Key Populations at Higher Risk

2 HIV Prevalence and Epidemiology (1990-2011) - People Who Inject Drugs - MSM - Sex Worker Risk Behaviors (2004-2009) Vulnerability and HIV Knowledge (2005-2009) HIV Expenditure (2006-2009) - Sources of AIDS Spending - Spending by Categories - Prevention Spending - Spending on Care and Treatment National Response (2005-2010) - Coverage and Prevention - HIV Testing - Care and Treatment - Monitoring and Evaluation Archives CONTENT

HIV prevalence and epidemiology

4 Global and regional HIV and AIDS statistics, 2010 Source : Prepared by www.aidsdatahub.org based on WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access.

5 Estimated number of people living with HIV, new infections, and AIDS-related deaths by region, 2001 and 2010 Source: Prepared by www.aidsdatahub.org based on WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access

Estimated number of adults and children living with HIV by region, 2010 6 Source : Prepared by www.aidsdatahub.org based on WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access.

Estimated adults and children newly infected with HIV by region, 2010 7 Source : Prepared by www.aidsdatahub.org based on WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access.

Percentage distribution of new HIV infections by sub-region, 2010 8 Source: Prepared by www.aidsdatahub.org based on WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access.

Estimated AIDS-related deaths among adults and children by region, 2010 9 Source : Prepared by www.aidsdatahub.org based on WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access.

Estimated number adults and children living with HIV, new infections, and AIDS-related deaths, Asia Pacific, 1990-2009 10 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Estimated number of women and adults (15+) living with HIV, Asia Pacific, 1990-2009 11 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Estimated proportion of adults (15-49) living with HIV by gender, Asia Pacifc, 1990-2009 12 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Estimated percent distribution of adults and children living with HIV in Asia Pacific, 2009 13 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Estimated proportion of female (15+) living with HIV among adults, 1990-2009, ASEAN countries and Papua New Guinea 14 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic. ASEAN = Association of Southeast Asian Nations

Estimated proportion of female (15+) living with HIV among adults, 1990-2009, SAARC countries 15 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic. SAARC = South Asian Association for Regional Cooperation

Estimated proportion of female (15+) living with HIV among adults, 1990-2009, high-income countries (Asia) 16 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Estimated HIV prevalence among adults (15-49), 1990-2009, SAARC countries 17 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic. * Estimated HIV prevalence among adults in Bangladesh, Maldives and Sri Lanka is < 0.1 % ( 1990-2009) SAARC = South Asian Association for Regional Cooperation

Estimated HIV prevalence among adults (15-49), 1990-2009, ASEAN countries 18 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic. *Estimated HIV prevalence among adults in Philippines is < 0.1 % ( 1990-2009) ASEAN = Association of Southeast Asian Nations

Estimated HIV prevalence among adults (15-49), 1990-2009, Pacific countries (where data is available) 19 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic.

Reported HIV cases by mode of transmissions in selected countries, 2009-2011 Sources: Prepared by www.aidsdatahub.org based on 1. UNGASS country Progress reports 2010; 2. China _China UNAIDS Country Office at UN Joint Programme Retreat, March 9, 2011; 3. Ministry of Health Indonesia. (2011‬). Quarterly Progress Report: HIV & AIDS Situation in Indonesia, November 2011; 4. National Epidemiology Center Philippines. (2011). Philippine HIV/AIDS Registry: December 2011 ; 5. National AIDS Control Organisation India, Department of AIDS Control, & Ministry of Health & Family Welfare. (2011). Annual Report 2010-11.; 6. Malaysian AIDS Council and Malaysian AIDS Foundation. (2011). 2010 Annual Report. + reported AIDS cases; only available as sexual transmission ( both hetero and homo) ++ “Others” may include mother-to-child transmission * homosexual transmission also includes bisexual ** data not available for homosexual

21 HIV- TB burden, 2010 Source: Prepared by www.aidsdatahub.org based on WHO. (2011). Global Tuberculosis Control & WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access.

