title: Changing patterns of HIV epidemic in 30 years in East Asia.
abstract: The HIV epidemic in East Asia started relatively late compared to the rest of the world. All countries or areas, except for North Korea, had reported HIV and AIDS cases, with China being the major contributor to the epidemic. Though initially driven by injecting drug use in China, East Asia did not experience an explosive spread. Strong commitment in China and early harm reduction programs in Taiwan managed to reduce transmission substantially among injecting drug users. In contrast to China and Taiwan, injection drug use has accounted just a little, if not at all, for the spread of HIV in other East Asian counties. However, following a global trend, sexual contact has become a major route of infection across the region. While much progress has been achieved in this region, with the epidemic among other key populations relatively stable, the emerging epidemic through sex between men is a growing concern. Recent estimates suggest that HIV prevalence among men who have sex with men (MSM) has reached 6.3 % in China, 7.5 % in Mongolia, and ranges between 8.1 %-10.7 % in Taiwan and between 2.7 %- 6.5 % in South Korea. In Japan, 74 % of male HIV cases were among MSM in 2012, while Hong Kong has witnessed a sharp increase of HIV cases among MSM since 2004. There is urgent need to address issues of discrimination and stigma toward homosexuality, and to strengthen the strategies to reach and care for this population.
authors.affiliation: Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan, suguimoto.pilar.2w@kyoto-u.ac.jp.
authors.forename: S Pilar
authors.initials: SP
authors.lastname: Suguimoto
authors.forename: Teeranee
authors.initials: T
authors.lastname: Techasrivichien
authors.forename: Patou Masika
authors.initials: PM
authors.lastname: Musumari
authors.forename: Christina
authors.initials: C
authors.lastname: El-saaidi
authors.forename: Bhekumusa Wellington
authors.initials: BW
authors.lastname: Lukhele
authors.forename: Masako
authors.initials: M
authors.lastname: Ono-Kihara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kihara
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology* / Q000266:history; D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D058872:Epidemics / Q000266:history / Q000706:statistics & numerical data*; D005202:Asia, Eastern / Q000453:epidemiology; D005260:Female; D014943:Global Health / Q000639:trends*; D015658:HIV Infections / Q000453:epidemiology* / Q000266:history; D049673:History, 20th Century; D049674:History, 21st Century; D018451:Homosexuality, Male; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008986:Mongolia / Q000453:epidemiology; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult