A Growing Concern: HIV in Asia
Asia is a large and diverse continent, but a growing concern for several countries within it is the growing number of HIV infections and the large percentage of people who remain undiagnosed and untreated. Approximately 6.5 million people in the Asia-Pacific region are living with HIV, and in 2022, an estimated 300,000 new cases were added to the toll.i For the entire region overall, the incidence has been declining, but in some countries (eg, the Philippines), the incidence of HIV has been rising.ii In this article, we explore this trend and what can be done to address it.
Our Best Tools: Early Detection and Prevention
Testing for HIV is the first and most important step in HIV prevention and treatment. About 78% of people in the Asia-Pacific region living with HIV are aware of their diagnosis,iii with significant variation by country. In the Philippines, for example, only 6 of every 10 people living with HIV is aware of their diagnosis.ivWith testing, people who are found to have HIV can start receiving treatment, which not only protects their own health but also prevents transmission of HIV. People who do not have HIV can take steps to protect themselves and may take advantage of one of the most impactful innovations in the fight against HIV - pre-exposure prophylaxis (PrEP). PrEP is medication that reduces the risk of acquiring HIV from sexual exposure by about 99%.v Many places across the globe have embraced utilizing PrEP to prevent HIV, but PrEP utilization in the Asia-Region is still low comparatively. Considering more than 6 million people are living with HIV within the Asia-Pacific region, it is quite concerning that PrEP utilization is so low.vi In places such as the Philippines, where they have region’s fastest-growing HIV epidemic,vii three-quarters of patients newly diagnosed with HIV are located outside Metro Manila, the country’s urban center, but PrEP is only available in Metro Manila.viii
Studies show that the sooner people start HIV treatment after diagnosis, the more they benefit. Therefore, the earlier we can screen for, and detect HIV, the more likely those living with the virus can live long, healthy lives. Early detection of HIV also benefits the surrounding society, as viral suppression can render the virus untransmissible. For several reasons, screening for HIV in Asia needs to be more common.
Stigma – The Unspoken Barrier to Screening, HIV Prevention, and Care
Often, religious and cultural factors deter many from seeking out HIV preventive counseling and testing. Complicating the problems further, people in sexual orientation or gender identity minority groups often face stigma and discrimination in their communities and health care settings, which also prevent testing and care.ix
“Discrimination can turn people away from healthcare altogether and undermines their trust in the system. Ending the HIV epidemic starts with ending discrimination and removing stigma, so no one misses out on screening and prompt treatment,” said Dr. Kris Bungay, Internist at Gotham Medical Group.
Unfortunately, these barriers limit access to quality HIV preventive services in geographic locations that desperately need it.
A Solution: Raise Awareness of Stigma and Other Barriers to HIV Prevention and Treatment Among Health Care Providers
What will it take to end the HIV epidemic in Asia? One key piece will be to raise awareness in health care providers in Asia of how stigma creates barriers to HIV screening and early treatment. The next step is to give them the knowledge and tools to overcome these barriers. Finally, we must provide the specific knowledge needed to better treat their patients.
It will take a concerted effort from organizations and people across the globe to end the HIV epidemic in Asia.
What We’re Doing
At DKBmed, we’re doing our small part by doing what we do best — developing high-quality educational initiatives that transfer expert knowledge to health care providers around the world.In 2022, we launched HIV Learning Lab China. This educational initiative was an early effort to raise awareness of these issues in China and provide health care providers with the knowledge and tools to screen more patients and provide better HIV treatment. Before participating in our HIV Learning Lab in China program, only 37% correctly identified contraindications to PrEP; after the education, 65% correctly identified contraindications.
In 2023, we launched Patient Voices: HIV & Treatment in Asia. After the education, we saw a 105% increase in participants’ knowledge of the WHO recommendation about the rapid initiation of antiretroviral therapy in those diagnosed with HIV. This initiative has the potential to impact the treatment of 90,768 patients at risk for/with HIV each month.
In May 2024, we will launch a new and wider-reaching educational initiative called Ask Me About HIV and PrEP: Education for Clinicians in Asia. This project will reach health care providers in South Korea, the Philippines, and Japan to educate them on the benefits of early HIV detection, prevention through PrEP, and the knowledge and tools to provide better HIV care. For more information on this project, you can contact us.
References
- UNAIDS.Core Epidemiology Slides. Available at: https://www.unaids.org/en/resources/documents/2023/core-epidemiology-slides
- Asia-Pacific Regional Factsheet 2023
- https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf
- UNAIDS. Country Factsheets. Philippines 2022. https://aphub.unaids.org and https://www.unaids.org/en/regionscountries/countries/philippines
- https://medlineplus.gov/hivprepandpep.html#:~:text=PrEP%20is%20very%20effective%20when,do%20not%20take%20it%20consistently.
- WHO.IT. About WHO in the Western Pacific. Accessed February 2024.
- https://www.cdc.gov/globalhivtb/where-we-work/philippines.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10034279/
- https://www.americanprogress.org/article/discrimination-prevents-lgbtq-people-accessing-health-care