HIV/AIDS in Laos

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Since the first HIV/AIDS case in the Lao People’s Democratic Republic (PDR) was identified in 1990, the number of infections has continued to grow. In 2005, UNAIDS estimated that 3,700 people in Lao PDR were living with HIV. [1]

Contents

Prevalence

Lao PDR’s currently faces a concentrated epidemic with an adult HIV prevalence of 0.1 percent. The low HIV prevalence does not necessarily indicate low risk. Moreover, the HIV-prevalence rate is increasing. Because of its geographical location in the heart of the Mekong region, injecting drug use, and unsafe sexual practices, Lao PDR is in danger of an expanded epidemic. Nearly 5 percent of injecting drug users (IDUs) were found to be HIV-positive in 2005. Although only 0 to 1.1 percent of sex workers were HIV-infected in 2000, a 2004 survey of the prevalence of sexually transmitted infections (STIs) among service women found that chlamydia/gonorrhea prevalence was 45 percent in the capital Vientiane, 43.6 percent in the border province of Bokeo, and 27.9 percent in the southern province of Champasak, indicating the vulnerability of these women to HIV. [1]

HIV human retrovirus, cause of AIDS

The human immunodeficiency viruses (HIV) are two species of Lentivirus that causes HIV infection and over time acquired immunodeficiency syndrome (AIDS). AIDS is a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype. In most cases, HIV is a sexually transmitted infection and occurs by contact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids. Non-sexual transmission can occur from an infected mother to her infant during pregnancy, during childbirth by exposure to her blood or vaginal fluid, and through breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells.

Champasak Province Province in Laos

Champasak is a province in southwestern Laos, near the borders with Thailand and Cambodia. It is one of the three principalities that succeeded the Lao kingdom of Lan Xang. As of the 2015 census, it had a population of 694,023. The capital is Pakse, but it takes its name from Champasak, the former capital of the Kingdom of Champasak.

Lao PDR is undergoing rapid socioeconomic changes, including increased international tourism, leading to sexual behaviors that may place some Laotians at increased risk for HIV infection. For instance, a report cited by UNAIDS found increasing sexual activity among young men in Vientiane in 2004, nearly 60 percent of whom reported having multiple partners in the first six months of the year and more than one-third of whom reported paying for sex. Many of Lao PDR’s men who have sex with men (MSM) also report having sex with women. Women are considered to be particularly vulnerable to HIV/AIDS because of their low literacy, education and health status. Women whose husbands have multiple sex partners and visit sex workers are particularly vulnerable. [1]

Vientiane Capital City in Vientiane Prefecture, Laos

Vientiane is the capital and largest city of Laos, on the banks of the Mekong River near the border with Thailand. Vientiane became the capital in 1563 due to fears of a Burmese invasion but was later looted then razed to the ground in 1827 by the Siamese (Thai). Vientiane was the administrative capital during French rule and, due to economic growth in recent times, is now the economic center of Laos. The city had a population of 820,000 as at the 2015 Census.

Men who have sex with men (MSM), also known as males who have sex with males, are male persons who engage in sexual activity with members of the same sex, regardless of how they identify themselves; many such men do not sexually identify as gay, homosexual or bisexual.

Compounding Lao PDR’s vulnerability to an expanding HIV epidemic is a low level of knowledge about the disease among the general population. According to one study reported in the World Bank-sponsored Lao PDR Gender Profile, 23 percent of respondents did not know that HIV was transmissible by blood, and more than half did not know that it could be transmitted from mother to child during pregnancy and breastfeeding. Implementing programs to increase knowledge and awareness is difficult in Lao PDR because the country is home to 47 different ethnic groups with multiple native languages and a variety of cultures. [1]

The World Bank is an international financial institution that provides loans to countries of the world for capital projects. It comprises two institutions: the International Bank for Reconstruction and Development (IBRD), and the International Development Association (IDA). The World Bank is a component of the World Bank Group.

According to the World Health Organization, Lao PDR had 69 new tuberculosis (TB) cases per 100,000 people in 2005, one of the highest incidence rates in the region. Although HIV-TB co-infection is relatively low, with only 0.7 percent of new TB cases occurring among HIV-infected individuals, the country is in danger of a combined epidemic. HIV-TB co-infection poses a challenge to providing treatment and care for both diseases. [1]

World Health Organization Specialised agency of the United Nations

The World Health Organization (WHO) is a specialized agency of the United Nations that is concerned with international public health. It was established on 7 April 1948, and is headquartered in Geneva, Switzerland. The WHO is a member of the United Nations Development Group. Its predecessor, the Health Organisation, was an agency of the League of Nations.

