Monday October 8 1:18 PM ET

AIDS Could Spread Exponentially in Asia: Experts

By Victoria Thieberger

MELBOURNE (Reuters) - The spread of AIDS in Asia risks rising exponentially unless renewed prevention efforts are undertaken in the next few years, health experts told a regional conference on Saturday.

At the opening of the 5-day International Congress on AIDS in Asia and the Pacific, around 3,000 delegates were told that a substantial proportion of the male population was at risk, mainly from sex with prostitutes, and that existing prevention programs still have not reached huge numbers of people in the region.

A lack of awareness of AIDS and HIV, the virus that causes AIDS, and the fear of disclosure meant many infected people only sought medical attention when other opportunistic infections such as tuberculosis had set in.

"The course of the epidemic in Asia in the next decade is largely going to be determined by the prevention that is undertaken in the next few years,'' said Tim Brown, of the UNAIDS center of the East/West Center in Hawaii.

"There is serious potential for further and extensive spread of HIV,'' he told the gathering in the southern Australian city.

Some health experts have said the potential maximum infection rates are around 2% to 3% of Asian populations, well below the rates of around 10% seen in sub-Saharan Africa.

But Brown said this could rise much higher given that men who visited sex workers were the largest group at risk, and studies have shown 5% to 20% of men across Asia go to prostitutes.

"This is a very substantial proportion of the male population we are dealing with, and should they become infected their wives and girlfriends are potentially exposed to HIV,'' Brown said.

Around 7 million people in Asia live with HIV/AIDS, while an estimated 500,000 people die of the disease each year. This is estimated to rise to 800,000 by 2005, according to figures from UNAIDS, the coordinating UN body.

Across countries, the highest rates of infection were in Cambodia at 2.7% of the general population, Myanmar at 2% and Thailand at 1.8%. These three countries also have the highest rates of heterosexual transmission.

Surveys have found 15% of married men and 21% of unmarried men in Cambodia had sex with prostitutes in 2000, compared with a total of 11% in Japan and 10% in Thailand.

Still, the spread of AIDS across Asia has been relatively contained to high-risk groups including sex workers, injection drug users and homosexuals. In Myanmar, 62% of injecting drug users and 38% of female sex workers were HIV positive, according to a study taken last year. In three provinces in Vietnam, infection among injection drug users ranged from 30% to 60%.

"There is an enormous lack of awareness out there,'' said the University of Malaya's Dr. Adeeba Kamarulzaman, noting late diagnosis of HIV was one of the greatest problems.

"The fear of disclosure is very real, the social stigma that continues in these countries, contributes to the late presentation of patients,'' she told Reuters.

At a time when sophisticated and expensive antiretroviral medication is widely used in developed nations to treat people with HIV, the drugs remain a luxury in developing Asian countries.

Meeting the cost of the HIV/AIDS epidemic in the developing world will be the most challenging imperative of this century, said Professor Stefano Vella, president of the International AIDS Society.

He estimated the cost, including the increasing availability of generic drugs, at around US$7 to $9 billion a year.

"This cost should be met by wealthy countries,'' Vella said.

"It is still a relatively young epidemic in Asia/Pacific, which could rise exponentially if appropriate interventions aren't put in place.''