The document summarizes HIV epidemiology among men who have sex with men (MSM) globally and in Asia Pacific. Some key points:
- HIV prevalence among MSM ranges from under 1% to over 25% depending on the country/region, with most of Asia and Africa over 5%.
- HIV is increasing among MSM in many countries as prevalence declines elsewhere, with urban areas often having much higher rates.
- Condom use and HIV testing is low among MSM in most areas. Criminalization and stigma also limit data collection and access to services.
- MSM population size estimates vary widely but are often in the hundreds of thousands to millions in Asia Pacific countries.
AIDSTAR-One WHO's 2010 Recommendations for HIV Treatment: National Guideline ...AIDSTAROne
In 2010, the World Health Organization released revised recommendations for adult and adolescent HIV treatment. This technical brief provides HIV policy makers and program managers with a point of reference as they adapt and implement revised national HIV treatment guidelines. Approaches that worked well, challenges and lessons learned from Sub-Saharan Africa, Latin America, and South-East Asia are highlighted. Links to key resources for countries revising guidelines and implementing revisions are also provided.
www.aidstar-one.com/focus_areas/treatment/resources/technical_briefs/who_2010_guidelines
WHRF - How can the law be used to scale up effective HIV responses among MSM ...FMDH
Présentation de Nadia RAFIF sur "How can the law be used to scale up effective HIV responses among MSM ?" lors du Forum Mondial des Droits de l'Homme, Novembre 2014.
Pour plus d'informations :
- Site web : http://fmdh-2014.org/fr/
- Facebook : https://www.facebook.com/FMDH2014
- Twitter : https://twitter.com/FMDH2014
- Youtube : https://www.youtube.com/user/FMDH2014
AIDSTAR-One WHO's 2010 Recommendations for HIV Treatment: National Guideline ...AIDSTAROne
In 2010, the World Health Organization released revised recommendations for adult and adolescent HIV treatment. This technical brief provides HIV policy makers and program managers with a point of reference as they adapt and implement revised national HIV treatment guidelines. Approaches that worked well, challenges and lessons learned from Sub-Saharan Africa, Latin America, and South-East Asia are highlighted. Links to key resources for countries revising guidelines and implementing revisions are also provided.
www.aidstar-one.com/focus_areas/treatment/resources/technical_briefs/who_2010_guidelines
WHRF - How can the law be used to scale up effective HIV responses among MSM ...FMDH
Présentation de Nadia RAFIF sur "How can the law be used to scale up effective HIV responses among MSM ?" lors du Forum Mondial des Droits de l'Homme, Novembre 2014.
Pour plus d'informations :
- Site web : http://fmdh-2014.org/fr/
- Facebook : https://www.facebook.com/FMDH2014
- Twitter : https://twitter.com/FMDH2014
- Youtube : https://www.youtube.com/user/FMDH2014
Achievements and Implications of HIV Prevention Programme among Female Sex wo...QUESTJOURNAL
Background: Plateau State, Nigeria with HIV prevalence rate of 7.7% as at 2010 had among the highest HIV and syphilis levels in Nigeria, earning itself a reputation of being one of the 12 + 1 states contributing the highest HIV prevalence in Nigeria and described as “hot zone” of HIV infections. Factors responsible for this were not unrelated to the high-risk activities of Female Sex Workers (FSWs). This paper therefore presents achievements and implications HIV prevention among FSWs in Plateau State, Nigeria Methods: This project was an intervention effort focused on delivering evidence-based HIV prevention activities among FSWs in 3 local government areas within the State. The estimated target population for the study was 460 and this project used the minimum prevention package intervention (MPPI). Peer educators were selected and trained among the FSWs to reach out to their peers using cohort session. Data were documented using various monitoring and evaluation tools, entered on the District Health Information Software version 2 and analyzed using Microsoft Excel. Results: A total of 68 community dialogues were held with 1,466 influencers participating in the process. In addition, 601 peers were registered, while 18 persons benefitted from 27 income generation activities aimed at capacity building for FSWs. A total of 642 persons were counseled, tested and shown their results, with 15 persons tested positive resulting in HIV prevalence of 2.3%. Although 10,560 condoms were distributed however, these numbers was below the number of condoms required during the intervention. Conclusion: This intervention was a success. However, more needs to be done with regards to condom distribution and supply among FSWs since there is a crucial role for FSWs to play in the plot of taking the HIV prevalence of Plateau State even further down
1/3 of all new HIV infections are attributable to MARPs
Bridge population for HIV to general public
HIV prevalence higher than general population. (Ranges 20-50% prevalence)
Estimating the size of MARPs population
FSWs :140,000 countrywide
IDUs: 18,000
MSMs: 30,000
33,000 new HIV Infections out of 100,000
Dr. Kathleen Brady of Philadelphia's AIDS Activities Coordinating Office (AACO) gave this presentation at the January 9, 2013 Comprehensive Planning Committee meeting.
Achievements and Implications of HIV Prevention Programme among Men who have ...inventionjournals
Background: Targeted interventions among men who have sex with men (MSM) could have a considerable effect in slowing the spread of HIV epidemic. This paper therefore presents the achievements and implications of HIV prevention programme among MSM in Bayelsa State, Nigeria Methods: The project was an intervention study carried out among MSM in Bayelsa State, Nigeria. The calculated sample size for this project was 155 MSM and snowball sampling technique was used for their selection. The project adopted the minimum prevention package intervention (MPPI) and data collected with output indicators were entered into the District Health Information Software (DHIS) 2, exported into Microsoft Excel and analysed using same. Results: The overall target population reached during this intervention was 381 MSM given a target reached of 245.8%. A total of 35 community dialogues were held within the duration of the intervention and 49 influencers participated. The number of peers registered during the intervention were 203 and out of the total number of condom (20582) required for this intervention, only 15235 (74.0%) were distributed. A total of 185 (91.1%) of the registered peers were reached with all the three stages of MPPI and 381 (245.8%) were reached with HCT. Among these, 17 (4.5%) were tested positive to HIV. Conclusion: This study showed an HIV prevalence of 4.5% among men who have sex with men in Bayelsa state at the time of the intervention. Given this high HIV prevalence, it is vital to enact more targeted and evidencebased prevention programs for these men.
