Transcript PLHIV

HIV and AIDS
Data Hub for Asia-Pacific
Review in slides
People living with HIV
(PLHIV)
Last updated: December 2014
www.aidsdatahub.org
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HIV and AIDS
Data Hub for Asia-Pacific
State of the epidemic: Global and Asia and the Pacific, 2013
Global
People living with HIV
Women living with HIV
Children living with HIV
New HIV infections
Adult HIV prevalence
AIDS-related deaths
Asia and the Pacific
35 million
4.8 million
[33.2 million – 37.2 million]
[4.1 million – 5.5 million]
16 million
1.7 million
[15.2 million – 16.9 million]
[1.4 million – 1.9 million]
3.2 million
210,000
[2.9 million – 3.5 million]
[190,000 – 270,000]
2.1 million
350,000
[1.9 million – 2.4 million]
[250,000 – 510,000]
0.8 %
0.2 %
[0.7% – 0.8%]
[0.2% – 0.2%]
1.5 million
250,000
[1.4 million – 1.7 million]
[210,000 – 290,000]
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report
HIV and AIDS
Data Hub for Asia-Pacific
Death (%)
Disease burden: Asia and the Pacific, and Sub-Saharan
Africa
Source: http://www.healthmetricsandevaluation.org
HIV and AIDS
Data Hub for Asia-Pacific
Number
Regional overview of trends in HIV infections and AIDSrelated deaths
2013 “zoom-in”
HIV and AIDS in Asia and the Pacific 1990-2013
People living with HIV
4.8 million
6,000,000
New HIV
infections
350,000
5,000,000
4,000,000
Young
people
living with
HIV
610,000
3,000,000
2,000,000
1,000,000
Women living with HIV
1.7 million
0
People living with HIV
Young people living with HIV
New HIV infections
Women living with HIV
Children living with HIV
AIDS-related deaths
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
Children living with HIV
210,000
Deaths
250,000
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HIV and AIDS
Data Hub for Asia-Pacific
Estimated number of adults and women living with HIV
in Asia and the Pacific region, 1990-2013
Number (Estimate)
6,000,000
5,000,000
4,600,000
4,000,000
3,000,000
2,000,000
1,700,000
1,000,000
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
0
Adults living with HIV [Estimate]
Women living with HIV [Estimate]
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report
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HIV and AIDS
Data Hub for Asia-Pacific
Number (Estimate)
Estimated number of children living with HIV and new HIV
infections among children in Asia and the Pacific region,
1990-2013
300,000
250,000
210,000
200,000
150,000
100,000
50,000
22,000
Children (0-14) years living with HIV
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
0
New Infections among children (0-14) years
6
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report
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HIV and AIDS
Data Hub for Asia-Pacific
Estimated number of young people (15-24) living with
HIV in Asia and the Pacific region, 1990-2013
800,000
Number (Estimate)
700,000
600,000
500,000
400,000
320,000
290,000
300,000
200,000
100,000
Young male (15-24) living with HIV
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
0
Young female (15-24) living with HIV
7
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report
HIV and AIDS
Data Hub for Asia-Pacific
HIV estimates among high HIV burden countries, 2013
New HIV infections
Estimate
People living with HIV
Low estimate High estimate
Estimate
Low estimate High estimate
India*
130,000
80,000
250,000
2,100,000
1,700,000
2,700,000
Indonesia
80,000
49,000
170,000
640,000
420,000
1,000,000
China*
48,000
41,000
54,000
780,000
620,000
940,000
Viet Nam
14,000
11,000
21,000
250,000
230,000
280,000
Pakistan
14,000
7,000
33,000
68,000
41,000
130,000
Thailand
8,200
4,100
17,000
440,000
400,000
470,000
Malaysia
8,000
5,500
12,000
86,000
66,000
120,000
Myanmar
6,700
5,300
8,400
190,000
170,000
220,000
Philippines
3,400
2,300
5,300
22,000
16,000
32,000
PNG
2,200
1,600
2,900
32,000
29,000
35,000
Cambodia
1,300
<1,000
3,000
75,000
41,000
130,000
Nepal
1,300
<1,000
2,400
39,000
31,000
52,000
* 2011 estimates
Source: Prepared by www.aidsdatahub.org based on UNAIDS Estimates 2013; Philippines HIV Estimations and Projections 2014 (Unpublished document);
and http://www.unaids.org.cn/en/index/page.asp?id=197&class=2&classname=China+Epidemic+%26+Response
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Data Hub for Asia-Pacific
New HIV infections have declined significantly since 2001,
but remain largely unchanged in past 5 years
New HIV infections (Number)
Estimated new HIV infections in Asia and the Pacific, 2001-2013
500,000
30% decline
400,000
350,000
300,000
200,000
New HIV infections
100,000
0
2001
2005
2009
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
2013
HIV and AIDS
Data Hub for Asia-Pacific
Half of all new infections among MSM by 2020 if ‘business
as usual’- Commission on AIDS in Asia
New HIV infections in year
Estimated annual new HIV infections by population group, Asian Epidemic Model
MSM
1,200,000
1,000,000
800,000
600,000
400,000
200,000
0
1985
1990
1995
2000
2005
Source: Commission on AIDS in Asia. (2008). Redefining Aids in Asia: Crafting an Effective Response.
