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CONTENT Data availability and population size estimates HIV prevalence and epidemiology Risk behaviors Vulnerability and HIV knowledge National response

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Page 1: People who inject drugs

www.aidsdatahub.org

HIV and AIDSData Hub for Asia-PacificReview in slides

People who inject drugsLast updated: November 2015

Page 2: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

2

Data availability and population size estimates

HIV prevalence and epidemiology

Risk behaviors

Vulnerability and HIV knowledge

National response

CONTENT

Page 3: People who inject drugs

www.aidsdatahub.org

Data availability and population size estimates

Page 4: People who inject drugs

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 36,000 2015 2015 Male - 4.4 (2012)

2 Australia 215,000 2005 2015 Total- 2.1 (2013)

3 Bangladesh 23,800 2009 2015 Total- 1.1 (2011)

4 Brunei 3,000 – 4,000 2004 Not available

5 Cambodia 1,300 2012 2015 Total- 24.8 (2012)

6 China 2,170,000 2011 2014 Total- 6 (2014)

7 India 177,000 2012 2014 Total- 7.2 (2010-11)

8 Indonesia 74,326 2012 2014 Total- 36.4 (2011)

9 Lao PDR 1,709 2014 2015 Not available

10 Malaysia 170,000 2014 2015 Male- 16.6 (2014)

11 Maldives 400 … 2010 0 (2008)

12 Myanmar 83,000 2014 2015 Total- 23.1 (2014)

13 Nepal 52,174 2012 2014 Male- 6.3 (2011)

14 Pakistan 104,848 2011 2015 Total- 27.2 (2011)

15 Philippines 14,400 (12,304-16,607) 2011 2011* Total- 44.9 (2013)

16 Papua New Guinea 5,000 – 10,000 2004* Not available

17 Singapore 10,000 – 20,000 2004* Total-1.5 (2014)

18 Sri Lanka 423 2013 2015 Total – 0 (2014)

19 Thailand 40,300 2010 2015 Total- 19 (2014)

20 Timor Leste 53 2014 2015 Not available

21 Viet Nam 271,506 2013 2014 Male- 10.5 (2014)

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 to 2015

* Year of source reference

Page 5: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

References: People who inject drugs population size estimates

5

1. Afghanistan Global AIDS Response Progress Reporting 20152. Australia Global AIDS Response Progress Reporting 20153. Bangladesh Global AIDS Response Progress Reporting 2015 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-

23035. Cambodia Global AIDS Response Progress Reporting 2015 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 2015 based on Ministry of Health.(2013). Estimasi Populasi Rawan Tertular HIV di Indonesia Tahun 2012

(In Indonesian Language) 9. Lao PDR Global AIDS Response Progress Reporting 201510. Malaysia Global AIDS Response Progress Reporting 201511. 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 201513. 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 -206914. Pakistan Global AIDS Response Progress Reporting 201515. Philippine National AIDS Council. (2011). Estimates of the Most At-Risk Population and People Living with HIV16. 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-

230317. Ibid.18. Sri Lanka Global AIDS Response Progress Reporting 2015 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 201520. Timor Leste Global AIDS Response Progress Reporting 201521. Viet Nam Global AIDS Response Progress Reporting 2014

Page 6: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Size estimates of PWID as proportion of adult male population (15-49) years

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 annual population based on UN Population Division. (2015). World Population Prospects: The 2015 Revision - Extended Dataset.

Sri Lan

ka

Timor L

este

CambodiaIndia

Banglad

esh

Philippines

Indonesia

Lao PDR

Thailan

d

Pakistan

Maldives

Afghanist

anChina

Myanmar

Nepal

Viet N

am

Malays

ia0

1

2

3

0.01 0.02 0.03 0.05 0.06 0.06 0.1 0.1 0.22 0.230.4 0.45

0.6 0.60.82

1

2

% Regional median 0.2%; Range 0.01% - 2%

Page 7: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Data availability of PWID in HIV sentinel surveillance surveys conducted between 2009 and 2013

7Source: Prepared by www.aidsdatahub.org based on National HIV Sentinel Surveys; Global AIDS Response Progress Reporting; and www.aidsinfoonline.org

Conducted between 2009-2013

Survey report available

Age disaggregated data reported in global ...

