1. Training Introduction and Overview
Effective HIV & SRH Responses among Most at Risk Populations in Papua New Guinea
Training Introduction and Overview

2. Overview Overview of training programme Introduction of participants
Overview of Regional HIV epidemics, with a focus on MARPs, and the implications
Overview of National HIV epidemics, with a focus on MARPs, and the implications

3. Facilitators and Participants Introductions
GROUP ACTIVITY
Facilitators and Participants Introductions

4. Asian epidemics are not driven by casual sex in general population …
Predictors and Patterns in Sex Work
Asian epidemics are not driven by casual sex in general population …
Source: CAA Report (2008)
… but by percentage of adult men visiting sex workers

5. Regional Data
HIV prevalence among female sex workers

6. Regional Data
National trends often mask high prevalence in specific locations
Indonesia : 2011 national prevalence among direct FSW 10% & indirect FSW 3% compared with:
Prevalence as high as 16% and 8.8% among direct and indirect FSW in Denpasar [1]
Range - 0.4% among indirect FSW in Bandung city to 25% among direct FSW in Jayawijaya [1]
India : Further declines in prevalence among FSW in southern states, but remains as high as 7% in Maharashtra and Andhra Pradesh [2].
China : National HIV prevalence among FSW was 0.3% in 2011, but the prevalence rates exceeded 1% in five provinces, Yunnan, Xinjiang, Guangxi, Sichuan and Guizhou, where there are relatively high rates of drug use [1]
Sources
Indonesia Directorate General of Disease Control and Environmental Health . (2011). IBBS 2011
National AIDS Control Organisation, Ministry of Health and Family Welfare, Government of India (Sept 2012), HIV Sentinel Surveillance : A Technical Brief. (unpublished draft report)
Ministry of Health of the People’s Republic of China (2012) China AIDS Response Progress Report.

7. Regional Data Myanmar: 2011 HIV prevalence among FSW was 9.4%
Range - 4.7% in Lashio to 18% in Yangon [1]
Thailand: HIV prevalence among direct FSW was 1.8%
Range- 0.2% in Bangkok to as high as 4.2% in Chiang Mai and 6.8% in Samut Sakhon provinces. [2]
Viet Nam:
HIV Sentinel Surveillance HIV prevalence among FSW was 3 %
Range – 0% in 6 provinces to 22.5% in Ha Noi [3]
IBBS HIV prevalence among FSW was 3.2 %
Range – 0.3% among street-based FSW in Da Nang to 23% among street-based FSW in Hai Phong [3]
Sources:
National AIDS Programme, Ministry of Health, Myanmar (2011). HIV Sentinel Sero-surveillance 2011.
Bureau of Epidemiology Thailand. (2011). HSS 2011 ( in Thai)
National Committee for AIDS, Drug and Prostitution Prevention and Control, Viet Nam. (2012). Global AIDS Response Progress reports 2012, Viet Nam.

8. Regional Data
HIV prevalence among male and female sex workers
* Port Moresby
** Venue-based FSWs (median prevalence)
Source: Prepared by based on Global AIDS Response Progress reports 2012

9. Regional Data
Data on male and transgender sex workers are scarce but show high HIV prevalence
18% of surveyed male sex workers in Indonesia and Thailand tested HIV positive [1], as did 31% of transgender (Waria) sex workers in Jakarta [2] and 19% in Maharashtra, India [3]
In Phnom Penh, Cambodia, HIV prevalence among transgender people was higher than among MSM (3.6% vs 3.1%) [4]
In Pakistan, 5.2% prevalence among transgender (Hijra) sex workers was much higher than male sex workers and female sex workers, 1.6% and 0.6% respectively [5]
Sources:
Indonesia and Thailand Global AIDS Response Progress reports
Indonesia Directorate General of Disease Control and Environmental Health . (2011). IBBS 2011.
National AIDS Control Organisation, Ministry of Health and Family Welfare, Government of India (Sept 2012), HIV Sentinel Surveillance : A Technical Brief.
National Center for HIV/AIDS, Dermatology and STDs (NCHADS), Ministry of Health, Cambodia and FHI 360.(2010). Bros Khmer: Behavioral Risks On-site Sero-survey among At-risk Urban Men in Cambodia.
National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.

10. Regional Data HIV Prevalence
Proportion of MARPs <25 years in countries with available age-disaggregated data
Source: Prepared by based on Behavior Surveillance Surveys

11. Regional Data MSM prevalence show rising trends 2000-2011
Source: Prepared by based on HIV Sentinel Surveillance reports, Integrated Biological and Behavioral Surveillance reports and other reports

12. Regional Data
Overlap between sex work & injecting drug use: % of FSW who injected drugs in last 12 months
Source: Prepared by based on Integrated Bio-Behavioural Surveys and Behavioural Surveillance Surveys

13. Regional Data
Estimated new HIV infections by transmission route based on AIDS Epidemic Model, 2012
* Estimated new HIV infections by sub-population

14. Regional Data
Insufficient coverage of HIV prevention among sex workers
Source: Prepared by based on Global AIDS Response Progress Reports- Country Reports (2012) ; UNGASS Progress Reports (2010).

15. Regional Data HIV testing among female sex workers still low
Source: Prepared by based on Global AIDS Response Progress Reports- Country Reports (2012) ; UNGASS Progress Reports (2010).

16. NATIONAL DATA ADPATED IN COUNTRY

17. Training Introduction and Overview
THANK YOU

18. References
Bureau of Epidemiology Thailand. (2011). HSS (published in Thai).
HIV and AIDS Data Hub for Asia Pacific Evidence to Action. Available at:
Indonesia Directorate General of Disease Control and Environmental Health. (2011). IBBS 2011.
Indonesia and Thailand Global AIDS Response Progress reports. (2012).
Ministry of Health of the People’s Republic of China (2012) China AIDS Response Progress Report.
National AIDS Programme, Ministry of Health, Myanmar (2011). HIV Sentinel Sero-surveillance 2011.
National AIDS Control Organisation, Ministry of Health and Family Welfare, Government of India (2012). HIV Sentinel Surveillance : A Technical Brief. (unpublished draft report)
National AIDS Control Program, Pakistan. (2011). HIV Second Generation Surveillance in Pakistan - National Report Round IV 2011.
National Committee for AIDS, Drug and Prostitution Prevention and Control, Viet Nam. (2012). Global AIDS Response Progress reports Viet Nam.
National AIDS Control Organisation, Ministry of Health and Family Welfare, Government of India (2012). HIV Sentinel Surveillance : A Technical Brief.
National Center for HIV/AIDS, Dermatology and STDs (NCHADS), Ministry of Health, Cambodia and FHI (2010). Bros Khmer: Behavioral Risks On-site Sero-survey among At-risk Urban Men in Cambodia.