Dr. Kathleen Brady (AACO)'s annual epidemiological update. This presentation was given to the Philadelphia EMA Ryan White Planning Council on Thursday, February 20, 2014.
По оценкам программы Организации Объединенных Наций по ВИЧ/СПИД UNAIDS, по количеству инфицированных и по методам борьбы с болезнью Россия занимает место в одном ряду с Центральноафриканской Республикой, Демократической Республикой Конго, Индонезией, Нигерией и Южным Суданом. В этих странах не только постоянно увеличивается и без того большое число инфицированных, но они также испытывают недостаток в антиретровирусных препаратах.
It's not so much a question of if IT will be attacked, but when. As threats evolve and new weaknesses are discovered, businesses are more vulnerable than ever. ePlus and HPE have the solutions you need to stay protected.
Achievements and Implications of HIV Prevention Programme among Female Sex wo...QUESTJOURNAL
Background: Plateau State, Nigeria with HIV prevalence rate of 7.7% as at 2010 had among the highest HIV and syphilis levels in Nigeria, earning itself a reputation of being one of the 12 + 1 states contributing the highest HIV prevalence in Nigeria and described as “hot zone” of HIV infections. Factors responsible for this were not unrelated to the high-risk activities of Female Sex Workers (FSWs). This paper therefore presents achievements and implications HIV prevention among FSWs in Plateau State, Nigeria Methods: This project was an intervention effort focused on delivering evidence-based HIV prevention activities among FSWs in 3 local government areas within the State. The estimated target population for the study was 460 and this project used the minimum prevention package intervention (MPPI). Peer educators were selected and trained among the FSWs to reach out to their peers using cohort session. Data were documented using various monitoring and evaluation tools, entered on the District Health Information Software version 2 and analyzed using Microsoft Excel. Results: A total of 68 community dialogues were held with 1,466 influencers participating in the process. In addition, 601 peers were registered, while 18 persons benefitted from 27 income generation activities aimed at capacity building for FSWs. A total of 642 persons were counseled, tested and shown their results, with 15 persons tested positive resulting in HIV prevalence of 2.3%. Although 10,560 condoms were distributed however, these numbers was below the number of condoms required during the intervention. Conclusion: This intervention was a success. However, more needs to be done with regards to condom distribution and supply among FSWs since there is a crucial role for FSWs to play in the plot of taking the HIV prevalence of Plateau State even further down
1/3 of all new HIV infections are attributable to MARPs
Bridge population for HIV to general public
HIV prevalence higher than general population. (Ranges 20-50% prevalence)
Estimating the size of MARPs population
FSWs :140,000 countrywide
IDUs: 18,000
MSMs: 30,000
33,000 new HIV Infections out of 100,000
Dr. Kathleen Brady of Philadelphia's AIDS Activities Coordinating Office (AACO) gave this presentation at the January 9, 2013 Comprehensive Planning Committee meeting.
Achievements and Implications of HIV Prevention Programme among Men who have ...inventionjournals
Background: Targeted interventions among men who have sex with men (MSM) could have a considerable effect in slowing the spread of HIV epidemic. This paper therefore presents the achievements and implications of HIV prevention programme among MSM in Bayelsa State, Nigeria Methods: The project was an intervention study carried out among MSM in Bayelsa State, Nigeria. The calculated sample size for this project was 155 MSM and snowball sampling technique was used for their selection. The project adopted the minimum prevention package intervention (MPPI) and data collected with output indicators were entered into the District Health Information Software (DHIS) 2, exported into Microsoft Excel and analysed using same. Results: The overall target population reached during this intervention was 381 MSM given a target reached of 245.8%. A total of 35 community dialogues were held within the duration of the intervention and 49 influencers participated. The number of peers registered during the intervention were 203 and out of the total number of condom (20582) required for this intervention, only 15235 (74.0%) were distributed. A total of 185 (91.1%) of the registered peers were reached with all the three stages of MPPI and 381 (245.8%) were reached with HCT. Among these, 17 (4.5%) were tested positive to HIV. Conclusion: This study showed an HIV prevalence of 4.5% among men who have sex with men in Bayelsa state at the time of the intervention. Given this high HIV prevalence, it is vital to enact more targeted and evidencebased prevention programs for these men.
Dr. Kathleen Brady (AACO)'s annual epidemiological update. This presentation was given to the Philadelphia EMA Ryan White Planning Council on Thursday, February 20, 2014.
По оценкам программы Организации Объединенных Наций по ВИЧ/СПИД UNAIDS, по количеству инфицированных и по методам борьбы с болезнью Россия занимает место в одном ряду с Центральноафриканской Республикой, Демократической Республикой Конго, Индонезией, Нигерией и Южным Суданом. В этих странах не только постоянно увеличивается и без того большое число инфицированных, но они также испытывают недостаток в антиретровирусных препаратах.
It's not so much a question of if IT will be attacked, but when. As threats evolve and new weaknesses are discovered, businesses are more vulnerable than ever. ePlus and HPE have the solutions you need to stay protected.
According to the Cisco 2015 Annual Security Report, “Security is no longer a question of if a network will be compromised. Every network will, at some point, be compromised. The report also poses the question, “What will an organization do then? And if security staff knew the network was going to be compromised, would it approach security differently?”
ePlus has the answer. Provide for a Secure Perimeter and Secure Data within your data centers and cloud solutions. We work with industry-leading partners to offer solutions to both, and wrapping services for a complete solution.
In today’s threat landscape, cyber security isn't just an enterprise concern, nor is it entirely a government concern. To learn what that stance is and what security challenges government agencies are facing, we spoke to retired US Air Force Colonel Cedric Leighton.
Cybersecurity - Tackling the treat with Dr. Simon Moores, Security Futurist a...SITA
In the digital age of air transport – with its ever-more connected industry operations, passengers and aircraft – air transport faces a constant threat of cyber attacks, both on the critical infrastructure that keeps the wheels of air travel in motion, and on passenger data. The spotlight on threat intelligence, identity protection, data privacy and security in air transport has never been more intense. As we navigate deepening ‘lakes’ of data to become smarter at every step, how do we protect our operations and passengers, ensuring the utmost security and resilience across the air transport community?