Age disaggregated data available from surv...

Gender disaggregated data reported in glob...

Gender disaggregated data available from s...HIV

sen

tinel

sur

veill

ance

sur

veys

0 26

6

5

4

2

4

0

Number of countries assessed

Bangladesh, China, India, Myanmar

Myanmar and Viet Nam

Bangladesh, China, India, and Viet Nam

Bangladesh, India, Myanmar, Thailand, and Viet Nam

Bangladesh, China, India, Myanmar, Thailand, and Viet Nam

Page 8: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Data availability of PWID in behavioral surveys conducted between 2009 and 2013

8

Conducted between 2009-2013

Survey report available

Age disaggregated data reported in glo...

Age disaggregated data available from...

Gender disaggregated data reported in...

Gender disaggregated data available f...Beh

avio

ural

sur

veys

incl

udin

g IB

BS

0 26

11

8

9

2

8

1

Number of countries assessed

Afghanistan, China, Indonesia, Malaysia, Nepal, Pakistan, Philippines, Thailand, Viet Nam

Afghanistan, China, Malaysia, Nepal, Pakistan, Philippines, Thailand, Viet Nam

Afghanistan, Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, Viet Nam

Afghanistan, Cambodia, China, India, Indonesia, Malaysia, Nepal, Pakistan, Philippines, Thailand, Viet Nam

Nepal, 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

Philippines

Page 9: People who inject drugs

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HIV prevalence and epidemiology

Page 10: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

HIV prevalence among people who inject drugs, 2010-2014

Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) www.aidsinfoonline.org

Sri Lanka (

2014)

Banglad

esh (2

011)

Afghanistan

(201

2)

China (201

4)

Nepal

(2011) *

India (201

0-11)

Viet N

am (2

014)

Malaysia

(2014)

Thailand (2

014)

Myanmar

(2014

)

Cambodia

(2012

)

Pakistan

(201

1)

Indonesia (2

011)

Philippines (

2013)

**0

10

20

30

40

50

0 1.14.4 6 6.3 7.2

10.5

16.619

23.1 24.827.2

36.4

44.9

HIV

pre

vale

nce

(%)

* Kathmandu ** Cebu and Mandaue

Page 11: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

HIV prevalence among people who inject drugs by gender, 2010-2014

11Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; and 3) www.aidsinfoonline.org

Bangladesh (2011)

Afghanistan (2012)

China (2014)

Nepal (2011)

India (2010-11)

Viet Nam (2

014)

Malaysia (2014)

Thailand (2

014)

Pakistan* (2011)

Philippines (2

013)0

10

20

30

40

50

1.04.4 6 6.3 7.0

10.516.6

25.2 27.3

47

1.16.2

13.0318

30.4

Men who inject drugs Female who inject drugs

HIV

pre

vale

nce

(%)

* Sample of women who inject drugs < 50

Page 12: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

HIV prevalence among people who inject drugs by age group, 2010-2014

12Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) www.aidsinfoonline.org

Banglad

esh (2

011)

Afghanist

an (201

2)

China (201

4)

India (20

10-11

)

Viet N

am (2

014)

Nepal (2

011)

Malaysia

(201

4)

Pakistan (2

011)

Myanmar

(2014

)

Thailand (2

012)

Indonesia (2

011)

Philippines (

2013

)0

10

20

30

40

50

60

0.7 2.7 3.0 5.3 2.8 1.1

33.9

16.8

25.0

11.6

41.2

<25 yr

HIV

pre

vale

nce

(%)

Page 13: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

HIV prevalence among PWID in geographical locations that are higher than national prevalence, 2010-2014

13Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) HIV Sentinel Surveillance Surveys; 3). Li L, Assanangkornchai S, Duo L, McNeil E, Li J (2014) Risk Behaviors, Prevalence of HIV and Hepatitis C Virus Infection and Population Size of Current Injection Drug Users in a China-Myanmar Border City: Results from a Respondent-Driven Sampling Survey in 2012. PLoS ONE 9(9): e106899. doi:10.1371/journal. pone.0106899

