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HIV/AIDS Activities by CountryBangladeshAll of the known HIV risk behaviours and factors (sex workers, men who have sex with men, injecting drug users (IDUs), and 'high' rates of sexually transmitted infections) are acknowledged to be present in Bangladesh. As a result, there is increasing concern that the epidemic might spread in a manner similar to that documented in neighbouring countries of India, Burma and Thailand. The Centre for Population Health Bangladesh Research
Australia funds three research studies being undertaken by the Centre for Population Health in Bangladesh: Understanding and overcoming barriers to condom use by sex workers; Evaluation of Partner Notifications for STI/HIV among service providers; and IDU cohort study in Dhaka, Phase II: Determination of risk factors for HIV and hepatitis C and enhancing interventions. BurmaThe HIV epidemic in Burma continues to expand rapidly and is considered to be one of the most serious in Asia with a total adult prevalence rate of 1.3 per cent and UNAIDS estimates up to 620,000 people are infected with HIV. Infection rates vary across the country with several regions showing a considerable increase in prevalence rates among less vulnerable populations. Surveillance figures show the virus has spread across the general population with a 2.2 per cent infection rate in pregnant women. Overall, 34 per cent of HIV cases occur in injecting drug users (IDU), who were the first group heavily affected by the epidemic. Within a year of the first infection being detected in Burma infection rates among IDU became the highest in the world, where they have remained. Australia supports a coordinated approach to HIV/AIDS control in Burma as a member of the UN Expanded Theme Group that oversees Burma's UN Joint Program on HIV/AIDS. Three Diseases Fund (3DF)
The fund has been developed by six donors (Australia, UK, the European Commission, the Netherlands, Norway and Sweden) as a joint donor response to counter HIV/AIDS, Tuberculosis and Malaria in Burma. The fund supports the prevention, treatment and care for the most vulnerable populations in Burma, and is managed by the United Nations Office of Project Services (UNOPS). The fund has been operational since 1 April 2007. Australia also supports five NGO projects which cover the four priority areas of the UN Joint Plan of Action: targeted condom promotion and STI prevention and care; injecting drug user interventions; awareness raising for the general population with a focus on young people; and care, compassion and support for people living with HIV/AIDS. CambodiaWhile national adult prevalence rates in Cambodia have fallen to an estimated 0.9% in 2007, there is increasing incidence of high risk behaviours. The epidemic was initially associated primarily with sex work, but new populations are increasingly at risk including wives of men who frequent sex workers, men who have sex with men and injecting drug users. Cambodia Ministry of Health and National Centre in HIV Epidemiology and Clinical Research (NCHECR) Research project
NCHECR is assisting the Cambodian Ministry of Health to undertake trials to determine the most effective means of providing treatment for HIV/AIDS in a resource poor setting. Through the appointment of an Australian medical advisor based in Cambodia, the project is assessing capacity building and research needs. It will determine priorities for research to support optimal HIV treatment and care, including the use of anti-retroviral therapy; conduct pilot projects; and develop proposals for full scale research projects. ChinaNational prevalence of HIV in China remains low at approximately 650,000 reported cases. However, HIV is now present in all 31 provinces and autonomous regions of the country. Clusters of high prevalence exist, both geographically and among specific sub-groups, including former commercial blood and plasma donors, injecting drug users in the South and West, commercial sex workers and men who have sex with men. At the same time, HIV prevalence is increasing rapidly. This has been estimated at 30 per cent each year in recent years, including escalating numbers of women. Moreover, the risk factors exist for a generalised epidemic. AusAID's new China Program Strategy 2006-2010 identifies HIV/AIDS as a priority for cooperation. Engagement focuses on high risk groups such as IDU, commercial sex workers and (as an emerging area for policy engagement) men who have sex with men. This reflects an analysis of both the status of the epidemic and current transmission trends, whilst building on existing AusAID project investments, and Australia's internationally recognised expertise in harm minimisation and community mobilisation. China Australia Integrated Health and HIVAIDS Program (CAIHHP)
The purpose of this program is to improve China's capacity to halt and reverse the spread of HIV, protect its population against emerging infectious diseases and strengthen health systems. The three objectives of the HIV/AIDS component are to: strengthen national and provincial leadership and coordination in the response to HIV/AIDS; extend the use of harm reduction techniques for HIV prevention among populations most likely to be exposed to HIV; and increase the adoption of policies for community based voluntary confidential counselling and testing, and care, treatment and support for people living with HIV/AIDS. Xinjiang HIV/AIDS Prevention and Care Project