2010
2015
2020
Treatment
www.aidsdatahub.org
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HIV and AIDS
Data Hub for Asia-Pacific
HIV testing is the entry point for treatment, but only around
1/3 of key populations know their HIV status
HIV testing coverage among key populations, regional median, 2007-2013
HIV testing coverage (%)
100
80
60
40
35
34
40
24
20
0
Female sex
workers
Men who have sex Male sex workers
with men
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
People who inject
drugs
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HIV and AIDS
Data Hub for Asia-Pacific
Access to treatment in Asia and the Pacific region
continues to grow: 1.63 million people living with HIV in the
region are receiving HIV treatment
People receiving antiretroviral therapy in Asia and the Pacific, 2003 – June 2014
Number of people receiving ART
2,300,000
Number of people receiving ART
Estimated 1.63 million
as of June 2014
25% increase
between 2012 and 2013
13% increase
between 2011 and 2012
0
Source: Prepared by www.aidsdatahub.org based on 1)UNAIDS. (2013). Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.; 2) www.aidsinfoonline.org; and
3) UNAIDS.(2014). The Gap Report.
HIV and AIDS
Data Hub for Asia-Pacific
Number of people receiving antiretroviral therapy by
sub-region, 2004-2013
1,560,000
Number of people on ART
Ocenia
East Asia
South-East Asia
South Asia
Note: Estimated
1.63 million people
are receiving ART
as of June 2014
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Source: Prepared by www.aidsdatahub.org based on 1)UNAIDS. (2013). Global Report: UNAIDS Report on the Global AIDS Epidemic 2013.; 2) www.aidsinfoonline.org;
and 3) UNAIDS.(2014). The Gap Report.
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HIV and AIDS
Data Hub for Asia-Pacific
Recent trends of ART coverage in global, and Asia and
the Pacific, 2011-2013
100%
90%
2011
2012
2013
50%
37%
33%
25%
27%
26%
31%
0%
Asia and the Pacific
Global
Note: ART coverage (%) represents the proportion of people receiving ART out of the total number of people living with HIV
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
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Data Hub for Asia-Pacific
Treatment saves lives: AIDS-related deaths are declining
in Asia and the Pacific
People on ART
1,560,000
1.56
million
9x
increase
since 2005
AIDS-related deaths, Asia and the Pacific, 2001-2013
AIDS-related deaths (Number)
People receiving ART
400,000
27% decline
since 2005
200,000
AIDS-related deaths [Estimate]
0
0
2005
2013
2001
Note: Estimated 1.63 million people are receiving ART as of June 2014
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
2005
2009
2013
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HIV and AIDS
Data Hub for Asia-Pacific
Proportion of people living with HIV and people who are
receiving ART in 10 high HIV burden countries in Asia
and the Pacific, 2013
100%
India
90%
Indonesia
80%
Thailand
70%
Viet Nam
60%
Myanmar
50%
Malaysia
40%
Cambodia
30%
20%
Pakistan
10%
Nepal
Papua New Guinea
0%
People living with HIV
(2013)
People on ART (2013)
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
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HIV and AIDS
Data Hub for Asia-Pacific
Treatment is expanding in the region, but still only 1 in 3
PLHIV are on ART and most start late
Regional median CD4 at ART initiation
500
CD4 cells/mm3
100%
80%
500
400
350
CD4 cells/mm3
60%
300
40%
67
20%
200
57
46 45
36 35 33 32
0%
23 20 20 19 18
14 11
6
100
33
5
185
0
CD4 count at ART initiation
ART coverage among countries in Asia and the Pacific, 2013
Regional
median CD4
at ART
initiation
Treatment gap
ART coverage
Note: ART coverage data is not available for China, Indonesia and Philippines
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report, www.aidsinfoonline.org , and information provided by
UNAIDS country offices for UNAIDS regional management meeting (RMM) 2014
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HIV and AIDS
Data Hub for Asia-Pacific
Trends in antiretroviral therapy coverage 2011-2013
100
ART coverage (%)
90
67
57
46
45
36
35
33
32
23
20
20
19
18
14
11
6
5
0
2011
2012
2013
ART coverage (%) =
Number of people receiving ARVs
Total number of people living with HIV
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
X 100
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HIV and AIDS
Data Hub for Asia-Pacific
Proportion of children (0-14 year) living with HIV
receiving antiretroviral therapy, 2011-2013
100
ART coverage (%)
90
50
22
28
32
2012
2013
0
2011
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
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HIV and AIDS
Data Hub for Asia-Pacific
ART coverage and treatment gap among children (0-14yr)
living with HIV, Asia and the Pacific, 2013
100%
80%
60%
40%
20%
85
78
Treatment gap
68
62
ART coverage (%)
43
35
34
30
0%
Source: Prepared by www.aidsdatahub.org based on UNAIDS. (2014). The Gap Report.
