On World AIDS Day, WHO draws attention to the alarming rise of new HIV infections among men who have sex with men and transgender people in Asia.

MANILA, 30 NOVEMBER 2012 - On World AIDS Day (1 December), the World Health Organization (WHO) in the Western Pacific calls on governments to do more to combat the HIV epidemic among men who have sex with men and transgender people. Unless countries urgently expand access to health services for these key populations, the gains made against the epidemic over the last decade could be jeopardized.

"We need to strengthen our programmes to ensure that these key populations receive the support they need to protect themselves," says Dr Shin Young-soo, WHO Regional Director for the Western Pacific. "We need to scale up and improve sustained, comprehensive, effective and stigma-free HIV prevention efforts focusing on and working with men who have sex with men and transgender people."

The theme for World AIDS Day 2012 is: "Getting to Zero: Zero new HIV infections. Zero Discrimination. Zero AIDS-related deaths". The message relates to a world where people are protected from acquiring HIV and where people living with HIV are able to live long, healthy lives. All people in need should have access to:

- early diagnosis and life-saving antiretroviral treatment
- essential health commodities: male and female condoms, lubricants and clean needles and syringes for effective prevention of HIV transmission
- high-quality and stigma-free health-care and prevention services

According to the Joint United Nations Programme on HIV/AIDS 2012 (UNAIDS) Global Report: UNAIDS report on the global AIDS epidemic 2012, HIV epidemics in Asia and the Pacific remain largely concentrated among people who inject drugs, men who have sex with men and sex workers. Low-risk women are increasingly affected.

HIV prevention coverage remains inadequate for men who have sex with men. There is low coverage in the Philippines and Viet Nam at 25%. Although China reported more than 75% coverage of such programmes, and a survey of Singaporean and Vietnamese men who have sex with men revealed a high rate of condom use (75%), HIV infection among men who have sex with men across the region continues to grow. This requires governments to re-assess the effectiveness and quality of existing interventions.

In 2011, an estimated 1.3 million people were living with HIV in the 37 countries and areas of the WHO Western Pacific Region, with 80 000 deaths attributed to AIDS. However, the number of people newly infected with HIV declined from 150 000 per year in 2000 to 130 000 in 2011.

In Cambodia, Malaysia and Papua New Guinea, the rate of new HIV infections fell by more than 25% between 2001 and 2011. On the other hand, in the Philippines, the rate of new HIV infections increased by more than 25% per year during the same period. In China, new HIV infections increased among men who have sex with men, while declining among people who inject drugs and remaining low among sex workers.

Globally, 8 million people, or 54% of those in need, were receiving antiretroviral therapy in 2011. In the Western Pacific, only Cambodia reached more than 80% coverage of antiretroviral therapy. In Papua New Guinea, more than 60% of people who needed the therapy were receiving it in 2011. Effective implementation of programmes to halt mother-to-child transmission resulted in a 36% decrease in the number of children born with HIV in the Pacific between 2009 and 2011. In Asia, there was a 12% decrease in new HIV infections among children over the same period.

"This shows that the acceleration of our response is producing results for people," says Dr Shin. "In particular, the early detection of HIV infections in pregnant women and the availability of antiretroviral medication to prevent mother-to-child transmission have significantly increased the number of children born free of HIV in the Region, and cleaner blood supplies and better hospital infection control have dramatically cut the number of people being infected through blood or unclean injecting equipment."

To achieve and sustain access to HIV prevention, treatment, care and support services for people in need in the Region by 2015, WHO in the Western Pacific has identified five critical issues and recommended actions:

- Increase coverage of effective, evidence- and rights-based prevention interventions, including HIV testing and counselling, among people who inject drugs, sex workers, men who have sex with men and transgender people.
- Renew commitments to achieve and sustain universal access to early diagnosis and antiretroviral treatment. Early antiretroviral treatment administered to an HIV-infected person who is in a sexual partnership with an uninfected person can prevent HIV transmission by 96%. Harnessing the benefit will require concerted efforts for early diagnosis and treatment.
- Integrate HIV-related services, such as prevention of mother-to-child transmission and treatment of tuberculosis/HIV and hepatitis/HIV co-infections, into the broader health system.
- Strengthen systems for detection, management and surveillance of sexually transmitted infections and link these to comprehensive HIV prevention strategies.
- Use data from HIV surveillance systems more effectively to trigger programmatic actions that ensure service availability, accessibility, effectiveness, coverage and quality

In 2011, WHO Member States adopted the WHO global health sector strategy on HIV/AIDS 2011-2015, which promotes a long-term, sustainable HIV response by strengthening health and community systems, tackling the social determinants of health that both drive the epidemic and hinder response, protecting and promoting human rights and promoting gender equity.