Cybersecurity - Dominic Nessi, Former CIO, Los Angeles World AirportsSITA
In the digital age of air transport – with its ever-more connected industry operations, passengers and aircraft – air transport faces a constant threat of cyber attacks, both on the critical infrastructure that keeps the wheels of air travel in motion, and on passenger data. The spotlight on threat intelligence, identity protection, data privacy and security in air transport has never been more intense. As we navigate deepening ‘lakes’ of data to become smarter at every step, how do we protect our operations and passengers, ensuring the utmost security and resilience across the air transport community?
Machine Learning: Artificial Intelligence isn't just a Science Fiction topicRaúl Garreta
In this presentation I show a brief introduction to Machine Learning and its applications. I also present two cloud platforms for Machine Learning: Microsoft Azure for Machine Learning and MonkeyLearn.
Formative study on hiv workplace for health workers - copySEJOJO PHAAROE
Heterogeneity of the HIV epidemic in Lesotho
Formative Assessment: MOHSW
SECTORAL RESPONSE -MOHSW
ACTIONS TAKEN AND TOOLS AVAILABLE - TO DATE
DISSEMINATION- tools
ADVOCACY FOR BUY IN- - PPP
WELLNESS CHAMPIONS AND STRUCTURES
ADVOCACY-WELLNESS ACTIVITIES
M/E Tools
Cost benefit analysis
Learning and sharing
Action Research : Sejojo Phaaroe
3D MEDIA
National and international perspectives of health.pptxlucascyrus
The HIV epidemic affects the health of individuals as well as the households. With effective awareness campaigns and UNAIDS cautions an equal progress in reduction of HIV infections have been observed.
Friday, February 7, 2014 Nonprofit Commons was happy to feature members of the nonprofit Protect Yourself1 (PY1), Executive Director, Monique Richert (Chayenn in SL), and PY1 Development Consultant, Tom Kujawski (Incarn8 in SL) who presented facts and statistics and PY1 Safe2Live Program in support of the National Black HIV/AIDS Awareness Day.
Similar to Scientific Sessions 2015: Global and sri lankan hiv situation among msm (20)
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Welcome to Secret Tantric, London’s finest VIP Massage agency. Since we first opened our doors, we have provided the ultimate erotic massage experience to innumerable clients, each one searching for the very best sensual massage in London. We come by this reputation honestly with a dynamic team of the city’s most beautiful masseuses.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Scientific Sessions 2015: Global and sri lankan hiv situation among msm
1. Global and Sri Lanka HIV
situation among MSM
15 th October 2015
SCOV Annual scientific sessions
2. Introduction
• HIV epidemic is declining , HIV prevelence , PLHIV & new infections are declining and AIDS free world is become a
reality
• Despite decades of research and community, medical, and public healt efforts, high HIV prevalence and incidence
burdens havebeen reported in MSM throughout the world. This risk has been presentsince the syndrome now
known as AIDS was fi rst described in previously healthy homosexual men in Los Angeles (CA, USA) in 1981. Past 3
decades HIV has severely affected gay & other MSM In many
• high-income settings—including Australia, France, the UK, and the USA—overall HIV epidemic trends are in
• decline except in MSM, where they have been expandin in the era of highly active antiretroviral therapy (HAART
• MSM excluded from surveillance in settings where same sex behaviour is stigmatised or criminalised
• Stigma , criminalisation bar access to asses burden, difficult to reach pockets
• size of the population /denominator
• Now LGBT made success international gay community developing through internet & other media, net working,
demanding recognition, rights , challenge social exclusion , discrimination
• data is sparse or limited ,96 out of 196 (most countries ) have not reported MSM rates last 5 years,
• Re-emergent MSM epidemics in high income countries UK, USA ,France , epidemic among MSM increase in
(HARRT) ART era increasing 8% /year since 2011
• Asia , Africa Latin america the highest rates of HIV among any KAP is is MSM
• 3% -5% middle east & North africa to caribbean
3. Who is a MSM
• Definition –introduced in 1992 to capture a range
of male to male sexual behaviour avoid
charactersing men engaging in these sexual
behaviours by gender identity or sexual
orientation that happens in any male setting
• TG -Biological men choosing to have female
identity -TG or transgendered women if gender
assignment surgery done carry risk if receptive
anal sex but due to nature of female identity is
not considered as MSM
4. Background
• From 2000 to 2014 new HIV infections fell by 35% globally ,sharpest declines
occurred in the Caribbean (50% decline) and sub-Saharan Africa (41% . Asia and
the Pacific fell by 31%.
• In 2 Regions Eastern Europe and central Asia and the Middle East and North Africa,
new infections however have increased since 2000.
• New infections appear to be stable among gay and other MSM ,with small peaks in
Caribbean , Eastern Europe and central Asia.
• overall HIV epidemic trends are in decline except in MSM. HIV prevalence has not
declined as seen among sex workers & IDU globally.
• Past 3 decades HIV has severely affected gay & other MSM In many high-income
settings—including Australia, France, the UK, and the USA—Re-emergent MSM
epidemics, epidemic among MSM increase 8% /year in (HARRT) ART era
increasing since 2011
• Prevalence is not a good indicator of disease burden in the ART Era , incidence
surveys are lacking
5. • MSM excluded from surveillance in settings where same sex behaviour is
stigmatised or criminalised . Data is sparse or limited ,96 out of 196 (most
countries ) have not reported MSM rates last 5 years
• MSM are 19 times more likely to have HIV than the general population, review of
15 countries found that around 20% transgender people are living with HIV.
Transgender women are almost 50 times at risk of HIV than adults in the general
population
• In China, it is estimated that more than one third of the people acquiring HIV
infection are men who have sex with men.
• Projections for Asia indicate that unprotected sex between men could account for
half or more of all new infections by 2020
• Fewer than one in 10 MSM worldwide have access to most basic package of
services , services are not sensitive to their need or they are not led by community
members
• HIV testing and know the status is low 42% and condom use at last sex is very low
among gay , MSM.
• a median of 69% of men who have sex with men were reportedly reached with HIV
prevention programmes .
