11 August 2009 An estimated 50 million women in Asia, who are either married or in long-term relationships with men who engage in high-risk sexual behaviours, are at risk of becoming infected with HIV from their partners, according to a new report published by the Joint United Nations Programme on HIV/AIDS (UNAIDS).
“HIV Transmission in Intimate Partner Relationships in Asia,” produced by UNAIDS and its partners, was released today in Bali at the 9th International Congress on AIDS in Asia and the Pacific.
According to the agency, the HIV epidemics in Asia vary between countries in the region, but are fuelled by unprotected paid sex, the sharing of contaminated injecting equipment by injecting drug users, and unprotected sex among men who have sex with men.
Men who buy sex constitute the largest infected population group – and most of them are either married or will get married. “This puts a significant number of women, often perceived as ‘low-risk’ because they only have sex with their husbands or long-term partners, at risk of HIV infection,” it stated in a news release.
UNAIDS estimated that more than 90 per cent of the 1.7 million women living with HIV in Asia became infected from their husbands or partners while in long-term relationships. In Cambodia, India and Thailand, the largest number of new HIV infections occur among married women.
“HIV prevention programmes focused on the female partners of men with high-risk behaviours still have not found a place in national HIV plans and priorities in Asian countries” said Dr. Prasada Rao, Director, UNAIDS Regional Support Team Asia and the Pacific, speaking at the launch of the report.
The report pointed out that the strong patriarchal culture in Asian countries severely limits a woman’s ability to negotiate sex in intimate partner relationships. While society tolerates extramarital sex and multiple partners for men, women are generally expected to refrain from sex until marriage and remain monogamous afterwards.
“Discrimination and violence against women and girls, endemic to our social fabric, are both the cause and consequence of AIDS,” said Dr. Jean D’Cunha, South Asia Regional Director for the UN Development Fund for Women (UNIFEM). “Striking at the root of gender inequalities and striving to transform male behaviours are key to effectively addressing the pandemic.”
The report makes a number of recommendations, including that HIV prevention interventions be scaled-up for men who have sex with men, injecting drug users, and clients of female sex workers and should emphasize the importance of protecting their regular female partners.
Also at the conference, the UN Development Programme (UNDP) warned that more than 90 per cent of men who have sex with men in the Asia-Pacific region do not have access to HIV prevention and care services, and without an urgent boost in interventions the spread of the disease in this population will escalate sharply in the very near future.
Moreover, legal provisions across the region need a significant overhaul to allow public health sector workers to reach out to men having sex with men, or the consequences could be dire and stretch to the general population.
“This will mean stepping up our investment in legal and social programmes which effectively address stigma and discrimination directed at MSM [men having sex with men] and TG [Transgender People],”said UNDP HIV Group Global Director Jeffrey O’Malley at a high-level symposium.
He noted that some 20 countries in the Asia-Pacific region currently criminalize male to male sex, which often leads to vigilante violence, abuse and human rights violations.
Even without criminalization, other legal provisions violate the rights of men who have sex with men and transgender people along with arbitrary and inappropriate enforcement, thereby obstructing HIV interventions, advocacy and outreach, and service delivery, he added.
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