1. People living with HIV (PLHIV)
Last updated: March 2018

2. CONTENT Overview Treatment - Treatment: Antiretroviral therapy
- Treatment: PMTCT
- Treatment: TB-HIV Co-treatment
Women living with HIV and reproductive health rights
Punitive laws hindering the HIV response among PLHIV

3. Overview

4. Countries in Asia and the Pacific that account for >90% of PLHIV and new infections, and percent change in new infections
New HIV infections
(2016)
% decline of new HIV infections between 2010 and 2016
% increase of new HIV infections between 2010
and 2016
People living with HIV
India
80,000
2,100,000
Indonesia
48,000
620,000
China*
45,000
850,000
Pakistan
19,000
130,000
Viet Nam
11,000
250,000
Myanmar
230,000
Philippines
10,500
56,000
Thailand
6,400
450,000
Malaysia
5,700
97,000
Papua New Guinea
2,800
46,000
Bangladesh
1,500
12,000
Nepal
<1,000
32,000
Cambodia
71,000
Source: Prepared by based on UNAIDS 2017 HIV Estimates
*2013 HIV estimates

5. Regional overview of trends in HIV infections and AIDS-related deaths
HIV and AIDS in Asia and the Pacific
Deaths
170,000
People living with HIV
5.1 million
Women living with HIV
1.8 million
2016 “zoom-in”
Children living with HIV
190,000
New HIV
infections
270,000
Source: Prepared by based on UNAIDS 2017 HIV Estimates

6. Trends in HIV infections and AIDS-related deaths among women in Asia and the Pacific, 1990-2016
Women living with HIV
New HIV infections
AIDS-related deaths
Women living with HIV
New HIV infections among women
AIDS-related deaths among women
Number
Number
78 000
44 000
Source: Prepared by based on UNAIDS 2017 HIV Estimates

7. Distribution of new HIV infections by age group, 2016
A significant variation in new HIV infections trend by age group in Asia and the Pacific
Distribution of new HIV infections by age group, 2016
Percent change in new HIV infections between 2010 and 2016 by age group
34%
33%
19% 6% 2%
Age group (year)
new HIV infections
in 2016
0 - 14
55 +
Total
% decrease
% increase
Source: Prepared by based on UNAIDS 2017 HIV Estimates

8. A significant variation in new HIV infections trends in Asia and the Pacific countries
Distribution of new HIV infections by country, 2016
Percent change in new HIV infections between 2010 and 2016
new HIV infections in
Asia and the Pacific in 2016
(10,500, 4%)
China
India
Indonesia
Myanmar
Pakistan
Philippines
Thailand
Vietnam
Source: Prepared by based on UNAIDS 2017 HIV Estimates

9. Diverse epidemic trends in Asia and the Pacific
Proportion of new HIV infections by risk groups
Indonesia
Thailand
Philippines
Pakistan
MSM
Male PWID
Female sex workers
Clients of sex workers
Transgender
MSW
Currently low risk females
Currently low risk males

10. Treatment

11. Treatment: Antiretroviral therapy

12. HIV testing coverage among key populations, 2013 - 2016
HIV testing is the entry point for prevention and treatment but about half of key populations do not know their HIV status
HIV testing coverage among key populations,
Source: Prepared by based on Global AIDS Monitoring (GAM) Reporting 2017

13. HIV testing is the entry point for prevention and treatment, but many key populations do not know their HIV status
Female sex workers
Male sex workers
Men who have sex
with men
Transgender people
People who inject
drugs
90%
90%
90%
90%
90%
Prepared by based on Global AIDS Monitoring 2017; Integrated Bio-Behavioural Surveys; and Behavioural Surveillance Surveys

14. Availability of community-based and lay provider testing approaches in Asia and the Pacific
Both community-based and lay provider HIV testing available
Community-based HIV testing available
Lay provider HIV testing available
Not available
No info
Source: based on Global AIDS Monitoring (GAM) 2017

15. Independent access to HIV testing and related services for young people in Asia and the Pacific
Age of legal capacity to consent independently to an HIV test, Asia and the Pacific
Source: UNICEF, UNESCO, UNFPA, UNODC, Youth LEAD, & Youth Voices Count. (2015). Adolescents Under the Radar in the Asia-Pacific AIDS Response.

