Condoms help beat worst of AIDS in Asia
Asia may have beaten the worst of its AIDS epidemic through condoms, although new infections are still rising in scattered areas, experts say.
Data from Thailand and Cambodia show that numbers living with HIV (the virus that causes AIDS) have dropped steadily in recent years.
New HIV infections each year in Thailand, for example, have dropped from 143 000 in 1991 to 20 000 in 2000.
But experts warn that the epidemic's future course still depends on how large countries such as China and India cope with the disease. And there is still much cause for concern:
- Infection of HIV is still on an upward trend in Myanmar and some Indian states;
- A rapidly growing sex industry across the region still poses continual new threats;
- There has been a constant spread of HIV among injecting drug users, with more than 50% infected in Nepal, southern China and north-east India.
The urgency for greater condom use in the region was stressed by experts at a meeting in Hanoi, entitled Condom Promotion in High Risk Situations in Asia, organized by the World Health Organization (WHO).
""The epidemic in Asia is not the same as that in Western countries or Africa,"" said Dr. Shigeru Omi, the WHO Regional Director for the Western-Pacific Region. He added: ""If we use the lessons learned in Thailand and Cambodia, we have a real chance to stop the growth of the epidemic in this part of the world.""
Cambodia is the worst hit country by AIDS outside Africa, with 2.8% of its adult population (aged 15 to 49) infected. Thailand, Myanmar and some Indian states also have infection levels of 2%-3% among adults.
Cambodia's condom coup
Both Thailand and Cambodia managed to turn the tide of rising HIV by focusing on the main driving force of the epidemic - commercial sex workers and their clients (who could then pass the disease to their partners).
Thailand's ""100% Condom Use Programme"" - which was directed at the sex industry - has been estimated to have prevented millions of HIV infections during the 1990s.
For example, in Thailand, HIV infection levels among pregnant women - a good indicator of how far the epidemic has spread within the general population - has dropped to 1.5%, compared with 2% in the mid-1990s.
In Cambodia, new HIV infections among sex workers under 20 years old has dropped from more than 40% in 1998 to 23% in 2000. Sales of condoms in the country, meanwhile, have jumped from about 100 000 in 1994 to 11.5 million in 1998.
Cambodia has also followed Thailand in setting up a national HIV blood surveillance system to monitor the growth of the epidemic effectively.
However, HIV infection levels have not yet peaked in Myanmar. Surveys in 1999 showed 56% of injecting drug users and 47% of sex workers in some areas were infected.
Four townships in Myanmar set up a 100% condom use programmes in 2000, but it is too early to measure the effects.
Aggressive programmes to prevent infection among injecting drug users are also needed, as this is a very vulnerable group.
More AIDS funerals
Although the percentage of the adult population infected is relatively small in most Asian countries, this still translates to huge numbers with HIV, because of the region's large populations.
In India, for example, it is estimated that 3.9 million people are infected - more than other country in the world except South Africa.
Asia is also expected to see a rising number of people developing AIDS. By the year 2005, 800 000 people will die of AIDS every year in the region.
In Thailand alone, more than 50 000 Thais will die from AIDS every year up to 2006. About the same number of Thais with HIV will develop their first serious AIDS-related illnesses and require medical care each year.
""The burden of AIDS on health systems will be felt heavily in many countries in the next few years,"" said the WHO Regional Director for the South-East Asia Region, Dr. Uton Muchtar Rafei.
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