• Countries lack legal protection for MSM , 25 countries had protecting laws while
75 reported negative
6. Total: 36.9 million [34.3 million – 41.4 million]
Middle East & North Africa
240 000
[150 000 – 320 000]
Sub-Saharan Africa
25.8 million
[24.0 million – 28.7 million]
Eastern Europe
& Central Asia
1.5 million
[1.3 million – 1.8 million]
Asia and the Pacific
5.0 million
[4.5 million – 5.6 million]
North America and Western and Central Europe
2.4 million
[1.5 million – 3.5 million]
Latin America
1.7 million
[1.4 million – 2.0 million]
Caribbean
280 000
[210 000 – 340 000]
Adults and children estimated to be living with HIV 2014
7. Estimated number of adults and children
newly infected with HIV 2014
Middle East & North Africa
22 000
[13 000 – 33 000]
Sub-Saharan Africa
1.4 million
[1.2 million – 1.5 million]
Eastern Europe
& Central Asia
140 000
[110 000 – 160 000]
Latin America
87 000
[70 000 – 100 000]
Caribbean
13 000
[9600 – 17 000]
Total: 2.0 million [1.9 million – 2.2 million]
Asia and the Pacific
340 000
[240 000 – 480 000]
North America and Western and Central Europe
85 000
[48 000 – 130 000]
8. New infections among key populations
70000110000
330000
140000
1865000
New infections among key populations
sex workers
people who injects drugs
Men who have sex with men
clients of sex workers
other adults
9. Why risk is high & what drives HIV in MSM-
• High probability of per act- and per partner transmission through
receptive anal sex
• Spread speedily in large networks
• Clustering of HIV is high in networks
• High rate of dual & multivariant HIV in MSM than heterosexual
11. Pooled HIV prevalence among men who have sex with men in
low- and middle income countries, by region, 2000–2010
0
5
10
15
20
25
30
HIV Prevalence among MSM
percentage
12. HIV prevalence by Region& country
0 5 10 15
Armenia
Belarus
Georgia
Kazakhstan
Kyrgyzstan
Republic of Moldova
Ukraine
Uzbekistan
Azerbaijan
Tajikistan
2011
2012
2013
2014
0 10 20 30 40 50 60
Democratic Republic of the Congo
Lesotho
Madagascar
Malawi
Mali
Mauritania
Senegal
United Republic of Tanzania
Benin
Botswana
Central African Republic
Congo
Nigeria
Seychelles
Togo
Uganda
Cameroon
Côte d'Ivoire
Ghana
Guinea
Mauritius
Kenya
Swaziland
2012
2013
2014
Latin America Sub Saharan Africa
percentage
13. 0 5 10 15 20 25 30 35 40
Belarus
Georgia
Kyrgyzstan
Republic of Moldova
Uzbekistan
Barbados
Cuba
Jamaica
Bahamas
Dominica
Haiti
Saint Vincent and the Grenadines
Argentina
Colombia
Guyana
Honduras
Nicaragua
Panama
Paraguay
Peru
Belize
Brazil
El Salvador
Mexico
Uruguay
Chile
Costa Rica
Ecuador
europe&CAcaribbeanlatinAmrica
2011
2012
2013
2014
Regional variation in HIV prevalence among MSM in Latin America, Caribbean
Europe & central America
14. Disparity by urban cities
• HIV epidemics among men who have sex with men are expanding rapidly in urban
areas across the region
• In Thailand overall, an average 7% of men who have sex with men are estimated to
be living with HIV, but in Bangkok, the figure is closer to 25%.
• Similarly, in Nigeria, the HIV infection level among men who have sex with men is
17%; in the Federal Capital Territory it is more than twice as high (38%)
• A study in 24 Mexican cities among men who have sex with men found that about
17% of them were HIV-positive.
• Since 2007 there has been an upwards trend of HIV infections from 1% to nearly
7%in Quezon city in Philippine
15. MSM behaviours by Region
Average condom use HIV test uptake
Sub Saharan Africa 54%
Caribbean 40 -80% 16-99%
Asia Pacific 1-90% 2-87%
Middle East & North America
<50%
(except 75% in Lebanon) 60%
Latin America
7-100%
Majority <50% < 50%
Western & central Europe 20-77%
majority less than
50%
Eastern Europe ¢ral Asia 50%-80% 24-74%
*Wide Variation between countries in the Regions Can we reach new global 90 90 90 Targets?
Is C urrent behavior modification (IEC/ BCC strategies make sense? Bio medical interventions?
16. MSM are disproportionately affected
In Asia
Have a higher risk of HIV infection
Asian Epidemic Model projects
by 2020, around 46% of new
infections in Asia will be among
MSM.
Estimated Population of MSM in
Soth East Asia & pacific is
17. Fig 14a :Adult new infections by mode of transmission
in Non-Papua Indonesia
-
20,000
40,000
60,000
80,000
100,000
120,000
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
2016
2018
2020
2022
2024
Husband->wife Wife->husband Casual sex Needle sharing
Sex work Male-male sex Waria sex
Source ;National AIDs control programme Indonesia, based on ASIA epidemic
model and spetcrum
19. MSM size estimates, countries where data is available
Estimated MSM (a) Year of estimate Year of reporting HIV prevalence (b)
1 Afghanistan (Kabul) 1,729 2012 2014 0.5 (2012)
2 Australia 190,000 2011 2014 10.9 (2012)
3 Bangladesh 110,581 2010 2014 0.7 (Dhaka, 2013)
4 Cambodia 21,000 2008 2014 2.1 (2010)
5 China 3,830,000 2011 2014 7.3 (2013)
6 Hong Kong SAR 120,000 2011 … 4.08 (2011)
7 India
427,000 [High risk MSM, interventions]
3,500,000 [MSM at-risk]
2012 2014 4.4 (2010-11)
8 Indonesia 1,095,970 2012 2014 8.5 (2011)
9 Lao PDR
17,000 [High risk MSM]
49,330 [All MSM and TG]
2011
2010
2014 3.1 (Vientiane, 2011)
10 Malaysia 173,000 2009 2014 12.6 (2012)
11 Maldives 4,100 2009* 0 (2008)
12 Mongolia 11,500 -15,000 (homo and bisexual) 2006 10.7 (Ulaanbaatar,2012)
13 Myanmar 230,000 2010 2014 10.4 (2013)
14 Nepal 196,270 2012 2014 3.8 (2012)
15 Philippines 540,000 (390,733-689,529) 2011 2011* 3.3 (2013)
16 Singapore 90,000 2011 3.1(2013)
17 Sri Lanka 7,551 2013 2014 0.9 (2011)
18 Thailand 550,571 2010 2014 7.1 (2012)
19 Timor Leste 11,197 2010 1.3 (2011)
20 Viet Nam 382,506 2013 2014 3.7 (2013)
Prepared by www.aidsdatahub.org ; Note: a) Please see next slide for references; b) National HIV Sentinel Surveillance surveys and Integrated
Biological and Behavioral surveys reported in GARPR 2013 and 2014
* Year of source reference
20. 0.1 1 1 1 1 1 1.5 1.6 1.6 2.2 2.3 3.1 3.1 4.3 4.8
0
5
%
Regional median 1.6%; Range 0.14% - 4.8%
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 the data on adult male population (15-
49) years is based on 2012 population based on UN Population Division. (2013). World Population Prospects: The 2012 Revision - Extended Dataset.
