Male clients of sex workers are the largest factor in the HIV epidemic in Asia Clients of female sex workers make up the largest HIV-affected population group in Asia. The Commission on AIDS in Asia estimates that on average, there are about 10 male clients for every sex worker. As many as 37 million men in China and 30 million men in India buy sex regularly. Many of these men are married (or will be married in the future) and if infected, may transmit HIV to their wives and children. The most effective way to prevent HIV infections in low risk women is to prevent their husbands from becoming infected. The proportion of men who visit sex workers and the levels of condom use during commercial sex are key factors in determining the rate of transmission of HIV. Data on men who buy sex are not routinely collected or uniformly reported. The data presented here are gleaned from DHS surveys, and from general population sexual behavior surveys in Bangladesh and Thailand. High-risk men are not an easily identifiable group within the general population and therefore prevention programmes often take advantage of the fact that paying for sex is more common among men in certain occupations. For example, 40% of urban moto-taxi drivers in Cambodia paid for sex in the past year, compared to 12.7% of urban men overall. [Technical note: moto-taxi drivers surveyed in BSS 2007 and urban men in DHS 2005. The slide value for Cambodia is for Phnom Penh only.]

Women, Children, and Young People

2 HIV prevalence and epidemiological status (1995-2009) Risk behaviors (2003-2009) Vulnerability and HIV knowledge (2003-2009) HIV Expenditure (2005-2009) National Response (2003-2010) - Coverage, prevention, care and treatment (Women and children) Women Children - Care and treatment (adults) - HIV testing - Data availability Archives CONTENT

Risk behaviours

% of young people (15-24) who had sex before the age of 15, countries where data is available, 2001-2009 4 Source: Prepared by www.aidsdatahub.org based on DHS and Youth Surveys reported in UNGASS Country Progress Reports 2006,2008 & 2010 + program based end line national survey ; Though 2009 BSS was done in 6 states, data is available only for Tamil Nadu and not presented in this slide

% of adult and young people who had sex with non-marital, non-cohabiting partner in the last 12 months, 2007-2008 5 Sources: Prepared by www.aidsdatahub.org based on 1. Statistics Indonesia (Badan Pusat Statistik-BPS), & Macro International. (2008). Indonesia Demographic and Health Survey 2007: Calverton, Maryland, USA: BPS and Macro International, and 2. National Statistics Office Philippines, & ICF Macro. (2009). Philippines National Demographic and Health Survey 2008 * Only among those who had sex in the last 12 months

% of men reported paying for sex in the last 12 months, countries where data is available, 2003 - 2009 Source: www.aidsdatahub.org based on Bangladesh, Assessment of Sexual Behavior of Men in Bangladesh (2006); Cambodia, DHS (2005); India, NBSS-General Population (2006) and BBS in 6 states (2009) cited in 2010 UNGASS Country Progress Report; Nepal, DHS (2006); Philippines, DHS (2003); Thailand, Revising HIV Estimates and Projection: Implication of the National Sexual Behavior Survey, in “The Era of ARV in the Generalized HIV Epidemic in Thailand: Research Approaches’; and Vietnam, Population and AIDS Indicator Survey (2005) 6 *Thailand, Age Adjusted Data from National Sexual Behaviour Survey (2006)

% of adults (15-49) who had more than one sexual partner in the last 12 months, countries where data is available , 1999-2007 7 Source: Prepared by www.aidsdatahub.org based on DHS and Behaviour Surveillance Surveys reported in UNGASS Country Progress Reports 2006,2008 & 2010 Though 2009 BSS was done in 6 states, data is available only for Tamil Nadu and not presented in this slide ; ** only the male respondents were asked

% of adults (15-49) who had more than one sexual partner in the last 12 months reported condom use at last sex, countries where data is available 2005-2007 8 Source: Prepared by www.aidsdatahub.org based on DHS and Behaviour Surveillance Surveys Reported in UNGASS country Progress Reports 2006,2008 & 2010 * Very small sample size among female; Myanmar 0 (numerator) / 8 (denominator) ; PNG 0 (numerator) / 1 (denominator)

9 Sources: Prepared by www.aidsdatahub.org based on 1. Chamratrithirong, A., Kittisuksathit, S., Podhisita, C., et al. (2006). National Sexual Behavior Survey of Thailand 2006, 2. National Institute of Public Health, National Institute of StatisticsCambodia, & ORC Macro. (2006). Cambodia Demographic and Health Survey 2005: Phnom Penh, Cambodia, 3. International Institute for Population Sciences India. (2007). National Family Health Survey (NFHS-3): Volume I - 2005-06, 4. Merhi, S., Cockcroft, A., & Andersson, N. (2004). Maldives Reproductive Health Survey: Follow Up. 5. Ministry of Health and Population Nepal, New ERA, & Macro International Inc. (2007). Nepal Demographic and Health Survey 2006: Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc. 6. PNG Institute of Medical Research and UNICEF 2003, and 7. National Institute of Hygiene and Epidemiology Vietnam, ORC Macro, USAID, et al. (2006). Vietnam Population and AIDS Indicator Survey 2005. 51 36 26 14 19 25 21 33 0.5 0.4 5 14 0.7 0 50 100 Thailand Cambodia India Maldives Nepal PNG Vietnam Male Female (%) Note: Higher-risk sexual intercourse refer to sex with a partner who was neither a spouse nor who lived with the respondent % of women and men (15-24) who reported higher-risk sex in the last 12 months, 2005-2006

% of young women and men (15-24) who reported the use of a condom during last higher-risk sex, 2005-2006 10 Note: Higher-risk sexual intercourse refer to with a partner who was neither a spouse nor who lived with the respondent Myanmar (%) 65.6 36.5 58.5 55.0 78.4 67.6 42.1 84.4 22.2 34.6 0 50 100 Thailand Cambodia India Mongolia Nepal Vietnam Male Female Sources: Prepared by www.aidsdatahub.org based on 1. Chamratrithirong, A., Kittisuksathit, S., Podhisita, C., et al. (2006). National Sexual Behavior Survey of Thailand 2006, 2. National Institute of Public Health, National Institute of Statistics,Cambodia, & ORC Macro. (2006). Cambodia Demographic and Health Survey 2005: Phnom Penh, Cambodia and Calverton, Maryland, USA: National Institute of Public Health, National Institute of Statistics and ORC Macro,, 3. International Institute for Population Sciences India. (2007). National Family Health Survey (NFHS-3): Volume I - 2005-06, 4. Mongolia STI/HIV/AIDS KAP Survey among Youth in Mongolia; 5. National AIDS Programme Myanmar. (2005). Behavioral Surveillance Survey 2003: General Population and Youth. 6. Ministry of Health and Population Nepal, New ERA, & Macro International Inc. (2007). Nepal Demographic and Health Survey 2006: Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc and 7. National Institute of Hygiene and Epidemiology Vietnam, ORC Macro, USAID, et al. (2006). Vietnam Population and AIDS Indicator Survey 2005.

11 THANK YOU slides compiled by www.aidsdatahub.org Data shown in this slide set are comprehensive to the extent they are available from country reports. Please inform us if you know of sources where more recent data can be used. Please acknowledge www.aidsdatahub.org if slides are lifted directly from this site