Papua New Guinea at Risk for AIDS Epidemic By MARGIE MASON, AP Medical Writer
Sun Jul 3, 6:58 AM ET
KOBE, Japan - Papua New Guinea is at risk of an African level HIV/ AIDS epidemic, while other Asia-Pacific nations like Malaysia, Vietnam and Myanmar are also worrisome as their infection numbers continue to rise, the head of the U.N. AIDS agency said Sunday. The epidemic is as vast and diverse as the region itself, with sex and injected drugs its main engines.
But there's simply not enough data to create a clear picture of the infection in many areas where other factors — such as men who have sex with men — could be contributing to rising numbers, Dr. Peter Piot, head of UNAIDS, told The Associated Press on the sidelines of a regional AIDS conference.
Asia has the world's second-largest number of people with HIV/AIDS after sub-Saharan Africa. An additional 12 million could be infected in the region over the next five years if nothing is done to slow the epidemic's pace, UNAIDS has said.
The impoverished Pacific nation of Papua New Guinea faces the region's biggest problem because the disease appears to have moved into the general population, and an estimated 1.7 percent of the country's adults were living with HIV last year, a UNAIDS report said.
It's "the one that I would see that could have an African-type of epidemic," Piot said during the Seventh International Congress on AIDS in Asia and the Pacific, held in Kobe, Japan. "That's the one country, I would say I think is really getting out of hand."
He said the epidemic there is heterosexually driven and largely connected to gender inequality and violence, along with unemployment and a lack of stability.
In places like Vietnam and Malaysia, people who inject drugs are a major force behind rising numbers. Piot said that top leadership must get involved to make a difference, and that countries should move away from incarcerating drug users and sex workers — instead arming them with education and treatment, including offering them clean needles and methadone.
Malaysia has recently announced it will move in that direction and China is also taking a more proactive approach. Piot says he hopes other Asian countries will follow.
In places like military-run Myanmar, the problems are more challenging because the country is largely isolated from the rest of the world, making surveillance and outreach difficult. An epidemic — driven largely by injecting drugs — is raging there, with about 1.2 percent of the adult population and an estimated 330,000 total people living with HIV/AIDS.
"We always have Myanmar — Burma — where I'm not totally sure what's going on," Piot said. "It certainly has a bad epidemic. There's no more doubt about it."
Countries must also keep a close eye on other populations that may not have traditionally been problem groups, Piot said.
More young people are having casual sex in places like Bangkok and Tokyo, he said, adding that now, more than ever, women are having sex with more partners at younger ages.
Children and Migrating populations, including laborers, are other groups that cannot be ignored.
About 121,000 children are estimated to have the virus in the Asia-Pacific region, with about 47,000 new infections last year alone, according to international children's agencies. More than 1.5 million children have lost one or both parents to AIDS.
"Even if there were no more new infections as of today in Asia and the Pacific, we will still not see the real impact upon children through orphaning until seven, 10, 15, 20 years down the line," said Ian Macleod, regional HIV/AIDS adviser for the United Nations Children's Fund in South Asia. "So, the worst is yet to come."
He said the only way to help is to increase prevention efforts, and make sure parents have better access to treatment. It's also important for adults to talk to children about protecting themselves during sex in a region where young people are often sexually active by age 12, said Kathleen Casey of Family Health International in Thailand.
And while the region has recently confronted other diseases like SARS and bird flu, leaders and citizens must understand that HIV/AIDS is on an entirely different scale, Piot said.
An estimated 8.2 million people were living with the virus in the Asia-Pacific region last year. About 1.2 million were newly infected in 2004, second only to sub-Saharan Africa.
"Let's assume there's an avian flu epidemic — that's going to be like a shock, a bomb," he said "Maybe millions of people will die suddenly but when it's over, it's over and we will have another flu epidemic maybe 30 years later. Whereas with AIDS, it just builds up across generations."