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HIV and AIDS Data Hub for Asia-Pacific Review in slides People who inject drugs Last updated: December 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 People who inject drugs population size estimates, countries where data is available Estimated PWID (a) Year of estimate Year of reporting HIV prevalence (b) 1 Afghanistan (6 cities) 17,460 2012 2014 Male - 4.4 (2012) 2 Australia 215,000 2005 2014 Total- 1.2 (2012) 3 Bangladesh 23,800 2009 2014 Total- 1.1 (2011) 4 Brunei 3,000 – 4,000 2004 5 Cambodia 1,300 2012 2014 Total- 24.8 (2012) 6 China 2,170,000 2011 2014 Total- 6.3 (2013) 7 India 177,000 2012 2014 Total- 7.2 (2010-11) 8 Indonesia 74,326 2012 2014 Total- 36.4 (2011) 9 Lao PDR 1,150 2011 2014 Not available 10 Malaysia 170,000 2009 2014 Total- 18.9 (2012) 11 Maldives 400 … 2010 0 (2008) 12 Myanmar 75,000 (60,000 – 90,000) 2010 2014 Male- 18.7 (2013) 13 Nepal 52,174 2012 2014 Male- 6.3 (2011) 14 Pakistan 91,000 2009 2014 Total- 27.2 (2011) 15 Philippines 14,400 (12,304-16,607) 2011 2011* Total- 46.1 (2013) 16 Papua New Guinea 5,000 – 10,000 2004* Not available 17 Singapore 10,000 – 20,000 2004* 0.5 (2013) 18 Sri Lanka 423 2013 2014 Not available 19 Thailand 40,300 2009 2014 Total- 25.2 (2012) 20 Timor Leste 90 - 120 2004* Not available 21 Viet Nam 271,506 2014 Male- 10.3 (2013) 2013 Not available Prepared by www.aidsdatahub.org ; Note: a) Please see next slide for references; b) National HIV Sentinel Surveillance surveys and Integrated Biological and Behavioral surveys reported in GARPR 2013 and 2014 * Year of source reference HIV and AIDS Data Hub for Asia-Pacific References: People who inject drugs population size estimates 1. Afghanistan Global AIDS Response Progress Reporting 2014 . (In 6 cities; Kabul, Herat, Mazar-i-Sharif, Jalalabad, Farah, and Nimroz) 2. Australia Global AIDS Response Progress Reporting 2014 based on Hepatitis C virus Projections Working Group: Estimates and projections of the hepatitis C virus epidemic in Australia. (2006). 3. Bangladesh Global AIDS Response Progress Reporting 2014 based on Population Size Estimates for Most at Risk Populations for HIV in Bangladesh 2009. 4. Aceijas, C., Stimson, G. V., Hickman, M., et al. (2004). Global Overview of Injecting Drug Use and HIV Infection among Injecting Drug Users. AIDS, 18(17), 2295-2303 5. Cambodia Global AIDS Response Progress Reporting 2014 based on NACD,NCHADS, and KHANA. (2014). National Population Size Estimation, HIV Related Risk Behaviours and HIV Prevalence among People Who Use Drugs in Cambodia in 2012. 6. Ministry of Health China, WHO, and UNAIDS. (2011). 2011 Estimates for the HIV/AIDS Epidemic in China (Unpublished). 7. National AIDS Control Organisation India, Department of AIDS Control, & Ministry of Health & Family Welfare. (2011). Annual Report 2010-11. 8. Indonesia Global AIDS Response Progress Reporting 2014 based on Ministry of Health.(2013). Estimasi Populasi Rawan Tertular HIV di Indonesia Tahun 2012 (In Indonesian Language) 9. Lao Global AIDS Response Progress Reporting 2014 based on National Committee for the Control of AIDS Lao PDR. (2010). National Strategy and Action Plan on HIV/AIDS/STI 2011-2015 10. Malaysia Global AIDS Response Progress Reporting 2014 based on Ministry of Health Malaysia, & World Health Organization. (2009). National Consensus Workshop: Estimation and Projection of the HIV Epidemic 11.Sharma, M., Oppenheimer, E., Saidel, T., et al. (2009). A Situation Update on HIV Epidemics among People Who Inject Drugs and National Responses in South-East Asia Region. AIDS, 23, 1405–1413. 12. Myanmar Global AIDS Response Progress Reporting 2014 based on National AIDS Programme Myanmar.