Publications

The objective of this paper is to give an overview of the potential impact of the current crisis on migrant and mobile populations in Southeast Asia, and assess how the likely increase in unsafe mobility with its accompanying risks and vulnerabilities for HIV transmission will affect the health of people on the move. The economic crisis will have severe consequences for employment and poverty in the region as it often pushes out of the labor market the most vulnerable, such as migrants. Migrant workers vulnerabilities to HIV will likely be exacerbated with increasing deterioration of their economic opportunities. Further, we know that even during the best economic times the combination of social, cultural, linguistic, legal and behavioral barriers affect migrants’ access to information and to prevention, health and social services. These conditions are likely to worsen during the economic downturn.

There are very limited data available on the state of HIV and AIDS in Afghanistan. The number of known cases of HIV infections has been relatively low so far. However, there is a risk of an escalation in HIV prevalence owing to a high and increasing number of injecting drug users in the country. The experience from other countries across Asia suggests the potential for rapid spread of HIV within the drug-injecting population and onward transmission of the virus (Friedman and Des Jarlais 1991; Riehman 1998; Monitoring of the AIDS Pandemic (MAP) 2005; Ohiri 2006). At the same time, opium production in Afghanistan reached record levels in 2007 (IMF 2007b). Keeping HIV prevalence low is one of the development objectives in Afghanistan. An increase in HIV and AIDS also has the potential to complicate progress in the attainment of other key development objectives.

India had an estimated 1.8 – 2.9 million HIV positive persons in 2007, with an estimated adult HIV prevalence of 0.34% (0.25%–0.43%). As the HIV Prevalence among the high risk groups (HRG) is very high compared to that among the general population, India continues to be in the category of concentrated epidemic. The sexual mode continues to be the major mode of transmission, though transmission through injecting drug use and Men having Sex with Men are on the rise in many new pockets. The annual HIV sentinel surveillance covered 1,215 sites in 2008-09. The National AIDS Control Programme (NACP) Phase-III (2007-2012) has the overall goal of halting and reversing the epidemic in India over the five-year period. It places the highest priority on preventive efforts while, at the same time, seeking to integrate prevention with care, support and treatment.

This report provides the results of the 2009 in-country  process of updating Population Size Estimates for MARPs.  The exercise has been undertaken at this juncture, not only because the previous estimates are already five years old, but because of newly available data that allows the country to improve  upon previous estimates.  A large-scale mapping exercise, known as the Rapid Situation and Response Assessment (RSRA) provided a major impetus for updating the 2004 estimates for IDUs and FSWs in particular. 

We explore the magnitude of and current trends in HIV infection among people who inject drugs and estimate the reach of harm reduction interventions among them in seven high-burden countries of the South-East Asia Region. Our data are drawn from the published and unpublished literature, routine national HIV serological and behavioural surveillance surveys and information from key informants. A mapping of harm reduction interventions suggests a lack of congruence between the location of established and emerging epidemics and the availability of scaled-up prevention services. Harm reduction interventions in closed settings are almost nonexistent. To achieve significant impact on the HIV epidemics among this population, governments, specifically national AIDS programmes, urgently need to scale up needle–syringe programmes and opioid substitution therapy and make these widely available both in community and closed settings.

This report has been prepared by the Western Pacific Regional Office of the WHO to describe the "compulsory treatment centres" in Cambodia, China, Malaysia and Viet Nam, and assess the treatment they provide. The main objective of this report is to use some key human rights principles as a lens through which to assess and document the situation in the compulsory drug treatment centres in a constructive way, as a basis for engaging in dialogue with policy-makers in these countries. The assessment suggests that these centres lack effective drug treatment services. There is also a lack of prevention or care services for HIV in closed settings, where the spread of the disease is much faster than in the community. People who use drugs in the region are at risk in these settings because they do not receive drug treatment and HIV prevention services.

A Computerised Management Information System (CMIS) for monitoring the implementation of the National AIDS Control Programme in India was initiated in 2001. The CMIS has been designed to provide continuous critical information on the response to the HIV/AIDS epidemic in India. The CMIS enables National AIDS Control Organisation, State AIDS Control Societies and district units to use programmatic information for evidence based planning, for identifying appropriate strategies and for developing district and state level capacities for collection, analysis, interpretation of data and relevant remedial actions.

The reported number of PLHIV in 2008 was again a record high at 1,126 cases. The number of newly reported PLHIV cases over the past five years represents 45.2% of the total. 1,033 cases were Japanese nationals and 93 cases were foreign nationals. In terms of exposure routes for the reported PLHIV cases in 2008, 779 cases (69.2%) were caused by homosexual sexual contact and 220 cases (19.5%) by heterosexual sexual contact, making a total of 999 cases (88.7%) by sexual contact. Age ranges centered on the 20-39 group (70.3%), with both Japanese and foreign nationals seeing most reports in the 25-34 age range for males and the 20-24 age range for females.

This paper will explore that proposition and discuss the future of the Thai epidemic by presenting revised HIV projections that incorporate new data on changes in sexual behaviors among heterosexual men and women in Thailand collected from The National Sexual Behavior Survey of Thailand 2006 (NSBS 2006). This new projection will also take into account expected changes in risk behaviors in both commercial and casual sex from 2007 until 2020. This revised scenario will then be compared to the current national HIV projection to illustrate the impact that heterosexual behavior changes are likely to have on the epidemic.

In 2007, it was estimated that there were 4.9 million people living with HIV in Asia, of whom 440,000 became newly infected in the past year and approximately 300,000 died from AIDS‐related illness (#UNAIDS, 2008a). While overall prevalence of HIV in Asia is lower than in certain other parts of the world, particularly Africa, there is a large variation in HIV prevalence within Asia – from almost 0%, up to 2.4% recorded in the Papua province of Indonesia (#UNAIDS & WHO, 2007).