16. Fast-Track Treatment to Reach 90–90–90 by 2020
ENDING AIDS BY 2030:
Fast-Track Treatment to Reach 90–90–90 by 2020
People receiving ART in Asia and the Pacific
15% annual increase
between 2013 and 2016
At current pace:
4.2 million
people on ART by 2020
Fast-Track Target 2020:
people on ART
2016 estimate:
2.4 million
*As of June 2017, estimated 2.5 million people were receiving ART in Asia and the Pacific region
Source: Prepared by based on UNAIDS 2017 HIV Estimates; Global AIDS Monitoring (GAM) 2017

17. PLHIV know their status Tested for viral load **
Asia and the Pacific
Towards Fast-Track
treatment targets
66%
5.1 M
Countries with CD4 threshold policy for treatment initiation
countries have national policy on routine viral load
monitoring for antiretroviral therapy
Estimated
PLHIV
PLHIV know their status
People on ART *
Tested for viral load **
Suppressed viral load
Treatment cascade, 2016
treat all regardless of CD4
CD4 ≤ 500 24
CD4 ≤ 500 but treat all key populations regardless of CD4
CD4 ≤ 350 but treat all key populations regardless of CD4 25 1 5 15 6 9 2
2016
2017
71%
83%
*As of June 2017, estimated 2.5 million people were receiving ART in Asia and the Pacific region
** China and India do not report viral load testing data in 2017 GAM reporting and Indonesia reported only 0.2% of people on ART tested for viral load in Estimated 52% of PLHIV who are on treatment in 18 reported countries had tested for viral load in the past 12 months.
Prepared by based on Global AIDS Monitoring 2017 Reporting and UNAIDS 2017 HIV Estimates

18. PROGRESS TOWARDS THE 90–90–90 TARGETS Global versus Asia and the Pacific, 2016
70%
[51 – 84%]
77%
[57 – >89%]
82%
[60 – >89%]
Asia and the Pacific
71%
[47 – >89%]
66%
[44 – >89%]
83%
[55 – >89%]
of people living with HIV know their status
of people living with HIV who know their status are on treatment
of people on treatment are virally suppressed
Source: Prepared by based on UNAIDS special analysis, 2017

19. Regional overview: 90-90-90 target and gaps
2nd 90 target
PLHIV know the status
3.6 M
0.98 M
1st 90 target
GAP
PLHIV are on treatment *
2.4 M
1.7 M
3rd 90 target
PLHIV are virally suppressed
1.97 M
ACHIEVED
Australia; Malaysia; Thailand
NOT ON-TRACK
Afghanistan; Bangladesh; Indonesia; Mongolia;
Sri Lanka
ACHIEVED
Australia; Singapore
NOT ON-TRACK
Afghanistan; Bangladesh; Fiji; Indonesia; Malaysia; Pakistan; Philippines
ACHIEVED
Cambodia; Singapore
NOT ON-TRACK
Afghanistan; Fiji;
Pakistan
*As of June 2017, estimated 2.5 million people were receiving ART in Asia and the Pacific region
Prepared by based on UNAIDS special analysis 2017; UNAIDS 2017 estimates and Global AIDS Monitoring 2017

20. HIV testing and treatment cascade among adolescents, select countries, 2016
Estimated adolescents living with HIV
Adolescents know their status
On ART
Tested for viral load
Suppressed viral load
Thailand
>95%
70%
87%
n/a
n/a
Estimated adolescents living with HIV
Adolescents know their status
On ART
Tested for viral load
Suppressed viral load
Indonesia 9%
Estimated adolescents living with HIV
Adolescents know their status
On ART
Tested for viral load
Suppressed viral load
Philippines
84% 3%
11%
n/a
Prepared by based on UNAIDS 2017 estimates and Global AIDS Monitoring 2017

21. ART coverage and treatment gap, Asia and the Pacific, 2016
Current treatment scale-up has made significant achievement but the region is lagging behind the global trend
ART coverage and treatment gap, Asia and the Pacific, 2016
ART coverage (%)
Treatment gap
Prepared by based on Global AIDS Monitoring 2017 Reporting and UNAIDS 2017 HIV Estimates

22. 3 in 5 children living with HIV are not receiving life-saving ART
Children ART coverage and treatment gap, Asia and the Pacific, 2016
2nd 90
target
Prepared by based on UNAIDS 2017 estimates and Global AIDS Monitoring 2017