Herat (2

012)

Dhaka (

2011

)

Phnom Penh (2

012)

Ruili City

(201

3)

Punjab (2

010-1

1)

Delhi (2

010-1

1)

Jaka

rta (2

011)

Surabay

a (20

11)

Kelantan

(201

4)

Myitky

ina (20

14)

Yangon (2

014)

Kathman

du (201

1)

Faisala

bad (2

011)

Karach

i (201

1)

Lahore

(2011

)

Cebu (2

013)

Bangko

k (20

12)

Hanoi (2

013)

Can Tho (2

013)

HCMC (201

3)0

10

20

30

40

50

60

15.7

5.3

33.7

18.3 21.1 18.3

56.448.8

35.5 33

6.3

52.5

42.2

30.8

52.3

23.7 24 23.518

Afghanistan Bangladesh Cambodia China India IndonesiaMalaysia Myanmar Nepal Pakistan Philippines ThailandViet Nam

HIV

pre

vale

nce

(%)

Page 14: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

HIV prevalence among PWID in geographical locations where rising HIV prevalence trends are observed, 2005-2013

14Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys; 3) www.aidsinfoonline.org

2005 2006 2007 2008 2009 2010 2011 2012 20130

10

20

30

40

50

60

36.4

56.4

27.2

42.246.1

52.4

Indonesia JakartaPakistan KarachiPhilippines ** Cebu*

HIV

pre

vale

nce

(%)

* male PWID

** 2013 data for Cebu and Mandaue reported as national

Page 15: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 20130

10

20

30

40

50

60

70

56.4

2012.5

52.4

18.54 1824

Indonesia (Jakarta) Myanmar (Lashio) Myanmar (Mandalay) Philippines (Cebu)*Thailand (Bangkok) Viet Nam (HCMC) Viet Nam (Hanoi)

HIV

pre

vale

nce

(%)

Trends in HIV prevalence among PWID in ASEAN states/cities, where data is available, 2003-2013

15Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys

* male PWID

Page 16: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Trends in HIV prevalence among PWID in SAARC states/cities, where data is available, 2002-2012

16Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys; 2) HIV Sentinel Surveillance Surveys

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120

10

20

30

40

50

60

70

15.7

5.3

18.3

6.3

42.2

30.8

Afghanistan (Herat) Bangladesh (Dhaka) India (Delhi)Nepal (Kathmandu) Pakistan (Karachi) Pakistan (Lahore)

HIV

pre

vale

nce

(%)

Page 17: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Hepatitis C and syphilis prevalence among PWID, countries where data is available, 2009-2014

17Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioural Surveys and 2) HIV Sentinel Surveillance Surveys

Afghanistan (H

erat, 2

012)

Afghanistan (K

abul, 2

012)

Banglades

h (Dhak

a, 20

11)

Bangladesh (C

handpur, 201

1)

India (Mah

arashtra

, 200

9-10)

Indonesia

(Medan

, 201

1)

Indonesia

(Jaka

rta, 2

011)

Myanmar

(Yan

gon, 2014

)

Nepal (K

athman

du, 201

1)

Nepal (P

okhara,

2011

)

Philippines

(Cebu, 2

013)

*

Philippines

(Ceb

u, 201

3) **

Philippines

(Man

daue,

2013

)*

Viet N

am (Can

Tho, 200

9)

Viet N

am (Hai

Phong, 200

9)0

20

40

60

80

100

71

2840

6452

88

56

3 6 4 6 8 6 4 110 0 6 13

2 2 2

Hepatitis CSyphilis

Prev

alen

ce (%

)

* male PWID; ** Female PWID

Page 18: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Proportion of HIV transmission through injecting drug use among reported HIV cases, 2011-2015

