Three recent studies out of Asia suggest that the HIV/AIDS crisis is spreading—to an alarming degree. Research focused on rural China, Hong Kong, and Thailand has all found increasing rates of HIV infection from both heterosexual contact and, especially, among MSM (the clinical term for men who have sex with men). This research suggests that Asia will be an expanding front in the war on AIDS for the foreseeable future.
The journal Nature reports that HIV/AIDS cases in rural China have been rising steeply. The research focused on Yunnan province, which is central to the heroin industry. Traditionally, HIV/AIDS cases there have been primarily among intravenous drug users. But the study's research found that 37.5 percent of cases in 2006 were the result of heterosexual contact, though cases among MSM rose over the same period, from .4 percent in 2005 to 3.3 percent in 2007. Women also comprise 35 percent of HIV/AIDS cases in the province, up substantially from 7.1 percent in 1996. And, because these cases are heavily concentrated among women of child-bearing years, generational transmission is an additional danger. Over the last decade, transmission among intravenous drug users was down 60 percent. All of which means, the researchers point out, that, "HIV/AIDS is spreading beyond the high-risk populations, largely due to increased transmission through sexual contact," says Zhang Linqi, director of the AIDS Research Center in Beijing. "It implies that HIV/AIDS is not only a disease that affects high-risk populations but the general population alike." This indicates a dangerous future for rural China, as HIV/AIDS spreads into a general population ill-prepared to protect itself.
In Hong Kong, the situation is similarly grim. Wong Ka-hing of the Hong Kong government's Center for Health Protection, warns as a result of his agency's research that, if prevention programs are not effective, one-third of the MSM in Hong Kong could be infected with HIV by 2020. Rates of infection among MSM have been on the rise for each of the last five years in Hong Kong, and though the absolute numbers are small (from 50 new cases in 2003 to 112 in 2006) the rate of increase is steep compared with heterosexual transmissions, which stayed constant within a range of 110 to 116 cases per year over the same period. The study found that four percent of MSM in Hong Kong are HIV positive, with three strains of HIV in the community. And, Wong Ka-hing reports, researchers found among these men, "common risk factors like a number of people attending the same sex parties, Internet use (to search for sex partners), using recreational drugs, unsafe sex." In Hong Kong, Wong says, "Not many people think safe sex is important." Condom use among MSM in Hong Kong is only 70 percent with casual partners, lower than among heterosexual men in many circumstances, including while engaging with prostitutes. Stopping the HIV tide in Hong Kong will clearly depend on education and prevention efforts, and will need to take place in a hurry.
Finally, new research out of Thailand this month indicates that, while the total number of HIV/AIDS cases is in decline, the rate of new cases among MSM has been rapidly increasing over the last several years. The director of Thailand's Department of Disease Control, Somchai Chakrabhand, released the results this month of a nationwide study of HIV/AIDS. The results were reported in the Thai newspaper the Nation. The rates of infection are shocking. In Bangkok, for instance, the rate of infection is up from 17 percent in 2003 to 30 percent in 2007. In Phuket, the increase was from 5.5 percent in 2005 to 20 percent in 2007. In the same survey, it was found that half of MSM do not use condoms. In describing the reasons for the rapid rise in infections, Chakrabhand cited the discontinuation of a public education program. Manoon Jaikueankaew of the Department of Disease Control's Chiang Mai Unit 10 told the Nation that an additional cause is the lack of resources and education particularly in rural areas, where men may not even know about the importance of condoms and lubricants. "A onestop service is really needed to provide information and healthcare to them. This is the only way for them to protect themselves from HIV," he said.