Indonesia and Others See \'Embarrassing\' Rise in H.I.V. Infections

HONG KONG - A new United Nations report on H.I.V.-AIDS has some encouraging findings, notably dramatic reductions in new infections in southern Africa, although several countries in Asia now have infection rates 25 percent higher than they were a decade ago.

One of those countries is Indonesia, the world's fourth most populous nation. The health minister, Nafsiah Mboi, called the U.N. findings “so embarrassing,” especially in light of large expenditures on prevention programs in Indonesia.

“I don't know what mistakes I have made,” she told reporters. “It was shocking to me.”

Statistics from Indonesia's National AIDS Commission cited by The Jakarta Post show that condom use remains low, especially consistent use among sex workers. Ms. Nafsiah, the paper said, has backed the distribution of free condoms to young people, an effort opposed by conservative lawmakers and religious groups in the predominantly Muslim country.

Cho Kah Sin, the co untry director for the Unaids agency, suggested that Indonesia's infection numbers appear higher because the epidemic reached full force there later than it did in other countries.

Another country with worrisome statistics is the Philippines.

Teresita Marie Bagasao, head of the Manila office of Unaids, told The Philippine Daily Inquirer that “while the absolute number of H.I.V. infections in the Philippines is still relatively low, the rate of increase in the number of cases is a cause for concern.”

The Philippine Department of Health said there were an estimated 600 H.I.V. cases in 2001. Last year, the number of new infections was 4,600.

“The Philippines is still one of only seven countries in the world to have recorded a sharp increase in the number of H.I.V. cases,” Ms. Bagasao said. “While other countries managed to stabilize their epidemics, the Philippines still needs to muster the political will to face the challenge posed by this gro wing epidemic.”

The news site Rappler, citing a national health survey, reported that “the proliferation of social media networks and online dating sites in the Philippines have also made casual sexual encounters extremely accessible among the MSM (men who have sex with men) community.”

The U.N. report, issued in conjunction with World AIDS Day this Saturday, shows nine countries with at least 25 percent increases in infection rates since 2001. Six of those countries are in Asia - Indonesia, the Philippines, Bangladesh, Sri Lanka, Kazakhstan and Kyrgyzstan - in addition to Georgia, Guinea-Bissau and Moldova.

Some 34 million people were living with H.I.V. last year, compared to 29.4 million in 2001, the report said.

“Still, 25 countries have witnessed a decline of 50 percent or more in new H.I.V. infections since 2001,” according to the Web site CSR-Asia. “Among the countries with the greatest declines are Papua New Guinea, Thailand, India and Cambodia.”

As Donald G. McNeil Jr. reported in The Times, the annual U.N. report shows that “globally, progress is steady but slow.”

“By the usual measure of whether the fight against AIDS is being won,” he wrote, “it is still being lost: 2.5 million people became infected last year, while only 1.4 million received lifesaving treatment for the first time.”

Donald cited comments by Michel Sidibé, the executive director of Unaids, about the successes in reducing infection rates, particularly in Africa:

The most important factor, Mr. Sidibé said, was not nationwide billboard campaigns to get people to use condoms or abstain from sex. Nor was it male circumcision, a practice becoming more common in Africa.

Rather, it was focusing treatment on high-risk groups. While saving babies is always politically popular, saving gay men, drug addicts and prostitutes is not, so presidents and religious leaders often had to be per suaded to help them. Much of Mr. Sidibé's nearly four years in his post has been spent doing just that.

Many leaders are now taking “a more targeted, pragmatic approach,” he said, and are “not blocking people from services because of their status.”

The Chinese health authorities last week ordered hospitals to stop refusing treatment to H.I.V. positive patients, state media reported.

The order came after social-media messages began circulating about a 25-year-old man with lung cancer who was denied surgery at a hospital in Tianjin because he was H.I.V. positive. He went to another hospital, did not reveal his infection and got the surgery, according to Xinhua, the official Chinese news agency.

The U.N. report said the number of people on H.I.V. treatment in China has increased nearly 50 percent in the last year.

An excerpt from a recent report on NPR:

New infections in China have nearly quadrupled since 20 07, the report found. HIV prevalence is still generally low in China compared to that in many African countries, but China had nearly 40,000 new diagnoses in 2011, and the steady incline is concerning.

“There is a significant epidemic in men having sex with men in China, which happens in almost all of the major cities,” said Dr. Bernard Schwartlander, a director at Unaids. “The Chinese are very pragmatic people. They have recognized the problem, and they have started a strong and proactive program to reach these populations.”

“They are completely controlling the epidemic among people who are injecting drugs,” said Mr. Sidibé. Even so, the epidemic is growing among homosexual men, he said, with over 30 percent of the new infections occurring among them.