Source: Prepared by www.aidsdatahub.org based on 1. Country Global AIDS Response Progress Reports 2015; 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. (2015). Philippines HIV/AIDS Registry: July 2015; 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 (2015). Update on the HIV/AIDS Situation in Singapore 2014.; 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. National Centre for AIDS and STD Control, Teku, Kathmandu (2014). Factsheet 2: Reported HIV Cases, as of Asar 2071 (15 July 2014). ; 9. Centre for Health Protection, Department of Health Hong Kong. (2014). Hong Kong STD/AIDS Update, Vol. 19, No.1, Quarter 1 2013

Singapore* (2014)

Sri Lanka** (

2013)

India* (2011-12)

Philippines**(J

uly 2015)

Hong Kong (March 2013)

China* (2014)

Indonesia* (2013)

Nepal ** (July 2014)

Malaysia*(2013)

Vietnam*(2011)0%

20%

40%

60%

80%

100%

Others

Injecting drug use

* New HIV cases

** Cumulative HIV cases

Page 19: People who inject drugs

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Risk behaviours

Page 20: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Average number of injections among people who inject drugs, 2006-2013

20

Pakistan (Larkana, 2011)

Pakistan (Faisalabad, 2011)

Philippines (2

013)*

Bangladesh (Dhaka, 2006-07)

Malaysia (2012)

Bangladesh (Rajshahi, 2

006-07)

Indonesia (Jakarta

, 2011)

Indonesia (Medan, 2011)

Nepal (Kathmandu, 2011)

Nepal (Pokhara, 2011)

02468

10

3 3 3 2 2 2

7 7

3.9 3.6

average injections per day (or) in the last dayaverage injections per week (or) in the last week

Num

ber o

f inj

ectio

ns

Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys;

* Cebu and Mandaue

Page 21: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Average duration of injecting drugs among PWID, 2006-2012

21Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys

0

2

4

6

8

10 98 7

7 6 65 5

43 3 2

Dur

atio

n of

inje

ctin

g dr

ugs

(yea

r)

* weighted years

Page 22: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Proportion of safe injection practices among PWID (regional median trend*)

22Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

2010 2012 2013 2014 20150

20

40

60

80

10084 82 80 79 78

%

* latest available data from UNGASS/ Global AIDS Response Progress Reporting (GARPR) 2010 to 2015

Page 23: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Proportion of PWID who reported safe injection practice at last injection, 2006-2014

23Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Nepal (2

011)

Viet N

am (2014

)

Malays

ia (20

14)

India (20

09) *

Indonesia

(2011

)

Myanmar (2

014)

Thailand (2

014)

Afghanist

an (201

2)

China (201

4)

Maldives

(200

8)

Pakistan (2

011)

Sri Lan

ka (20

14)

Banglad

esh (2

006-07

)

Philippines (

2013

)

Cambodia (2

012)

Regional

median

0

20

40

60

80

10095 95 93

87 87 86 8578 78

7266

4636 33 29

78

Safe

inje

ctio

n (%

)

*Manipur

Page 24: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

24

Proportion of PWID who reported safe injection practice at last injection by gender, 2006-2014

Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Bangladesh (2006-07)

Philippines (2

013)

Pakistan (2011)

China (2014)

Afghanistan (2012)

India (2009)*

Thailand (2

014)

Malaysia (2014)

Viet Nam (2

014)

Nepal (2011)

0

20

40

60

80

100

74

27

85 7990

Men who inject drugs

Safe

inje

ctio

n (%

)

*Manipur

Page 25: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

25

Proportion of PWID who reported safe injection practice at last injection by age group, 2006-2014

Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Philippines (

2013

)

Banglades

h (2006

-07)

Pakistan (2

011)

China (201

4)

Afghanist

an (201

2)

Myanmar (2

014)

India (200

9)*

Indonesia (2

011)

Thailand (2

014)

Malays

ia (20

14)

Nepal (2

011)

Viet N

am (2

014)

0

20

40

60

80

100

36 41

63 65 64

87 85 8296 97 94

< 25 yr 25 + yr

Safe

inje

ctio

n (%

)

*Manipur

Page 26: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Pakistan (Lahore, 2011)

