HIV/AIDS in the south-east Asia region

This annual progress report, published by the World Health Organisation (WHO), presents key achievements in prevention and control of HIV in the South-East Asia Region and highlights areas where further work is needed.

Key findings of this report are:

• an estimated 3.5 million people were living with HIV/AIDS in the South-East Asia Region in 2009. Women account for 37% of the total number of people living with HIV.
• annually, there are an estimated 220,000 new HIV infections and 230,000 AIDS deaths.
• five countries (namely India, Indonesia, Myanmar, Nepal and Thailand) account for the majority of HIV infections. No case of HIV has been reported from the Democratic People’s Republic of Korea.
• the number of new infections every year is showing a downward trend in four of the five high HIV burden countries (namely India, Myanmar, Nepal and Thailand). In Indonesia, the HIV epidemic is still on the rise.
• the majority of HIV infections are transmitted sexually; injecting drug use is the second most common mode of HIV transmission.
• the South-East Asia Region accounts for nearly 15% of the global burden of new HIV-positive tuberculosis (TB) cases. HIV prevalence among new TB patients is 5.7%
• the overall HIV prevalence among the adult population is very low (0.3%) in the region, but sex workers and their clients, men who have sex with men, transgenders and people who inject drugs are disproportionately affected by HIV.
• consistent condom use is reaching high levels among sex workers; however, men who have sex with men and transgenders have low rates of condom use. Coverage of a comprehensive package of HIV interventions for people who inject drugs continues to be low.
• currently, 577,000 people with advanced HIV infection are receiving antiretroviral treatment.

The authors note that the key challenges in achieving universal access to HIV prevention, care and treatment services include: continuing stigma and discrimination faced by people living with HIV and most-at-risk populations; limited capacity of health systems; still high prices of antiretroviral drugs; and lack of sustained finances.

In light of the above challenges, the authors argue that the critical priorities for the future include:

• reducing HIV transmission among most-at-risk populations.
• minimizing HIV- associated stigma and discrimination in community and health care settings.
• decentralizing HIV testing and counseling services further to enable more people to know their status.
• ensuring timely access to treatment and improving the quality of antiretroviral treatment.
• continuing advocacy for reducing prices of antiretroviral drugs.
• investing in building health systems and human resources to increase the implementation capacity for scaling-up HIV interventions.