Wall Street Journal - June 1, 2001
Michelle Munn, Staff Reporter

Two Asian nations with the worst rates of HIV/AIDS are making modest progress. Cambodia and Thailand -- notorious for their extensive sex industries -- are showing signs of getting the epidemic under control.

In Thailand, the Thai Working Group on HIV/AIDS estimates the number of people infected with the virus will drop to about 200,000 by 2015 from 770,000 in 2000, as fewer new cases of HIV are diagnosed, and those with AIDS succumb to the disease. In Cambodia, the World Health Organization estimates that 2.8% of the adult population were infected by last year, down from 3.9% in 1997.

Unlike in the West, where AIDS has disproportionately hit the homosexual community, HIV in Asia primarily has been spread through heterosexual contact, a fact that has worried experts who see the potential for a surge in the region's rate of infection. However, several Asian governments have taken steps to target high-risk groups, such as prostitutes and intravenous drug users, while educating the public about the disease.

"In many countries in Asia there is a commitment to HIV and AIDS prevention and control," said Gilles Poumerol, WHO AIDS adviser for the Western Region. In Cambodia and Thailand, a "100% Condom Use" campaign aimed at sex workers and their clients, along with public awareness campaigns, are helping decrease the rates of HIV-infection in these two nations, he said.

But not all countries approach the issue as openly. Malaysia doesn't have an anonymous HIV-testing program, because the government registers the names of anyone testing positive. It also notifies the partners of those testing positive if the infected person fails to do so himself within 48 hours. This, combined with the social stigma associated with AIDS, makes people leery of testing.

And treatment for the country's estimated 42,000 HIV-positive residents is difficult to find and costly. "In terms of health treatment, we have most of the drugs available on the market, but available only to certain people," said Azrul Mohd Khalib, resource manager for the Malaysian AIDS Council. "Typically a person with HIV would have to fork out 2,000 ringgit," or about $526 a month, for treatment. "And in terms of terminal treatment or hospice care we really don't have a system made available nationwide."

Two countries, China and India, will be bellwethers of the epidemic's pan-Asian impact. India already accounts for half of Asia's HIV-positive population, with 3.9 million cases. China has about 600,000, mainly among intravenous drug users in interior provinces like Yunnan and Xinjiang. Increasing overlap among those injecting drugs and those plying the sex trade makes the problem particularly acute, as sexual activity could spread the disease to more populous coastal regions.

"Both countries have been slow to react in the past few years. There was a lot of skepticism and denial," said Dr. Poumerol. "But now things are changing. Leaders are recognizing it is a possible threat and are more active in fighting it."

In Japan, where the virus initially was mainly confined to hemophiliacs who had contracted it through tainted blood supplies, more men are contracting the disease. Men infected from prostitutes in foreign countries account for a growing percentage of the country's HIV-positive population, which the WHO estimates to be about 8,100, 76% of whom are male.

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