Indonesia (2011) Bangladesh (Dhaka, 2011)**

India (Maharastra, 2009-10)

Myanmar (Yangon, 2013)***

Nepal (Kathmandu,

2011)

0

40

80

28 38 45 47 58

9731 36

5 14 16 6

Consistent use of sterile injecting equipment * HIV prevalence%

2005 2006-07

2008 2009 2010 20110

20406080

100

010203040

45 4327.53.8

30.8

Pakistan, Lahore (2005-2011)

Safe

inje

ctio

n in

the

past

mon

th(%

)

HIV

pre

vale

nce

(%)

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

020406080

100

020406080

54.178.3 88.1 93.1 97.468

6.3

Nepal, Kathmandu (2002-2011)

Safe

inje

ctio

n in

the

past

wee

k(%

)

HIV

pre

vale

nce

(%)

Correlation between safe injection practice and HIV prevalence among PWID

* 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

Page 27: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Proportion of PWID engaged in commercial sex in the past 12 months, 2006-2013

27Source: Prepared by www.aidsdatahub.org based on 1) Integrated Biological and Behavioral Surveys; 2) Behavioral Surveillance Surveys

Afghanistan* (H

erat, 2

012)

Bangladesh

(Dhaka

, 2006-

07)

Pakista

n** (Turbat,

2011)

Bangladesh

(Rajs

hahi, 2006

-07)

Viet Nam

(Da N

ang, 2009)

Afghanistan* (M

azar-i-

Sharif, 2

012)

Viet Nam

(Hanoi, 2

009)

Nepal (Pokhara

, 2011)

India (Mahara

shtra, 20

09-10)

Pakista

n** (Kara

chi, 2011

)

Nepal (Kath

mandu, 2011)

Malaysi

a (201

2)

Pakista

n** (201

1)

Philippines

(Cebu, 2013)

Philippines

(Mandaue, 2

013)

0

20

40

60

80

100

7366

5547 45 45

38 38 34 30 2720

14 10 121 2

15 10 7

Had sex with female sex workers

Sold sex

%

* ever had sex with FSW **had sex with FSW in the past 6 months

Page 28: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Proportion of PWID who reported condom use at last sex, 2006-2014

Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Cambodia(20

12)

India (20

13)

Viet N

am(20

14)

Bhutan(2008

)

Indonesia(

2011)

Thailand(20

14)

Nepal(201

1)

Banglad

esh(200

6-07)

China(2014

)

Sri Lan

ka (20

14)

Afghanist

an(2012

)

Myanmar(2

014)

Pakistan(20

11)

Malays

ia(201

4)

Philippines(2

013)

Regional

median0

20

40

60

80

100

65 63 59 54 52 47 47 45 45

26 23 23 23 2113

45

%

Page 29: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Proportion of PWID reported condom use at last sex by gender, 2006-2014

Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org and India UNGASS Country Progress Report 2010

Philippines (2

013)

India * (2009)

Malaysia (2014)

Pakistan (2011)

Sri Lanka (2

014)

China (2014)

Bangladesh (2006-07)

Thailand (2

014)

Nepal (2011)

Viet Nam (2

014)

Myanmar (2008)

0

20

40

60

80

100

11

45 4655

Men who inject drugs Women who inject drugs

Con

dom

use

at l

ast s

ex (%

)

* Manipur

Page 30: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Proportion of PWID reported condom use at last sex by age group, 2006-2014

Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org and India UNGASS Country Progress Report 2010

India* (2009)

Philippines (2013)

Pakistan (2011)

Myanmar (2014)

Malaysia (2014)

Nepal (2011)

Bangladesh (2006-07)

China (2014)

Thailand (2014)

Indonesia (2011)

Viet Nam (2014)

0

20

40

60

80

100

13 1522 22

3040 43

53 5666

< 25 yr

25 + yr

Con

dom

use

at l

ast s

ex (%

)

* Manipur

Page 31: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Proportion of PWID reported consistent condom use, 2006-2011

31

0

20

40

60

80

100in the past 12 months in the past 6 months in the past month

Con

sist

ent c

ondo

m u

se (%

)

* 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

Page 32: People who inject drugs

www.aidsdatahub.org

Vulnerability and HIV knowledge

Page 33: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Proportion of PWID with comprehensive HIV knowledge, 2006-2012

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.

