Up to 10 million women in Asia sell sex and at least 75 million men pay for it regularly. With an estimated 10 male clients for every sex worker in Asia, men who go for unprotected commercial sex are probably the single most important determinant of the size of HIV epidemics in most of Asia, followed by sharing of contaminated needles and syringes and unprotected sex between men.
These were the findings of the Independent Commission on AIDS in Asia in its report, Redefining AIDS in Asia: Crafting an Effective Response, which was released by Prime Minister Manmohan Sigh on Monday. According to UNAIDS, an estimated 4.9 million Asians are currently infected with HIV. In 2007, 440,000 people were infected with HIV and 300,000 died of AIDS-related infections and diseases.
By pragmatically focusing prevention programmes to the sex trade and on drug use, the commission suggests that governments would make considerable progress in halting and reversing the epidemic. In most Asian countries, an increase in casual and premarital sex among women is unlikely to lead to a net increase in new infections, notes the commission, which is supported by UNAIDS.
India as had some successes. Though the country has 2.5 million people infected with HIV, which is over half of Asia's 4.9 million HIV population, effective initiatives such as condom promotion among sex workers, raising awareness, lowering stigma and making treatment accessible has slowed down new infections in some states such as Tamil Nadu. Other Asian countries, however, are lagging behind in their response to AIDS. If countries do not change policies, HIV would infect 10 million Asians and claim 500,000 lives annually by 2020.
"Countries at the early stages of the epidemic needed to spend an average of 50 cents per capita to reverse the epidemic. Every dollar spent on early prevention would save $8 in treatment costs later. Yet, the money spent on HIV programmes from national budgets decreased over the past decade in the 23 countries surveyed, the only exceptions being India and China," said C Rangarajan, chairman of the nine-member commission and chairman of the Economic Advisory Council to the PM.