Percentage of sex workers, MSM and people who inject drugs who are under 25 years of age, countries where data is available 22 Source: Prepared by www.aidsdatahub.org based on Behavior Surveillance Surveys

People Who Inject Drugs

Estimated size and HIV prevalence among people who inject drugs in Asia-Pacific 24 Source: (a) Please see the next slide; (b) UNGASS Country Progress reports 2010 and Global AIDS Response Progress Reports 2012 based on HIV Sentinel Surveillance surveys and Integrated Biological and Behavioural surveys

References , people who inject drugs populations estimation 25 UNODC, & Ministry of Counter Narcotics Afghanistan. (2009). Drug Use Survey 2009 cited in Afghanistan Global AIDS Response Progress Report, 2012 Population Size Estimates for Most at Risk Populations for HIV in Bangladesh, 2009 (Unpublished) Aceijas, C., Stimson, G. V., Hickman, M., et al. (2004). Global Overview of Injecting Drug Use and HIV Infection among Injecting Drug Users. Aids, 18(17), 2295-2303 Drug User Population Size Estimates 2007 cited in Cambodia Global AIDS Response Progress Report, 2012 UNAIDS China. China AIDS Fact Sheet 2009 (Unpublished) National AIDS Control Organisation India, Department of AIDS Control, & Ministry of Health & Family Welfare. (2011). Annual Report 2010-11. Ministry of Health . (2009). Estimasi Populasi Dewasa Rawan Terinfeksi HIV 2009 ( In Indonesian Language) National Committee for the Control of AIDS. (2012).Lao PDR Global AIDS Response Progress Report 2012 Ministry of Health Malaysia, & World Health Organization. (2009). National Consensus Workshop: Estimation and Projection of the HIV Epidemic (Unpublished). Sharma, M., Oppenheimer, E., Saidel, T., et al. (2009). A Situation Update on HIV Epidemics among People Who Inject Drugs and National Responses in South-East Asia Region. AIDS, 23, 1405–1413. National AIDS Programme Myanmar (2009). HIV Estimates and Projections, Myanmar 2008-2015 Nepal HIV/AIDS and STI Control Board, & National Centre for AIDS and STD Control. (2011). Mapping and Size Estimation of Most-At-Risk-Population in Nepal-2011: Vol.2 Injecting Drug Users. National AIDS Control Program, Ministry of Inter-Provincial Coordination. (2012). Pakistan Global AIDS Response Progress Report 2012 Philippine National AIDS Council. (2011). Estimates of the Most At-Risk Population and People Living with HIV. Aceijas, C., Stimson, G. V., Hickman, M., et al. (2004). Global Overview of Injecting Drug Use and HIV Infection among Injecting Drug Users. AIDS, 18(17), 2295-2303 Ibid. National STD/AIDS Control Programme Sri Lanka. (2010). Report on HIV Estimates and Projections 2009 Aramrattana, A. (2012). Estimated Size of Injecting Drug Users (IDU). Unpublished Power Point Presentation at Size Estimation Stake-Holder Seminar January 10th, 2012, Richmond Hotel, Nonthaburi. Aceijas, C., Stimson, G. V., Hickman, M., et al. (2004). Global Overview of Injecting Drug Use and HIV Infection among Injecting Drug Users. AIDS, 18(17), 2295-2303 Ministry of Health and National Technical Working Group on HIV Estimates and Projections. (2011). Preliminary Viet Nam HIV/AIDS Estimates and Projections 2011 cited in Viet Nam Global AIDS Response Progress Report 2012

Prevalence of injecting drug use among population (15-64), 2001-2007 26 Source: Prepared by www.aidsdatahub.org based on Bergenstorm A, Abdul-Quader A.S. Injection drug use, HIV and the current response in selected low-income and middle-income countries, AIDS 2010, 24 (suppl 3) : S 20- S29.