21
20
32
7
4
21
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HIV and AIDS
Data Hub for Asia-Pacific
Proportion of 12 months retention on antiretroviral therapy,
2013
100%
80%
Drop out
60%
96
40%
95
95
93
86
85
12 months retention
on ART
85
84
84
83
77
70
20%
0%
Source: Prepared by www.aidsdatahub.org based on 1) Global AIDS Response Progress Reporting 2014 and country narrative reports; 2) www.aidsinfoonline.org;
Treatment: PMTCT
www.aidsdatahub.org
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HIV and AIDS
Data Hub for Asia-Pacific
Mother-to-child transmission rates in women with low
CD4 counts, during pregnancy, labour and breastfeeding
Mother-to-child transmission rate (%)
Maternal CD4 count (cells/ul)
0
>500
10
20
30
40
50
3.9 4.5 1.9
during pregnancy
350-500
3.5 2.3
7.4
during delivery
200-350
7.6
<200
7.6
7.3
13.3
15.5
through breastfeeding
20.8
Source: Prepared by www.aidsdatahub.org based on Kuhn,L., et al., 'Potential Impact of New WHO Criteria for Antiretroviral Treatment for Prevention 24
of
Mother-to-Child HIV Transmission'. AIDS, vol. 24, no.9, 1 June 2010, pp. 1374-1377 cited in UNICEF (2010). Children and AIDS: Fifth Stocktaking Report.
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HIV and AIDS
Data Hub for Asia-Pacific
Region lags behind the global average in
eliminating new HIV infections among children
Elimination of mother-to-child transmission in Asia and the Pacific, 2011-2013
PMTCT coverage (%)
100
Global average 67%
50
30%
18%
19%
2011
2012
0
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
2013
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HIV and AIDS
Data Hub for Asia-Pacific
PMTCT coverage with effective ARV regimen, global and
Asia and the Pacific, 2013
PMTCT coverage (%)
100
>95
86
79
72
67
65
41
0
36
27
18
30
13
PMTCT coverage data is not available for China
Source: Prepared by www.aidsdatahub.org based on UNAIDS 2013 Estimates for UNAIDS. (2014). The Gap Report.
9
9
2
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HIV and AIDS
Data Hub for Asia-Pacific
Infants born to HIV+ women receiving a virological test
for HIV within 2 months of birth, 2013
100 %
80
60
95
40
79
78
68
20
40
0
23
6
5
4
3
2
2
1
27
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
TB-HIV Co-treatment
www.aidsdatahub.org
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Data Hub for Asia-Pacific
Estimated HIV in new TB cases (%)
Estimated HIV in new TB cases, Asia and the Pacific, 2013
20
16
12
8
15
11
4
0
9.2 8.8
7.2 6.7
5.7
3.9 3.6 3.2
2.6 2.6 2.2 1.5 0.5 0.5 0.4 0.3 0.2 0.2 0.1 0.1 0.1 0.1 0.1 0.1
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
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HIV and AIDS
Data Hub for Asia-Pacific
TB patients tested for HIV (number)
Trends in number of TB patient tested for HIV in Asia
and the Pacific, 2006-2013
1,200,000
1,130,803
South and South-East Asia
1,000,000
East Asia
800,000
Ocenia
600,000
400,000
335,014
200,000
0
2006
2007
2008
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
2009
2010
2011
2012
7,817
2013
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HIV and AIDS
Data Hub for Asia-Pacific
Number
Scaling-up HIV and TB co-infection screening in Asia
and the Pacific, 2004-2013
2,000,000
PLHIV screened for TB
1,519,853
1,500,000
1,473,634
TB patients tested for HIV
1,000,000
500,000
2004
2005
2006
2007
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
2008
2009
2010
2011
2012
2013
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HIV and AIDS
Data Hub for Asia-Pacific
Scaling-up HIV and TB co-infection screening in Asia
and the Pacific, 2009-2013
0%
50%
100%
0%
50%
100%
PLHIV
screened for TB
TB patients
tested for HIV
2009
2010
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
2011
2012
2013
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HIV and AIDS
Data Hub for Asia-Pacific
Estimated HIV+ incident TB cases that received treatment
for TB and HIV, 2010-2013
100 %
80
60
40
24
20
17
22
23
0
2010
2011
2012
2013
TB-HIV co-treatment (regional median)
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
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HIV and AIDS
Data Hub for Asia-Pacific
Estimated HIV+ incident TB cases that received treatment
for TB and HIV, 2013
100 %
80
60
40
23
20
0
Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org
Women living with HIV and
reproductive health rights
www.aidsdatahub.org
HIV and AIDS
Data Hub for Asia-Pacific
Proportion of women living with HIV who had a desire to
have children reported being coerced to undergo
sterilization, 2012-2013
35%
30%
25%
20%
33%
15%
22%
10%
5%
11%
11%
Indonesia
(2012-2013)
Philippines
(2012-2013)
5%
0%
Lao PDR
(2013)
Pakistan
(2012-2013)
Nepal
(2012-2013)
36
Source: Prepared by www.aidsdatahub.org based on http://apnmata.org/country-profiles/
HIV and AIDS
Data Hub for Asia-Pacific
Proportion of surveyed HIV-positive pregnant women
who were asked to undergo sterilization, 2011
50%
40%
30%
20%
10%
35%
15%
15%
18%
Nepal
Bangladesh
Viet Nam
39%
40%
India
Indonesia
0%
Cambodia
Source: Prepared by www.aidsdatahub.org based on Women of the Asia Pacific Network of People Living with HIV. (2012). Positive and pregnant, How dare you. A study on access to
reproductive and maternal health care for women living with HIV in Asia
37
HIV and AIDS
Data Hub for Asia-Pacific
Number of HIV-positive pregnant women who were asked
to undergo sterilization and had the option to decline, 2011
Number of HIV-positive
pregnant women
80
70
70
67
60
50
40
34
39
44
39
36
25
30
20
10
Asked to undergo
sterilisation
5
2
6
1
Had the option to
decline
0
Source: Prepared by www.aidsdatahub.org based on Women of the Asia Pacific Network of People Living with HIV. (2012). Positive and pregnant, How dare you. A study on access to
reproductive and maternal health care for women living with HIV in Asia
38
Punitive laws hindering
the HIV response among
PLHIV
www.aidsdatahub.org
Latest!
HIV and AIDS
Data Hub for Asia-Pacific
Punitive laws hindering the HIV response among PLHIV
in South Asia
Restriction on entry, stay,
Laws that specifically
and residence based on HIV criminalize HIV transmission
status
or exposure
Afghanistan
NO
YES
Bangladesh
NO
NO
Bhutan
NO
NO
India
NO
NO
Maldives
NO
NO INFO
Nepal
NO
NO INFO
Pakistan
NO
NO INFO
Sri Lanka
NO
NO
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
40
Latest!
HIV and AIDS
Data Hub for Asia-Pacific
Punitive laws hindering the HIV response among PLHIV
in South-East Asia
Restriction on entry, stay,
Laws that specifically
and residence based on
criminalize HIV
HIV status
transmission or exposure
Brunei
Cambodia
Indonesia
Lao PDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
Viet Nam
YES
NO
NO
NO
YES
NO
NO
YES
NO
NO INFO
NO
YES
YES
NO
YES
NO
NO
NO
YES
NO INFO
NO INFO
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
41
Latest!
HIV and AIDS
Data Hub for Asia-Pacific
Punitive laws hindering the HIV response among PLHIV
in East Asia
Restriction on entry, stay,
Laws that specifically
and residence based on HIV criminalize HIV transmission
status
or exposure
China
NO
CONTRADICTORY INFO
Japan
NO
NO INFO
Mongolia
NO
YES
DRP Korea
YES
NO INFO
Rep of Korea
NO
NO INFO
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
42
Latest!
HIV and AIDS
Data Hub for Asia-Pacific
Punitive laws hindering the HIV response among PLHIV
in the Pacific
Restriction on entry, stay,
and residence based on
HIV status
Fiji
Kiribati
Marshall Islands
FSM*
Nauru
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
NO
NO
YES
NO
NO INFO
NO INFO
YES
YES
YES
YES
NO INFO
NO
Laws that specifically
criminalize HIV
transmission or exposure
NO
NO
YES
YES
NO
NO
YES
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
43
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
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