BANGKOK, July 6 (AFP) - The AIDS epidemic is spreading unchecked throughout parts of Asia and threatens to top Africa as the world's worst-hit region unless its leaders act within three years, the United Nations said on Tuesday.
More people were infected with HIV in the region during 2003 than ever before, according to a new UNAIDS report, and officials said time was running out before the epidemic got out of control in the region.
Sharp increases in HIV infections were reported in China, Indonesia and Vietnam with the number of Asians having the AIDS-causing virus rising to an estimated 7.4 million, the 2004 Report on the global AIDS epidemic said.
"Asia is facing life and death choices when it comes to the epidemic," Kathleen Cravero, deputy executive director of UNAIDS, told reporters in Bangkok.
"We have a real window of opportunity, particularly in Asia, if we don't take it, it will slam shut forever.
"If we miss it we will see an epidemic the likes of which we have never imagined despite what we have seen in Africa."
Record sums are being spent on research and educating the public but more than 20 years since the world's first AIDS diagnosis in 1981, huge swathes of the region's population remain ignorant about the disease and how to protect themselves.
AIDS experts warn the fast-growing epidemic in Asia, with a record 1.1 million new HIV infections last year, has huge worldwide implications since the continent is home to 60 percent of the world's population.
One in four new infections worldwide are recorded in Asia and epidemics are already particularly serious in the Southeast Asian nations of Myanmar, Thailand and in Cambodia where three percent of the population is infected with HIV -- the highest proportion in Asia.
Experts say that after more than one percent of the population is infected, the task of fighting back against HIV/AIDS becomes significantly more difficult, and a number of Asian nations are hovering around that mark.
Despite successes in some countries over reversing the upward trend of cases, the United Nations warns that many national leaders remain in denial about the impact of AIDS on their people.
While in many countries the response of the authorities is improving, it falls well short of what is needed, the report said.
Prevention work is also failing for those on the margins of society who need it most -- notably homosexuals, migrants and drug users -- who are systematically ignored in some of Asia's most conservative societies.
Women, who account for 28 percent of all infections in the region, also face particular difficulties in parts of Asia where seeking birth control or treatment can result in social alienation.
"New epidemics appear to be advancing unchecked... notably Eastern Europe and Asia -- regions that are experiencing the fastest-growing epidemics in the world," said the report.
While sub-Saharan Africa currently remains the worst-hit place in the world, UN experts predicted that Asia would need 28 percent of an estimated 20 billion dollar budget required by 2007 for prevention and care. Less than five billion dollars was spent worldwide in 2003.
China alone has an estimated 840,000 people living with HIV but the report warns that 10 million people may be infected by 2010 unless effective action is taken since it has spread across the country.
Intravenous drug use is fuelling the spread in some areas but in parts of central China, a blood-selling scandal designed to supplement meagre incomes among the farming community in the 1990s instead spread HIV and led to infections rise to 60 percent in some places.
In India, which at 5.1 million has the largest number of people outside of South Africa living with HIV, a study three years ago found that a quarter of the population had never even heard of AIDS.
Although most infections were through sexual activity, injecting drug use in the north-east of the country bordering Myanmar and close to the notorious Golden Triangle drug-producing area saw HIV infection rates of up to 75 percent.
Elsewhere in south Asia "behavioural information suggests that conditions are ripe for HIV to spread," according to the report.
In Bangladesh despite currently low HIV rates, a rise in drug use in some areas, a highly active commercial sex trade and the widespread shunning of birth control threatens a spike in infections.
Surveys there showed fewer than 20 percent of married women and 33 percent of married men had heard of AIDS.
There have been some notable successes, particularly in Cambodia and Thailand where vigorous campaigns have altered the sexual behaviour of the populations.
Infections have fallen sharply among brothel workers in both countries, with men scared off from visiting prostitutes. But in Thailand the trend has been accompanied by a rise in extramarital and casual sex that threatens to push faithful and monogamous wives into a high-risk category.
One of the newest epidemics is in Vietnam, the report said. While it still has a prevalence rate of less then one percent, drug use and unsafe sex has seen rates soar to more than 20 percent among sex workers in major cities.
Infections are unevenly spread in Indonesia, home to 210 million people, where six of the 31 provinces are badly affected, driven by the use of dirty needles among drug users.
"There is strong evidence that various sexual and injecting drug-user networks in Indonesia overlap significantly, thus creating an ideal environment for HIV to spread," the report said.
And in Australia, after a long-term decline, new cases of HIV have again risen from about 650 in 1998 to 800 in 2002, mainly through male homosexuality.
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