Commercial sex, drug use biggest drivers of HIV in Asia - Xinhua

Commercial sex, drug use biggest drivers of HIV in Asia

www.chinaview.cn 2005-07-05 09:48:41

KOBE, Japan, July 5 (Xinhuanet) -- As commercial sex and unsafe injecting drug use are the biggest drivers of HIV in most Asia countries, supportive government policies that address these behaviors are urgently needed to slow the spread of AIDS, according to a series of reports by the Monitoring AIDS Pandemic (MAP) Network.

The MAP reports, with the last one released on Tuesday -- the close day of the 7th International Congress on AIDS in Asia and the Pacific in west Japan city Kobe, focus on the three behaviors that are fueling the AIDS epidemics in Asia -- injecting drug use, sex between men, and sex work.

The reports caution that HIV could rapidly spread from these vulnerable groups to the wider population through sexual transmission to their partners or clients.

They warn that a sharp rise among injecting drug users could kick-start an AIDS epidemic, given that many drug users also sell sex to buy drugs. Parts of Indonesia and Vietnam have already seenHIV take off among drug injectors in recent years.

In Asia's sex work industry, which has become very lucrative, condoms as well as testing and treatment for sexually transmitted infections are not widely available. In Karachi, Pakistan, for example, one in five sex workers cannot recognize a condom, and three quarters of those surveyed by MAP Network did not know that condoms prevent HIV transmission.

Other MAP surveys have shown that even if condoms are availableto sex workers in the Asian countries, clients there often refuse to use them.

However, Cambodia, Thailand and Tamil Nadu in India have successfully managed to reduce the spread of HIV infection among sex workers and their clients due to their condom promotion programs.

As for injecting drug use, existing evidence shows that access to clean needles lowers the risk of HIV transmission among drug users. According to MAP reports, Asian countries that have promoted safe injecting practices, including access to clean needles, are being rewarded with lower risk behavior.

In most countries in Asia, the very first cases of HIV were identified in men who have sex with other men. But other risk factors, such as sex work and injecting drug use, have become moreprominent and the issue of male-to-male sex has been ignored.

"Recent high levels of HIV prevalence among men who have sex with men -- 17 percent in Bangkok -- should serve as a wake-up call," the reports say, adding that focused prevention interventions have shown to be effective in Indonesia, with condomuse among men who have sex with men doubling in just a two-year period.

The reports conclude that unless prevention services are specifically tailored to sex workers and their clients, drug usersand men who have sex with men, AIDS in Asia will continue to expand.

"Closing our eyes to these marginalized populations and behaviors will not make them go away," said MAP Chair Karen Stanecki. "Supporting prevention services for these populations will reduce their risk to HIV and will help prevent the spread to the wider population."