HIV/AIDS in Asia
Asia is home to the fastest growing HIV/AIDS epidemic in the world. If current trends continue within the next five years, Asia is set to take over from Africa as the continent with the most infections.
India alone, where the infection is spiralling out of control, is projected to overtake South Africa as the country with the largest HIV infected population worldwide.
There are more than eight million people living with HIV in Asia. In 2004 there were1.2million new cases and a further 540,000 people died of AIDS. The main causes are heterosexual sex, gay sex and injecting drug use (IDU).
The figures are largely due a very sharp increase in cases in China, Indonesia and Vietnam which alone make up 50% of the continent’s population. The lack of anti HIV drugs doesn’t help matters.
China and India in particular are suffering from very serious local epidemics. In China nearly one million people were infected in 2004 and experts predict this could rise to 10 million by 2010 unless urgent action is taken.
In India 5.1 million people are infected. The majority of infections result from heterosexual sex but injecting drug use dominates in the north east of the country bordering the famous drugs Golden Triangle. Here 75% of injecting drug users are HIV positive.
Asia has an extremely migrant population. It’s a continent that has suffered much socio-economic deprivation and this has encouraged people – mainly men – to move away from their families in search of work. Migrant workers and sex go hand in hand. It’s common for them to visit prostitutes while away and then come home and infect their partners who in turn pass the infection on to their babies.
Asia is a traditionally male dominated continent. A woman’s place is in the home and for many women marriage proves a major HIV risk factor. Extra marital sex among men is rife (whether it’s with a mistress or prostitute). Fear of domestic violence or the belief that “it’s my duty” forces women to have sex without condoms with their husbands, even when they know they are HIV positive.
Education among women is poor and there is very little access to information about how to protect themselves. This is reflected in the alarmingly high number of mother to child HIV infections. In India alone 30,000 babies are born HIV positive every year.
It’s also important to remember that in some parts of Asia such as Cambodia and Vietnam, war and civil unrest have destroyed vast amounts of infrastructure including the public health system. People have been forced to turn to commercial sex and drug use as ways of coping or making money.
In most of Asia injecting drugs users and female prostitutes were the first to be gripped by the virus.
However in Thailand, where the sex industry is still rife, there has been some success in curbing the epidemic. The number of new infections fell from 140,000 in 1991 to 21,000 in 2003 thanks to a prevention program encouraging men to use condoms and reduce their use of brothels.
In Indonesia IDU drives the HIV epidemic. In the capital city Jarkarta around 80% of injecting drug users test positive.
To have any success at stemming the problem in Asia, prevention programs and public information will have to overcome a local culture which sees sex, prostitution and drug use as taboo subjects.