0

20

40

60

80

100

20 23 27 2944 45 49 49 54 57

6476

Com

preh

ensi

ve H

IV K

now

ledg

e (%

)

*Kathmandu

Page 34: People who inject drugs

www.aidsdatahub.org

HIV expenditure

Page 35: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

HIV prevention spending in Asia and the Pacific – low on HIV prevention among people who inject drugs, latest available year reported by countries, 2009-2013

Note: China and India did not report prevention spending breakdown

Total prevention spending

Prevention spending on key populations

Prevention spending on PWID

-

50,000,000

100,000,000

150,000,000

200,000,000

250,000,000

197,599,340

64,274,57027,893,182

Page 36: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Trends in spending on PWID harm reduction programmes out of total prevention spending, countries where HIV prevalence among PWID is more than 10%, 2006-2013

36Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

2006 2007 2008 2009 2010 2011 2012 20130%

50%

100%

5%

0.45

22%

0.52

10%3%

25%

Cambodia

Indonesia

Malaysia

Myanmar

Pakistan

Philippines

Thailand

Viet Nam

Spen

ding

on

PWID

out

of t

otal

pr

even

tion

spen

ding

(%)

Page 37: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Regionally, less than one-fifth of PWID prevention spending comes from domestic public sources

37Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Afghanist

an (2

013)

Bangladesh (2

013)

Cambodia (20

12)

Indonesia

(2012

)

Lao PDR (2

011)

Malays

ia (201

3)

Myanmar

(2011)

Nepal

(2009)

Pakist

an (2

013)

Philippines

(201

3)

Sri Lan

ka (2

010)

Thailand (2

013)

Viet N

am (2

012)

Regional0%

20%

40%

60%

80%

100%

100 100 99

7

100

23

100 10072

9570

9481

19

Percent distribution of prevention spending on PWID by financing source, 2009-2013

InternationalDomestic

Page 38: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Proportion of AIDS spending by major spending category, Asia and the Pacific, 2009-2013

38Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

AIDS spending breakdown is not available for China and India

Pala

u (2

013)

Tong

a (2

009)

DPR

Kore

a (2

011)

Papu

a Ne

w G

uine

a (2

012)

Mal

aysi

a (2

013)

Thai

land

(201

3)

Tim

or-L

este

(200

9)

Kirib

ati (

2012

)

Cam

bodi

a (2

012)

Indo

nesi

a (2

012)

Viet

Nam

(201

2)

Tuva

lu (2

013)

Naur

u (2

009)

Mon

golia

(201

1)

Phili

ppin

es (2

013)

Mya

nmar

(201

1)

Bang

lade

sh (2

013)

Mic

rone

sia

(201

3)

Lao

PDR

(201

1)

Nepa

l (20

09)

Solo

mon

Isla

nds

(201

1)

Mar

shal

l Isl

ands

(201

2)

Paki

stan

(201

3)

Sam

oa (2

013)

Vanu

atu

(201

3)

Afgh

anis

tan

(201

3)

Sri L

anka

(201

0)

Regi

onal

0%

20%

40%

60%

80%

100%

26

45

17

12

Prevention Care and treatment Programme management Others

Perc

ent S

pend

ing

(%)

Page 39: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Proportion of prevention spending by category, 2009-2013

Note: Data from latest available year. China and India did not report prevention spending breakdown.

Myanmar (2011)Afghanistan (2013)Bangladesh (2013)

Pakistan (2013)Malaysia (2013)

Cambodia (2012)Palau (2013)Nepal (2009)

Lao PDR (2011)Viet Nam (2012)Sri Lanka (2010)Thailand (2013)

Marshall Islands (2012)Philippines (2013)

Indonesia (2012)Solomon Islands (2011)

Samoa (2013)Timor-Leste (2009)

0% 20% 40% 60% 80% 100%

Youth

Prevention mother-to-child

General prevention and others

Sex workers and their clients

People who inject drugs

Men who have sex with men

Page 40: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Spending on HIV prevention programmes focused on PWID, 2009-2013

40Source: Prepared by www.aidsdatahub.org based on www.aidsinfoonline.org

Note: Data from latest available year. China and India do not report prevention spending breakdown.

