Responding to the AIDS epidemic in Asia and the Pacific: report on the Third International Conference on AIDS in Asia and the Pacific, Chiang Mai, Thailand, 17-21 September, 1995.

Abstract

The Third International Conference on AIDS in Asia and the Pacific was held in Chiang Mai, Thailand, in conjunction with the Fifth National AIDS Seminar in Thailand. These geographical areas accounted for less than 7% of global cumulative AIDS cases, but nearly 20% (over 3.5 million) of global cumulative HIV infections as of mid-1995. The Thai national AIDS program comprises information, education, and communication and the development of sexually transmitted disease (STD) health care with counseling to reduce risk behavior. Safer sex practices among commercial sex workers and injecting drug users (IDUs) have led to a dramatic decline of HIV infection. The impact of the HIV/AIDS epidemic so far has had a small negative effect economically, but the social implications are more serious. There were 160,000 HIV-infected people in 1995 in these areas; the number is expected to rise to 700,000 by the year 2000. The major source of HIV infection in Asia is unprotected sexual intercourse and injecting drug use. HIV-1 subtype E is the most dominant strain in Asia, yet little research has been done on it. In several countries the major focus of prevention research has been on prostitutes, STD clinic attenders, long-distance truck drivers, and IDUs. In Bombay, India, HIV prevalence among prostitutes was found to be 51% vs. 0.8% among women attending a prenatal clinic. Despite an active prevention program in Chiang Mai, 33% of brothel inmates were infected with STDs. Effective programs should include the development of self-esteem and self-protective behavior. Although condom use has soared in recent years, men refusing its use continue to infect their wives and girlfriends. HIV seroprevalence among women attending prenatal clinics in Bangkok increased from 1% to 2% from 1991 to 1994. One Burmese study indicated that 1.1% of the soldiers were HIV-infected; in northern Thailand ethnic minorities have substantial HIV rates; and unsafe behavior among homosexual males in Australia is continuing.