22. 7.1 7.3
8.5
10.4
12.6
0
5
10
15
20
Thailand (2012) China (2013) Indonesia (2011) Myanmar (2013) Malaysia (2012)
%
Countries with >5% HIV prevalence among MSM in
national estimates from surveys, 2011-2013
23. 6.0 6.5
7.7 7.9 8
10.1 10.3 10.4 10.7
12.4 12.5
13.6 13.7
14.8 15
17.2 17.8
19.5
24.4
0
5
10
15
20
25
30%
Source: Prepared by www.aidsdatahub.org based on National AIDS Committee Thailand. (2012). Thailand Global AIDS Response Progress Report, 2012;
HIV Sentinel Surveillance Reports; Integrated Biological and Behavioral Surveillance Reports; Lan, W., et al. (2012). HIV Prevalence and Influencing
Factors Analysis of Sentinel Surveillance among Men who have Sex with Men in China, 2003-2011 and Chengdu Center for Disease Control and
Prevention. (2014). Intensifying HIV response among MSMs with city-approach in Chengdu city, China.
24. Countries and select cities with rising HIV prevalence trend
among MSM, Asia pacific 2000-2013
7.3
17.8
8.5
17.2
3.3
7.7
0
5
10
15
20
%
China
China (Chengdu)
Indonesia
Indonesia (Jakarta)
Philippines
Philippines (Cebu)
Source: www.aidsdatahub.org
25. Cities with stabilizing/ declining HIV prevalence trend among
MSM, 2000-2013
10.5
6.0
3.8
0
10
20
30
40
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
%
Bangladesh (Dhaka) India (Manipur)
Myanmar (Mandalay) Nepal (Kathmandu Valley)
Source: Prepared by www.aidsdatahub.org
26. HIV prevalence among MSM by region, latest available
year, 2008-2013
0
0.7 0.5 0.9
3.8
4.4
0.5
4.4
7.3
10.7
1.3
2.1
3 3.1 3.1 3.3 3.7 4.2
7.1
8.5
10.4
12.6
0
5
10
15
20 Maldives(2008)
Bangladesh(2013)*
Afghanistan(2012)
SriLanka(2011)
Nepal(2012)
India(2010-11)
Fiji(2011)
PNG(2009)**
China(2013)
Mongolia(2012)***
Timor-Leste(2011)
Cambodia(2010)
Rep.ofKorea(2011)
Singapore(2013)
LaoPDR(2011)****
Philippines(2013)
VietNam(2013)
Japan(2010)
Thailand(2012)
Indonesia(2011)
Myanmar(2013)
Malaysia(2012)
South Asia Pacific East Asia South-East Asia
%
*Dhaka, ** Port Moresby, *** Ulaanbaatar,
****Vientiane
27. 54
22 21
11
2 1 4
12
41
66
70
0
20
40
60
80
100
%
newly reported HIV cases cumulative HIV cases
* both homosexual and bisexual
Proportion of newly reported and cumulative HIV cases
attributable to homosexual transmission, 2011-2014
Source: Prepared by www.aidsdatahub.org
28. Adult new infections by mode of transmission
in Non-Papua Indonesia
-
20,000
40,000
60,000
80,000
100,000
120,000
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
2016
2018
2020
2022
2024
Husband->wife Wife->husband Casual sex Needle sharing
Sex work Male-male sex Waria sex
Source ;National AIDs control programme Indonesia, based on ASIA epidemic
model and spetcrum
29. HIV and AIDS Data Hub for Asia-Pacific
Correlation between reported homosexual mode of
transmission and HIV prevalence among MSM
Source: Prepared by www.aidsdatahub.org based on data from Ministry of Health HIV statistics and AIDS Registry; HIV Sentinel Surveillance Reports; Country Global AIDS
Response Progress Reports 2012 to 2014
3 6
9
12
15
19 21
7.3
0
2
4
6
8
0
5
10
15
20
25
2007 2008 2009 2010 2011 2012 2013
%HIVprevalence
%homosexual
transmission
China
% homosexual transmission
HIV prevalence (National)
2
5
7
11
8.5
0
2
4
6
8
10
0
2
4
6
8
10
12
2007 2008 2009 2010 2011 2012 2013
%HIVprevalence
%homosexual
transmission
Indonesia
% homosexual transmission
HIV prevalence (National)
70.4 72 78 80 79
3.3
0
1
2
3
4
0
20
40
60
80
100
2007 2008 2009 2010 2011 2012 2013
%HIVprevalence
%homosexual
transmission
Philippines
% homosexual transmission
HIV prevalence (National)
34 41 36
46 51 51 54
3.1
0
1
2
3
4
0
10
20
30
40
50
60
2007 2008 2009 2010 2011 2012 2013
%HIVprevalence
%homosexual
transmission
Singapore
% homosexual transmission
HIV prevalence (National)
30. Syphilis prevalence among MSM, 2011-2013
0.7
0.8
1.7
2
4.1
6
7.1
7.5
8.4
10.2
18.4
19.9
2
24.4
0 5 10 15 20 25 30
Viet Nam (2013)
Nepal (2012) *
Bangladesh (2013) *
Philippines (2013)
Mongolia (2012) *
Myanmar (2013)
Timor-Leste (2011)
China (2012)
Guangxi, China…
Afghanistan (2012) *
Singapore (2013) #
Indonesia (2013) #
Sri Lanka (2011) **
Thailand (2013) #
%
Source: Prepared by www.aidsdatahub.org based on 1) HIV Sentinel Surveillance Reports; 2) Integrated Biological and Behavioral Surveillance Reports; 3) Global AIDS Response Progress
