HIV and AIDS Data Hub for Asia-Pacific: Review of Epidemiological Indicators

HIV and AIDS Data Hub for Asia-Pacific Review in slides Hong Kong, SAR www.aidsdatahub.org

HIV and AIDS Data Hub for Asia-Pacific Content Basic socio-demographic indicators HIV prevalence and epidemiological status (1984-2011) Risk behaviors (1998-2009) Vulnerability and HIV knowledge (2000-2004) National Response (1985-2009) Archives 2

HIV and AIDS Data Hub for Asia-Pacific Basic socio-demographic indicators 7,069 (2010)1 0.9% (2010-2015)1 Total population (in thousands) Annual population growth rate Population aged 15-49 (thousands) 3,792 (2010)2 100 (2010)3 11.7 (2009)4 Percentage of population in urban areas Crude birth rate (births per 1,000 population) N/A 21/0.862 (2010)5 82.5 (2010)5 Under-5 mortality rate (per 1,000 live births) Human development index (HDI) - Rank/Value Life expectancy at birth (years) N/A 102% (2009)6 44,303 (2008)4 Adult literacy rate Ratio of girls to boys in primary and secondary education (%) GDP per capita (PPP, $US) Source: 1. UN Statistics Division. (2010). Demographic and Social Statistics. Retrieved 10 January 2011, from http://unstats.un.org/unsd/demographic/products/socind/population.htm 2. UN Population Division. (2011). World Population Prospects, the 2010 Revision. Retrieved 10 January 2011, from http://esa.un.org/unpd/wpp/Excel-Data/population.htm 3. UNFPA. (2010). State of World Population 2010. 4. World Bank. World Development Indicators & Global Development Finance. Retrieved 10 January 2011, from http://databank.worldbank.org/ddp/home.do?Step=12&id=4&CNO=2 5. UNDP. (2010). Human Development Report 2010. 6. World Bank. World Development Indicators: Ratio of Girls to Boys in Primary and Secondary Education (%). Retrieved 10 Jan 2011, from http://data.worldbank.org/indicator/SE.ENR.PRSC.FM.ZS

HIV prevalence and epidemiological status www.aidsdatahub.org

HIV and AIDS Data Hub for Asia-Pacific Cumulative number of HIV infections and AIDS cases, 1984 March 2011 Number 4935 5000 4000 3000 2000 1000 0 Mar-11 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 HIV infections AIDS cases Source: Prepared by www.aidsdatahub.org based on 1. Special Preventive Programme, Centre for Health Protection, Department of Health. (2011). HIV/AIDS Situation in Hong Kong [2010] Factsheet. and 2. Special Preventive Programme, Centre for Health Protection, Department of Health Hong Kong. (2011). Hong Kong STD/AIDS Update: A Quarterly Surveillance Report Vol. 17 No. 1 Quarter 1 2011 5

HIV and AIDS Data Hub for Asia-Pacific Annual new HIV infections by gender, 1984- March 2011 Number 500 450 400 350 300 250 Female Male 200 150 100 50 0 Mar-11 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Source: Prepared by www.aidsdatahub.org based on 1. Wong Ka-hing, Department of Health. Press Meeting Presentation 26 May 2009 and 2. Special Preventive Programme, Centre for Health Protection, Department of Health Hong Kong. (2011). Hong Kong STD/AIDS Update: A Quarterly Surveillance Report Vol. 17 No. 1 Quarter 1 2011 6

HIV and AIDS Data Hub for Asia-Pacific Annually reported HIV infections and AIDS cases by gender, 2000 March 2011 HIV infections AIDS cases 500 400 300 200 100 0 100 200 300 400 500 100 80 60 40 20 0 20 40 60 80 100 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Mar-11 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Mar-11 139 158 201 175 205 255 304 342 349 308 282 44 55 59 54 63 58 69 72 57 10 12 12 12 Number Number 48 41 44 44 5 51 13 12 11 15 12 14 61 68 86 87 108 81 64 65 77 26 11 2 Male Female Male Female Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health Hong Kong. (2011). Hong Kong STD/AIDS Update: A Quarterly Surveillance Report Vol. 17 No. 1 Quarter 1 2011. 7

