1. Doing the Right Thing Karen A. Stanecki XV International AIDS Conference

2. Trends in global adult HIV prevalence 0 10 20 30 40 50 1991199319951997199920012003 Millions Estimated number of people living with HIV Global Report 2002 Global Report 2004

3. 0 1 2 3 4 5 1991199319951997199920012003 Millions Global Sub-Saharan Africa New infections Global Sub-Saharan Africa Deaths due to AIDS Steadily rising annual HIV infections and AIDS deaths

4. Rising HIV infection among injecting drug users, followed by rising infection among sex workers % HIV positive 0 10 20 30 40 50 60 70 80 90 100 1994199519961997199819992000200120022003 IDU (Jakarta, Indonesia) Sex workers (Jakarta, Indonesia) IDU (Guangxi, China) Sex workers (Guangxi, China) IDU (Hanoi, Vietnam) Sex workers (Hanoi, Vietnam)

5. 0102030405060708090100 Central Bangladesh Sichuan, China* Delhi, India Surabaya, Indonesia Katmandhu Valley, Nepal Bangkok, Thailand** Hanoi, Vietnam Unprotected commercial sexCommercial sex with a condom Source: Behavioural surveillance reports High proportions of men who inject drugs are also clients of sex workers %

6. Condom use, Female sex workers HIV prevalence, female sex workers 0 20 40 60 80 100 19951997199920012003 % Source: Cambodia National Center for HIV/AIDS Dermatology and STDs, Ministry of Health Increasing condom use and decreasing HIV infections in Cambodia

7. Used needle after other injector last time Used needle after other injector in the last week Reported STI symptom past year* Sought medical treatment for STI** Percent Participated in needle exchange Did not participate 51 59 72 90 38 16 21 17 0 10 20 30 40 50 60 70 80 90 100 Needle-exchange programmes promote healthy sexual behaviour and safe injection Source: National behavioural surveillance data * of sexually active respondents; ** of respondents reporting STIs Bangladesh

8. Asia’s HIV prevention successes have three features in common 1.They recognize and target the behaviors that are causing most new infections 2.They use the most effective interventions that directly reduce the risk of HIV transmission 3.They provide the services to the population at greatest risk of HIV exposure

9. 63 000 115 000 200 000 8 500 110 000 050 000100 000150 000200 000250 000 Men and women needing antiretrovirals Prisoners needing prevention services High-risk MSM needing condoms and lubricant Drug injectors needing needles and condoms Sex workers needing condoms and STI services Source: Based on national estimates of people at risk for HIV, Ministry of Health, Indonesia Treatment is critical, and HIV prevention services remain a major priority in Indonesia

10. Adult prevalence % 15.0% − 39.0% 5.0% − 15.0% 1.0% − 5.0% 0.5% − 1.0% 0.1%− 0.5% 0.0% − 0.1% not available HIV prevalence in adults, end 2003 38 million people [range: 35-42 million] living with HIV as of end 2003

11. HIV prevalence among 15−24-year-olds in selected sub-Saharan African countries, 2001−2003 0 5 10 15 20 Niger (2002) Mali (2001) Burundi (2002) Kenya (2003) Zambia (2001-2002) South Africa (2003) Zimbabwe (2001-2002) % HIV prevalence MenWomen 2004 Report on the Global AIDS Epidemic (Fig 7)

12. And the more people have access to effective prevention, the fewer people will be in need of treatment. It’s about human rights Every person in need must have access to HIV treatment.