Publications

Today, 1.2 billion adolescents stand at the challenging crossroads between childhood and the adult world. Nine out of ten of these young people live in the developing world and face especially profound challenges, from obtaining an education to simply staying alive – challenges that are even more magnified for girls and young women. In the global effort to save children’s lives, we hear too little about adolescence. Given the magnitude of the threats to children under the age of five, it makes sense to focus investment there – and that attention has produced stunning success. In the last 20 years, the number of children under five dying every day from preventable causes has been cut by one third, from 34,000 in 1990 to around 22,000 in 2009. This report catalogues, in heart-wrenching detail, the array of dangers adolescents face: the injuries that kill 400,000 of them each year; early pregnancy and childbirth, a primary cause of death for teenage girls; the pressures that keep 70 million adolescents out of school; exploitation, violent conflict and the worst kind of abuse at the hands of adults.

The South Asian Roundtable was a joint initiative of SAARCLAW, the International Development Law Organization (IDLO), the World Bank, United Nations Development Program (UNDP) and the Joint United Nations Programme on HIV/AIDS (UNAIDS); under an overarching goal to promote a legal enabling environment and strengthen the legal response to HIV in South Asia. The Roundtable was designed to build an informed and engaged group of legal professionals and advocates committed to leading the legal response to HIV in their home countries. In pursuance of this aim, the Roundtable created a forum for the examination and evaluation of legal and policy barriers to the HIV response in South Asia. During the course of the Roundtable, the following law and policy issues were identified as key barriers to the HIV response: the criminalization of behaviors of key populations at higher risk of HIV exposure; law enforcement policy and practices; lack of sensitivity, knowledge and awareness by law and justice sector leaders and stakeholders; the gap between black letter law and practice; and the clear need for greater coordination and collaboration within the law and justice sector.

In response to the rapid increase in HIV infections among men who have sex with men (MSM) and transgender people in developed Asia, the International Planned Parenthood Federation (IPPF) launched its ‘Metropolitan Man Initiative’ in 2010 to support civil society organizations in the region to respond to issues related to men's sexual health, including HIV. This report summarizes key findings from community organizations that provide HIV and sexual health services to the MSM and transgender populations in six metropolitan areas in developed Asia: Kuala Lumpur, Singapore, Hong Kong, Taipei, Seoul and Busan.

This report, HIV in Asia and the Pacific: Getting to Zero, comes at a decisive point in the international and regional response to the HIV epidemic. In June 2011, 192 Member States of the United Nations agreed to bold new targets and commitments that can make AIDS a thing of the past, including: • reducing sexual transmission of HIV by 50%; • halving HIV infection among people who inject drugs; • eliminating new HIV infections among children; • increasing in the number of people on lifesaving treatment to 15 million; and • closing the US$ 6 billion global AIDS resource gap. World leaders pledged to achieve these goals by 2015, which will move us closer towards the vision of Zero new HIV infections, Zero discrimination and Zero AIDS-related deaths. 'Getting to Zero' in Asia and the Pacific demands evidence-based responses that solidly focus on and involve key populations most at risk, are adequately resourced and grounded in human rights. Increasingly, countries are acting on this knowledge – and reaping the rewards. Tremendous progress has already been made, proving that the epidemic can be reversed, and that HIV treatment and care can be brought to those who need it.

To increase the momentum and effectiveness of the HIV response in Asia and the Pacific, UNFPA, UNAIDS and the Asia Pacific Network of Sex Workers (APNSW) joined hands to organize, in collaboration with governments, UNAIDS cosponsors, national and local sex worker organizations, and civil society organizations, the first Asia and the Pacific Regional Consultation on HIV and Sex Work in October 2010 in Pattaya, Thailand. This Regional Consultation, which was the result of an extensive and participatory process spanning over a year, brought together some 140 participants from eight countries in the region as well as selected national, regional and global resource persons that have experience or influence in the area of HIV and sex work. These resource persons included representatives from regional community networks, sex worker organizations, NGOs, researchers, government organizations, and United Nations (UN) agencies. Country teams comprising representatives from national AIDS authorities, Ministries of Health, Ministries of Justice or police, sex worker communities and the UN system participated from Cambodia, China, Fiji, Indonesia, Myanmar, Pakistan, Papua New Guinea, and Thailand.

Review of new NSPs in Asia and the Pacific Region Scoring and Explanations

The 2011 Integrated Biological and Behavioural Surveillance (IBBS) was conducted to obtain a picture of the magnitude of the problems, risk factors, knowledge and program scope, with the aim of understanding the dynamics of the HIV epidemic in Indonesia. The 2011 IBBS was conducted in 23 cities/regencies in 11 provinces, with most of the cities/regencies selected being those also surveyed in the 2007 IBBS.

On 1 February 2010, the Crimes Decree 2009 (Decree No. 44) of the Republic of Fiji Islands took effect. A report on sex work and HIV prevention in Fiji had very recently been released. UNAIDS Pacific funded the authors of that report to conduct follow-up research investigating any impacts of the new Decree on sex work and related HIV prevention activities. Thus, the original study was extended to encompass and take account of a changed legal environment. This report is the result. Sex workers are among those who are most affected by HIV. The availability of appropriate and accessible services, information and resources are necessary conditions for HIV prevention. Nonetheless, prevention efforts will not be effective unless legal, political and social environments enable sex workers to protect themselves and their clients.

The overall aim of the assessment was to gather strategic information about the behaviours and needs of vulnerable and at-risk adolescents in Bhutan aged 13-18 years. The focus of the assessment was on specific behaviours and settings that make this important, yet sometimes forgotten, group of adolescents susceptible to negative social and health outcomes including: tobacco use, alcohol and drug misuse; early school leaving; pregnancy; sexually transmitted infections, including HIV; and violence. HIV prevalence is currently low in Bhutan however understanding the context for sexual behaviour, violence, and drug use is important for planning future adolescent related policies and programmes - not just for HIV prevention but also to foster healthy sexuality and positive relationships; tobacco, alcohol and drug education; prevention of gender based violence and promotion of mental health.

In 2011, the implementation of the second National Strategic Plan on AIDS in Myanmar started. The NSP II covers the period from 2011‐2015. It builds upon the NSP I, but introduces also some changes to the structure and approach. Notably, prevention is further prioritized and aligned to the latest epidemiological data, the provision of ART set at the center of the provision of care and treatment and finally impact mitigation is highlighted as distinct strategic priority. The NSP II has a set of ambitious targets that intend to lead the country towards achieving universal access by 2015. The targets were developed and agreed by all stakeholders through the Technical and Strategy Group as well as its technical Working Groups.