Education programs for sex workers have helped arrest the spread of HIV/AIDS in some Asian countries, but drug use and unprotected sex threaten to reverse the gains across the region, a UN agency said.
An annual update on the AIDS epidemic, released yesterday by UNAIDS, gives a mixed report card to Asia, where an estimated 4.9 million people harbored HIV infections this year, including 440,000 newly infected people. The agency is the UN's coordinating body for fighting HIV/AIDS.
The report's major finding was that HIV prevalence -- the percentage of people living with HIV -- had leveled off, with an estimated 33.2 million people worldwide carrying the virus this year.
The total is much less than last year's estimate of almost 40 million people, but mostly reflects new research and analysis methods, rather than representing a real decline, UNAIDS said.
The new accounting showed a sharp drop in the figures for India, where about 2.5 million people are now believed to be living with HIV.
But the lower total does not mean there should be a letup in tackling the disease there, because the number is still huge and the nature of the challenge remains the same, said Peter Ghys, chief of UNAIDS' epidemiology and analysis division.
The cause and extent of India's HIV epidemic ranges widely by region, he said, speaking to reporters on Tuesday by phone from his office in Geneva.
Pakistan is one of several countries where HIV prevalence is increasing among drug users.
The disease typically spreads when needles used for intravenous injections of drugs like heroin are shared among users.
One study cited by the report showed the HIV prevalence rate in Karachi rising from under 1 percent in early 2004 to 26 percent in March 2005.
Thailand, Cambodia and Myanmar have registered declines.
All three countries have major prevention programs aimed at sex workers.
"The trends suggest that HIV prevention efforts are making a difference," Ghys said.
But HIV is rising in Thailand among men who have sex with men, and remains high -- as high as 50 percent -- among injecting drug users, he said.
The report said that Myanmar's HIV epidemic "is also showing signs of a decline," though was still a matter for concern.
Indonesia and Vietnam are two countries where the HIV epidemic is still evolving, Ghys said.
"The HIV epidemic in Indonesia is among the fastest growing in Asia," the report said.
"The majority of HIV infections are estimated to occur through the use of contaminated injecting equipment, unprotected paid sex and, to a lesser extent, unprotected sex between men," it said.
The report cited Vietnam's Health Ministry as saying that the estimated number of people living with HIV in that country had more than doubled to 260,000 in 2005 from 120,000 in 2000.