Publications

This report documents the findings of a qualitative investigation into the context of HIV vulnerability and risk for women who engage in sex work on board foreign boats. The research aims to inform HIV prevention strategies and programs for this group, and is based on fieldwork carried out between February and August 2010 in Tarawa, Kiribati.

The aim of this study is to identify the prevalence of intimate partner violence (IPV) against Japanese women (JW) and non-Japanese women (NJW) in a perinatal setting. Additional purposes were to identify the associated factors of IPV, describe the characteristics of IPV against NJW, and assess the acceptability of the Violence Against Women Screen (VAWS) instrument as a screening tool. A cross-sectional survey was conducted from September to November 2007 in an urban hospital maternity clinic in Tokyo, Japan. Women who attended the maternity clinic received the VAWS instrument, which was translated into four languages (Japanese with Kanji and Hiragana, English, Chinese, and Tagalog) and was used to identify IPV.

Violence against female sex workers (FSWs) can impede HIV prevention efforts and contravenes their human rights. We developed a multi-layered violence intervention targeting policy makers, secondary stakeholders (police, lawyers, media), and primary stakeholders (FSWs), as part of wider HIV prevention programming involving >60,000 FSWs in Karnataka state. This study examined if violence against FSWs is associated with reduced condom use and increased STI/HIV risk, and if addressing violence against FSWs within a large-scale HIV prevention program can reduce levels of violence against them.

Over the past ten years, there has been a remarkable and virtually unprecedented global scaleup of a life-saving medical technology: antiretroviral therapy for people with advanced HIV infection. This therapy not only prolongs life for most patients, it keeps people healthy enough to work, to continue their lives in families and as parents, and to contribute to their communities and countries. We now know that antiretroviral therapy also lowers the amount of HIV in the bloodstream, thus making people less infectious and contributing to HIV prevention goals as well. The successes of the past ten years are directly linked to the drastic fall in the price of these drugs. The cost of first generation antiretrovirals has decreased from over ten thousand US dollars to as low as 67 dollars per person per year. This amazing reduction has been achieved largely thanks to competition from generic manufacturers, which, for millions of people worldwide, has been the difference between life and death. Such competition has in large part been made possible by countries' utilization of the public health flexibilities in the World Trade Organization's TRIPS Agreement. The Good Practice Guide analyses each of the public health flexibilities in the TRIPS Agreement and provides examples where and how have they been used by national governments. The Guide also provides some examples on the effect of adopting intellectual property protection measures, which exceed the minimum requirements of TRIPS and which are often introduced through bilateral trade instruments.

The latest studies show that a reduction in new HIV infections of up to a third could be achieved globally if there is a radical overhaul of the way that the world provides antiretroviral therapy and if global leaders meet their commitments of ensuring that all people in need of treatment are on it. It's called treatment as prevention and it is one of the five pillars of the new Treatment 2.0 platform. In an effort to maximize the value of antiretroviral therapy, a radically simplified approach is needed. This includes the development of better combination treatment regimens, cheaper and simplified diagnostic tools, and a low-cost community-led approach to delivery.

Stigma and discrimination surrounding HIV/AIDS pose critical barriers to prevention, treatment, care and support programs. There is currently little reliable data or documentation relating to stigma and discrimination against people living with HIV (PLHIV) in Cambodia. The study was carried out in five selected provinces where a total number of 394 PLHIV were interviewed, 71% of whom are females and 29% of whom are males. About 80% of respondents were aged 30-49 years. The gender and age profiles of respondents maybe reflective of the large proportion of respondents who belonged to self-help groups and not of the PLHIV population in general. There was a low level of schooling (75% received either no schooling or primary schooling only) and >70% of respondents were working as farmers or sellers. The study methodology included a quantitative method based on the global HIV Stigma Index questionnaire and a qualitative method which involved focus group discussions and key informant interviews.

While Pacific Island Countries and Territories (PICTs) have been collecting HIV and AIDS case data for many years, 2009 was the first year in which routine data on other sexually transmitted infections (STIs) were collected and reported. Eleven PICTs with access to laboratory testing facilities (either in country or by referral) reported on three STIs; chlamydia, gonorrhoea and syphilis. STIs are an important cause of morbidity in adults and also infants born to infected parents. While many chlamydia infections are asymptomatic, if left untreated, both chlamydia and gonorrhoea infection can cause pelvic inflammatory disease, ectopic pregnancy and infertility. They may also cause conjunctivitis and pneumonia in newborns. Syphilis can cause miscarriage, stillbirth and congenital syphilis. The latter may cause irreversible damage to cardiovascular and nervous system of the newborn infected child. Amongst both men and women, HIV transmission is facilitated by the presence of any STI, including asymptomatic chlamydia.

Since the 1990s the majority of countries in the South-East Asia Region have experienced a significant injecting drug use problem, accompanied by explosive rates of HIV at some sites. Over time the national response has increasingly been to implement various harm reduction interventions to reduce the HIV prevalence and address the health needs of people who inject drugs (PWID). This assessment examines the current situation of HIV and injecting drugs and of the national responses. The focus is on countries with a high and medium burden of illicit drug injecting. In most of these countries PWID are either HIV infected or have the potential for being infected. The countries reviewed are Bangladesh, India, Indonesia, Maldives, Myanmar, Nepal and Thailand.

In essence, the present document describes the priority health sector interventions recommended to achieve universal access for the prevention, treatment, care and support of HIV and sexually transmitted infections among MSM in the broader perspective of male sexual health. It summarizes key policy and technical recommendations developed by WHO related to each priority health sector intervention. It guides the selection and prioritization of interventions for HIV prevention, treatment, care and support. Finally, it directs readers to key resources of WHO and other organizations containing the best available information on the health sector response to HIV among MSM. Relying on a rigorous background of male sexual health and strategic information, this document is, to the extent possible, based on scientific evidence and programmatic experience in prevention, care, support and treatment of HIV, as well as male sexual health. It is also intended to be as specific as possible for its implementation in the context of Asia and the Pacific, addressing a broad audience including public health decision-makers, national AIDS programme managers, health care providers, community-based organization managers, MSM living with and affected by HIV, and development agencies.

Since their inception in 2003, UNDP’s Asia-Pacific Human Development Reports have been stimulating a lively dialogue within the region on a range of important issues. Prepared by experts from Asia and the Pacific, the Reports present an authentic account of human development progress, possibilities, and challenges in this vibrant and fastgrowing region. This year’s Report focuses on the critical question of advancing gender equality, as seen through the prism of women’s unequal power, voice, and rights. Despite the region’s many economic gains, the Report chronicles how in many instances women across the region continue to be held back and disadvantaged. Even as many women have benefited from their countries’ improved education, health, and prosperity, they continue to face barriers to the same opportunities available to men.