Sri Lan

ka (20

10)

Indonesia (2

012)

Thailand (2

013)

Cambodia (2

012)

Lao PDR (2

011)

Philippines (

2013

)

Nepal (2

009)

Banglad

esh (2

013)

Myanmar (2

011)

Viet N

am (2012

)

Malays

ia (20

13)

Pakistan (2

013)

Afghanist

an (201

3)0

2000000

4000000

6000000

8000000

10000000

0%

20%

40%

60%

80%

100%

31,948361,8361,250,551

626,957508,952445,5741,660,9382,199,191

4,404,891

6,752,371

4,381,9983,084,691

2,183,284

Share of harm reduction spending for PWID in total prevention spending (%)

PWID harm reduction spending (US $)

Am

ount

Spe

ndin

g (in

thou

sand

s)

Perc

ent s

pend

ing

(%)

Page 41: People who inject drugs

www.aidsdatahub.org

National response

Page 42: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Number of syringes distributed per PWID per year by Needle and Syringe Programmes (NSP), 2014

Medium coverage: >100–<200

syringes per PWID per year

Low coverage: <100 syringes

per PWID per year

High coverage: >200 syringes

per PWID per year

Source: Prepared by www.aidsdatahub.org based on 1) www.aidsinfoonline.org; and 2) Global AIDS Response Progress Reporting 2015

Cambodia

India

Banglad

eshChina

Pakistan

Myanmar

Afghanist

an

Viet N

am

Indonesia

Nepal

Malaysia

Thailand

Regional

median

0

100

200

300

124

Num

ber s

yrin

ges

dist

ribut

ed p

er

PWID

per

yea

r

Page 43: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Medium coverage: >100–<200

syringes per PWID per year

Low coverage: <100 syringes

per PWID per year

High coverage: >200 syringes

per PWID per year

Afghanist

an

Banglad

esh

Cambodia

ChinaIndia

Indonesia

Lao PDR

Malays

ia

Myanmar

Nepal

Pakistan

Philippines

Thailand

Viet N

am

Regional med

ian0

100

200

300

400

124

2012 2013 2014

Num

ber o

f syr

inge

s di

strib

uted

pe

r PW

ID p

er y

ear

Number of syringes distributed per PWID per year, 2012-2014

43Source: Prepared by www.aidsdatahub.org based on 1) www.aidsinfoonline.org; and 2) Global AIDS Response Progress Reporting 2015

Page 44: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Number of needle and syringe programme (NSP) sites, 2011-2014

44Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Reporting 2015

Afghanist

an

Banglad

esh

CambodiaChina

India

Indonesia

Lao PDR

Malays

ia

Mongolia

Myanmar

Nepal

Pakistan

Thailand

Viet N

am*

0

1000

2000

3000

4000

5000

27 88 5

814401 232

692

51 60 14 425 1

37552011 2012 2013 2014

Num

ber o

f NSP

site

s

* reported 230 districts have NSP sites in 2014 but data not available for the number of NSP sites

Page 45: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Reported number of people who use drugs received opioid substitution therapy, 2012-2014

45

China

Malays

ia

Viet N

am India

Myanmar

Thailan

d

Indonesia*

Nepal

Banglad

esh

Cambodia

Afghanist

an

Maldives

0

50000

100000

150000

200000

250000

184,199

74,816

25,223 18,000 7,872 3,646 2,529 640 487 130 71 26

2012

2013

2014

Num

ber o

f peo

ple

on O

ST

Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Reporting 2015

* only number people on methadone is reported in 2014. 2012 and 2013 reported numbers includes number of people on methadone and estimate people on buprenorphine.