27 Trends in HIV prevalence among people who inject drugs, countries where data is available, 2001-2011 Source: Prepared by www.aidsdatahub.org based on Sentinel Surveillance and  Integrated HIV Behavioral and Serologic Surveillance Data reported by National AIDS programs

HIV prevalence among people who inject drugs, countries where data is available, 2008-2009 28 Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2008 & 2010

HIV prevalence among people who inject drugs who are <25 years old vs over 25 years old, countries where data is available, 2007-2009 29 Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2008 & 2010

Men Who Have Sex With Men

Estimated size and HIV prevalence among MSM in Asia-Pacific 31 Source: (a) Please see the next slide; (b) UNGASS Country Progress reports 2010 and Global AIDS Response Progress Reports 2012 based on HIV Sentinel Surveillance surveys and Integrated Biological and Behavioural surveys

References , MSM population estimation 32 icddr-b. (2012). Experience Conducting Male Sexual Health Survey and MSM Mapping and Enumerations in Bangladesh. Presented at the South Asia Regional MSM and Transgender Size Estimation Workshop: Strengthening National Reporting on HIV among MSM and Transgender persons Colombo, Sri Lanka. Khmer HIV/AIDS NGO Alliance (KHANA) and FHI estimation cited in “ National AIDS Authority.(2011).Cambodia Country Profile on HIV and AIDS 2009-2010: Onwards Towards Universal Access” UNAIDS China. (2009). China AIDS Fact Sheet 2009 (Unpublished) Mok, P. (2011). Sex Between Men in Your City. National AIDS Control Programme. (2011). NACP- IV National Strategy for HIV prevention among MSM : Strategic Approach for Targeted Intervention among MSM. Ministry of Health . (2009). Estimasi Populasi Dewasa Rawan Terinfeksi HIV 2009 ( In Indonesian Language) National Committee for the Control of AIDS Lao PDR. (2010). National Strategy and Action Plan on HIV/AIDS/STI 2011-2015 and Lao PDR Global AIDS Response Progress Report 2012 Ministry of Health Malaysia, & World Health Organization. (2009). National Consensus Workshop: Estimation and Projection of the HIV Epidemic (Unpublished). WHO. (2009). HIV/AIDS in the South-East Asia Region 2009. National Committee on HIV/AIDS. (2010). National Strategic Plan on HIV, AIDS and STIs : 2010-2015. Ulaanbaatar. National AIDS Programme Myanmar (2009). HIV Estimates and Projections, Myanmar 2008-2015 HIV/AIDS and STI Control Board, & National Centre for AIDS and STD Control. (2011). 2011 estimate used for EPP Spectrum HIV estimates 2012 based on extrapolation of MSW, and MSW, Transgender and Clients estimates. (Unpublished) Philippine National AIDS Council. (2011). Estimates of the Most At-Risk Population and People Living with HIV. Mok, P. (2011). Sex Between Men in Your City. National STD/AIDS Control Programme. (2012). Sri Lanka Global AIDS Response Progress Report 2012 Peerapatanapokin, W. Estimated sizes of Men who have Sex with Men (MSM). Unpublished Power Point Presentation at Size Estimation Stake-Holder Seminar January 10th, 2012, Richmond Hotel, Nonthaburi, Thailand. National AIDS Programme, Ministry of Health as cited in WHO SEARO (2010).Timor Leste: Epidemiological Situation and Health Sector Response Ministry of Health and National Technical Working Group on HIV Estimates and Projections. (2011). Preliminary Viet Nam HIV/AIDS Estimates and Projections 2011 cited in Viet Nam Global AIDS Response Progress Report 2012

Size estimates of MSM as proportion of adult male population (15-49) years Source: Prepared by www.aidsdatahub.org based on size estimates of MSM ( please see the information provided in the previous 2 slides) and adult male population (15-49) years retrieved from the UN Population Division http://esa.un.org/unpd/wpp/index.htm

Prevalence of MSM among adult male population, their heterosexual behavior and marital status, 2003-2007 34 Source: Prepared by www.aidsdatahub.org based on Cáceres, C. F., Konda, K., Segura, E. R., et al. (2008). Epidemiology of Male Same-Sex Behaviour and Associated Sexual Health Indicators in Low- and Middle-Income Countries: 2003–2007 Estimates

