08.03.2003 ACA External Consultancy Review
Hong Kong's Evolving Epidemic - the Current Situation
HIV prevalence in Hong Kong remains low at present. To date 1,005 HIV
infections have been reported, and unlinked anonymous testing in various
populations supports the idea that total cumulative HIV infections in Hong
Kong are on the order of a few thousand at most. However, the social,
economic, and behavioural landscape is evolving rapidly, creating new
opportunities for exposure to HIV both within and outside of Hong Kong.
Continuing risk behaviour also creates the potential for substantial
indigenous spread of HIV if no actions are taken to reduce those risks.
Key areas of concern include:
* Travellers to and from neighboring provinces in China. China has a
growing HIV problem, and studies have found many male travellers engage in
commercial and casual sex while there before returning to Hong Kong.
* Sex workers and clients in Hong Kong. At present, their numbers,
origins, and levels of risk remain largely uncharacterised and few
prevention efforts have been undertaken.
* Men who have sex with men (MSM). While they account for over one-quarter
of all reported HIV infections, only limited prevention activities have
been undertaken and most MSM remain outside the reach of current
behavioural and epidemiological monitoring systems.
* Youth. Young people around the globe are increasing sexually active, and
Hong Kong is no exception. Marginalised youth are particularly at risk.
Yet difficulties remain with sex education efforts and reluctance to
provide youth with the knowledge and skills they need to protect
themselves.
* Injecting drug users. While prevalence remains low, as does needle
sharing, the speed with which HIV can spread through these populations
call for careful monitoring and sustained prevention efforts.
Hong Kong's low prevalence has helped to keep medical and support care
burdens comparatively low, with only 379 people currently under care in
the two designated government clinics that serve all but a handful of
people living with HIV and AIDS. But clinical improvements since 1995, in
particular the introduction of combinations of three drugs that are
extremely effective in delaying severe illness, have started to drive the
overall costs of care upwards. These improved treatments reduce demands on
hospital and other palliative care services, but call for expanded HIV
testing and public education to make those living with HIV aware of their
treatment options, improved medical follow-up, strengthened protection
against discrimination in the workplace, and increased psychosocial
support services.
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