Page 46: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Number of opioid substitution therapy (OST) sites, 2011-2014

46

Afghanist

an

Banglades

h

CambodiaChina

India

Indonesia

Lao PDR

Malays

ia

Maldives

Myanmar

Nepal

Pakistan

Thailand

Viet N

am0

200

400

600

800

1000

1 4 1

767

17890

838

1 35 15

140 134

2011 2012 2013 2014

Num

ber o

f OST

site

s

Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Reporting 2015

Page 47: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Number of NSP and OST sites by country where data is available, 2014

47

 

Number of needles/syringes programme sites

Number of opioid substitution therapy sites

Afghanistan 27 1 Bangladesh 88 4 Cambodia 5 1 China 814 767 India 401 178 Indonesia 232 90 Lao PDR  5*  8* Malaysia 629 838 Maldives 0 1 Mongolia  1** 0 Myanmar 51 35 Nepal 60 15 Pakistan 14  1* Thailand 42 140 Viet Nam  230*** 134

*2012 data; **2013 data; ***reported number of districts that have NSP sites in 2014 but data not available for the number of NSP sites

Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Reporting 2015

Page 48: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

HIV testing coverage among PWID, countries where data is available, 2006-2014

48Source: Prepared by www.aidsdatahub.org based on Ministry of Health Indonesia.(2014). Recalculated HIV Testing Coverage presented at the Regional Management Meeting (RMM) 2014 using IBBS 2011 Data; Global AIDS Response Progress Reporting 2015; and www.aidsinfoonline.org

* Programme data

Note: 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.

India (20

14)*

Indonesia (2

011)

Thailand (2

014)

China (201

4)

Malaysia

(201

4)

Bhutan (2

008)

Viet N

am (2

014)

Afghanist

an (201

2)

Myanmar

(2014

)

Nepal (201

1)

Maldives (

2008

)

Cambodia (2

014)*

Pakistan

(201

1)

Sri Lan

ka (20

14)

Philippines (

2013

)

Banglad

esh (2

006-07

)0

20

40

60

80

100

68 63 61

41 3828 28 23 22 21 17 15 9 8 7 5

HIV

test

ing

cove

rage

(%)

Page 49: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Latest!

Stalled progress in HIV testing coverage among key populations

49

2010 2012 2013 2014 20150

20

40

60

80

100

2228 28 24 22.35

HIV

test

ing

cove

rage

(%)

Note: regional median testing coverage is calculated using latest available data from UNGASS and GARPR 2010 to 2015 reporting rounds

HIV testing coverage among PWID (regional median)

Source: Prepared by www.aidsdatahub.org based on Global AIDS Response Progress Reporting 2015; and www.aidsinfoonline.org

Page 50: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Punitive laws hindering the HIV response among PWID in South Asia

50

Compulsory detention centres for people who use

drugs

Death penalty for drug-related 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

Page 51: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Punitive laws hindering the HIV response among PWID in South-East Asia

51

  Compulsory detention centres for people who use

drugs

Death penalty for drug-related offences

Brunei YES   YES   Cambodia YES   NO   Indonesia YES   YES   Lao PDR YES   YES   Malaysia YES   YES   Myanmar YES   YES   Philippines NO   NO   Singapore YES   YES   Thailand YES   YES   Timor-Leste NO   NO   Viet Nam 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

Page 52: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Punitive laws hindering the HIV response among PWID in East Asia

52

  Compulsory detention centres for people who use

drugs

Death penalty for drug-related 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

Page 53: People who inject drugs

HIV and AIDS Data Hub for Asia-Pacific

Punitive laws hindering the HIV response among PWID in the Pacific

53

  Compulsory detention centres for people who use drugs

Death penalty for drug-related offences

Fiji NO   NO INFO   Kiribati NO   NO   Marshall Islands NO   NO   FSM* NO   NO   Nauru NO   NO   Palau NO   NO   Papua New Guinea NO   NO INFO   Samoa NO   NO   Solomon Islands NO   NO   Tonga NO   NO   Tuvalu NO   NO   Vanuatu NO   NO  

*Federated States of MicronesiaSource: 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

Page 54: People who inject drugs

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54

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