Percentage of men who ever had sex with men, countries where data is available, 2000-2006 35 Sources: Prepared by www.aidsdatahub.org based on 1. FHI, ICDDR, B., & USAID. (2006). Assessment of Sexual Behavior of Men in Bangladesh: A Methodological Experiment, 2. National AIDS Programme Myanmar. (2005). Behavioral Surveillance Survey 2003: General Population and Youth, 3. National Institute of Medical Statistics, & National AIDS Control Organisation. (2008). National Behavioural Surveillance Survey (BSS) 2006: Youth (15-24 Years), 4. Hong Kong,and Lao PDR_ power point presentation by Frits van Grensven, Thai MOPH-US CDC Collaboration, Recognizing and confronting the epidemic of HIV among MSM in South-East Asia, September 2006, and 5. National Statistics Office Philippines, & ORC Macro. (2004). Philippines National Demographic and Health Survey 2003. * % of man who had sex with a man in the last 12 months

36 Trends in HIV prevalence among MSM, countries where data is available, 2002-2011 Sources: Prepared by www.aidsdatahub.org based on Chengdu MSM HIV/AIDS Prevention Team. (2010). Chengdu MSM HIV/AIDS Prevention Situation and Response Analysis. Presented at the Men Who Have Sex with Men and Transgender Populations Multi-City HIV Initiative Meeting; National AIDS Control Organisation India. (2008). HIV Sentinel Surveillance and HIV Estimation in India 2007: A Technical Brief; van Griensven, F., & de Lind van Wijngaarden, J. W. (2010). A review of the epidemiology of HIV infection and prevention responses among MSM in Asia. AIDS, 24, S30-S40; National Epidemiology Center, & Department of Health Philippines. (2002-2011). Integrated HIV Behavioral and Serologic Surveillance; Bureau of Epidemiology, Department of Disease Control, Ministry of Health Thailand. (2010). Prevalence and Incidence of HIV Infections in Thailand (in Thai).; National AIDS Programme Myanmar. (2010). Results of HIV Sentinel Sero-surveillance 2009 Myanmar ; National Institute of Hygiene and Epidemiology Vietnam, FHI, Vietnam Administration of HIV/AIDS Control, et al. (2006). Results from the HIV/STI Integrated Biological and Behavioral Surveillance (IBBS) in Vietnam 2005 – 2006.

HIV prevalence among MSM, countries where data is available, 2008-2009 37 Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2008 & 2010 Country data are not strictly comparable because methods and sampling varied. In addition, many surveys were conducted in a few large urban areas & it might not necessarily reflect prevailing conditions at the national level.

HIV prevalence among MSM who are <25 years old vs over 25 years old, countries where data is available, 2005-2009 38 Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2006, 2008 & 2010

39 HIV prevalence among MSM and transgender, selected cities, 2005-2009 Source: Prepared by www.aidsdatahub.org based on WHO. (2010). HIV/AIDS in the South-East Asia Region: Progress Report 2010.; Kanter, J., Koh, C., Razali, K., et al. (2009). Risk Behavior and HIV Prevalence among MSM: A Venue-Based Study in Kuala Lumpur, Malaysia.

Median positivity of active syphilis among sex workers and MSM, East, South and South-East Asia, 2008 and 2010 40 Source: Prepared by www.aidsdatahub.org based on WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access. Number of reporting countries – Sex workers  2008 = 13, 2010 = 14 MSM  2008= 11, 2010 = 12

Percentage of sex workers and MSM seropositive for syphilis, 2008-2010 41 Source: Prepared by www.aidsdatahub.org based on WHO, UNAIDS, & UNICEF. (2011). Global HIV/AIDS Response: Epidemic Update and Health Sector Progress Towards Universal Access. * 2007 data, ** 2005 data