23. Low level of access to treatment among key populations
ART coverage: Female sex workers living with HIV vs. Female PLHIV 2X
24X
11X
81%
Prepared by based on Global AIDS Monitoring 2017

24. Low level of access to treatment among key populations
ART coverage: Male key populations living with HIV vs. Male PLHIV
81%
ART coverage (%)
Prepared by based on Global AIDS Monitoring 2017

25. Late diagnosis: Proportion of PLHIV with initial CD4 count <200%
Note: Lao PDR and Viet Nam reported 47% and 59% of PLHIV respectively were reported with initial CD4 count <350
Prepared by based on UNAIDS 2017 estimates and Global AIDS Monitoring 2017

26. HIV self-testing policy landscape, 2016
As of October 2016, 4 countries in Asia and the Pacific report
having policies supportive of HIV self-testing
Source: WHO.(2016). Overview of the New Guidelines on HIV Self-Testing and Partner Notification: What You Need to Know

27. Generic competition lowers live-saving ART prices
Evolution in price of different first-line regimens
X 10
times lower
Prepared by based on Medecins Sans Frontieres (MSF) (2016). Untangling the Web of Antiretroviral Price Reductions -18th Edition

28. Generic ARVs and impact on government budget: Thailand example
Cost saving comparing with originated product price
Antiretroviral drug (GUL- Government use of license)
Year
Cost saving
Mil THB
Mil USD
2010
866.3
27.3
2011
1,732.8
56.8
2012
2,319.0
74.6
2013
2,377.1
77.3
2014
2,870.0
88.4
Total saving
10,165.2
338.8
Source: Presentation by Chutima Akaleephan presented at the Regional Experts Consultation on Access to Affordable Medicines, Diagnostics and Vaccines in Bangkok, March 2016 based on NHSO Thailand data

29. Newer, more effective, less toxic medicines often unaffordable for the poor and developing countries
First-line regimen
Second-line regimen
Third-line regimen
US$ per person per year
Prepared by based on Medecins Sans Frontieres (MSF) (2016). Untangling the Web of Antiretroviral Price Reductions -18th Edition

30. High out of pocket health payment in countries with highest HIV burden
Out-of-pocket payment as % of total health expenditure
Prepared by based on

31. Treatment: PMTCT

32. 2020 estimate based on current trend: Falls short of target by 8 000
Estimated new HIV infections among children (0-14 years) in Asia and the Pacific: current trend and trend to Fast-Track target
Estimate 2016:
16 000
2020 estimate based on current trend:
10 000
new HIV infections
Fast-Track Target 2020:
1900
Falls short of target by 8 000
Source: Prepared by based on UNAIDS 2017 HIV Estimates

33. Efforts are needed to eliminate new HIV infections among children (0-14 years) in Asia and the Pacific
Prevention of mother-to-child transmission (PMTCT) coverage,
Global and Asia and the Pacific,
Prepared by based on Global AIDS Monitoring 2017 Reporting and UNAIDS 2017 HIV Estimates

34. 46% received ARVs for PMTCT 52% early infant diagnosis
Towards ending AIDS in children starts with mothers: time to improve linkages and prevent leakages
Service cascade of prevention of mother-to-child transmission of HIV in Asia and the Pacific, 2016
46% received ARVs for PMTCT
52% early infant diagnosis
Note: PMTCT testing and coverage of infant ARV prophylaxis are not captured in GAM 2017 reporting
Prepared by based on Global AIDS Monitoring 2017 Reporting and UNAIDS 2017 HIV Estimates

35. Regional overview: Prevention of mother-to-child transmission
Pregnant women living with HIV who received ARVs to reduce the risk of mother-to-child transmission of HIV, 2016
PMTCT coverage (%)
Prepared by based on UNAIDS 2017 estimates and Global AIDS Monitoring 2017

36. Regional child new HIV infections gap
Regional PMTCT gap, 2016
Regional child new HIV infections gap
GAP
2020
target
95%
32000
35000
Received PMTCT (2016)
15000
1900
13000
2020
target
GAP
Children new infections (2016)
Indonesia,
21%
Pakistan, 6%
Proportion of regional child new infections gap by country
Proportion of regional PMTCT gap by country
Indonesia,
28%
Pakistan, 7%
India,
60%
Prepared by based on UNAIDS 2017 estimates and
Global AIDS Monitoring 2017

