estimated 700,000 adults, 450,000 of them men, have become infected in
South and South-East Asia in the year 2000. East Asia and the Pacific
is mostly still keeping HIV at bay, with some 130,000 new infections this
year. Overall, as of end 2000, the two regions combined are estimated
to have 6.4 million people living with HIV/AIDS.
- In comparison with
the rates of HIV infection in Africa, those in the general population
of Asia are still low. The prevalence among 15-49-year-olds exceeds
1% in only three countries - Cambodia, Myanmar and Thailand. In other
countries, it is often far lower. In Indonesia, the world's fourth most
populous country, fewer than 5 people in 10,000 are living with HIV.
In the Philippines, the rate of HIV infection is 7 per 10,000.
- Epidemics driven
by unsafe drug-injecting practices dominate in some provinces
of China, Malaysia, Nepal and Viet Nam. Recent reports suggest that
a similar situation is emerging in Indonesia, notably Jakarta.
- According to some
estimates, there are 3 million drug users in China. Needle-sharing
appears common, with more than 45% of injectors sharing needles. HIV
infection is reported among injecting drug users from 25 provinces.
In both China and Viet Nam, 65-70% of detected HIV infections
have been among injectors.
- In parts of north-east
India, too, widespread injecting drug use provided an early entry point
for HIV. In Manipur, the prevalence of HIV infection among injecting
drug users shot up from virtually nothing in 1988 to over 65% just four
years later. It has remained at these high levels ever since. Most cases
of infection among women appear to have been acquired from husbands
who had been infected in turn by sex workers, themselves part of a longer
chain of transmission. In other parts of the country, there is evidence
that unsafe sex is spreading HIV within the general population.
- With 100 million
people or more on the move, China is experiencing population
movement that dwarfs any other in recorded history. In addition, having
practically eradicated sexually transmitted infections by the 1960s,
China is now seeing a steep rise in these rates over the last several
years. Reported cases increased from 5,800 in 1985 to over 836,000 in
- China and India
between them account for around 36% of the world's population. With
such huge populations, even low HIV prevalence rates translate into
huge numbers of infections. In India, where only 7 adults in
1000 are infected, 3.7 million people were living with HIV/AIDS at the
beginning of the millennium - more than in any other country in the
world except South Africa. In both China and India, the epidemic varies
widely from region to region, both in size and in method of transmission.
- Countries where
HIV has spread significantly through unsafe sex include Cambodia,
Myanmar and Thailand.
well-publicized success in curbing a rampant heterosexual epidemic has
brought to light other routes of transmission against which HIV prevention
programmes have been far less successful. HIV continues to spread virtually
unchecked through the sharing of drug-injecting equipment and through
unprotected sex between men.
is already in the throes of a major epidemic while Cambodia has
the highest HIV prevalence rates in the region, fuelled by sexual transmission
against a background of social and economic fragility.
- Viet Nam's
HIV epidemic, until now largely confined to the south and the central
provinces, has expanded to the northern provinces as well. There, as
in the rest of the country, the virus is spread through injecting drug
use and there is ample evidence of steadily increasing sexual transmission.
- A number of factors
have played a significant role in the spread of HIV in Asia and are
likely to continue having an impact: injecting drug use, commercial
sex, literacy, dependency, access to information and services, migration
and population mobility.
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