Changing Patterns of HIV Epidemic in 30 Years in East Asia

Abstract

The HIV epidemic in East Asia started relatively late compared to the rest of the world. All countries or areas, except for North Korea, had reported HIV and AIDS cases, with China being the major contributor to the epidemic. Though initially driven by injecting drug use in China, East Asia did not experience an explosive spread. Strong commitment in China and early harm reduction programs in Taiwan managed to reduce transmission substantially among injecting drug users. In contrast to China and Taiwan, injection drug use has accounted just a little, if not at all, for the spread of HIV in other East Asian counties. However, following a global trend, sexual contact has become a major route of infection across the region. While much progress has been achieved in this region, with the epidemic among other key populations relatively stable, the emerging epidemic through sex between men is a growing concern. Recent estimates suggest that HIV prevalence among men who have sex with men (MSM) has reached 6.3 % in China, 7.5 % in Mongolia, and ranges between 8.1 %-10.7 % in Taiwan and between 2.7 %- 6.5 % in South Korea. In Japan, 74 % of male HIV cases were among MSM in 2012, while Hong Kong has witnessed a sharp increase of HIV cases among MSM since 2004. There is urgent need to address issues of discrimination and stigma toward homosexuality, and to strengthen the strategies to reach and care for this population.

Alcohol misuse, risky sexual behaviors, and HIV or syphilis infections among Chinese men who have sex with men

“…The countrywide scale-up of harm-reduction programs for persons who inject drugs and law enforcement campaigns on banning illegal plasma collection has significantly decreased and stabilized the HIV epidemic among both drug injectors and plasma donors (Shan et al, 2002; Suguimoto et al, 2014; Wu et al, 2007). In contrast, the proportion of new HIV cases due to sexual transmission increased from 33.1% in 2006 to 92.2% in 2014, during which male-to-male sexual transmission surged from 2.5% to 25.8% (Ministry of Health of the People's Republic of China AIDS Response Progress Report, 2015).…”

Increases in Entamoeba histolytica Antibody–Positive Rates in Human Immunodeficiency Virus–Infected and Noninfected Patients in Japan: A 10-Year Hospital-Based Study of 3,514 Patients

“…The spread of sexually transmitted diseases, especially HIV, is expected to rise in Japan, particularly among young adults 15. There is an established government scheme for free and anonymous testing and counseling for HIV, syphilis, Chlamydia , and gonorrhea at public health centers to improve access.…”

“…On the other hand, there are a limited number of studies on the trends of invasive amebiasis in nonendemic countries 13. In Japan, invasive amebiasis is an emerging sexually transmitted parasitic disease, increasing alongside the incidence rates of other sexually transmitted infections (STIs) including human immunodeficiency virus (HIV), chlamydial, and gonococcal infections 14,15. Previous studies have indicated that HIV infection is a risk factor for invasive amebiasis 11,13,16,17.…”

‘Get an early check – Chrysanthemum tea’: An outcome evaluation of a multimedia campaign promoting HIV testing among men who have sex with men in Hong Kong

“…HIV infection among men who have sex with men (MSM) is a serious public health threat, both locally and internationally [1][2][3][4][5]. In Hong Kong, the HIV prevalence increased alarmingly from 4.08% in 2011 [6] to 5.85% in 2014 [7].…”