(2009). HIV Estimates and Projections, Myanmar 2008-2015 13. Nepal Global AIDS Response Progress Reporting 2014 based on Central Bureau of Statistics, Ministry of Home Affairs. (2013). Survery Report on Current Hard Drug Users in Nepal -2069 14. Pakistan Global AIDS Response Progress Reporting 2014 based on extrapolation and triangulation from mapping conducted as part of IBBS Round II, 2007. 15. Philippine National AIDS Council. (2011). Estimates of the Most At-Risk Population and People Living with HIV 16. Aceijas, C., Stimson, G. V., Hickman, M., et al. (2004). Global Overview of Injecting Drug Use and HIV Infection among Injecting Drug Users. AIDS, 18(17), 2295-2303 17. Ibid. 18. Sri Lanka Global AIDS Response Progress Reporting 2014 based on National STD/AIDS Control Programme and the Family Planning Association of Sri Lanka. (2013). National Size Estimation of Most at Risk Populations (MARPs) for HIV in Sri Lanka 19. Thailand Global AIDS Response Progress Reporting 2014 based on Aramrattana, A. (2012). Estimated Size of Injecting Drug Users (IDU). Unpublished Power Point Presentation at Size Estimation Stake-Holder Seminar January 10th, 2012, Richmond Hotel, Nonthaburi. 20. Aceijas, C., Stimson, G. V., Hickman, M., et al. (2004). Global Overview of Injecting Drug Use and HIV Infection among Injecting Drug Users. AIDS, 18(17), 2295-2303 21. Viet Nam Global AIDS Response Progress Reporting 2014 5 HIV and AIDS Data Hub for Asia-Pacific Size estimates of PWID as proportion of adult male population (15-49) years %3 Regional median 0.2%; Range 0.01% - 2.3% 2.3 0.8 0 0.01 0.03 0.1 0.1 0.1 0.1 0.1 0.2 0.2 0.3 0.4 0.5 1 0.6 * Size estimate from 6 cities Source: Prepared by www.aidsdatahub.org based on size estimates of PWID ( please see the information provided in the previous 2 slides) and adult male population (15-49) years is based on 2012 population based on UN Population Division. (2013). World Population Prospects: The 2012 Revision - Extended Dataset. HIV and AIDS Data Hub for Asia-Pacific Data availability of PWID in HIV sentinel surveillance surveys conducted between 2009 and 2013 HIV sentinel surveillance surveys Number of countries assessed 0 26 Conducted between 2009-2013 6 Survey report available 5 Age disaggregated data reported in global AIDS reporting 4 Age disaggregated data available from survey reports 2 Gender disaggregated data reported in global AIDS reporting Gender disaggregated data available from survey reports Bangladesh, China, India, Myanmar, Thailand, and Viet Nam Bangladesh, India, Myanmar, Thailand, and Viet Nam Bangladesh, China, India, Myanmar Myanmar and Viet Nam 4 Bangladesh, China, India, and Viet Nam 0 7 Source: Prepared by www.aidsdatahub.org based on National HIV Sentinel Surveys; Global AIDS Response Progress Reporting; and www.aidsinfoonline.org HIV and AIDS Data Hub for Asia-Pacific Data availability of PWID in behavioral surveys conducted between 2009 and 2013 Behavioural surveys including IBBS 0 Number of countries assessed 26 Conducted between 2009-2013 11 Survey report available 9 Age disaggregated data available from survey reports 2 Gender disaggregated data reported in global AIDS reporting Gender disaggregated data available from survey reports Afghanistan, Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, Viet Nam 8 Age disaggregated data reported in global AIDS reporting Afghanistan, China, Indonesia, Malaysia, Nepal, Pakistan, Philippines, Thailand, Viet Nam Nepal, Philippines 8 1 Afghanistan, Cambodia, China, India, Indonesia, Malaysia, Nepal, Pakistan, Philippines, Thailand, Viet Nam Afghanistan, China, Malaysia, Nepal, Pakistan, Philippines, Thailand, Viet Nam Philippines Source: Prepared by www.aidsdatahub.org based on Behavioral Surveillance Surveys; Integrated Biological and Behavioral Surveys; Global