HIV and AIDS Data Hub for Asia-Pacific Cumulative reported HIV infections and AIDS cases by age group and gender, March 2011 AIDS cases HIV infections 1,500 1,200 900 600 300 0 300 600 900 1,200 1,500 500 400 300 200 100 0 100 200 300 400 500 <10 yr 29 10 <10 yr 6 1 Number Number 10-19 yr 44 13 10-19 yr 8 4 20-29 yr 873 366 20-29 yr 103 52 30-39 yr 1,476 378 30-39 yr 382 55 40-49 yr 822 138 40-49 yr 269 42 50-59 yr 368 48 50-59 yr 149 17 60+ 248 26 60+ 104 6 Unknown 74 22 Male Female Male Female Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health Hong Kong. (2011). Hong Kong STD/AIDS Update: A Quarterly Surveillance Report Vol. 17 No. 1 Quarter 1 2011. 8

HIV and AIDS Data Hub for Asia-Pacific Percent distribution of reported new HIV infections by mode of transmission, 2000 March 2011 100% 90% Heterosexual 80% Homosexual 70% Bisexual 60% Injecting Drug Use 50% 40% Blood contact 30% Perinatal 20% Undetermined 10% 0% 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Mar-11 Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health Hong Kong. (2011). Hong Kong STD/AIDS Update: A Quarterly Surveillance Report Vol. 17 No. 1 Quarter 1 2011. 9

HIV and AIDS Data Hub for Asia-Pacific Percent distribution of cumulative HIV infections by mode of transmission, 1984 - March 2011 Heterosexual 0% 18% Homosexual 2% 43% 6% Bisexual 4% Injecting Drug Use Perinatal 27% Blood/ blood product infusion Undetermined Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health Hong Kong. (2011). Hong Kong STD/AIDS Update: A Quarterly Surveillance Report Vol. 17 No. 1 Quarter 1 2011. 10

HIV and AIDS Data Hub for Asia-Pacific Annual number of HIV cases reported among heterosexual men and MSM, 1995-2008 Number 200 180 160 150 105 120 125 90 88 84 84 84 84 84 80 75 105 77 75 70 80 56 72 59 40 50 44 44 44 35 35 30 30 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Heterosexual men MSM Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health Hong Kong. (2008). Fact Sheet: HIV/AIDS Situation in Hong Kong [2008]. 11

HIV and AIDS Data Hub for Asia-Pacific Comparison of expected number of current infections in Hong Kong with and without a strong intervention programme for MSM (Number) Year 12 Source: Brown, T. (2006). HIV/AIDS in Hong Kong: Living on the Edge. Honolulu, USA: East-West Center.

HIV and AIDS Data Hub for Asia-Pacific HIV prevalence among MSM, social hygiene service attendees and TB & chest clinic attendees, 2000 - 2008 % 3 Note: Samples taken for HIV testing were blood samples through voluntary HIV testing 2.5 2.4 2 1.8 1.7 1.6 1.2 1.0 0.8 1 0.7 0.9 0.9 0.8 0.3 0.3 0.2 0.1 0.1 0.23 0.15 0.13 0.11 0.08 0.08 0.07 0.06 0.04 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 MSM Social hygiene service attendees TB & chest clinic attendees Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme Centre for Health Protection Department of Health Hong Kong. (2009). Hong Kong HIV Surveillance Report 2008 Update. 13

HIV and AIDS Data Hub for Asia-Pacific HIV prevalence among newly admitted prisoners, TB & chest clinic attendees and drug treatment center attendees, 2000-2008 Note: Samples taken for HIV testing were urine samples through unlinked anonymous screening % 1.5 1.2 1.2 0.9 0.9 0.9 0.8 0.8 0.7 0.6 0.6 0.6 0.5 0.5 0.5 0.5 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.2 0.0 0.0 0.0 0.0 0.0 2000 2001 2002 2003 2004 2005 2006 2007 2008 Newly admitted prisoners TB & chest clinic attendees drug users attending inpatient drug treatment centres Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health. (2009). Hong Kong HIV Surveillance Report 2008 Update. 14