Reporting 2013 and 2014 ; 4) Wang et al.(2014). HIV and syphilis prevalence trends among men who have sex with men in Guangxi, China: Yearly cross-sectional surveys, 2008–2012. BMC
Infectious Diseases 2014, 14:367
32. Mean number of male sexual partners among MSM in
last month, countries where data is available, 2006-
2012
1.3
2.7
3
2.5
3.2
6
0
1
2
3
4
5
6
7
8
9
10
Bangladesh
(2006-07) *
Cambodia
(2010)
PNG
(2010) *
Nepal
(2012) *
Philippines
(2011)
Viet Nam
(2009) *
Meannumber
male commercial partner male sex partner
33. 58
49 48
43
38
13
4
34
8
23
60
10
27
64 63
44
0
10
20
30
40
50
60
70
80
90
100
%
last 12 months last 6 months last 3 months
last month last sex Undefined period
Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys; 2) Lan, W., Lu, W.,
L.Norris, J., Dong-min, L., Wei, G., Zheng-wei, D., & Ning, W. (2012). HIV Prevalence and Influencing Factors Analysis of Sentinel Surveillance among Men who
have Sex with Men in China, 2003-2011. Chinese Medical Journal, 125(11), 1857-1861.; 3) Bavinton, B., Singh, N., Naiker, D. S., Deo, M. N., Talala, M., Brown,
M.,Navokavokadrau, S. (2011). Secret Lives, Other Voices: A Community-based Study Exploring Male-to-Male Sex, Gender Identity and HIV Transmission Risk in
Fiji.;4) Philippines Department of Health, National Epidemiology Center (2013). 2011 Integrated HIV Behavioral and Serologic Surveillance (IHBSS)
34. Proportion of MSM who reported buying sex from male
and female, 2006-2013
8 8
19 20
27 29
58
62
3
6
14
16
4
49 50
25
0
10
20
30
40
50
60
70
80
90
100
%
bought sex from male
bought sex from female
Source: Prepared by www.aidsdatahub.org based on Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys
35. 23 27
34 36 36
44 49
56
0
20
40
60
80
100
Sri Lanka
(2006-07)
Nepal
(2012)*
Philippines
(2011)
Cambodia
(2013)
Mongolia
(2012) *
Fiji
(2010) **
Viet Nam
(2009) *
Bangladesh
(2006-07) *
%
Risk of transferring infection
to General population
Proportion of MSM who had sex with female partners
in the last year, 2006- 2013
36. Proportion of MSM who reported condom use at last anal sex
with male partner, 2006-2013
91
87 86
82
79 77
70
66 66
63 61 60
51 49
41
21
17
1
65
0
20
40
60
80
100
Condomuseatlastsex(%)
Still many have not
reached the target
37. Condom use at last anal sex and consistent use among
MSM, 2009-2013
90
85
64
74
70
60 5868 68 66
41 43
48
25
6
57
0
20
40
60
80
100
National,2013*
National,2013*
National,2010
Bangkok,2010
ChiangMai,2010
National,2012
National,2012
National,2011
National,2011
Ulaanbaatar,2011
Ulaanbaatar,2011
National,2011
Jakarta,2011*
Bandung,2011*
Manipur,2009
**Mumbai,2009
Cambodia Thailand Viet Nam China Mongolia Indonesia India
% Condom use at last sex Consistent condom use
38. Figure 24: Percentage of men who have sex with men using condoms during last anal
sex, South-East Asia Region 2011
0
20
40
60
80
100
Condom use at last anal
sex all
<25 years >25 years
82
84
78
75 75
76
85
85
85
66
61 61 61
60
64
58
29
37
23
%ofMSMusingcondom
Myanmar Nepal Thailand Timor Leste
Sri Lanka Indonesia Bangladesh
Target
Condom use in
MSM is below the
target in
most countries
Source: Monitoring and reporting on the global response to HIV and AIDS 2008- 2011; Reports of behavioural surveys, national AIDS programmes. Sample size was
adequate as per national protocols.
39. 0
20
40
60
80
100 %
Total <25 yr 25+ yr
Percentage of MSM with comprehensive HIV knowledge, by
age group, countries where data is available, 2005-2009
Source: Prepared by www.aidsdatahub.org based on UNGASS Country Progress Reports 2006,2008 & 2010
40. 77
70 69 68 67
64 64
53
46
42
24 23 23
64
0
20
40
60
80
100
Preventioncoverage(%)
Definition of reach : Know where to go to receive an HIV test
and had been given condoms in the last 12 months * Programme data
** Data for Kathmandu
Proportion of MSM reached with HIV prevention programmes
in the last 12 months, 2009-2013
41. Proportion of MSM who received an HIV test in the last 12
months and know their results, 2006-2013
87
79
68
65
56
48 46
42 39 36
33
29
26
17 16 15 14
10 9
0
10
20
30
40
50
60
70
80
90
100
Testingcoverage(%)
Data is not strictly comparable across countries since
methods and sampling varied.
42. HIV and AIDS Data Hub for Asia-Pacific
Criminalisation of same-sex sexual activities between
consenting adult males in South-East Asia and the Pacific
countries
42Sources: Prepared by www.aidsdatahub.org based on UNAIDS, Data Hub, UNDP, UNFPA, and UNODC.
(2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014 *Federated States of Micronesia
South-East Asia Pacific
Brunei YES Fiji NO
Cambodia NO Kiribati YES
Indonesia NO Marshall Islands NO
Lao PDR NO FSM* NO
Malaysia YES Nauru YES
Myanmar YES Palau NO
Philippines NO Papua New Guinea YES
Singapore YES Samoa YES
Thailand NO Solomon Islands YES
Timor-Leste NO Tonga YES
Viet Nam NO Tuvalu YES
Vanuatu NO
43. HIV and AIDS Data Hub for Asia-Pacific
Criminalisation of same-sex sexual activities between
consenting adult males in South Asia and East Asia
countries
43
South Asia East Asia
Afghanistan YES China NO
Bangladesh YES Japan NO
Bhutan YES Mongolia NO
India YES DRP Korea NO
Maldives YES Rep of Korea NO
Nepal NO
Pakistan YES
Sri Lanka YES
Sources: Prepared by www.aidsdatahub.org based on UNAIDS, Data Hub, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in
Asia and the Pacific in October 2014
44. HIV and AIDS Data Hub for Asia-Pacific
Adult new infections by mode of transmission
in Non-Papua Indonesia
-
20,000
40,000
60,000
80,000
100,000
120,000
1990
1992
1994
1996
1998
2000
2002
2004
2006
2008
2010
2012
2014
2016
2018
2020
2022
2024
Husband->wife Wife->husband Casual sex Needle sharing
Sex work Male-male sex Waria sex
Source ;National AIDs control programme Indonesia, based on ASIA
epidemic model and spetcrum
45. HIV and AIDS Data Hub for Asia-Pacific
Young Key Populations
45
46. HIV and AIDS Data Hub for Asia-Pacific
46
“The analysis carried out by the Commission shows
that over 95% of all new HIV infections among young
people occur among most-at-risk adolescents.”
Report of the Commission on AIDS in Asia. Redefining AIDS in Asia: Crafting an
Effective Response (2008), p. 146.
47. HIV and AIDS Data Hub for Asia-Pacific
The ethical considerations needed to include minors in
studies that ask questions that relate to their sexual
behavior, use of drugs and other risk behaviors
What is different about surveying young key
populations(YKPs)?
48. HIV and AIDS Data Hub for Asia-Pacific
Data need for young key populations
To understand how HIV affects young key populations…
• Surveys have to include enough of young key populations
to yield meaningful results
• Reports of surveys have to include the age disaggregated
data and results
• Age of inclusion differs , comparison difficult
Age of inclusion
49. HIV and AIDS Data Hub for Asia-Pacific
Age of inclusion of YKPs in surveys of key populations, based on
available data from survey reports
49Source: Prepared by www.aidsdatahub.org based on National HIV Sentinel Surveillance, HIV Prevalence Surveys and Behavioral Surveys; Global AIDS Response Progress
Reports 2012 to 2014; UNGASS Progress Reports (2010).
HIV prevalence surveys
– 9-14yrs : Maldives (FSW 13, MSM 10); Pakistan (MSW 13); PNG (FSW 14, MSW 9)
– 15+yrs : Cambodia (FSW 15, MSM 18); Lao (MSM, TG 15); Maldives (PWID 17); Myanmar
(FSW, MSM, PWID 15); Nepal (FSW, MSM, PWID 16); Pakistan (FSW, Hijra 15); Viet Nam (FSW,
MSM, PWID 16)
– 18+yrs : Afghanistan (FSW,MSM, PWID 18); India (FSW, MSM, TG, PWID 18); Pakistan
(PWID 18); Malaysia (MSM,PWID 18)
Behavioral surveys
– 9-14yrs : Maldives (FSW 13, MSM 10); Pakistan (MSW 13); PNG (FSW 14, MSW 9 )
– 15+yrs : Bangladesh (FSW, MSW, MSM, TG, PWID 15); Lao (FSW, MSM, TG 15); Maldives
(PWID 17); Myanmar (FSW, PWID 15); Nepal (FSW, MSM, PWID 16); Pakistan (FSW, Hijra 15); Sri
Lanka (FSW, MSM 16, PWID 17); Timor Leste (FSW, MSM 16)
– 18+yrs : Afghanistan (FSW, MSM,PWID 18); Cambodia (FEW, MSM 18);India (FSW, MSM,
TG, PWID 18); Pakistan (PWID 18); Malaysia (MSM,PWID 18)
50. HIV and AIDS Data Hub for Asia-Pacific
Young MSM are getting infected with HIV!
50
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
HIV prevalence among MSM by age group, countries where the data
is available from 2009- 2013
0.0 0.0 0.8 1.1 1.9 1.9 2.0 2.5 3.0 3.5 5.3 5.6 6.1 6.2 8.8 10.0
1.1 0.9 0.6
4.1
5.3 6.4 6.7
4.8
30.4
4.9
16.3
7.3
9.8
16.0
12.4
11.1
0
5
10
15
20
25
30
35
%HIVprevalence
<25 yr
25+ yr
Countries with HIV prevalence
< 5% among MSM < 25 years
Countries with HIV prevalence
> 5% among MSM < 25 years
51. HIV and AIDS Data Hub for Asia-Pacific
Young PWID are getting infected with HIV!