AIDS Response Progress Reporting; and www.aidsinfoonline.org 8 HIV prevalence and epidemiology www.aidsdatahub.org Latest! HIV and AIDS Data Hub for Asia-Pacific HIV prevalence among people who inject drugs, 2010-2013 HIV prevalence (%) 50 46.1 40 36.4 30 24.8 18.7 20 25.2 27.2 18.9 10.3 10 4.4 6.3 6.3 7.2 1.1 0 * Kathmandu; ** Cebu and Mandaue Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) www.aidsinfoonline.org Latest! HIV and AIDS Data Hub for Asia-Pacific HIV prevalence among people who inject drugs by gender, 2010-2013 HIV prevalence (%) 50 Men who inject drugs 40 Women who inject drugs 30.4 30 27.8 29.7 18 20 13 10 6.3 1.1 0 * Sample of women who inject drugs < 50 11 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; and 3) www.aidsinfoonline.org Latest! HIV and AIDS Data Hub for Asia-Pacific HIV prevalence (%) HIV prevalence among people who inject drugs by age group, 2010-2013 60 <25 yr 50 41.2 25+ yr 40 33.9 30 25 20 11.7 10 0.7 2.7 1.1 3.4 5.3 11.6 4.8 0 12 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) www.aidsinfoonline.org Latest! HIV and AIDS Data Hub for Asia-Pacific HIV prevalence (%) HIV prevalence among PWID in geographical locations that are higher than national prevalence, 2010-2013 56.4 60 52.5 Afghanistan 52.4 50 Bangladesh 40 30 24.5 20 15.7 10 0 China 35.5 21 24 India Indonesia 5.3 Myanmar Pakistan Philippines Viet Nam Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) Zhang L, Chow EPF, Jing 13 J, et al. HIV prevalence in China: Integration of surveillance data and a systematic review. Lancet Infect Dis 2013; published online Oct 7. http://dx.doi.org/10.1016/S14733099(13)70245-7. Latest! HIV and AIDS Data Hub for Asia-Pacific HIV prevalence among PWID in geographical locations where rising HIV prevalence trends are observed, 2005-2013 56.4 HIV prevalence (%) 60 52.4 46.1 50 42.2 36.4 40 30 27.2 20 10 0 2005 2006 Indonesia Pakistan Philippines ** 2007 2008 Jakarta Karachi Cebu* 2009 2010 2011 2012 2013 * male PWID ** 2013 data for Cebu and Mandaue reported as national 14 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) www.aidsinfoonline.org Latest! HIV and AIDS Data Hub for Asia-Pacific Trends in HIV prevalence among PWID in ASEAN states/cities, where data is available, 2003-2013 HIV prevalence (%) 70 56.4 60 52.4 50 40 30 20 18.5 10 24 20 18 12.5 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 Indonesia (Jakarta) Myanmar (Lashio) Myanmar (Mandalay) Thailand (Bangkok) Viet Nam (HCMC) Viet Nam (Hanoi) 2012 2013 Philippines (Cebu)* * male PWID Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys 15 Latest! HIV and AIDS Data Hub for Asia-Pacific Trends in HIV prevalence among PWID in SAARC states/cities, where data is available, 2002-2012 HIV prevalence (%) 70 60 50 40 42.2 30 30.8 20 18.3 10 15.7 6.3 5.3 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Afghanistan (Herat) Bangladesh (Dhaka) India (Delhi) Nepal (Kathmandu) Pakistan (Karachi) Pakistan (Lahore) Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys 16 Latest! HIV and AIDS Data Hub for Asia-Pacific Hepatitis C and syphilis prevalence among PWID, countries where data is available, 2009-2013 94 Prevalence (%) 100 80 Hepatitis C 71 64 Syphilis 60 52 40 40 28 20 3 0 51 6 4 6 8 6 4 3 0 0.3 4 0 5 2 2 * Cebu and Mandaue 17 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) www.aidsinfoonline.org Latest! HIV and AIDS Data Hub for Asia-Pacific Proportion of HIV transmission through injecting drug use among reported HIV cases, 2011-2014 100% 80% 60% Others 40% 20% Injecting drug use 0% * New HIV cases ** Cumulative HIV cases Source: Prepared by www.aidsdatahub.org based on 1. Country Global AIDS Response Progress Reports 2012; 2. Directorate General of Disease Control and Environmental