Risk behaviours www.aidsdatahub.org 15

HIV and AIDS Data Hub for Asia-Pacific % of FSWs who used a condom at last vaginal sex with client and over 50% condom use with their clients in last 7 days, 2006 and 2009 % 100 96 95 93 92 80 60 40 20 0 2006 2009 2006 2009 condom use at last vaginal sex with client over 50 % condom useage with their clients in the last 7 days Source: Prepared by www.aidsdatahub.org based on 1. Special Preventive Programme, Centre for Health Protection, Department of Health. (2007). CRiSP-Community Based Risk Behavioural and Seroprevalence Survey for Female Sex Workers in Hong Kong 2006 Factsheet. and 2. Special Preventive Programme, Centre for Health Protection, Department of Health. (2010). CRiSP-Community Based Risk Behavioural and Seroprevalence Survey for Female Sex Workers in Hong Kong 2009 Factsheet. 16

HIV and AIDS Data Hub for Asia-Pacific % of MSM who reported always using condoms during anal sex in the last six months by type of partner, 2006 and 2008 % 0 20 40 60 80 100 with regular partner 2006 41 2008 45 with non-regular 2006 73 partner 2008 75 Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health. (2009). PRiSM - HIV Prevalence and Risk behavioural Survey of Men who have sex with men in Hong Kong 2008 Factsheet. 17

HIV and AIDS Data Hub for Asia-Pacific Condom use among MSMs attending government AIDS counseling and testing service, 1998-2005 70 60 50 Percentage (%) Regular use with regular partners Regular* use with casual partners Use for last sex - regular partners Use for last sex - casual partners 40 30 20 Note: Regular condom use is defined as always or usually using a condom on a 4 level scale 10 0 1998 1999 2000 2001 2002 2003 2004 2005 Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Department of Health, as cited in Stanley Ho Centre for Emerging Infectious Diseases, & The Chinese University of Hong Kong. (2007). Report on the Assessment of Recently Acquired HIV Infection in MSM in Hong Kong. 18

HIV and AIDS Data Hub for Asia-Pacific % of MSM who reported the consistent condom use during commercial and non-commercial sex, 2001 (%) 100 Note: Respondents were MSM who had anal sex, n=72 50 42.9 35.7 0 Commercial sex Non-commercial sex Source: Prepared by www.aidsdatahub.org based on J T F Lau, J H Kim, M Lau, & Tsui, H.-Y. (2004). HIV Related Behaviors and Attitudes among Chinese MSM in Hong Kong: A Population Based Study. Sex Transm Infect , 80: 459-465. 19

HIV and AIDS Data Hub for Asia-Pacific Selected risky behaviors among newly admitted and readmitted clients of methadone service, 1999-2005 63.7 Unprotected sex 60.6 8.8 Multiple sex partners 10.1 Notes: admissions; 35585 readmissions. New admission: first time registering clients; Readmission: clients who have dropped out of the methadone service for 28 days or more Sample sizes: 5106 new 2.1 Current needle sharing 2.1 7 Past needle sharing 5.1 Current unclean syringe use 13.6 17.6 52.6 Current injection 25.9 0 10 20 30 Percentage (%) 40 50 60 70 Readmission New admission Source: Prepared by www.aidsdatahub.org based on Li, H., Goggins, W., & Lee, S. S. (2009). Multilevel Analysis of HIV Related Risk Behaviors among Heroin Users in a Low Prevalence Community. BMC Public Health, 9. 20

HIV and AIDS Data Hub for Asia-Pacific Regular condom use with female sex workers among adult heterosexual men, 2000-2005 (%) SHS: Social Hygiene Services ACS: AIDS Counseling Service CRPA: Community Research Programme on AIDS, Center for Epidemiology and Biostatistics Data from CRPA is suspended since 2002. H: household survey; T: Travelers survey Source: Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2006). HIV Surveillance Report 2005 Update. 21

