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HIV and AIDS Data Hub for Asia-Pacific Review in slides Male Sex Workers Last updated: November 2014 www.aidsdatahub.org HIV and AIDS Data Hub for Asia-Pacific CONTENT Data availability and population size estimates HIV prevalence and epidemiology Risk behaviors Vulnerability and HIV knowledge National Response 2 Data availability and population size estimates www.aidsdatahub.org HIV and AIDS Data Hub for Asia-Pacific Male sex workers (MSW) size estimates, countries where data is available, 2007-2011 Country Estimated male sex workers Year of Estimate 1 Bangladesh 32,484 2010 2 Malaysia 5,000 2009 10,450 - 12,302 2011 Highway Districts 4,733 - 5,767 2011 Kathmandu Valley 5,717 - 6,535 2011 Nepal 3 4 Pakistan 63,000 2007 5 Thailand 18,239 2010 Source: Prepared by www.aidsdatahub.org based on 1.Bangladesh Global AIDS Response Progress Reporting 2014; 2. Ministry of Health Malaysia, & World Health Organization. (2009). National Consensus Workshop: Estimation and Projection of the HIV Epidemic; 3. HIV/AIDS and STI Control Board, & National Centre for AIDS and STD Control. (2011). Mapping and Size Estimation of Most-At-Risk-Population in Nepal-2011: Vol.1 Male Sex Workers, Transgender, and their Clients; 4. National AIDS Control Program, Ministry of Inter-Provincial Coordination. (2012). Pakistan Global AIDS Response Progress Report 2012; and 5. Sub-Technical Working Group on Projection and Estimation, Situation Analysis Working Group. (2012). Size Estimation for Sex Workers, Power Point Presentation at Size Estimation Stakeholder Seminar, 10th January, 2012, Richmond Hotel, Nonthaburi. HIV and AIDS Data Hub for Asia-Pacific Inclusion of MSW in latest available sentinel and biobehavioural surveys Country Sentinel and/or Bio-behavioural surveys Behavioural surveys Comment HSS 2011 2013* *Midline survey among MSM, MSW, and TG in Dhaka - Behavioural study 2010 1 Bangladesh 2 Fiji 3 Nepal IBBS 2012 IBBS 2012 4 Pakistan SGS 2011 SGS 2011 5 PNG IBBS 2010 IBBS 2010 6 Philippines IBBS 2013 IBBS 2013 7 Thailand IBBS 2010 HSS 2013 IBBS 2010 Source: Prepared by www.aidsdatahub.org based on HIV Sentinel Surveys and Bio-Behavioural Surveys MSM/MSW/TG-SW in Kathmandu valley 5 HIV and AIDS Data Hub for Asia-Pacific Proportion of MSM who sold sex to men, 2008-2013 % 100 90 80 70 60 50 40 30 20 10 0 58 last 12 months last 6 months last 3 months last month last sex Undefined period 64 60 49 48 43 63 44 38 34 27 23 13 4 8 10 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys and Behavioural Surveillance Surveys; 2) Lan, W., Lu, W., L.Norris, J., Dong-min, L., Wei, G., Zheng-wei, D., & Ning, W. (2012). HIV Prevalence and Influencing Factors Analysis of Sentinel Surveillane among Men who have Sex with Men in China, 2003-2011. Chinese Medical Journal, 125(11), 1857-1861.; 3) Bavinton, B., Singh, N., Naiker, D. S., Deo, M. N., Talala, M., Brown, M.,Navokavokadrau, S. (2011). Secret Lives, Other Voices: A Community-based Study Exploring Male-to-Male Sex, Gender Identity and HIV Transmission Risk in Fiji.;4) Philippines Department of Health, National6 Epidemiology Center (2013). 