Changing Patterns of HIV Epidemic in 30 Years in East Asia
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.
KeywordsEast Asia Japan China Taiwan Hong Kong South Korea Mongolia HIV AIDS HIV testing MSM Epidemiology Global epidemic
This study was supported by a grant from the Ministry of Health, Labour and Welfare in Japan. We greatly appreciate the help of Altanchimeg Delegchoimbol at UNAIDS Mongolia, Sergelen Munkhbaatar at Mongolia Ministry of Health, and Jin Young Ahn at Yonsei University College of Medicine in South Korea for facilitating us with national data and/or country reports. Finally, our appreciation goes to Bishal Gyawali at the University of Southern Denmark for his assistance in the early stages of this review.
Compliance with Ethics Guidelines
Conflict of Interest
S. Pilar Suguimoto, Teeranee Techasrivichien, Patou Masika Musumari, Christina El-saaidi, Bhekumusa Wellington Lukhele, Masako Ono-Kihara, and Masahiro Kihara declare that they have no conflict of interest
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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