AIDS may cripple south Asia, warns WB

[नेपाली]

KATHMANDU, Aug. 14: South Asia's HIV and AIDS epidemic is likely to grow rapidly unless the countries in the region, mainly India, can saturate high-risk groups such as commercial sex workers and their clients, injecting drug users and men having sex with men with better HIV prevention measures.

According to a World Bank report, AIDS in South Asia: Understanding and Responding to a Heterogeneous Epidemic, 5.5 million people are infected with HIV in South Asia, with the epidemic increasingly driven by the region's flourishing sex industry and injecting drug use.

"Contributing regional risk factors include widespread stigma and discrimination; poverty and inequality; illiteracy; the low social status of women; and trafficking of women into commercial sex,"according to the report launched at the 16th International AIDS Conference in Toronto, Canada.

The report has identified porous borders; widespread migration; high levels of mobility; cultural restrictions on discussing sex; high rates of sexually transmitted infections; and limited condom use as other risk factors.

"Reaching and involving people at risk of HIV is the greatest challenge in South Asia because they're frequently marginalised within their own communities because of what they do, and are therefore difficult to involve and reach with conventional programme,"said Julian Schweitzer, Director for Human Development in the World Bank's South Asia regional team. "But our experience shows that where governments, civil society and other partners make a concerted effort to work closely, including there at-risk groups, you can achieve positive results whit specially tailored programmes that reduce people's HIV risks.?

The report said Nepal appeared to have the potential for a substantial epidemic, at least among high-risk groups, especially female sexual workers and injecting drug users. "Injecting drug use occurs across the country and significantly overlaps with commercial sex.?

According to the report, a high number of women migrate or are trafficked to work as female sexual workers in India, especially Mumbai. Those returning to Nepal from Mumbai have much higher HIV prevalence than those who have remained in the country, so migration and trafficking to and from Mumbai can rapidly increase HIV prevalance in Nepalese sex workers, it added. "As with other South Asian countries, injecting drug use as well as female and male sex work, is likely to continue to drive the HIV epidemic in Nepal, particularly in light of the nexus between injecting drug se and sex work.?

Focussing mainly on Bangladesh, India, Nepal, Pakistan and Sri Lanka, the new report concluded that countries must tailor their HIV prevention programmes to suit their own local conditions rather than rely on generic global or regional approaches which have failed to make a difference in individual countries.