37. Commitment of member states on eMTCT in Asia and the Pacific

38. Treatment: TB-HIV Co-treatment

39. 2/3 1/5 1/2 TB snapshot 2016 Asia and the Pacific is the home for…
852 K
7.1 M
199 K
1/5
of estimated TB-HIV co-infections globally
2/3
of estimated new TB cases globally
More than
1/2
of estimated TB mortality globally
(both HIV-negative and HIV-positive)
Source: Prepared by based on WHO. (2017). Global TB Report 2017

40. Over a third of high TB burden countries are in Asia and the Pacific
30 high-burden countries (Tuberculosis)
Angola
Bangladesh
Brazil
Cambodia
Central African Republic
China
Congo
DPR Korea
DR Congo
Ethiopia
India
Indonesia
Kenya
Lesotho
Liberia
Mozambique
Myanmar
Namibia
Nigeria
Pakistan
Papua New Guinea
Philippines
Russian Federation
Sierra Leone
South Africa
Thailand
UR Tanzania
Viet Nam
Zambia
Zimbabwe
Asia and the Pacific
Source: Prepared by based on WHO. (2017). Global TB Report 2017

41. Estimated HIV prevalence in incident TB cases, 2016
Source: Prepared by based on WHO. (2017). Global TB Report 2017

42. Need to scale-up HIV testing among TB patients in Asia
Proportion of TB patients with known HIV status, 2016
Source: Prepared by based on WHO. (2017). Global TB Report 2017

43. Need to scale-up HIV testing among TB patients in the Pacific
Proportion of TB patients with known HIV status, 2016
Source: Prepared by based on WHO. (2017). Global TB Report 2017

44. of diagnosed TB patients tested for HIV
Integrated approaches need to strengthen in diagnosis, treatment, and care of TB-HIV co-infections in Asia and the Pacific
Continuum of HIV testing, diagnosis, and access to ART among patients enrolled in TB programmes , 2016
47%
of diagnosed TB patients tested for HIV 4%
HIV positivity rate
82%
of diagnosed PLHIV
on ART
Source: Prepared by based on WHO. (2017). Global TB Report 2017

45. HIV-positive TB patients were
Tuberculosis diagnosis and treatment continuum among HIV-positive TB patients in Asia and the Pacific, 2016
63% of estimated new TB cases who are co-infected with HIV did not know their HIV status
18% of identified
HIV-positive TB patients were
NOT on ART
Programmatic gap
37%
82%
70%
30%
Source: Prepared by based on WHO. (2017). Global TB Report 2017

46. Estimated new TB cases who are HIV- positive
About 70% of people with TB-HIV co-infection did not have access to antiretroviral therapy in Asia and the Pacific, 2016
Access to antiretroviral therapy among PLHIV vs. people with TB-HIV co-infection, 2016
Denominator:
Estimated total PLHIV
Estimated new TB cases who are HIV- positive
Source: Prepared by based on WHO. (2017). Global TB Report 2017

47. Low coverage of TB preventive treatment among PLHIV newly enrolled in HIV care in Asia and the Pacific
Proportion of PLHIV newly enrolled in HIV care who were started on TB preventive treatment in 2016, countries where data is available
Source: Prepared by based on WHO. (2017). Global TB Report 2017

48. TB co-infection: preventable death among PLHIV
Estimated number of AIDS-related deaths and TB deaths among PLHIV in 2016, Asia and the Pacific versus global
Proportion of TB deaths
among PLHIV
AIDS-related deaths
About 1 in 4
AIDS deaths are among people with
TB-HIV co-infection
170 K
Asia and the Pacific
24%
1 M
About 1 in 3
AIDS deaths are among people with
TB-HIV co-infection
Global
37%
Source: Prepared by based on WHO. (2017). Global TB Report 2017

49. 8 countries account for 95% of all TB-related deaths among PLHIV in Asia and the Pacific
Source: Prepared by based on WHO. (2017). Global TB Report 2017

50. Considerably high proportion of deaths among PLHIV is attributable to TB
Source: Prepared by based on WHO. (2017). Global TB Report 2017

51. 59% decline in TB deaths among PLHIV between 2010 and 2016
15%
decline
59%
Source: Prepared by based on WHO. (2017). Global TB Report 2017

