Epidemic Updates Of HIV Among MSM and TG

  • 78 million have become infected with HIV since the start of the epidemic
  • An estimated 39 million have died since the start of the epidemic
  • Incidence meter: Towards Zero new infection
    • The rate of new HIV Infections has been reduced by more than 50% among adults (15-49 yrs) in 26 low and middle – income countries between 2001 to 2012
    • Large number of PLHIV – Nepal, India, Myanmar, Papua New Guinea, and Thailand – reduced new HIV infection by >50%
    • Malaysia new infection dropped by 34%
    • However, The epidemic significantly increased in Bangladesh, Indonesia, Philippines and Sri Lanka
    • Despite the encouraging news, national epidemics in many parts of the world continue to expand
  • State of HIV Epidemics

1) Low Level Epidemics

    • HIV prevalence < 5% in all sub population with high risk behavior and < 1% in general population.

2) Concentrated Epidemics

    • HIV prevalence >5% among any sub population with high risk behavior and < 1% in general population.

3) Generalized Epidemics

    • HIV > 1% in general population
  • Key populations are central to the region’s HIV epidemics
    • Asia’s HIV epidemics remain largely concentrated among injecting drug users (IDU), men who have sex with men (MSM) and commercial sex workers (CSW).
    • About 16% of people who inject drugs in Asia are living with HIV. In some countries, this estimate is considerably higher: 30%–50% in Thailand and 32%–58% in Viet Nam.
    • High prevalence among men who have sex with men has been reported in several countries in the region: 29% in Myanmar, 5% in Indonesia, and between 7%–18% in parts of southern India.
    • Nearly one in five (18%) female sex workers surveyed in Myanmar tested positive for HIV in the mid-2000s.
  • HIV impact by severity
    • Severe >10%
    • Intermediate  2–10%
    • Emerging >1%
    • MSM/TG HIV – Severe epidemics
      • Severe MSM epidemics in the region [>10%]
      • Bangkok, Thailand: 17.3% 2003 | 30.8% 2007 |22.2% for age 15-22 in 2007
      • Myanmar: 23.5-35% in cross-sectional investigation across 4 sites in 2007
      • Mumbai India: 9.6% in 2007. Over 20% in some studies
    • MSM/TG HIV – Intermediate epidemics [2-10%]
      • Intermediate MSM epidemics
        • Vietnam, Hanoi,Lao PDR,Indonesia,China,Nepal,India
    • MSM/TG HIV – Emerging epidemics [>1%]
      • Pakistan,Bangladesh,Timor-Leste, Philippines
         
  • Conclusions
      • Current HIV efforts have not contained or reduced HIV among MSM
      • Trend of increasing HIV in developed and developing economies – new, newly identified and re surging epidemics among MSM
      • Globally, there are only a handful of studies among MSM and transgender people esp. among YMSM and YTGP
      • Predictions are dire

[Source: van Griensven, van Wijngaarden, Baral and Grulich 2009] & NCASC Nepal