Health, Ministry of Health, Indonesia (Feb 2014). Situation Progress Report of HIV and AIDS in Indonesia in 2013 (Laporan Situasi Perkembangan HIV & AIDS di Indonesia tahun 2013, Kementerian Kesehatan RI 2013) ; 3. National Epidemiology Center Philippines. (2014). Philippines HIV/AIDS Registry: August 2014; 4. National AIDS Control Organisation India, Department of AIDS Control, & Ministry of Health and Family Welfare. (2012). Annual Report 2011-12.; 5. Ministry of Health Malaysia (2014). HIV and AIDS Reporting (1986-2013); 6. Ministry of Health Singapore. (2013). Retrieved August 2013, from http://www.moh.gov.sg/content/moh_web/home/statistics/infectiousDiseasesStatistics/HIV_Stats.html ; 7. National AIDS Control Programme Sri Lanka. (2013). Retrieved 10 October 2014, from http://www.aidscontrol.gov.lk/web/index.php/en/statistics/hiv ; and 8. Ministry of Health and Population Nepal, National Center for AIDS and STD control. Factsheet Number 2: Cumulative cases in Nepal, As of Mangsir 2070 (Nov 2013); 9. Centre for Health Protection, Department of Health Hong Kong. (2014). Hong Kong STD/AIDS Update, Vol. 19, No.1, Quarter 1 2013 Risk behaviours www.aidsdatahub.org Latest! HIV and AIDS Data Hub for Asia-Pacific Number of injections Average number of injections among people who inject drugs, 2006-13 10 8 7 7 6 4 3 3 2 3 4 2 2 4 2 0 average injections per day (or) in the last day * Cebu and Mandaue average injections per week (or) in the last week Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys; 20 Latest! HIV and AIDS Data Hub for Asia-Pacific Duration of injecting drugs (year) Duration of injecting drugs among PWID, 2006-2012 10 8 9 8 7 7 6 4 6 6 5 5 4 2 3 3 2 0 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys 21 Latest! HIV and AIDS Data Hub for Asia-Pacific Trend of regional median on safe injecting practices among PWID for countries that reported consistently in the Global AIDS Reporting between 2010 to 2013 Safe injection (%) 100 80 83 81 80 UNGASS 2010 Global AIDS Response Progress Report 2012 Global AIDS Response Progress Report 2013 60 40 20 0 11 countries (Afghanistan, Bangladesh, China, Indonesia, Malaysia, Myanmar, Nepal, Pakistan, Philippines, Thailand, and Viet Nam) reported in all three rounds of Global AIDS Reporting between 2010 to 2013 22 Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org Latest! HIV and AIDS Data Hub for Asia-Pacific Proportion of PWID who reported safe injection practice at last injection, 2006-2013 Safe injection (%) 100 98 80 97 95 87 81 60 80 78 72 78 70 66 40 36 20 34 31 0 Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org 23 Latest! HIV and AIDS Data Hub for Asia-Pacific Proportion of PWID who reported safe injection practice at last injection by gender, 2006-2013 Safe injection (%) 100 85 85 74 80 90 97 74 60 40 27 20 0 Men who inject drugs Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org Women who inject drugs 24 Latest! HIV and AIDS Data Hub for Asia-Pacific Safe injection (%) Proportion of PWID who reported safe injection practice at last injection by age group, 2006-2013 94 100 82 83 98 97 85 73 80 58 60 63 64 50 41 40 28 20 < 25 yr 25 + yr 0 Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org 25 Latest! HIV and AIDS Data Hub for Asia-Pacific 80 68 78 88 93 97 60 40 54 6.3 20 0 Pakistan, Lahore (2005-2011) 100 80 60 40 20 0 45 3.8 Consistent use of sterile injecting equipment * 100 % 80 60 40 20 0 35 30 25 20 15 10 5 0 30.8 43 28 HIV prevalence 97 36 31 28 38 Pakistan (Lahore, Indonesia (2011) 2011) 45 5 Bangladesh (Dhaka, 2011)** 47 14 58 16 6 India (Maharastra, Myanmar (Yangon, Nepal 2009-10) 2013)*** (Kathmandu, 2011) * Duration of consistent use of sterile injecting equipment varies from last week to last 6 