The first HIV-positive case was reported in the country in 1990 and the first AIDS case in 1992. Since then, the number of HIV and AIDS cases has grown and by the end of 2007, 5,500 people were estimated to be living with HIV (up from 1,200 in 2001). In 2007, the HIV prevalence was 0.2% among adults (aged 15-49), 0.2% among young men (aged 15-24) and 0.1% among young women (aged 15-24). The number of women becoming infected with HIV has increased from <500 in 2001 to 1,300 in 2007.
The most common mode of HIV transmission in Lao PDR is through heterosexual contact, which accounted for 9 in 10 cumulative HIV infections at the end of 2004. Less than 1% of transmission is attributed to homosexual encounters. Lao PDR has high fertility rates, which can lead to higher numbers of children infected through vertical transmission from mother-to-child. Available surveillance data indicates an increase in such vertical transmission of HIV from 2.2% in 2003 to 3.6% in 2004.
In mid-2005, prevention programmes were launched in 3 out of 5 provinces; however, they must be sustained in order to be effective. These low levels of coverage continued as of 2007, when 49% of FSWs (n=1425) had been reached with HIV prevention programmes.
Prevention and treatment are still unbalanced and the continuum of care is limited. As of December 2008, 3 out of 1594 health facilities were offering ART. This has increased since 2007, when only one site (Savannakhet province) provided care and support services, including (ART). Fifty-four per cent of adults in need of ART received treatment, but only 15% of pregnant women in need of ART received it.
As of December 2008, 891 facilities were providing ANC services. Meanwhile, only 5 facilities providing ANC services were also providing HIV testing and counseling for pregnant women. At the same time, only 4 out of 891 health facilities providing ANC services also offer both HIV testing and ARVs for the prevention of mother-to-child transmission on site. Three out of 1594 health facilities were offering pediatric ART. Furthermore, Multiple Indicator Cluster Survey (MICS) 2006 data showed that only 7.6% of women who gave birth in the two years preceding the survey (n=1532) were offered HIV counseling, and 1.5% were tested for HIV at ANC visits (1.1% received their results).
National AIDS financing is extremely dependant on external assistance. The recent reports from major donors such as GFATM and ADB showed that Lao PDR is receiving an increasing amount of funding for HIV and AIDS programmes. For example, GFATM committed $3.4 million in the first round and almost $9.0 million in round 6.
Expenditure on AIDS prevention has fluctuated from year to year, yet it now accounts for the largest share of the budget compared to other programmatic components. By the end of 2007, prevention-related activities received nearly 60% of the total National AIDS programme budget. On the other hand, a reduction in expenditure on AIDS programme costs as well as on treatment and care occurred from 2006 to 2007.