52. Tuberculosis treatment success rate (%), 2015 cohort
Low TB treatment success rate among HIV-positive TB patients underscores the importance of prevention of opportunistic infections among PLHIV
Tuberculosis treatment success rate (%), 2015 cohort
Source: Prepared by based on WHO. (2017). Global TB Report 2017

53. Higher rate of deaths and lower rate of treatment success among HIV-positive TB cases
Outcomes of TB treatment among new and relapse TB cases versus HIV-positive TB cases, 2015 cohort
Source: Prepared by based on WHO. (2017). Global TB Report 2017

54. 11 out of 12 high TB burden countries in Asia and the Pacific also have high MDR-TB burden, 2016
High TB burden
High MDR-TB burden
Bangladesh
Cambodia
China
DPR Korea
India
Indonesia
Myanmar
Pakistan
Papua New Guinea
Philippines
Thailand
Viet Nam
Source: Prepared by based on WHO. (2017). Global TB Report 2017

55. Estimated incidence of MDR/RR-TB in 2016
GLOBAL
MDR/RR-TB burden is in ASIA-PACIFIC
97% of
ASIA-PACIFIC
MDR/RR-TB burden is in 11 countries
MDR/RR-TB = Rifampicin Resistant (RR) -TB cases including MDR-TB cases
601,000
363,000
351,300
11 high MDR/RR-TB burden = Bangladesh, China, DPR Korea, India, Indonesia, Myanmar, Pakistan, PNG, Philippines, Thailand, Viet Nam
Source: Prepared by based on WHO. (2017). Global TB Report 2017

56. Reported budget in National Strategic Plan for TB, high TB burden countries, 2017
Source: Prepared by based on WHO. (2017). Global TB Report 2017

57. TB financing in high TB burden countries are heavily dependent on international sources
Proportion of total TB budget from domestic and international sources in high TB burden countries in Asia and the Pacific, 2017
Source: Prepared by based on WHO. (2017). Global TB Report 2017

58. Women living with HIV and reproductive health rights

59. Proportion of women living with HIV who had a desire to have children reported being coerced to undergo sterilization,
Source: Prepared by based on

60. Proportion of surveyed HIV-positive pregnant women who were asked to undergo sterilization, 2011
Source: Prepared by based on Women of the Asia Pacific Network of People Living with HIV. (2012). Positive and pregnant, How dare you. A study on access to reproductive and maternal health care for women living with HIV in Asia

61. Number of HIV-positive pregnant women who were asked to undergo sterilization and had the option to decline, 2011
Source: Prepared by based on Women of the Asia Pacific Network of People Living with HIV. (2012). Positive and pregnant, How dare you. A study on access to reproductive and maternal health care for women living with HIV in Asia

62. Punitive laws hindering the HIV response among PLHIV

63. Punitive laws hindering the HIV response among PLHIV in South Asia
Restriction on entry, stay,
and residence based on
HIV status
Laws that specifically criminalize HIV transmission or exposure
Afghanistan NO
YES
Bangladesh
Bhutan
India
Maldives
NO INFO
Nepal
Pakistan
Sri Lanka
Source: Prepared by based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014

64. Punitive laws hindering the HIV response among PLHIV in South-East Asia
Restriction on entry, stay, and residence based on
HIV status
Laws that specifically criminalize HIV transmission or exposure
Brunei
YES
Cambodia NO
Indonesia
Lao PDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
NO INFO
Timor-Leste
Viet Nam
Source: Prepared by based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014

65. Punitive laws hindering the HIV response among PLHIV in East Asia
Restriction on entry, stay, and residence based on
HIV status
Laws that specifically criminalize HIV transmission or exposure
China NO
CONTRADICTORY INFO
Japan
NO INFO
Mongolia
YES
DRP Korea
Rep of Korea
Source: Prepared by based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014

66. Punitive laws hindering the HIV response among PLHIV in the Pacific
Restriction on entry, stay, and residence based on
HIV status
Laws that specifically criminalize HIV transmission or exposure
Fiji NO
Kiribati
Marshall Islands
YES
FSM*
Nauru
NO INFO
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
*Federated States of Micronesia
Source: Prepared by based on UNAIDS, UNDP, UNFPA, and UNODC. (2014). Punitive Laws Hindering the HIV Response in Asia and the Pacific in October 2014

67. slides compiled by www.aidsdatahub.org
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