What impact might the economic crisis have on HIV epidemics in Southeast Asia?
OBJECTIVE
To evaluate the potential impact of the current global economic crisis (GEC) on the spread of HIV.


METHODS
To evaluate the impact of the economic downturn we studied two distinct HIV epidemics in Southeast Asia: the generalized epidemic in Cambodia where incidence is declining and the epidemic in Papua New Guinea (PNG) which is in an expansion phase.


METHODS
Major HIV-related risk factors that may change due to the GEC were identified and a dynamic mathematical transmission model was developed and used to forecast HIV prevalence, diagnoses, and incidence in Cambodia and PNG over the next 3 years.


RESULTS
In Cambodia, the total numbers of HIV diagnoses are not expected to be largely affected. However, an estimated increase of up to 10% in incident cases of HIV, due to potential changes in behavior, may not be observed by the surveillance system. In PNG, HIV incidence and diagnoses could be more affected by the GEC, resulting in respective increases of up to 17% and 11% over the next 3 years. Decreases in VCT and education programs are the factors that may be of greatest concern in both settings. A reduction in the rollout of antiretroviral therapy could increase the number of AIDS-related deaths (by up to 7.5% after 3 years).


CONCLUSIONS
The GEC is likely to have a modest impact on HIV epidemics. However, there are plausible conditions under which the economic downturns can noticeably influence epidemic trends. This study highlights the high importance of maintaining funding for HIV programs.
National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia.
Richard T
RT
Gray
Kelly-Jean
KJ
Heymer
Alexander
A
Hoare
Jisoo A
JA
Kwon
Hla-Hla
HH
Thein
Namarola
N
Lote
Peter
P
Siba
Sarun
S
Saramony
Vonthanak
V
Saphonn
Heather
H
Worth
John M
JM
Kaldor
David P
DP
Wilson
D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D002160:Cambodia / Q000453:epidemiology; D004196:Disease Outbreaks; D057172:Economic Recession; D005260:Female; D005544:Forecasting; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*; D006301:Health Services Needs and Demand / Q000191:economics; D006801:Humans; D015994:Incidence; D008297:Male; D010219:Papua New Guinea / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors
D044966:Anti-Retroviral Agents