Article: Census Official Says "No Society Is Immune" from HIV/AIDS in Asia

29 October 2001

Article: Census Official Says "No Society Is Immune" from HIV/AIDS in Asia

New report on AIDS tracks epidemics in Asia-Pacific

By Nadine Leavitt Siak
Washington File Staff Writer

Washington -- Karen Stanecki, chief of the Health Studies Branch of the U.S. Census Bureau, stressed to reporters October 26 that even those countries in the Asia-Pacific region that have relatively low rates of HIV/AIDS infection now "have no guarantee" they will not soon be affected by the disease.

"No society is immune," Stanecki emphasized while speaking at the Foreign Press Center about the recently released "Monitoring the AIDS Pandemic" (MAP) report entitled "The Status and Trends of HIV/AIDS/STI Epidemics in Asia and the Pacific."

The report states that just a few years ago only a few countries -- Thailand, Burma and Cambodia -- were reporting substantial nation-wide epidemics.

"But now we're seeing emerging flashpoints in other countries," such as Nepal, China, Indonesia, and Vietnam, Stanecki said.

Stanecki illustrated the point by noting that there was no evidence of HIV among even high-risk groups in Vietnam for a long time.

"In recent years, the [rate of infection] has just gotten much higher -- for example, in Hai Phong, there was no evidence of HIV infection among injecting drug users up to 1997, and now it has gone from no evidence to 70 percent" in just three years.

"Indonesia provides us with a great example of sudden emergence of HIV infections after long years of silence," she continued.

"For many years, HIV prevalence was virtually non-existent among [sex workers in Indonesia], and in recent years ... it has increased ... and the other concern about Indonesia is that it's not only in one area, but it has spread across the archipelago."

"This is really of great concern, and should trigger some concern in other countries in the region that still have very low levels of HIV prevalence, such as the Philippines and Bangladesh, but where we have risk behavior similar to that we've seen in Indonesia," she said.

Regarding the future of HIV/AIDS in Asia, Stanecki said, "we have to keep in mind ... that societies are changing, so that what we might have seen in the past does not mean that it's going to remain that way for the next 10 years."

For example, she said, sexual behavior in the youth of Japan is very different from their parents' generation: "STDs are increasing, induced abortions among teenage women have nearly doubled in the past five years, and the 18-24 year olds are initiating sexual intercourse earlier, are having more casual partners, and have more concurrent sexual partnerships."

"Another factor in this region that is important is the mobility of the population," Stanecki said.

The types of mobility that promote HIV transmission -- particularly labor migration, uurbanization, the trafficking in women, and displacement of refugees -- are regularly found throughout Asia.

Stanecki said both Cambodia's and Thailand's successes in combating the spread of HIV through strong and comprehensive programs show that it can be done.

She added, however, that such programs must continually be re-evaluated over time and adapted to changing patterns of transmission.

Citing Thailand as an example, Stanecki said the programs have targeted casual sex and heterosexual transmissions related to sex work. Between 1990 and 2000, transmissions from sex workers to male clients has declined from 77 percent to 12 percent of all new infections in Thailand -- but the rate of new infections transmitted from husbands to wives has increased from 9 percent to 43 percent during the same period.

She said the focus of intervention efforts in Thailand, however, has not changed to reflect these new dynamics.

"The spread of HIV is not inevitable, and there are positive examples that we can do something about it, and we feel that there's no time to waste," Stanecki said.

MAP is a network of internationally recognized technical experts seeking to assess the status and trends of the global HIV/AIDS pandemic. It is supported by the United States Agency for International Development and the Joint United Nations Programme on HIV/AIDS; the MAP Secretariat is run by the U.S. Census Bureau's International Programmes Center. The recently released report draws upon presentations made by MAP network members at a symposium held September 30 to October 2, 2001 in Melbourne, Australia.

MAP reports can be accessed at the U.S. Census Bureau's website: http://www.census.gov.ipc