months; ** Behavioral data for 2006-07, Never used used-needles and syringes; *** Behavioral data for 2008 Source: Prepared by www.aidsdatahub.org based on National HIV Sentinel Surveillance Reports; Integrated Biological and Behavioral Surveillance Reports HIV prevalence (%) 100 80 60 40 20 0 Safe injection in the past month(%) Nepal, Kathmandu (2002-2011) HIV prevalence (%) Safe injection in the past week(%) Correlation between safe injection practice and HIV prevalence among PWID Latest! HIV and AIDS Data Hub for Asia-Pacific Proportion of PWID engaged in commercial sex in the past 12 months, 2006-2012 Had sex with female sex workers 100 % 80 73 Sold sex 66 55 60 47 45 40 20 1 45 38 38 34 30 27 20 2 23 22 1415 13 10 0 * ever had sex with FSW; **had sex with FSW in the past 6 months 27 Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys HIV and AIDS Data Hub for Asia-Pacific Condom use at last sex (%) Proportion of PWID who reported condom use at last sex, 2006-2013 100 80 78 60 65 63 54 40 52 49 20 0 Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org 47 45 45 46 41 27 23 23 13 Latest! HIV and AIDS Data Hub for Asia-Pacific Condom use at last sex (%) Proportion of PWID reported condom use at last sex by gender, 2006-2013 100 80 60 40 20 48 45 55 30 11 0 * Manipur Men who inject drugs Women who inject drugs Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org and India UNGASS Country Progress Report 2010 40 Latest! HIV and AIDS Data Hub for Asia-Pacific Proportion of PWID reported condom use at last sex by age group, 2006-2013 Condom use at last sex (%) 100 79 77 80 60 40 40 20 56 52 13 17 22 23 43 45 47 45 49 47 47 50 40 25 + yr 25 27 15 13 0 * Manipur Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org and India UNGASS Country Progress Report 2010 < 25 yr Latest! HIV and AIDS Data Hub for Asia-Pacific Consistent condom use (%) Proportion of PWID reported consistent condom use, 2006-2011 in the past 12 months in the past 6 months in the past month 100 80 60 40 20 0 * PWID in community **PWID in rehabilitation centres Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys 31 Vulnerability and HIV knowledge www.aidsdatahub.org HIV and AIDS Data Hub for Asia-Pacific Comprehensive HIV Knowledge (%) Proportion of PWID with comprehensive HIV knowledge, 2006-2012 100 76 80 60 44 40 20 20 23 27 45 49 49 54 57 64 29 0 *Kathmandu Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys; 3) UNAIDS. (2010). Global Report: UNAIDS Report on the Global AIDS Epidemic. HIV expenditure www.aidsdatahub.org Latest! HIV and AIDS Data Hub for Asia-Pacific US$ in Millions HIV prevention spending in Asia and the Pacific – low on HIV prevention among people who inject drugs, latest available year reported by countries, 2009-2012 200 180 160 140 120 100 189 80 60 40 67 20 39 Total prevention spending Prevention spending on key populations Note: China and India do not report prevention spending breakdown Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org Prevention spending on PWID Latest! HIV and AIDS Data Hub for Asia-Pacific Trends in spending on PWID harm reduction programmes out of total prevention spending, countries where HIV prevalence among PWID is more than 10%, 2006-2012 Spending on PWID out of total prevention spending (%) 100% Cambodia Indonesia 67% 57% Malaysia Myanmar 50% Pakistan Philippines 20% 10% 0% 2006 2007 2008 2009 2010 22% 7% 1% 2011 5% Thailand Viet Nam 2012 36 Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org Latest! HIV and AIDS Data Hub for Asia-Pacific Regionally, less than one-fifth of PWID prevention spending comes from domestic public sources Percent distribution of prevention spending on PWID by financing source, 2009-2012 100% 24 80% 60% 100 40% 100 99 97 100 39 100 76 100 