International Report Warns of Impending AIDS Crisis in Asia, Says Action Must be Swift
According to a report released today in preparation for the 6th International Congress on AIDS in Asia and the Pacific, set to begin tomorrow in Melbourne, Australia, "there is a clear potential for extensive population spread of HIV [in Asia] if preventive action is too little or too late," a UNAIDS release states. The report, "Status and Trends of the HIV/AIDS Epidemic in Asia and the Pacific," was published by Monitoring the AIDS Pandemic, an international consortium of HIV/AIDS experts. The fact that only three countries in the region -- Thailand, Cambodia and Myanmar -- have registered prevalence rates above 1% is "not particularly meaningful" because the Asian epidemics "have yet to mature," and natural infection rates of around 3% "in no way represent a 'natural limit' imposed by behavior patterns in the region," the report states. According to the report, the low rates "mask an uneven geographic spread" and should be scrutinized more closely, as the use of certain groups as a "yardstick" is problematic when attempting to determine national figures. The sheer size of the populations in China and India, where provincial populations outnumber those of many other countries, also render national figures "meaningless," the report adds. Rob Moodie, co-chair of the congress, said, "What emerges from the report is that the epidemics of the region are geographically diverse. While HIV has made substantial inroads, the situation still varies dramatically between and within countries."
Link to the Sex Trade
Recent increases in HIV prevalence among sex workers in specific areas, such as Guangxi province in China, Ho Chi Minh City in Vietnam and three sites in Indonesia, should be "seen as a serious warning that the [area] is poised for a more widespread epidemic," the report cautions. The increase in HIV among sex workers is particularly important because the epidemic in Asia is "driven by five overlapping and closely intertwined waves of infection," with sex workers, their clients and their wives or girlfriends being one prong, the report states. Men who have sex with men, injection drug users, newborns and breastfed infants are the other factors contributing to the spread of HIV. According to the report, most drug users are sexually active young men, many of whom frequent sex workers. A growing number of sex workers themselves have also begun using IV drugs, contributing to the spread of HIV.
Hope for Containment
Although the potential for an outbreak remains high, the fact that HIV is relatively contained to certain populations is a "blessing in disguise," according to the report, which adds that the concentrated epidemic leaves "enormous potential for containment" (UNAIDS release, 10/4). Speaking at a press conference to unveil the report, UNAIDS Executive Director Peter Piot said that the countries that began prevention efforts early are "reaping the benefits today." He added, however, that "epidemics will continue their natural courses unless prevention programs quickly reach the population groups most vulnerable to HIV" (Agence France-Presse, 10/4). The "criminal nature" of some risky behaviors and a lack of support from the public for their prevention will make implementing prevention programs difficult (UNAIDS release, 10/4). "The good news for Asia is that because the majority of the population does not engage in high-risk behavior, focusing on those who do is both affordable and effective," the report states (Pugh, Reuters/Contra Costa Times, 10/4). Although targeted programs are needed, programs that educate the general population about sexual health and HIV must also be implemented, the report concludes (UNAIDS release, 10/4). Peter Canavan, president of the Australian National Association of People Living With HIV/AIDS, said prevention messages were already "getting through" in Australia, but added that "[m]ore money definitely needs to be spent on education and prevention" among IV drug users and men who have sex with men to stem the spread of the disease (Foley, The Age, 10/4). The full MAP report is available online at the UNAIDS Web site.