This project aims to reduce the economic and social impact of HIV/AIDS on the region by assisting regional, prefecture and county-level governments to develop and implement an effective multi-sectoral approach to HIV/AIDS. There are three technical components: planning and coordination, including leadership and advocacy; health promotion, including anti-discrimination; and direct and indirect care, including acute and palliative care in hospitals and community based preventative and palliative care. Tibet Health Sector Support Program
The project aims to raise awareness of HIV/AIDS and help reduce risky behaviours amongst vulnerable groups. Safer blood supply practices will also be supported. Australian project partners:
China HIV/AIDS Roadmap Tactical Support Project
The project aims to strengthen China's strategic capacity to deliver an effective, coordinated response to HIV/AIDS. The four components are: to strengthen leadership and coordination of HIV/AIDS responses at national level; to improve mechanisms for information exchange and utilisation; to enhance capacity for sub-national level implementation and monitoring; and to ensure effective mobilisation and utilisation of resources. AusAID's contribution will expand the project's geographic coverage (currently at seven provinces) to the Xinjiang Uygur Autonomous Region, linking to the existing Xinjiang HIV/AIDS Project. The Asia Regional HIV/AIDS Project covers two provinces in Southern China - Yunnan and Guangxi. East TimorBased on available data, the prevalence of HIV infection in East Timor is probably low. There is a small but growing sex industry in East Timor, and other behavioural and cultural risk factors are consistent with vulnerability within society to HIV transmission. Australian assistance has included support for a national conference on HIV/AIDS and the development of a National Strategy for the prevention of HIV/AIDS. According to an AusAID study there were an estimated 133 adults (15-49 years old) living with HIV/AIDS in East Timor in 2005, a prevalence of 0.03 per cent. If interventions remain at their current level, the study predicted that by 2025 East Timor would be facing a mostly urban epidemic of around 5,000 people living with HIV, a prevalence of 0.6 per cent of the adult population nationally. This prevalence would jump to 34 per cent for sex workers and six percent for men who have sex with men, creating conditions for a severe epidemic to develop after 2025. IndiaAlthough new estimates for India have revised the number of people living with HIV/AIDS down to 2.5 million, HIV continues to emerge in new areas. Most infections are acquired sexually, but a small proportion is acquired through injecting drug use. Regional Framework Agreement with UNAIDSAustralia and UNAIDS have entered into a strategic partnership under which AusAID will support HIV/AIDS programs in South Asia using the comparative advantages of the UNAIDS co-sponsors under the general coordination of UNAIDS. HIV/AIDS Prevention and Care Program in North East India - coordinated by UNAIDS India
This activity, which will be the first to be programmed under the proposed framework agreement with UNAIDS (see above), and will aim to improve the quality and delivery of the national HIV/AIDS prevention and control program in Nagaland, Manipur, Mizoram and Meghalaya. Integrated Approach towards Prevention of Mother to Child Transmission of HIV/AIDS through Safe Motherhood Initiatives, implemented by MAMTA
The aim of this NGO project is to prevent mother to child transmission of HIV/AIDS. It expects to do so through community mobilisation, building the capacities of stakeholders eg. local NGOs, district and state level government functionaries, developing mechanisms for referrals and linkages, and advocacy both at district and state level. IndonesiaReported HIV prevalence varies. A recent AusAID study estimated that in 2005 HIV prevalence in the adult population in Papua and West Papua was 1.03% and 0.17% in the rest of Indonesia. The study predicts that, unless the response is scaled up, by 2025 adult prevalence will rise in Papua and West Papua to 7% and in the rest of Indonesia to 1.08%. Estimates of the number of people living with HIV vary widely, between 80,000 and 290,000 people, with 25%-30% of these in Papua and West Papua, approximately 50% in Java and the remainder spread across the archipelago. Conditions also favour HIV spread through sex work, with high rates of sexually transmitted infections (STIs) and low levels of consistent condom use. In Papua, where prevalence rates are the highest in the country, the situation is particularly troubling, with recent surveys also suggesting dynamic HIV spread in the general population on Papua through heterosexual transmission, similar to patterns seen in Papua New Guinea. HIV/AIDS Prevention and Care Project Phase 2
