English Wire

AIDS battle reaches new climax in Asia with aggressive condom policy

No condom, no sex. In an aggressive policy to stem the growing HIV/AIDS problem, the World Health Organisation (WHO) wants sex workers in Asia to adopt this uncompromising stand when facing clients.

WHO is working together with authorities in China, Myanmar, Mongolia, Vietnam, Laos and the Philippines to implement 100 percent condom use in commercial sex establishments in these HIV/AIDS-hit countries.

The "100 percent condom use programme" has been highly successful in Thailand and Cambodia where new infections have nose-dived by more than 80 percent since the peak of the HIV/AIDS epidemic in the two Southeast Asian countries in the last decade, WHO officials say.

"There has been amazing success with this strategy," said Shigeru Omi, the Manila-based regional director of WHO's Western Pacific region. "We need to make sure this continues. Any gains can be undone quickly."

But the WHO policy has been criticised by some non-governmental groups, which argue that the UN agency is effectively condoning prostitution by encouraging condom use among sex workers.

Some governments in the region, including in the Philippines where the Church strongly campaigns against artificial contraceptives, are also treading carefully on the issue, considering religious and cultural taboos.

But health experts underline the need for a swift response as commercial sex is fuelling the spread of HIV/AIDS in the Asia-Pacific region, where already seven million people suffer from the deadly disease.

Although the HIV/AIDS problem has not reached dangerous levels, as in Africa, the Asia-Pacific region "is set to become the epicentre of the global pandemic in the next decade," according to the WHO.

It warns that at least 30 million people are expected to be infected with HIV/AIDS in the world's most populous nations China and India by 2010.

To contain the crisis, the WHO is working together with governments to push the 100 percent condom use policy in brothels and other commercial sex establishments mushrooming in the region.

WHO officials acknowledge that they initially faced difficulties in getting the message across to governments but that the authorities in the region are now far more open due to the urgency of the issue.

Often cited by the WHO are the efforts of Cambodia and Thailand, which had pushed for maximum condom usage in sex establishments as a key pillar of their battle against HIV/AIDS.

"We want to replicate the success we had in Cambodia and Thailand elsewhere in Asia, where AIDS is becoming a big problem," said Bernard Fabre-Teste, head of the HIV and sexually transmitted infections unit in the WHO regional office here.

"The 100 percent condom use programme will be crucial in our efforts to contain AIDS, particularly in the world's most populous country China," said Ong Gaik Gui, a technical officer at the unit.

"If we do not act quickly to prevent infection, the epidemic will spread very quickly into the wider community," Ong said.

Aside from China, the new campaign will focus on Laos, Mongolia, Myanmar, the Philippines and Vietnam, where condom usage is low and prevalence of sexually transmitted infections is high, WHO officials say.

For example, 20 percent of sex workers in China have never used a condom before.

In Vietnam, nearly a quarter of sex workers in bustling Ho Chi Minh city are infected with HIV/AIDS.

Particularly in southern Vietnam, only seven percent of men surveyed while attending clinics for sexually transmitted infections had used condoms.

Cambodia and Thailand are the only two Asian countries where HIV/AIDS cases are declining, largely because of widespread condom usage — more than 90 percent — in their commercial sex establishments.

Prostitution is also no longer the driving force of AIDS/HIV infections in these countries, the WHO says.

Only 16 percent of HIV/AIDS cases in Thailand and 21 percent cases in Cambodia developed from the sex industry compared with 80 to 90 percent previously during the peak of the epidemic in the last decade.

At one time, about half the number of sex workers in Thailand's northern Chiang Mai city and Cambodia's Sihanoukville city were ill with HIV/AIDS.

Now, most new infections are contracted through marital and casual sex, where condom use is low.