Country profiles - South East Asia

Cambodia

Cambodia’s HIV epidemic can be traced back to 1991. After an initial rapid increase, HIV infection levels declined after the late 1990s and by 2003 HIV prevalence was estimated at 1.2%.²³ Results published in 2009 from the first national population-based survey estimated HIV prevalence at 0.6%.²⁴ It’s believed that interventions with sex workers, carried out by the government and non-governmental organisations (NGOs), played a role in this decline. The adoption of a ‘100% condom’ policy that enforced condom use in brothels led to a substantial rise in condom use among sex workers and their clients and a drop in HIV infection levels among brothel-based sex workers. However, ongoing concerns include low levels of condom use among MSM, an increase in sex work occurring outside of brothels (making it harder to reach sex workers with interventions), and mother-to-child transmission of HIV – around one third of new infections occur through this route. HIV is mostly transmitted through heterosexual sex in Cambodia, and concerns are growing about the number of married women who are infected through their husband.²⁵

Indonesia

Around 314,000 people are living with HIV in Indonesia.²⁶ This number has risen sharply in recent years due to several factors, including: the country’s extensive sex industry; limited testing and treatment clinics and laboratories for sexually transmitted infections (STIs); a highly mobile population; a rapidly growing population of people who inject drugs; and the challenges created by major economic and natural crises that Indonesia has experienced (the Asian financial crisis heavily affected the country in 1997, and the 2004 Tsunami devastated parts of Northern Sumatra, the largest island in Indonesia). High levels of HIV infection are found amongst injecting drug users, sex workers and their clients and to a lesser extent, men who have sex with men.²⁷ In 2007, 8,700 people died from AIDS in Indonesia.²⁸

Lao People's Democratic Republic (Laos)

Despite being surrounded by countries that have relatively high HIV infection levels (Thailand, China, Vietnam, Cambodia and Myanmar), Laos has a comparatively small HIV problem. There are various reasons for this: the government was quick to acknowledge AIDS when it first emerged in the country, and took action to warn people about it; Laos has not seen the same level of large-scale migration that has occurred in other parts of Asia; there are relatively high rates of condom use among sex workers and their clients; and it’s thought that very few people in the country inject drugs.^{29 30} However in recent years there has been an increase of HIV infection among the most vulnerable groups, especially MSM and migrant workers.³¹

Malaysia

An HIV prevention billboard in Malaysia

HIV and AIDS statistics from Malaysia show that an estimated 0.5 percent of the population are living with HIV.³² Although most people infected with HIV in the country are male, there has been a steep increase in the number of new cases among women. During the late 1990s women made up around 5 percent of new infections, compared to around 20 percent in 2006.

Malaysia's epidemic is largely driven by injecting drug use, but heterosexual transmission is accounting for an increasing number of new infections. Recent trends have demonstrated a promising decrease in annual HIV infections, from 7,000 in 2002 to 5,830 in 2006.³³ In 2006 the government launched a five-year strategic plan to tackle HIV, which includes drug substitution therapy and needle exchange programmes for drug users.³⁴

In 2007, 3,900 people died from AIDS in Malaysia.³⁵

Myanmar (Burma)

Myanmar is facing a serious epidemic - an estimated 240,000 of the adult population is infected with HIV.³⁶ Myanmar’s authoritarian military regime is widely condemned for its human rights abuses, and in 2005 these concerns led the Global Fund to fight AIDS, TB & Malaria, to withdraw its proposed $98.4 million grants for the country.³⁷ Prevention services for injecting drug users are severely lacking with needle exchange programmes operating in just a few locations. Drug users are dealt with heavy-handedly and crackdowns on drug production have led to a scarcity of opium and heroin. This has resulted in drug inhalation being replaced by injecting, as a more cost-effective way of drug consumption, carrying with it a higher risk of HIV transmission. In 2006 methadone substitution therapy was introduced in a small number of government locations.³⁸

The Philippines

An estimated 8,300 people were living with HIV in The Philippines in 2007.³⁹ The country has traditionally had a very low HIV prevalence, with under 0.1% of the population infected. Even in groups such as sex workers and MSM that are typically associated with higher levels of HIV, prevalence rates above 1% have not yet been detected.⁴⁰ In the case of sex workers, this is possibly due to efforts to screen and treat those selling sex since the early 1990s. However, there are reasons to believe that this situation may not last. In early 2010 the Department of Health in the Philippines stated the country was now on the brink of a "concentrated epidemic", due to a rise in prevalence.⁴¹ Condom use is not the norm in paid sex, drug users commonly share injecting equipment in some areas, and among Filipino youth, there is evidence of complacency about AIDS.^{42 43} National HIV prevalence among the most at risk populations (MARPs) which includes sex workers, men who have sex with men and injecting drug users, has increased more than five fold from 0.08 % in 2007 to 0.47 % in 2009. ⁴⁴

Singapore

Although the number of people living with HIV in Singapore is relatively small, the country’s status as an international travel and business hub, along with the high number of infections found in surrounding countries, make it possible that the country will experience a more serious epidemic in the future. The number of annual new infections has been rising in Singapore. In 2006, a record 357 people were newly diagnosed with HIV, compared to 423 cases in 2007 and then 456 in 2008.⁴⁵ The majority of these new infections (50%) are diagnosed at a late-stage of HIV infection, by which point HIV treatment should already have started. To combat these rising figures, the government has chosen to focus on preventing mother-to-child transmission, but controversially, has rejected widespread condom promotion.⁴⁶ Another controversial policy in Singapore is the strict law banning sex between men, which campaigners argue undermines efforts to promote safe sex among MSM.^{47 48}

Thailand

AIDS education for young people in Thailand

Thailand is an example of a country where a strong national commitment to tackling the HIV and AIDS epidemic has paid off, with widespread access to treatment and an admirable history of HIV prevention efforts. However, some of these past prevention successes are starting to be undermined by a current lack of HIV prevention and rising STD rates. New infections are highest among MSM and women who have become infected by their husbands or sexual partners.⁴⁹ An estimated 610,000 people (equating to a prevalence of 0.43 %) are now living with HIV and AIDS in Thailand.^{50 51}

Vietnam

Around 254,000 people are living with HIV and AIDS in Vietnam.⁵² Vietnam's epidemic is still in a concentrated phase; injecting drug users, female sex workers and men who have sex with men are the groups primarily affected.⁵³ The number of people living with HIV in Vietnam doubled between 2000 and 2005. This rise included a large increase in the number of people who became infected through injecting drug use.⁵⁴ There is evidence of HIV increasing among the MSM population with approximately 60% of HIV-positive MSM reporting inconsistent condom use with male partners in the previous month.⁵⁵

See our South East Asian statistics page for more data on this region.