Vulnerability and HIV knowledge www.aidsdatahub.org 22

HIV and AIDS Data Hub for Asia-Pacific % of key affected populations with comprehensive HIV knowledge, 2004 % 100 99 80 66 60 40 45 20 0 IDUs FSWs MSM Source: Prepared by www.aidsdatahub.org based on Hong Kong Advisory Council on AIDS. (2007). Recommended HIV/AIDS Strategies for Hong Kong 2007-2011. 23

HIV and AIDS Data Hub for Asia-Pacific % of MSM engaged in unprotected sex in last 6 months who disagreed with these statements, 2001 (%) You have a total control in deciding whether to use condom Among the peers you know, most of them would use condom during sexual intercourse 50 45.9 40 32.8 29.0 28.8 30 20 18.1 14.9 10 0 Not engaged in anal sex (n=220) Engaged in anal sex (n=72) Total (n=292) Source: Prepared by www.aidsdatahub.org based on J T F Lau, J H Kim, M Lau, & Tsui, H.-Y. (2004). HIV Related Behaviors and Attitudes among Chinese MSM in Hong Kong: A Population Based Study. Sex Transm Infect , 80: 459-465. 24

HIV and AIDS Data Hub for Asia-Pacific % of population (18-50) willing to take care of a family member who is HIV infected, 2000 (%) Source: Prepared by www.aidsdatahub.org based on Lau JT, & Tsui HY. (2005). Discriminatory Attitudes Towards People Living with HIV/AIDS and Associated Factors: A Population Based Study in the Chinese General Population. Sex Transm Infect. , 81(2), 113-119. 25

National response www.aidsdatahub.org 26

HIV and AIDS Data Hub for Asia-Pacific % of key affected populations who received an HIV test in the last 12 months and knew the results, 2001-2009 0 20 40 60 80 100 % IDUs Users 2005 91 Heroi Drug 2009 81 n 2004 15 FSWs 2009 49 2001 14 MSM 2006 24 2008 36 Sources: Prepared by www.aidsdatahub.org based on 1. Hong Kong Advisory Council on AIDS. (2007). Recommended HIV/AIDS Strategies for Hong Kong 2007-2011. 2. Special Preventive Programme, Centre for Health Protection, Department of Health. (2009). PRiSM - HIV Prevalence and Risk behavioural Survey of Men who have sex with men in Hong Kong 2008 Factsheet 3. Special Preventive Programme, Centre for Health Protection, Department of Health. (2010). CRiSP-Community Based Risk Behavioural and Seroprevalence Survey for Female Sex Workers in Hong Kong 2009 Factsheet. and 4. State Council AIDS Working Committee Office China (2010). UNGASS Country Progress Report: China. 27

HIV and AIDS Data Hub for Asia-Pacific Number of MSM having undergone voluntary HIV testing and % tested positive at AIDS Concern s MSM voluntary HIV testing service, 2000 - 2008 Number % 1000 10 905 800 8 723 610 600 6 483 400 4 332 223 2.5 2.4 200 2 130 1.8 107 1.7 1.6 38 0.9 0.9 0.8 0 0 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 Number of blood samples tested % tested (+) Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2009). HIV Surveillance Report 2008 Update. 28

HIV and AIDS Data Hub for Asia-Pacific Number of urine samples tested and % tested positive among methadone clinic attendees through universal HIV antibody (urine) testing programme, 2003-2008 Number % 10000 10 8812 8696 8000 8 7955 7730 7314 6000 6 4000 4 2000 2 1834 0.5 0.5 0.4 0.4 0.3 0.2 0 0 2003 2004 2005 2006 2007 2008 (July-Sept) Number of urine samples tested % tested (+) Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2009). HIV Surveillance Report 2008 Update. 29

HIV and AIDS Data Hub for Asia-Pacific Number of urine samples tested and % tested positive among drug users attending treatment centers/ institutions through unlinked anonymous screening, 1998-2008 Number % 2500 10 2286 2000 8 1675 1500 6 1165 1137 1000 4 786 761 630 387 369 500 2 361 0.3 0.6 0.5 0.2 0.2 0.1 0 0 0 0 0 0 1998 1999 2000 2001 2002 2003 2005 2006 2007 2008 Number of urine samples tested % tested (+) Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2009). HIV Surveillance Report 2008 Update. 30

