Dramatic uptick
in HIV rates feared for Asia-Pacific region

More work must focus on injection-drug users and men who have sex with men to prevent the spread of HIV in the Asia-Pacific region, a top World Health Organization official said.

Kevin De Cock, director of the WHO's Geneva-based HIV/AIDS department, told the Associated Press on Monday that the human immunodeficiency virus that causes AIDS could spread quickly, even in countries currently with very low HIV rates like the Philippines, if there's a jump in injection-drug use.

"I think that's the danger," he said. "I would predict that if some of these countries suddenly turn, a very rapid spread in injection-drug users would be the likeliest scenario."

Some countries in the region have already experienced HIV spikes from contaminated-needle use. HIV infections in pockets of India's northeast, along with some areas of Vietnam, for example, are being driven up by injection-drug users.

De Cock, on a two-day fact-finding mission to Vietnam that ends Tuesday, said more work must also be done to reach men who have sex with men. Research is lacking for this vulnerable group in the region, even as some developed countries see infection rates among this group continue to climb.

"I think it's a very worrying situation, and it needs much more attention," he said, adding that men who swap sex for drugs could serve as a bridge for the infection to spread.

"Places like London and Amsterdam are among the most supportive environments in the world, and yet we're still seeing a lot of transmission," he said. "And you wonder, What is lacking here?"

An estimated 8.3 million people were living with the virus last year in the Asia-Pacific region, where infections have largely remained concentrated within high-risk groups such as sex workers and drug users.

India alone is home to an estimated 5.7 million cases--more infections than any other country, according to figures from the Joint United Nations Programme on HIV/AIDS. In China there were some 650,000 people infected last year, nearly half of them injection-drug users, UNAIDS estimated.

"Anything that happens in those countries, be it policies or epidemiological changes, are potentially important for the region," he said of India and China, both with populations of over 1 billion.

Of all the countries in the Asia-Pacific region, De Cock said Papua New Guinea appears to be the only one with a general epidemic similar to some African countries. It shares an island north of Australia with Indonesia's easternmost Papua province, and the nation of 5.7 million is plagued by political instability, poverty, and rampant sexual violence against women.

The adult per capita infection rate is 1.8%, according to UNAIDS. Last month at a WHO regional meeting in New Zealand, the country's health minister said isolated pockets could have HIV infection rates as high as 30%.

"Papua New Guinea is somewhat in a class of its own in this region," De Cock said, adding that more data is needed to better understand the epidemic there.

De Cock was scheduled to leave Vietnam on Tuesday after he and a high-level delegation met with government officials. Experts fear that Vietnam, which has an estimated 260,000 people living with the virus, is at a critical point. So far, most cases have been concentrated in vulnerable groups such as sex workers and injection-drug users, but officials worry the epidemic could soon become more general. (AP)