International 100 100 100 98 82 61 Domestic 20% 0% Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org 18 37 Latest! HIV and AIDS Data Hub for Asia-Pacific 11% 18% 47% Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org 76% Program Management Others AIDS spending breakdown is not available for China and India Regional Sri Lanka (2010) Bangladesh (2012) Nepal (2009) Lao PDR (2011) Afghanistan (2012) Philippines (2011) Myanmar (2011) 24% Pakistan (2010) Micronesia (2012) Mongolia (2011) Viet Nam (2010) Nauru (2009) Indonesia (2010) 44% 44% 44% 69% Marshall Islands (2012) Care and Treatment Timor Leste (2009) Fiji (2012) Cambodia (2012) PNG (2010) Malaysia (2012) Thailand (2011) Samoa (2011) 36% 36% 29% 30% 31% 34% 21% 25% 26% 58% 51% 52% 53% 56% Solomon Islands (2011) Prevention Tuvalu (2011) DPR Korea (2011) Tonga (2009) 9% 9% 10% 11% 12% 2% 3% 7% Vanuatu (2012) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Kiribati (2012) Percent spending (%) Proportion of AIDS spending by major spending category, Asia and the Pacific, 2009-2012 38 Latest! HIV and AIDS Data Hub for Asia-Pacific Proportion of prevention spending by category, 2009-2012 Papua New Guinea (2010) Philippines (2011) Indonesia (2010) Sri Lanka (2010) Fiji (2012) Viet Nam (2010) Lao PDR (2011) Nepal (2009) Thailand (2011) Afghanistan (2012) Cambodia (2012) Bangladesh (2012) Malaysia (2012) Pakistan (2010) Myanmar (2011) General prevention and others Youth Prevention mother-to-child People who inject drugs Sex workers and their clients Men who have sex with men 0% 20% Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org 40% 60% 80% 100% Note: Data from latest available year. China and India do not report prevention spending breakdown. Latest! HIV and AIDS Data Hub for Asia-Pacific 10,000 8,000 Share of harm reduction spending for PWID in the total prevention spending (%) 100% 8,249 PWID harm reduction spending (US$) 80% 6,000 60% 4,405 4,000 2,295 2,000 21 32 627 2,060 1,661 509 3,813 3,771 40% 2,407 789 - 0% Note: Data from latest available year. China and India do not report prevention spending breakdown. Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org 20% 40 Percent Spending (%) Amount Spent on PWID HIV prevention ( USD,000) Spending on HIV prevention programmes focused on PWID, 2009-2012 National response www.aidsdatahub.org HIV and AIDS Data Hub for Asia-Pacific Number syringes distributed per PWID per year Number of syringes distributed per PWID per year by Needle and Syringe Programmes (NSP), 2013 400 326 300 287 246 200 High coverage: >200 syringes per PWID per year 194 193 147 100 139 131 98 Medium coverage: >100–<200 syringes per PWID per year 92 31 26 Low coverage: <100 syringes 12 0 Source: Prepared by www.aidsdatahub.org based on 1) www.aidsinfoonline.org; and 2) Global AIDS Response Progress Reporting 2014 per PWID per year Latest! HIV and AIDS Data Hub for Asia-Pacific Number of syringes distributed per PWID per year Number of syringes distributed per PWID per year, 2011-2013 400 2011 2012 2013 300 High coverage: >200 syringes per PWID per year 200 139 Medium coverage: >100–<200 syringes per PWID per year 100 Low coverage: <100 syringes per PWID per year 0 43 Source: Prepared by www.aidsdatahub.org based on 1) www.aidsinfoonline.org; and 2) Global AIDS Response Progress Reporting 2014 Latest! HIV and AIDS Data Hub for Asia-Pacific Number of needle and syringe programme (NSP) sites, 2011-2013 Number of NSP sites 5,000 2011 2012 2013 3755 4,000 3,000 2,000 898 1,000 35 0 88 20 728 286 215 1 22 39 35 38 44 Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Report 2014 – Online Country Reports Latest! HIV and AIDS Data Hub for Asia-Pacific Number of people on OST Reported number of people who use drugs received