Indonesia and Pakistan were on the "brink" of a major epidemic and were urged to speed up "their responses if they are to avoid serious HIV epidemics," a UN report said on Monday.
In Indonesia, the "rapidly worsening AIDS epidemic (was) mainly due to injecting drug use," while in Pakistan, the combination of risky behaviour and limited knowledge among injecting drug users and sex workers "favours the rapid spread of HIV."
"New data suggests that the country (Pakistan) could be on the verge of a serious HIV epidemic." "A major epidemic has already been detected among injecting drug users in Karachi," the report said, adding that "one in five sex workers cannot recognise a condom and three quarters did not know that condoms prevented AIDS."
China and Myanmar are not doing enough to prevent the spread of AIDS, the report said, praising Thailand as the Asian success story for bringing about a decline in the number of new HIV cases.
China had made slow progress in fulfilling a 2003 pledge to provide anti-retroviral treatment to all who needed it, warned the AIDS Epidemic Update 2005, released in New Delhi ahead of World AIDS day on December 1.
"By June 2005, about 20,000 people were receiving the drugs in 28 provinces and autonomous regions," the report said.
Most of China's cases were detected in Yunnan and Henan provinces and in the Guangxi autonomous region, it said, adding that the least affected areas "for the moment" were Qinghai province and the Tibet autonomous region.
HIV cases had been found in all 31 provinces of China, the UN's annual report said, warning that the combination of commercial sex and injecting drug use "is likely to become the main driver of China's epidemic."
China officially has an estimated 840,000 people infected with HIV, including 80,000 with full-blown AIDS. The prevalence rate is 0.1 percent.
"In Myanmar, limited prevention efforts led HIV to spread freely - at first within the most at-risk groups and later beyond them. Consequently Myanmar had one of the most serious AIDS epidemics in the region," it said.
In contrast, Thailand offered something of a success story in the fight against AIDS.
"By 2003 the estimated national adult HIV prevalence had dropped to its lowest level ever, approximately 1.5 percent," the report said but noted that only 51 percent of Thai sex workers reported using condoms.
On India, which has more than 5.13 million people living with HIV/AIDS, second only to South Africa (5.3 million), the world body said overall HIV prevalence continued to rise as it was affecting high-risk population groups.
"Transmitted mainly through unprotected sex in southern India and injecting drug use in the (country's) north-east, HIV is spreading beyond urban areas," it said.
Large numbers of Indian sex workers were unaware that condoms could prevent infection while a survey found 42 percent of sex workers believed they could tell whether a client had HIV on the basis of his physical appearance, it said.
Only 30 percent of sex workers used condoms, S Y Qureshi, the outgoing chief of India's National AIDS Control Organisation, told reporters after the release of the report.
If this situation remained unchanged, "India could have an estimated 50 million HIV cases by 2025," he said.
In Bangladesh and the Philippines, HIV prevalence has been low but there were signs the situation could change for the worse, the UN report warned.
Asia accounts for roughly 20 percent, or 8.3 million people, of the 40 million plus people infected with HIV world-wide. But the prevalence rate remains a relatively low 0.4 percent of the adult population, according to UNAIDS.
Injecting drug use is the strongest initial driver of HIV infection in Asia, the report said.
"The majority of drug users are sexually active ... large proportions of them buy or sell sex", causing the large-scale spread of the disease, it said.
This process was "well underway" in several Asian countries including Indonesia and China and unless halted early would cause "millions of new HIV infections."
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