51
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
HIV prevalence among PWID by age group, countries where the data
is available from 2010- 2013
1.1
13.0
5.1 6.5
19.4
7.7
43.9
20.7
25.3 25
48.1
0.7 1.1 2.7 3.7 4.8 5.3
11.6 11.7
25
33.9
41.2
0
10
20
30
40
50
60
%HIVprevalence
25+ yr
<25 yr
Countries with HIV prevalence
< 5% among PWID < 25 years
Countries with HIV prevalence
> 5% among PWID < 25 years
52. HIV and AIDS Data Hub for Asia-Pacific
Condom use among young MSM is generally lower than
their older counterparts
52
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
Condom use at last anal sex among MSM by age group, countries where
the data is available, 2007-2013
17
24
38 44 45
60 61 64 66 69 70 72 76
84 86 91
65
18
24
45
69
52
66
61 58
69
62
69
79 76 78
88
92
68
0
20
40
60
80
100
Condomuse(%)
< 25 yr 25+ yr
53. HIV and AIDS Data Hub for Asia-Pacific
Proportion of MSM with comprehensive HIV knowledge, by
age group, countries where data is available, 2007-2013
53Source: Prepared by www.aidsdatahub.org based on 1.UNAIDS Report on The Global AIDS Epidemic, 2010; 2. UNGASS Country Progress Reports ;
3. Integrated Biological and Behavioural Survey Reports
0
20
40
60
80
100%
Total <25 yr 25+ yr * Manipur
54. HIV and AIDS Data Hub for Asia-Pacific
Laws and regulations that allow adolescents to seek services without
parental/spousal consent, countries where data is available
54
Source: Prepared by www.aidsdatahub.org based on Department of Maternal, Newborn, Child, and Adolescent Health (WHO) at
http://www.who.int/maternal_child_adolescent/documents/countries/indicators/dashboards/en/ (accessed Feb 4, 2015)
Country
(reporting period)
Contraceptive services
except sterilization
HIV testing and
counselling services
Cambodia (Dec-2013)
India (Feb-2014)
Indonesia (Jan-2014)
Kiribati (Jun-2014)
Lao PDR (Dec -2013)
Malaysia (Dec -2013)
Myanmar (Feb- 2014)
Nepal (Jan-2014)
Pakistan (Feb-2014)
Papua New Guinea (Jan-2014)
Philippines (Mar-2014)
Solomon Islands (Dec-2013)
Sri Lanka (Jan-2014)
Timor Leste (Jan-2014)
Vanuatu (Dec -2013)
Viet Nam (Jan-2014)
Yes
No
No
information
55. HIV and AIDS Data Hub for Asia-Pacific
Compared to their older counterparts,
55
• less young key populations are being reached
by prevention programmes
• less young key populations have access to
HIV testing services and approximately 3 in 4
young key populations do not know their
HIV status
56. HIV and AIDS Data Hub for Asia-Pacific
21
30
25
21
52
47
61
73
78
64
68
78 80
61
12
18 20
29
39
43
49
55
62 63
71
76
80
49
0
20
40
60
80
100%
Proportion of MSM reached with HIV prevention programmes in
the last 12 months, 2008-2013
25+ yr
< 25 yr
Proportion of MSM reached by prevention programmes, by
age group, 2008-2013
56
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
57. HIV and AIDS Data Hub for Asia-Pacific
3 in 4 young MSM surveyed in the region do not know
their HIV status….
57
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
7 7 7 12 15 17 22 24 33 36 38 39 45 56 63
24
20 22
13
8
20
37
13
41
36
48
33
45
51
69
51
36
0
20
40
60
80
100 %
Proportion of MSM who received an HIV test in the last 12 months
and know their results, 2008-2013
< 25
25+
Malaysia and Indonesia data is not included in regional median calculation
since the denominators of reported proportion for HIV testing coverage do
not reflect total surveyed MSM and these denominators represent only
those who answered HIV testing related questions
59. People living with HIV/AIDS
Adults >15 Years - 3200 (2200-5600)
Children <15 Years - 100
AIDS deaths in 2014 - 100
Adult HIV Prevalence rate - <0.1%
60. 2133
•Cumulative Number of HIV
Positives as of 2015 2nd quarter
568
•Cumulative Number of AIDS
Cases Reported
348
•Cumulative Number of AIDS
deaths reported
61.
62. Cumulative HIV Cases by District as of end 2014 (N= 1985)
Data not available for 88 cases.
Courtesy :Epidemiologist
63.
64. 69%
24%
5%
2%0%
Probable Mode of transmission among cumulative
reported HIV
Hetero Sexual
Same sex/Bisexual
MTCT
DU/IVDU
N = 783
65. PLHIV (newly diagnosed) reported male to male
transmission shows an increasing trend annually….
1
2.4
6 6
8
3
12
7
16
20
27 28
0
33
72
0
10
20
30
40
50
60
70
80
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
all age groups 15-24
percentage
76.3
18.2
0.7 0.3
4.4
Hetero
Homo/Bi
IDU
Blood
Perinatal
66.
67. MSM population in Sri Lanka
National estimate for MSM in 2013
7551
Range (6547- 8554)
68. Distribution by locations and type of MSM.
home /shanty 16%
lodge hotel, 4%
night club /massage
parlour, 0%
street /public places ,
78%
others , 6%
Cruising sites
Source :2013 size estimation survey
35%
36%
29%
MSW Nachchi
other MSM
typology
70. Progressive coverage of MSM by provinces …….3 provinces
can prioritise to cover 80% of MSM to have an impact
0 10 20 30 40 50 60 70 80 90 100
western
southern
central
N central
northern
north western
Eastern
Sabaragamuwa
Uva
65%
73%
81%
86%
90%
93%
97%
99%
100%
Cumulative coverage
72. Sexual Risk behaviours among MSM
• Mean number of partners ranged , 10.7-12.5 in the last 6
months
• 27.5% MSM have sold sex while 19.6% have bought sex
in colombo
• 58.9% ever had sex with women, 73% during last 12
months, condom use was less than 46% , risk for
transmitting HIV to general population
• Almost all had ever anal sex 96%
73. Are MSM safe ? Risk reduction Behaviours among MSM
63.7
13.6
57.9
15.4
19.3
30.46
0 20 40 60 80 100
condom use
HIV testing
reached with prevention
comprehensive knowledge 2014 2006
percentage
74. limitations
• Data gap
Even after 30 years 90 countries have no reports past 5 years .the available available HIV prevalence and
incidence data are incomplete. Lack of population based prevalence estimates and same sex behaviour .
only one incidence estimate in Africa, 2 in Asia. few prospective cohort studies .
Social response bias in reporting anal receptive sex affects estimates of risks
Heavily Urban sampling
Lack of data from middle East & North Africa
Limited data among young MSM – shows high incidence, TI cannot wait till 18 years
Interventions
If transmission is heavily biologically determined , the current programmes Heavily dependent in IEC &
behaviour modification approaches make sense.?
Combined approaches –bio medical interventions –ART for treatment & prevention, Prep
medical circumcision , with BCC & structural interventions –reduce stigma, discriminatory laws.
More research on biology & epidemiology
Simulationmodels –converting homosex-heterosex reduces transmission by80-96%, role change from
receptive to insertive sex to
Highrates ofSTI have the same risk ofHIV transmission to no condoms