Pubdate: Tue, 06 Jun 2006
Source: Herald News (West Paterson, NJ)
Copyright: 2006 North Jersey Media Group Inc.
Author: Margie Mason, Associated Press
Bookmark: (Women)
Bookmark: (Harm Reduction)


BANGKOK, Thailand -- When HIV first escalated in Africa and the 
Caribbean, Asia remained virtually untouched and unaware. But the 
world's most populous continent is catching up.

Today, 25 years into an epidemic that has claimed 40 million lives 
worldwide, the Asia-Pacific region has the highest number of 
infections after sub-Saharan Africa.

The big question now is: How far will it go?

"I don't think it will go the African way," where in some areas up to 
a third of the population is infected, UNAIDS chief Dr. Peter Piot 
said in an interview with The Associated Press. But "there's slow but 
steady growth and with that kind of population denominator, the 
numbers are staggering,"

UNAIDS, the U.N. body leading the global war on AIDS, estimated 8.3 
million people were living with the virus last year in the 
Asia-Pacific -- and nearly 85 percent of those infected had no access 
to antiretroviral treatment.

Spread quickly

The disease, first identified in the United States in an announcement 
by health officials on June 5, 1981, quickly went global. In Asia, a 
vast, diverse and mobile population has helped spread the virus, 
starting with unprotected sex and dirty needles. It first devastated 
Thailand's infamous sex industry, later reached millions in India and 
has pushed once-isolated communist Vietnam to the brink of an HIV explosion.

India is home to more HIV/AIDS-infected people than any other 
country, according to new UNAIDS numbers. Its estimated 5.7 million 
infections last year comprise more than two-thirds of all cases in 
the Asia-Pacific region.

In a country of more than 1 billion people, that number shrinks to a 
small fraction -- 0.9 percent of adults compared to South Africa's 
almost 19 percent. But a small percentage can cause the problem to be 

"Because of this low percentage, the issue doesn't seem to be a 
priority for political leaders and also for the man on the street," 
said Dr. Shigeru Omi, the Western Pacific regional director for the 
U.N.'s World Health Organization.

India's epidemic is largely driven by heterosexual sex -- mainly 
prostitutes and their clients who do not use condoms.

In the country's south, a recent report found, prevention campaigns 
targeting sex workers have resulted in a 35 percent drop in new cases 
among 15 to 24 year olds.

But there has been little progress in India's highly populated north 
or drug-ridden northeast, said Prabhat Jha, of the University of 
Toronto, one of the study's authors.

"It's too early and one wouldn't want to be the fellow on the Titanic 
who said, 'All clear,' because the north is 70 percent of the 
population," said Jha, who's spent a decade researching AIDS in 
India. "If it explodes, you can imagine what would happen."

Chandi Sayeed, 39, of Bombay's gritty brothel district, said she was 
sold into prostitution at age 16 when she was already a mother of two.

"The problem is most women don't use condoms with their husbands or 
with customers they love," she said. "They only use it with men who 
aren't regulars. They say, how can we use it with our lovers? But 
women must think of their children and their family first."

Another trouble spot is Papua New Guinea, which shares an island 
north of Australia with Indonesia's easternmost Papua province.

The country of 5.7 million is plagued by political instability, 
poverty and rampant sexual violence against women. It has the 
Asia-Pacific's highest adult per capita infection rate of 1.8 
percent, but the political will to tackle the problem is absent.

"Papua New Guinea is a very, very, very serious situation," Omi said. 
It "needs some special attention, otherwise there's a possibility 
that Papua New Guinea will become like Africa in the future."

In China, the AIDS picture is still a bit unclear. But its sheer size 
- -- some 1.3 billion people -- is enough to worry experts.

In January, China and the United Nations lowered HIV/AIDS estimates 
there, saying roughly 650,000 people were infected in 2005 -- nearly 
200,000 fewer than an earlier projection.

Injecting drug users accounted for nearly half the infections in 
China, where the government was accused of being slow to address the 
problem. HIV took off in China in the early 1990s when farmers began 
selling blood plasma to earn extra money.

AIDS activists and people infected with the virus have been harassed, 
but top leaders have finally admitted publicly that a problem exists.

In late 2004, President Hu Jintao was photographed shaking hands with 
HIV-infected Zhang Hulin. It was a major step for the communist 
government, but Zhang says he and his family suffered even greater 
stigma and discrimination after the photos circulated.

In Vietnam, the bulk of infections are among prostitutes and 
injecting drug users. But the virus has spread to all provinces and 
cities, and the country is at a very critical moment, Omi said.

With prevention campaigns, "they may be able to avert transmission 
into the community. But if they fail, they may end up having 
widespread transmission among the general public," he said.

Thailand and Cambodia, in contrast, have been hailed as two bright 
spots in Asia. Both still have adult per capita infection rates over 
1.4 percent, but the governments have largely reversed 
once-devastating epidemics by promoting 100 percent condom use among 
prostitutes working in brothels.
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MAP posted-by: Beth Wehrman