An Asian perspective on HIV/AIDS

Almost 5 million Asians are currently living with HIV Without good prevention efforts, HIV prevalence in the region could double by 2020. AIDS is estimated to be the largest cause of death and morbidity due to disease for Asian adults aged between 15 and 44 years. HIV transmission in Asia is driven by three high risk behaviours, and these are unprotected commercial sex, injecting drug use and unprotected sex between men. Approximately three quarters of the people living with HIV in Asia are men, and in many countries, the men who buy sex are a powerful driving force in Asia's HIV epidemics. These men and others exhibiting high risk behaviours can transmit HIV to their female sexual partners, who can in turn pass HIV onto their unborn or newly born children through mother to child transmission of HIV Regionally relevant, effective prevention programmes now provide good evidence for changing the course of HIV epidemics: Thailand and Cambodia have demonstrated that even in the face of a severe epidemic, targeted interventions are successful if implemented both with high coverage and intensity. Some countries in the region have seemingly been protected to date, but risk serious epidemics if prevention services are denied to those who need them. When designing intervention strategies, it is important to consider the social, political and cultural contexts which shape risk behaviours in any particular country, so that appropriate and effective prevention strategies can be implemented. The provision of effective antiretroviral treatment must be seen as a complimentary strategy to other behavioural and risk reduction interventions. Commitment and integrated action by country leaders, health care providers and all sectors of the community are essential so that effective prevention and treatment programmes can become a reality for all Asian countries.