Tuberculosis Infectious disease caused by the bacterium Mycobacterium tuberculosis

Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, in which case it is known as latent tuberculosis. About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected. The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss. It was historically called "consumption" due to the weight loss. Infection of other organs can cause a wide range of symptoms.

National Response

The Lao PDR government initiated its response to the HIV/AIDS epidemic in 1992, when participants at an AIDS conference agreed that the spread of HIV was inevitable and would likely occur via young male urban or international migrants who returned to their villages and via women who became commercial sex workers out of economic necessity. The National Committee for the Control of AIDS is in charge of policy matters related to HIV/AIDS prevention and control. The committee consists of 14 members from 12 government ministries. The National Action Plan on HIV/AIDS/STIs for 2006–2010 focuses on achieving universal access to treatment, care and support. [1]

The National Socioeconomic Development Plan for 2006–2010 addresses HIV/AIDS, indicating the government’s commitment to expanding the national response. Since implementing the plan, national authorities have worked to target people most likely to be exposed to the disease; scale up prevention, treatment, care and support; and improve strategic information. Activities to fight HIV/AIDS, including Behavior Change Communication (BCC) interventions, peer education, life skills training, and a 100 percent condom use program, have been integrated into Lao PDR’s general development programs. The Ministry of Education is promoting HIV/AIDS and sex education by training school principals and teachers in these areas, so they can transfer their knowledge to students. The objective is to reduce risky sexual behavior to help keep down the number of new HIV infections in the country. According to UNAIDS, as of 2005, 49 percent of HIV-infected women and men were receiving antiretroviral therapy. [1]

Lao PDR receives support in its response to HIV/AIDS from various international donors, including the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Global Fund approved a sixth-round grant from Lao PDR to scale up HIV/AIDS prevention, care, and treatment in 2006. [1]

Related Research Articles

Epidemiology of HIV/AIDS

HIV/AIDS is a global pandemic. As of 2017, approximately 36.9 million people are living with HIV globally. In 2018, approximately 43% are women. There were about 940,000 deaths from AIDS in 2017. The 2015 Global Burden of Disease Study, in a report published in The Lancet, estimated that the global incidence of HIV infection peaked in 1997 at 3.3 million per year. Global incidence fell rapidly from 1997 to 2005, to about 2.6 million per year, but remained stable from 2005 to 2015.

The Caribbean is the second-most affected region in the world in terms of HIV prevalence rates. Based on 2009 data, about 1.0 percent of the adult population is living with the disease, which is higher than any other region except Sub-Saharan Africa. Several factors influence this epidemic, including poverty, gender, sex tourism, and stigma. HIV incidence in the Caribbean declined 49% between 2001 and 2012. Different countries have employed a variety of responses to the disease, with a range of challenges and successes.

Although Senegal is a relatively underdeveloped country, HIV prevalence in the general population is low at around 0.08 per 1000 people, under 1% of the population. This relatively low prevalence rate is aided by the fact that few people are infected every year– in 2016, 1100 new cases were reported vs 48,000 new cases in Brazil. Senegal's death due to HIV rate, particularly when compared it to its HIV prevalence rate, is relatively high with 1600 deaths in 2016. Almost two times as many women were infected with HIV as men in 2016, and while almost three times as many women were receiving antiretroviral therapy (ARV) as men, only 52% of HIV positive people in Senegal received ARV treatment in 2016.

HIV/AIDS in Eswatini was first reported in 1986 but has since reached epidemic proportions due in large part to cultural beliefs which discourage safe-sex practices. Coupled with a high rate of co-infection with tuberculosis, life expectancy has halved in the first decade of the millennium. As of 2016, Eswatini has the highest prevalence of HIV among adults aged 15 to 49 in the world (27.2%). The HIV/AIDS epidemic in Eswatini, having contributed largely to high mortality rates among productive Swazi age groups, has adversely affected the country’s socioeconomic status and hindered its overall development.

With less than 0.1 percent of the population estimated to be HIV-positive, Bangladesh is a low HIV-prevalence country.

