Asia health experts to step up anti-AIDS programme for sex workers

By Ben Rowse
August 21, 2003

Hanoi — Asian health experts agreed Thursday to expand a programme to ensure rigorous condom use in the sex industry in a bid to prevent the escalation of the HIV/AIDS epidemic.

The pledge was made at the conclusion of a four-day meeting in the Lao capital Vientiane examining the success of the '100 percent condom use programme'.

The programme, which is being heavily promoted across the region by the World Health Organisation (WHO), involves distributing condoms to sex workers, teaching them about safe sex, and enlisting the support of the police.

Representatives from national AIDS programmes concluded the evidence showed that it was a highly effective response to address Asia's AIDS epidemic, the WHO said in a statement.

"There are few success stories in AIDS. This is one of them," said Dr Bernard Fabre-Teste, who heads the HIV and sexually transmitted infections (STI) unit at the WHO's Western Pacific Regional Office in Manila.

"The epidemic in Asia is still concentrated in certain areas. If this programme is expanded, we have a real chance at containing this epidemic."

The WHO said pilot programmes begun in several countries over the last few years had effectively boosted condom use and reduced new HIV infections.

"This is a response developed in Asia, for Asian countries, to address an AIDS situation that is quite unique to the region," said Dr Giovanni Deodato, the WHO representative to Laos.

Prostitution is a major factor driving of the AIDS epidemic in Asia.

As most Asian women have few sexual partners, high risk sexual behaviour is usually centred in the clandestine and thriving sex trade, which is sometimes brothel-based and often linked to entertainment establishments such as karaoke lounges, the WHO said.

Relatively high rates of HIV infection have been seen among sex workers in many part of the region, including in Cambodia, Myanmar and Vietnam with the virus rapidly spreading into the general population," the UN agency added.

"The most effective and responsible public health measures against HIV/AIDS in Asia need to focus on high-risk behaviours, which is commercial sex and injecting drug use," said Fabre-Teste.

The WHO pointed to the implementation of the '100 percent condom use programme' in Thailand and Cambodia, which has led to new HIV infections declining by more than 80 percent.

In the last few years, the programme was piloted in sex establishments in China, Myanmar, Mongolia and Vietnam and more recently initiated in the Philippines and Laos.

The UN agency said the continuation of the programme was essential to controlling the spread of HIV in Myanmar, which is considered to have one of the most potentially explosive AIDS epidemics in Asia, with relatively high HIV infection rates and a widespread sex trade.

It also labelled China a "potential AIDS tinderbox". One million people are infected with the virus and knowledge about how to prevent its transmission was poor, the organization said.

Participants at the conference, which brought together central and local government health officials from across Asia, however, stressed that strong political and financial support for the programme was essential.

"There has been good progress but we still have many hurdles to cross to expand the programme. Political support is critical. We need to advocate to parliamentarians and ASEAN that this programme works," said Fabre-Teste.

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