2011 Integrated HIV Behavioral and Serologic Suveillance (IHBSS) HIV prevalence and epidemiology www.aidsdatahub.org HIV and AIDS Data Hub for Asia-Pacific HIV prevalence among MSW, countries where data is available, 2009-2013 % 20 18.3 16 14.2 12.2 12 8.7 8 4.5 4 0.6 1.1 1.6 0 * Dhaka, **Shenzhen, *** Port Moresby Source: Prepared by www.aidsdatahub.org based on 1.Integrated Biological and Behavioural Surveys; 2.HIV Sentinel Surveillance Surveys; 3. www.aidsinfoonline.org; 4.J Zhao, W. Cai, L. Chen, J. Cheng, H. Ma, & X. Wang. (2012). A Comparison of HIV infection and Related Risk Factors between Money Boys and Non-commercial Men who have Sex with Men in Shenzhen, China. Poster presented at the IAS 2012, Washington, D.C., USA. HIV and AIDS Data Hub for Asia-Pacific HIV prevalence data on MSW is scarce but it indicates higher HIV prevalence than FSW in most of the countries, 2011-2013 % FSW MSW 25 19.0 18.3 20 14.2 15 10 5 8.7 7.0 0.3 0.6 12.2 1.7 0.6 1.6 0.3 1.1 2.2 0 Bangladesh* Indonesia (2013) (2011) Nepal** (2012) Pakistan (2011) PNG ***(2011) Philippines* Thailand**** (2013) (2012) * FSW data is for 2011 ** Kathmandu data reported as national; FSW data is for 2011 *** Data for Port Moresby **** MSW data is for 2010 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) icddr,b, 2013. HIV Midline 9 survey among MSM, MSW & TG (unpublished); and 4) www.aidsinfoonline.org HIV and AIDS Data Hub for Asia-Pacific Syphilis prevalence among MSW, countries where data is available, 2009-2012 Shenzen, China (2009) 12.9 Port Moresby, PNG (2010) 6.5 Dhanka, Bangladesh (2011) 4.2 Kathmandu valley, Nepal (2012) 2.2 Ho Chi Minh City, Viet Nam (2009) 1.9 % 0 5 10 15 Source: Prepared by www.aidsdatahub.org based on 1.J Zhao, W. Cai, L. Chen, J. Cheng, H. Ma, & X. Wang. (2012). A Comparison of HIV infection and Related Risk Factors between Money Boys and Non-commercial Men who have Sex with Men in Shenzhen, China. Poster presented at the IAS 2012, Washington, D.C., USA. ; 2.Kelly, A., Kupul, M., et al. (2011). Askim Na Save (Ask and Understand): People Who Sell and Exchange Sex in Port Moresby. Key Quantitative Findings. Sydney: Papua New Guinea Institute of Medical Research and the University of New South Wales.; 3. IEDCR, & ICDDR, B. (2011). National HIV Serological Surveillance, 2011 Bangladesh - 9th Round Technical Report.; 4.Ministry of Health Viet Nam. (2011). Integrated Biological and 10 and Behavioural Survey 2009; 5. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) Transgender (TG) People in Kathmandu Valley, Nepal Risk behaviours www.aidsdatahub.org HIV and AIDS Data Hub for Asia-Pacific Years (Mean) Average duration in the profession of selling sex among MSW, countries where data is available, 2007-2011 10 9 8 7 6 5 4 3 2 1 0 8 6 5 Quetta Peshawar Pakistan (2011) 5 Dhaka Chittagong Bangladesh (2007) Source: Prepared by www.aidsdatahub.org based on 1.National AIDS/STD Programme Bangladesh. (2008). Behavioral Surveillance Survey 2006-07: Technical Report.; 12 2. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011 HIV and AIDS Data Hub for Asia-Pacific Number of clients Average number of clients among MSW in the last month, 2007-2012 56 60 50 40 30 20 10 10 4 5 6 7 Ho Chi Minh City Hanoi Kathmandu Peshawar Nepal (2012) Pakistan (2011) 0 Chittagong Dhaka * Bangladesh (2007) * Last week Viet Nam (2009) Source: Prepared by www.aidsdatahub.org based on 1.National AIDS/STD Programme Bangladesh. (2008). Behavioral Surveillance Survey 2006-07: Technical Report.; 2. Ministry of Health Viet Nam. (2011). Integrated Biological and Behavioural Survey 2009; 3. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepal; 4. National AIDS Control 13 Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011 HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW reported condom use at last sex, 2010-2013 % 100 98 90 76 80 60 49 55 55 40 27 20 0 Pakistan (2011) Indonesia Bangladesh Philippines (2011) (2013) (2013) Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org PNG (2010) Nepal (2012) Thailand (2012) HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW reported consistent condom use with male clients, 2007-2012 0 20 40 60 80 100 % 16 Dhaka ,Bangladesh (2007) last week 32 Chittagong ,Bangladesh (2007) Larkana ,Pakistan (2011) Karachi ,Pakistan (2011) last month 7 last 6 months 9 84 Kathmandu ,Nepal (2012)* Port Moresby ,PNG (2010) Shenzhen ,China (2008) undefined period 27 * with one time paying male anal sex partner 37 Source: Prepared by www.aidsdatahub.org based on 1. National AIDS/STD Programme Bangladesh. (2008). Behavioral Surveillance Survey 2006-07: Technical Report.; 2. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.; 3. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepal. ; 4.Askim Na Save (Ask and Understand): People Who Sell and Exchange Sex in Port Moresby. Key Quantitative Findings. Sydney: Papua New Guinea Institute of Medical Research and the University of New South Wales.; 5. Cai, W.-D.,15 Zhao, J., Zhao, J.-K., et al. (2010). HIV Prevalence and Related Risk Factors among Male Sex Workers in Shenzhen, China: Results from a Time–location Sampling Survey. Sexually Transmitted Infections, 86(1), 15-20. HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW who reported transactional sex with female, 2007-2012 0 10 20 30 40 Last month Kathmandu, Nepal (2012) Dhaka,Bangladesh (2007) Chittagong,Bangladesh (2007) 4 5 3 9 4 40 Last 6 Last 12 months months Pakistan (2011) Shenzhen,China (2008) Ho Chi Minh City,Viet Nam (2009) Hanoi,Viet Nam (2009) 50 % 32 18 Had sex with FSW 10 20 Sold sex to female 14 Source: Prepared by www.aidsdatahub.org based on 1. National AIDS/STD Programme Bangladesh. (2008). Behavioral Surveillance Survey 2006-07: Technical Report.; 2. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.; 3.Cai, W.-D., Zhao, J., Zhao, J.-K., et al. (2010). HIV Prevalence and Related Risk Factors among Male Sex Workers in Shenzhen, China: Results from a Time–location Sampling Survey. Sexually Transmitted Infections, 86(1), 15-20.; 4.Ministry of Health Viet Nam. (2011). Integrated Biological and Behavioural Survey 2009; 5. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepal HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW with overlapping risk behaviours, countries where data is available, 2007-2012 50 % Inject drugs Had sex with PWID 40 34 30 20 18 16 10 5 1 11 7 2 7 8 2 0 Dhaka Chittagong * Bangladesh (2007) * In last year Kathmandu **Nepal (2012) ** In last month Quetta Karachi *** Pakistan (2011) *** In last 6 months Hai Phong Ho Chi Minh City ****Viet Nam (2009) **** Ever injected drugs; Had sexual partner who inject drugs Source: Prepared by www.aidsdatahub.org based on 1. National AIDS/STD Programme Bangladesh. (2008). Behavioral Surveillance Survey 2006-07: Technical Report.; 2. National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.; 3. Ministry of Health Viet Nam. (2011). Integrated Biological and Behavioural Survey 2009; 4. National Centre for AIDS and STD Control. (2012). Integrated Biological and Behavioral Surveillance (IBBS) Survey among Men who have Sex with Men (MSM) and Transgender (TG) People in Kathmandu Valley, Nepal Vulnerability and HIV knowledge www.aidsdatahub.org HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW with comprehensive HIV knowledge, 2007-2009 100 % 80 60 40 20 0 Pakistan, 2008 Thailand, 2009 Bangladesh, 2007 Indonesia, 2007 Nepal, 2009 Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic. National response www.aidsdatahub.org HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW reached with HIV prevention programmes, 2007-2013 % 100 74 80 54 60 62 34 40 20 79 9 9 12 0 Definition of reach : Know where to go to receive an HIV test and had been given condoms in the last 12 months 21 Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org HIV and AIDS Data Hub for Asia-Pacific Proportion of MSW who received an HIV test in the last 12 months and know their results, 2010-2013 Indonesia*, 2011 89 Nepal, 2012 59 Thailand, 2012 52 PNG, 2010 44 Bangladesh, 2013 35 Philippines, 2013 15 Pakistan, 2011 5 0 * denominator is only those who answered HIV testing related questions and not all surveyed population. 20 40 60 80 % 100 It is not strictly comparable across countries since methods and sampling varied. In addition, many surveys were conducted in a few urban areas and it might not necessarily reflect prevailing conditions at the national level. Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response in South Asia Sex Workers Afghanistan Bangladesh Bhutan India Maldives Nepal Pakistan Sri Lanka Criminalize sex work in private Criminalize soliciting Men who have sex with men Criminalize maleto-male sex YES NO YES NO YES NO YES NO YES YES YES YES YES YES YES YES YES YES YES YES YES NO YES YES Sources: Prepared by www.aidsdatahub.org based on UNAIDS, AIDS Data Hub, UNODC, UNFPA, and UNDP. (2014). Punitive Laws Hindering the HIV Response in 23 Asia and the Pacific (October 2014) HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response in South-East Asia Sex Workers Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Timor-Leste Viet Nam Criminalize sex work in private NOT ILLEGAL NO NOT ILLEGAL YES NOT ILLEGAL YES YES NO YES NO YES Criminalize soliciting YES YES NOT ILLEGAL YES YES YES YES YES YES NO YES Men who have sex with men Criminalize male-tomale sex YES NO NO NO YES YES NO YES NO NO NO Sources: Prepared by www.aidsdatahub.org based on UNAIDS, AIDS Data Hub, UNODC, UNFPA, and UNDP. (2014). Punitive Laws Hindering the HIV Response in 24 Asia and the Pacific (October 2014) HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response in East Asia Sex Workers Men who have sex with men Criminalize sex work Criminalize soliciting Criminalize male-toin private male sex China YES YES NO Japan YES YES NO Mongolia YES YES NO DPR Korea YES YES NO Republic of Korea YES YES NO Sources: Prepared by www.aidsdatahub.org based on UNAIDS, AIDS Data Hub, UNODC, UNFPA, and UNDP. (2014). Punitive Laws Hindering the HIV Response in 25 Asia and the Pacific (October 2014) HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response in the Pacific Sex Workers Fiji Kiribati Marshall Islands FSM* Nauru Palau Papua New Guinea Samoa Solomon Islands Tonga Tuvalu Vanuatu Criminalize sex work in private NO NO YES YES NO YES YES NO NO NO NO NO Criminalize soliciting YES YES YES YES NO INFO YES NOT ILLEGAL YES YES YES YES YES Men who have sex with men Criminalize maleto-male sex NO YES NO NO YES NO YES YES YES YES YES NO *Federated States of Micronesia Sources: Prepared by www.aidsdatahub.org based on UNAIDS, AIDS Data Hub, UNODC, UNFPA, and UNDP. (2014). Punitive Laws Hindering the HIV Response in 26 Asia and the Pacific (October 2014) HIV and AIDS Data Hub for Asia-Pacific THANK YOU slides compiled by www.aidsdatahub.org Data shown in this slide set are comprehensive to the extent they are available from country reports. Please inform us if you know of sources where more recent data can be used. Please acknowledge www.aidsdatahub.org if slides are lifted directly from this site 27