HIV/AIDS in Nepal

Nepal's first cases of HIV/AIDS were reported in 1988 and the disease has primarily been transmitted by intravenous drug use and unprotected sex. Among the two, HIV epidemic is largely attributed to sexual transmissions which account for more than 85% of the total new HIV infections.Available data indicate that there was a sharp increase in the number of new infections starting in 1996, coinciding with the outbreak of civil unrest. The infection rate of HIV/AIDS in Nepal among the adult population is estimated to be below the 1 percent threshold which is considered "generalized and severe". However, the prevalence rate masks a concentrated epidemic among at-risk populations such as female sex workers (FSWs), male sex workers (MSWs), injecting drug users (IDUs), men who have sex with men (MSM), Transgender Groups (TG), migrants and Male Labor Migrants(MLMs) as well as their spouses. Cultural factors have also been shown to play a significant role in the spread of HIV and AIDS in Nepal. Some of these cultural factors are related with social taboos which creates challenges for open discussions regarding sex and sexual habits, as do denial, stigma, and discrimination that surround HIV and AIDS. Other factors such as poverty, low levels of education and literacy, political instability combined with gender inequality make the tasks challenging.

HIV/AIDS infection in the Philippines might be low but growing. The estimated incidence of HIV/AIDS in the country remains under 0.1% of the total population in 2015. The Philippines has one of the lowest rates of infection, yet has one of the fastest growing number of cases worldwide. The Philippines is one of seven countries with growth in number of cases of over 25%, from 2001 to 2009.

Since HIV/AIDS was first reported in Thailand in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008. In 2009 the adult prevalence of HIV was 1.3%. As of 2016, Thailand had the highest prevalence of HIV in Southeast Asia at 1.1 percent, the 40th highest prevalence of 109 nations.

HIV/AIDS in Bolivia has a less than 1 percent prevalence of Bolivia's adult population estimated to be HIV-positive and therefore the country has one of the lowest HIV prevalence rates in the Latin America and Caribbean region.

Cases of HIV/AIDS in Peru are considered to have reached the level of a concentrated epidemic. According to a population-based survey conducted in Peru’s 24 largest cities in 2002, adult HIV prevalence was estimated to be less than 1 percent. The survey demonstrated that cases are unevenly distributed in the country, affecting mostly young people between the ages of 25 and 34. As of July 2010, the cumulative reported number of persons infected with HIV was 41,638, and there were 26,566 cases of AIDS, according to the Ministry of Health (MOH), and the male/female ratio for AIDS diagnoses in 2009 was 3.02 to 1. The Joint United Nations Program on HIV/AIDS (UNAIDS) estimates 76,000 Peruvians are HIV-positive, meaning that many people at risk do not know their status. There were 3,300 deaths due to AIDS in Peru in 2007, down from 5,600 deaths in 2005.

The Dominican Republic has a 0.7 percent prevalence rate of HIV/AIDS, among the lowest percentage-wise in the Caribbean region. However, it has the second most cases in the Caribbean region in total, with an estimated 46,000 HIV/AIDS-positive Dominicans as of 2013.

HIV/AIDS in El Salvador has a less than 1 percent prevalence of the adult population reported to be HIV-positive, El Salvador and therefore there is a low-HIV-prevalence country, but the virus remains a significant threat in high-risk communities, such as commercial sex workers (CSWs) and men who have sex with men (MSM).

HIV/AIDS in Jamaica has a 1.5 percent prevalence of the adult population estimated to be HIV-positive and no significant change over the last five years and therefore Jamaica appears to have stabilized its HIV/AIDS epidemic.

With less than 1 percent of the population estimated to be HIV-positive, Egypt is a low-HIV-prevalence country. However, between the years 2006 and 2011, HIV prevalence rates in Egypt increased tenfold. Until 2011, the average number of new cases of HIV in Egypt was 400 per year. But, in 2012 and 2013 it increased to about 600 new cases and in 2014 it reached 880 new cases per year. According to UNAIDS 2016 statistics, there are about 11,000 people currently living with HIV in Egypt. However, unsafe behaviors among most-at-risk populations and limited condom usage among the general population place Egypt at risk of a broader epidemic.

Prostitution in Laos

Prostitution in Laos is regarded as a criminal activity and can be subject to severe prosecution. It is much less common than in neighbouring Thailand. Soliciting for prostitution takes place mainly in the city's bars and clubs, although street prostitution also takes place. The visibility of prostitution in Laos belies the practice's illegality. UNAIDS estimates there to be 13,400 prostitutes in the country.

References

  1. 1 2 3 4 5 6 7 8 "Laos: HIV/AIDS Health Profile". USAID (March 2008). PD-icon.svgThis article incorporates text from this source, which is in the public domain.
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