Crystal Gao, Editorials and Publications Team PMSA
HIV (human immunodeficiency virus) is a severe viral disease that attacks and destroys the cells of the immune system, resulting in an increased risk of secondary infections and certain cancers. In its advanced stages, HIV becomes known as AIDS (acquired immunodeficiency syndrome) and can be fatal without treatment(1). In the Western Pacific Region (WPR), HIV/AIDS is not considered a serious epidemic due to the overall prevalence being <1% in most areas. In fact, in 2012, the regional prevalence amongst adults was reported to be only 0.1%(2).
However, let us put this “0.1%” into context. As of 2012, this 0.1% was >1.4 million people living with HIV in the WPR, of which ~30,000 were children less than 15 years old. As of 2012, >100,000 people were newly infected with HIV, almost 1/3 of which were, again, children. As of 2012, >62,000 deaths occurred as a result of HIV/AIDS-related illnesses. Despite the superficially optimistic figures, it is evident that HIV/AIDS still affects a large number of people in the WPR and that, for them, the devastating consequences have been anything but optimistic. This raises the question – have we been undervaluing the impact of HIV/AIDS on the Western Pacific community, and in doing so, allowed the suffering of hundreds of thousands to fly under the radar?(2)
To date, just 5 countries in the WPR account for nearly 90% of all reported HIV cases; China, Cambodia, Malaysia, Vietnam and Papua New Guinea. In these countries, which are also some of the most densely populated countries in the WPR, the incidence of HIV/AIDS has been estimated to be >5%. However, variation in disease burden across different countries means that the true number of HIV/AIDS cases in the WPR has likely been underreported.
Currently in the WPR, many countries do have HIV screening and surveillance programs in place; however, these programs are often fraught with gaps and inconsistencies. For example, in 2011, a survey showed that Vietnam does not routinely screen for HIV in the MSM (men-who-have-sex-with-men) population, despite it being one of the highest-risk groups for HIV(3). Due to historical stigma surrounding homosexuality and illicit drug use, many individuals who are in these vulnerable groups, and who have the highest risk of contracting HIV, are scared or reluctant to come forward and seek medical treatment.
In order to reduce the incidence of HIV, better surveillance programs must be established in order to ensure that all high-risk groups of the population are adequately screened and receive the necessary care. However, in order to truly address the HIV epidemic in the WPR, we must start by addressing the social stigma surrounding this disease by improving the regional awareness and knowledge of this disease.
1. BetterHealth Channel. HIV and AIDS. 2018. [Online] Available at https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hiv-and-aids. Accessed 26 May 2018.
2. WHO. HIV in the Western Pacific Region. 2018. [Online] Available at http://www.wpro.who.int/hiv/about/programme/en/. Accessed 26 May 2018.
3. Yu D, Wi T, Calleja JG. How are countries in the Western Pacific Region tracking the HIV epidemic? Results from a 2011 survey of ministries of health. Western Pacific Surveillance and Response Journal : WPSAR. 2012;3(3):3-8.