HIV Epidemic and Response in Asia and the Pacific Presentation
  By Steve Kraus
  UNAIDS Regional Support Team Asia-Pacific.
  Judicial Dialogue on HIV, Human Rights and the Law in Asia and the Pacific Meeting
  2-4 June 2013 Bangkok, Thailand

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Over the course of the HIV epidemic’s 30-year history, notable strides have been made globally to reduce stigma and discrimination towards people living with HIV (PLHIV) and key affected populations (KAPs) such as female sex workers (FSW), men who have sex with men (MSM), transgender (TG) people and people who use drugs (PWUD). These efforts have included the development of supportive legislation and policies, advocacy and community mobilization through networks and collectives, and media campaigns featuring celebrities and societal leaders. In addition, strategic and sustained efforts with the news media have not only facilitated increased and improved coverage, but have also served to advocate for changes in policies and programmes, and of equal importance, to fighting stigma and discrimination relating to key affected populations.

In this assessment, the forms of gender-based violence studied include physical, sexual, and emotional abuse of women by their husbands and partners; sexual assault by non-partners; and the physical, sexual, and emotional abuse of children. The needs of men who have sex with men; transgender people; and male, female, and transgender sex workers were also included because these groups are often targets of genderbased violence, including harassment, blackmail, and police violence [United Nations Development Programme (UNDP) and Asia Pacific Coalition on Male Sexual Health (APCOM), as cited in Godwin, 2010]. GBV victims and survivors may have also experienced accusations of sorcery, and discrimination in relation to their HIV status.

Why do we need to estimate HIV incidence? The estimation of HIV incidence, or the rate at which new HIV infection is acquired in a population, is required to evaluate the impact of HIV prevention measures, and to identify populations for recruitment into clinical trials of interventions to prevent infection or treat early infection. A number of different methodological approaches have been used to estimate HIV infection. All have their strengths and limitations.

Data was collected via individual face-to-face interviews, using a structured questionnaire. The survey was conducted with a sample of male injecting drug users (IDUs), using a respondent driven sampling method.

A total of 1,094 injecting drug users were interviewed for the behavior survey. An injecting drug user (for this study) was defined as any male who had injected in the past 1 month and who are aged between 18-40 years.

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It is estimated that there are nearly 10 million transgender people in this region, many of who often endure stigma and prejudice every day of their lives. Governments and communities alike must take steps to fully recognize, and begin to protect, the individual rights of all of citizens - including transgender people - if the region is to reach the goals in the UNAIDS strategic vision for the year 2015 of "Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths."

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Despite being a low HIV/AIDS prevalence country, Bangladesh has all the characteristics of high-risk behaviors for initiating an HIV/AIDS epidemic. This includes considerable high prevalence of pre and extra-marital sex, low condom use, less awareness but significant prevalence of STIs, low knowledge of HIV/AIDS prevention, high prevalence of STIs among sex workers, existence of needle/syringe sharing among drug users and high prevalence of HIV infection among injecting drugs users.

WHO presents World Health Statistics 2013 as an integral part of its ongoing efforts to provide enhanced access to comparable high-quality statistics on core measures of population health and national health systems. Unless otherwise stated, all estimates have been cleared following consultation with Member States and are published here as official WHO figures. However, these best estimates have been derived using standard categories and methods to enhance their cross-national comparability. As a result, they should not be regarded as the nationally endorsed statistics of Member States which may have been derived using alternative methodologies.

Primary objective:
•To determine national prevalence estimates of and related risk behaviors for Neisseria gonorrhoeae, Chlamydia trachomatis, syphilis, HIV and Hepatitis B among Female Entertainment Workers.

Secondary objectives:
•To provide data for program planning and management of STI control and prevention programs for FEWs and their clients.
•To validate the current clinical algorithm for presumptive treatment of FEWs and explore alternative algorithms for improved sensitivity and specificity (results are not presented at this time).

In the Asia region, an increasing number of HIV infections occur among men who have sex with men (MSM) and transgender people. Unless effective HIV prevention strategies are implemented, the Commission on AIDS in Asia’s regional projections predict that about half (46%) of all new HIV infections in Asia will soon be among MSM, an increase of 13% from 2008. While inadequate HIV data exists on transgender women due to their limited inclusion in national HIV surveillance systems, studies that do exist show transgender women are at disproportionate risk for HIV infection.

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