HIV and AIDS Data Hub for Asia-Pacific Number of blood and urine samples tested and % tested positive among newly admitted prisoners through unlinked anonymous screening, 1995-2008 Number % 3000 10 2796 2500 2718 8 2000 2231 6 2007 1980 1500 1580 1571 1516 1503 1502 1502 1500 1474 4 1000 2 500 653 0.9 0.6 0.5 0.5 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.2 0 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Blood samples Urine samples Number of samples tested % tested (+) Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2009). HIV Surveillance Report 2008 Update. 31

HIV and AIDS Data Hub for Asia-Pacific Number of urine samples tested and % tested positive among TB and chest clinic attendees through unlinked anonymous screening, 1995-2008 Number % 2000 10 8 1500 6 1166 1000 1071 1056 1018 1003 1000 998 4 920 895 887 841 840 833 783 500 2 1.2 0.9 0.8 0.8 0.7 0.7 0.6 0.50 0.5 0.5 0.4 0.4 0.2 0.2 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Number of urine samples tested % tested (+) Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2009). HIV Surveillance Report 2008 Update. 32

HIV and AIDS Data Hub for Asia-Pacific Number of TB and chest clinic attendees having undergone voluntary HIV testing and % tested positive, 1995-2008 Number % 5000 10 4511 4000 8 4209 4121 4075 3726 3633 3524 3426 3404 3000 6 3202 3186 3157 3122 2548 2000 4 1000 2 1.2 1.0 0.8 0.7 0.3 0.3 0.3 0.2 0.2 0.1 0.1 0.1 0.1 0.1 0 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Number of blood samples tested % tested (+) Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2009). HIV Surveillance Report 2008 Update. 33

HIV and AIDS Data Hub for Asia-Pacific Number of social hygiene service attendees having undergone voluntary HIV testing and % tested positive, 1985-2008 % Number 100000 1.0 80000 0.8 53363 51639 51209 51197 46127 43980 42764 60000 0.6 38978 38779 37126 37120 33896 33841 33553 33039 31040 0.23 30162 29663 28736 27334 27179 27045 27013 40000 0.4 0.130.15 7911 0.06 0.01 0.01 0.010.020.030.070.040.06 20000 0.2 0.040.07 0.070.06 0.060.040.060.08 0.080.110.07 0.1 0 0.0 198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008 Number of blood samples tested % tested (+) Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2009). HIV Surveillance Report 2008 Update. 34

HIV and AIDS Data Hub for Asia-Pacific Number of pregnant women tested for HIV and % tested positive through universal antenatal HIV testing programme, 2001-2008 Number % 60000 0.1 50000 0.08 51737 47472 40000 43297 42750 41932 41070 0.06 36366 30000 0.05 0.04 20000 0.02 0.02 0.02 0.02 0.02 10000 12965 0.01 0.01 0.0040 0 2001 2002 2003 2004 2005 2006 2007 2008 (Sept-Dec) Number of tests % tested (+) Source: Prepared by www.aidsdatahub.org based on Special Preventive Programme, Centre for Health Protection, Department of Health, Hong Kong SAR. (2009). HIV Surveillance Report 2008 Update. 35

HIV and AIDS Data Hub for Asia-Pacific Formulation of HIV and AIDS Strategies by the Hong Kong Advisory Council on AIDS, 1994-2011 Year Formulation 1994 Strategies for AIDS Prevention, Care and Control in Hong Kong 1999 AIDS Strategies for Hong Kong, 1999-2001 2002 Recommended HIV/AIDS Strategies in Hong Kong 2002-2006 2007-2011 Recommended HIV/AIDS Strategies for Hong Kong 2007-2011 36 Source: Hong Kong Advisory Council on AIDS. (2007). Recommended HIV/AIDS Strategies for Hong Kong 2007-2011.

HIV and AIDS Data Hub for Asia-Pacific THANK YOU slides compiled by www.aidsdatahub.org Data shown in this slide set are comprehensive to the extent they are available from country reports. Please inform us if you know of sources where more recent data can be used. Please acknowledge www.aidsdatahub.org if slides are lifted directly from this site 37