Sex Workers

Estimated size and HIV prevalence among sex workers in Asia-Pacific 43 Source: (a) Please see the next slide; (b) UNGASS Country Progress reports 2010 and Global AIDS Response Progress Reports 2012 based on HIV Sentinel Surveillance surveys and Integrated Biological and Behavioural surveys

References , FSW population estimation 44 Chase R, Foran J, Rasheed A, et al. (2008). Mapping and Situation Assessment of Key Populations at High Risk of HIV in Three Cities of Afghanistan. Population Size Estimates for Most at Risk Populations for HIV in Bangladesh, 2009 (Unpublished) National AIDS Authority.(2011).Cambodia Country Profile on HIV and AIDS 2009-2010: Onwards Towards Universal Access UNAIDS China. (2009). China AIDS Fact Sheet 2009 (unpublished) Hong Kong Advisory Council on AIDS. (2006). Report of Community Assessment and Evaluation of HIV Prevention for Commercial Sex Workers and their Clients in Hong Kong 2006. National AIDS Control Organisation India, Department of AIDS Control, & Ministry of Health & Family Welfare. (2011). Annual Report 2010-11. Ministry of Health . (2009). Estimasi Populasi Dewasa Rawan Terinfeksi HIV 2009 ( In Indonesian Language) National Committee for the Control of AIDS Lao PDR. (2010). National Strategy and Action Plan on HIV/AIDS/STI 2011-2015. Lim HE, Ang CL and Teh YK., Size estimation for Local Responses in Malaysia for HIV Prevention in Sex Work, 2010 (unpublished) cited in Malaysia Global AIDS Response Progress Report 2012 WHO. (2009). HIV/AIDS in the South-East Asia Region 2009. National Committee on HIV/AIDS, UN, & gtz. (2008). Comprehensive Review of the National Response to HIV and STIs in Mongolia. Ministry of Health Myanmar. (2011). Myanmar National Strategic Plan on HIV and AIDS 2011-2015. HIV/AIDS and STI Control Board, & National Centre for AIDS and STD Control. (2011). Mapping and Size Estimation Of Most-At-Risk-Population In Nepal-2011: Vol.3 Female Sex Workers National AIDS Control Program,Ministry of Inter-Provincial Coordination. (2012). Pakistan Global AIDS Response Progress Report 2012 Philippine National AIDS Council. (2011). Estimates of the Most At-Risk Population and People Living with HIV. Asian Development Bank. (2005). Socioeconomic Implications of HIV/AIDS in the Pacific. National STD/AIDS Control Programme. (2012). Sri Lanka Global AIDS Response Progress Report 2012 Sub-Technical Working Group on Projection and Estimation. (2012). Size Estimation for Sex Workers. Unpublished Power Point Presentation at Size Estimation Stake-Holder Seminar January 10th, 2012, Richmond Hotel, Nonthaburi. National AIDS Programme, Ministry of Health as cited in WHO SEARO (2010).Timor Leste: Epidemiological Situation and Health Sector Response Ministry of Health and National Technical Working Group on HIV Estimates and Projections. (2011). Preliminary Viet Nam HIV/AIDS Estimates and Projections 2011 cited in Viet Nam Global AIDS Response Progress Report 2012

45 Trends in HIV prevalence among female sex workers, countries where data is available, 2001-2011 Source: Prepared by www.aidsdatahub.org based on Sentinel Surveillance Data Reported by National AIDS programs

HIV prevalence among female sex workers, countries where data is available, 2005-2009 46 Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2006, 2008 & 2010

HIV prevalence among female sex workers, countries where data is available, 2007-2009 47 Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2006, 2008 & 2010

HIV prevalence among male and female sex workers, countries where data is available, 2007-2009 48 Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2008 & 2010 * Kathmandu valley

HIV prevalence among sex workers who are <25 years old vs over 25 years old, countries where data is available, 2007-2009 49 Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2008 & 2010

Percentage of sex workers who are under 25 years of age, countries where data is available 50 Source: Prepared by www.aidsdatahub.org based on Behavior Surveillance Surveys, Integrate Biological and Behavioural Surveys, HIV Sentinel Surveillance Surveys.

51 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