000 to 1.1 million of the new infections in this region. AIDS related deaths in the region amounted to approximately 330,000 to 590,000 deaths in 2003.

The driving force for the epidemic in this region are heterosexual transmission and injecting drug users. Over 50% of injecting drug users in Malaysia , Myanmar , Nepal, Thailand and Manipur (in India) have been infected by HIV. Injecting drug use was unknown to Indonesia a decade ago. However, this is a fast growing phenomenon in urban areas in Indonesia. In 2002, national estimates indicated that approximately 43,000 injecting drug users in Indonesia were already infected with HIV.

The same scenario is predominant in Iran, where there are an estimated 200,000 to 300,000 injecting drug users. 1% of this population is already estimated to be infected by HIV. Extramarital relations and sharing of contaminated drug injecting equipment is the main reason for the rapid spread of the epidemic in Iran.

The area hit worst by the HIV/AIDS epidemic in South Asia occurs in India, where, ay the end of 2002, between 3.82 and 4.58 million people had been infected. In 2003, it is estimated that there were at least 300,000 new infections, and serious epidemics are now under way in several states--including Maharashtra and Tamil Nadu where HIV prevalence of over 50% has been found in sex workers in some cities, and in Manipur where HIV prevalence among injecting drug users ranges between 60% and 75%.

In neighboring Bangladesh and Nepal, national HIV prevalence is under 1%, but risky behavior is so predominant that it could be just a matter of time before wider epidemics erupt. Injecting drug users and sex workers are driving the epidemic up in these countries. Sharing of contaminated injecting equipment and unsafe sexual practices account for majority of the new infections in Pakistan. However, the few HIV surveillance studies available for Pakistan suggest that HIV prevalence among people injecting drugs and sex workers has been low (ranging from 0% to 11.5%).

In both Cambodia and Thailand , two breakthroughs spearheaded their achievements: condom use in commercial sex increased, and men sought the services of sex workers less frequently. Analysis suggests, however, that HIV transmission between spouses has become a more prominent cause of new infections--a reminder that it is inadequate to only target vulnerable groups.

Vietnam faces the possibility of a serious epidemic. About 65% of Vietnam 's HIV infections are occurring among drug users, due to the use of contaminated injecting equipment. HIV prevalence rates of 11% and 24% have been detected among sex workers in certain areas of Vietnam .

HIV prevalence in Myanmar ranges from 1-2% among 15-24-year-olds in urban areas. Injecting drug use and commercial sex are responsible for most HIV infections in the country, and there are reports that migrant workers are becoming a major conduit for the virus's spread into the wider population.

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