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HIV battle slowly being won, but new fronts opening

Mechai Pattana School students from Buri Ram promote the use condoms to prevent sexually transmitted diseases, at a World Population Day event in Bangkok earlier this year. Photo: Chanat Katanyu

Investments to combat HIV/Aids and help those living with HIV are increasing across Asia Pacific, with generally encouraging results, but experts agree that reaching vulnerable groups with preventive messages is a never-ending challenge.

Approximately 5.1 million people live with HIV in the region, with about 300,000 new HIV infections recorded in 2016 alone, according to the UNAIDS Prevention Gap Report published last year.

To tackle the Aids epidemic, UNAIDS came up with its "90-90-90" target in 2014. The target states that by December 2020, 90% of all people with Aids will know their status, 90% will receive antiretroviral therapy, and 90% of those receiving antiretroviral therapy will have viral suppression.

Currently, about 60% of the money spent on fighting Aids in the region comes from national governments, primarily in Thailand, Malaysia and India. The good news is that more governments are starting to invest in programmes that work on HIV/Aids prevention, treatment, care and support, according to Steven Kraus, director of the UNAIDS regional support team for Asia and the Pacific.

"If you look at the trend, more and more countries say investing in Aids is not an expense, it is an investment that pays dividends. You can prevent an infection today, and that pays back many times over by not having a person take daily medication," he said.

Some countries are approaching Aids in a direct way and have faced less of a challenge in carrying out policies to help target populations, he added.

Mr Kraus made the comments at Connecting Asia, a regional forum held in Bangkok by Apcom, a coalition of governments, UN partners, non-profit and community-based organisations working in the field.

Participants discussed ways to meet the 90-90-90 target as well as how to make more use of social and digital media to combat HIV, particularly within the gay, MSM (men who have sex with men) and transgender communities. The conference was supported by the US President's Emergency Plan for Aids Relief (Pepfar) via the US Agency for International Development (USAID), as well as UNAIDS.

Apcom executive director Midnight Poonkasetwattana said Thailand had long been "a hub" for innovative programmes and was a lot more accepting than other countries where LGBTQ policies were concerned. A highly successful free-condom campaign in the 1990s was among its standout achievements.

Vietnam is also pursuing innovative ways to raise awareness and interact with people living with HIV.

Dustin Phuc Nguyen, a video jockey at MTV Vietnam, hosts a show called MTV Bus. He travels around Ho Chi Minh City in a bus with a built-in studio, featuring members of the LGBTQ community in 30- and 40-minute episodes. The show is produced in partnership with Path, a Hanoi-based non-profit that works with USAID. About 65% of the show's funding comes from MTV, and the rest comes from Path and USAID.

"It's a simple concept -- you talk to someone on the street and they share their story," Nguyen told Asia Focus. "Our job is to direct a camera to go to their workplace, interview their surrounding friends, families and partners. Everything is straightforward and there's no hiding. They are proud to represent the community."

According to Nguyen, the mobile studio is a highly effective platform because it is spontaneous and allows the show to travel all over the country and reach people from many backgrounds.

"I am surprised by how seriously people are taking this issue. In Vietnam, there isn't much discrimination above the line because [gay sex] isn't criminalised. However, a lot of the population still doesn't know much not about HIV," he said.

In Indonesia, however, conditions are very different, said Adi Nugroho, operations manager with the community-based sexual health rights group GWL-INL. He points to two unique legal challenges: a law banning pornography and the electronic information and transactions law. Because of these laws, any content that GWL-INL produces promoting safe sex and other issues could be considered a crime.

While homosexuality is not illegal in Indonesia, it is not necessarily accepted, he said. "Indonesia is the biggest Muslim country in the world, so most of our values as a country are influenced by Muslim culture," he told Asia Focus.

"We need to use technology not just to educate people about their rights, but also to understand the situation they are in. We also need to prepare them for steps they can take if they face a serious problem such as sexual assault or arrest, as not many people know what they should do."

Most of Apcom's work involves issues that affect the health and human rights of sexual minorities including gay men, MSM and the transgender community. But reaching younger people requires new approaches, Mr Midnight said.

"Younger people are now not in the traditional venues where LGBT people used to meet -- in clubs, pubs and parks," he said. "It's not a physical venue anymore, it's now increasingly online and on social media. This is where the younger, new generation is not receiving information. This conference aims to create strategies to reach these younger individuals."

Governments must become increasingly involved in the global fight against Aids, he continued.

"The funding in this kind of work is declining. We are looking to governments to ensure they provide community organisations with funding and support, rather than thinking about international funding only. Countries in this region are growing richer so they will not be eligible for international funding for much longer. Organisations such as Apcom rely greatly on this funding to operate, so governments should pitch in too."

Glyn Davies, the US ambassador to Thailand, attended the Apcom event and told Asia Focus: "Asia is the most connected place in the world. Young people here have the world in their pockets, in their phones. There are many ways to potentially reach them, to get these messages to them in the virtual world they live in.

"One of the biggest challenges is how to get the word to them, that they need to get themselves tested, find their HIV status, and if they test positive, seek the proper treatment. Only then can these rates be brought low."

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