The project aims to provide capacity building support for AIDS commissions at the national, provincial and district level. Assistance focuses on vulnerable groups such as injecting drug users (IDUs), sex workers and their clients. The project is operating in 6 provinces: DKI Jakarta, West Java, Bali, South Sulawesi, Papua and Nusa Tenggara Timur. For IDUs the project is using a harm reduction approach. This has involved high level advocacy with the National Narcotics Control Board (BNN) and the Department of Justice and Human Rights, which supervise prisons, and the national and local police forces. Australia-Indonesia Partnership for HIV (AIPH)
In July 2007, the $100 million Australia-Indonesia Partnership for HIV (AIPH) was launched. The aim of this Partnership mirrors the Government of Indonesia's goal in the National HIV/AIDS Strategy 2007 - 2010, which is to prevent and limit the spread of HIV, to improve the quality of life for people living with the virus and to alleviate its socio-economic impacts in Indonesia. The main implementing partners for AIPH will be the National AIDS Commission, Ministry of Health, Ministry of Law and Human Rights (for prisons program) and the National Development Planning Board. Lao PDRLao PDR is covered by the Asia Regional Transboundary Program See HIV/AIDS Activities by Region NepalNepal is covered by the Regional South Asia Program See HIV/AIDS Activities by Region PakistanPakistan is covered by the Regional South Asia Program See HIV/AIDS Activities by Region Papua New GuineaPNG has the highest incidence of HIV/AIDS in the Pacific region and was the fourth nation in the Asia Pacific Region to have a generalised epidemic (greater than 1%). The 2007 Estimation Report on the HIV Epidemic in Papua New Guinea indicates the national HIV prevalence is 1.28% among adults aged 15-49 years, and the number of people living with HIV is estimated to have been 46,275 at December 2006. Heterosexual transmission is the predominant means of infection, with approximately equal numbers of men and women affected. Since 2003, more HIV infections have been detected in women than men. More than twice as many young women aged 15-24 have been diagnosed with HIV than young men, whereas males tend to have higher infection levels in older age groups. Papua New Guinea-Australia HIV and AIDS Program - Sanap Wantaim (Stand Together)
Sanap Wantaim (Stand Together) commenced in January 2007, building on the achievements of the $66.5 million PNG National HIV/AIDS Support Project (NHASP) which concluded in December 2006. Sanap Wantaim is supporting PNG to respond to its own priorities as outlined in the PNG National Strategic Plan on HIV/AIDS 2006 - 2010. The program is working through PNG Government systems as well as with civil society and the private sector to not only prevent the spread of HIV but also to provide treatment, care and support for those infected and affected by HIV/AIDS. PhilippinesFrom 1984 to September 2004, the National AIDS Registry recorded a total of 2,165 cases, while UNAIDS estimates the number of people living with HIV/AIDS as of the end of 2003 to be 9,000. A large number of these cases are people aged between 20 and 39. Sexual intercourse (both heterosexual and MSM) remains the leading mode of HIV transmission (92 per cent) and returning overseas workers account for a substantial percentage of reported cases. While transmission remains slow, UNAIDS considers the epidemic to have a 'huge explosion potential' due to: high rates of sexually transmitted infections; widespread high-risk behaviours; little knowledge of HIV/AIDS; low condom usage; and active government impediments to condom access. Australia is contributing $2.59 million to the United Nations Population Fund (UNFPA) for reproductive and adolescent sexual health projects that include HIV/AIDS components. Institutionalizing Adolescent Reproductive Health Through Life Skills-Based Education
This activity seeks to contribute to improved adolescent sexual and reproductive health through increased adolescents' access and utilisation of comprehensive, high-quality, gender-responsive sexual and reproductive health services. Advocating for a stronger, more responsive population and reproductive health policy and program
This activity seeks to improve the policy environment that supports population, reproductive health and gender programs, particularly for vulnerable and poor populations. Australia is also providing $22.8 million to UNICEF's 6th Country Program for Children for 2005-2009, of which HIV/AIDS prevention is one of the components - focusing on policy advocacy, social mobilisation, and capacity building of implementing partners and target beneficiaries as well as delivering appropriate services to disadvantaged youth. This builds on the achievements from the 5th program, which Australia also supported. VietnamVietnam is experiencing an expanding HIV/AIDS epidemic. Cases have been reported from all provinces and there are a number of sub-epidemic 'hot-spots'. These include Ho Chi Minh City, Hai Phong and Quang Ninh. The epidemic is largely driven by injecting drug use, although transmission through sex is becoming more prevalent. See HIV/AIDS Activities by Region Project Partner Websites (external)
2007
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