opioid substitution therapy, 2012-2013 250,000 2012 201,730 200,000 2013 150,000 100,000 65,249 50,000 15,542 15,000 0 5,329 4,397 4,068 494 411 252 109 71 45 Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Report 2014 – Online Country Reports Latest! HIV and AIDS Data Hub for Asia-Pacific Number of opioid substitution therapy (OST) sites, 20112013 Number of OST sites 1000 763 800 2011 811 2012 2013 600 400 200 0 147 147 87 1 3 1 80 1 22 6 1 46 Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Report 2014 – Online Country Reports Latest! HIV and AIDS Data Hub for Asia-Pacific Number of NSP and OST sites by country where data is available, 2013 Afghanistan Bangladesh Cambodia China India Indonesia Lao PDR* Malaysia Maldives Mongolia Myanmar Nepal Pakistan Thailand Viet Nam Number of needles/syringes programme sites Number of opioid substitution therapy sites 35 88 20 898 286 215 5 728 0 1 22 39 35 38 3755 1 3 1 763 147 87 8 811 1 0 22 6 1 147 80 *2012 data Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Report 2014 – Online Country Reports 47 Latest! HIV and AIDS Data Hub for Asia-Pacific Testing coverage (%) HIV testing coverage among PWID, countries where data is available, 2006-2013 100 90 80 70 60 50 40 30 20 10 0 78 63 * Programme data 63 44 38 35 27 24 23 21 17 9 6 Data 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. 48 Source: Prepared by www.aidsdatahub.org based on 1. Ministry of Health Indonesia.(2014). Recalculated HIV Testing Coverage presented at the Regional Management Meeting (RMM) 2014 using IBBS 2011 Data; and 2. www.aidsinfoonline.org 5 Latest! HIV and AIDS Data Hub for Asia-Pacific Stalled progress in HIV testing coverage among key populations 100 HIV testing coverage among PWID (regional median trend*) HIV testing coverage (%) 90 80 70 60 50 PWID 40 30 28 28 2012 2013 22 24 20 10 0 2010 2014 * latest available data from UNGASS/ Global AIDS Response Progress 49 Reporting (GARPR) 2010 to 2014 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 among PWID in South Asia Compulsory detention centres for people who use drugs Death penalty for drugrelated offences Afghanistan NO NO INFO Bangladesh NO YES Bhutan NO NO India NO YES Maldives NO NO INFO Nepal NO NO Pakistan NO YES Sri Lanka YES YES Source: Prepared by www.aidsdatahub.org based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014 50 HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response among PWID in South-East Asia Compulsory detention centres for people who use drugs Brunei Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Timor-Leste Viet Nam YES YES YES YES YES YES NO YES YES NO YES Death penalty for drugrelated offences YES NO YES YES YES YES NO YES YES NO YES Source: Prepared by www.aidsdatahub.org based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014 51 HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response among PWID in East Asia Compulsory detention centres for people who use drugs Death penalty for drugrelated offences China YES YES Japan NO NO Mongolia NO NO DRP Korea NO YES Rep of Korea NO YES Source: Prepared by www.aidsdatahub.org based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014 52 HIV and AIDS Data Hub for Asia-Pacific Punitive laws hindering the HIV response among PWID in the Pacific Compulsory detention centres Death penalty for drug-related for people who use drugs offences Fiji Kiribati Marshall Islands FSM* Nauru Palau Papua New Guinea Samoa Solomon Islands Tonga Tuvalu Vanuatu NO NO NO NO NO NO NO NO NO NO NO NO NO INFO NO NO NO NO NO NO INFO NO NO NO NO NO *Federated States of Micronesia Source: Prepared by www.aidsdatahub.org based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014 53 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 54