BANGKOK (Thomson Reuters Foundation) – HIV/AIDS is the leading cause of premature death and disability from disease in Thailand and the death toll is rising in some other Southeast Asian countries, findings from a new U.S. study published on Wednesday showed.

While the epidemic in Thailand and elsewhere in Southeast Asia is not nearly as severe as that in sub-Saharan Africa, the problem is significant, especially because HIV/AIDS largely affects young adults, the study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington said.

The study, which appeared in the peer-reviewed journal AIDS, examines the impact of HIV/AIDS in terms of “disability-adjusted life years”, a measurement which combines years of life lost to premature death with years lived with disability.

Thailand remains one of the countries most severely affected by HIV/AIDS, despite a strong public health response and a fall of nearly 59 percent in deaths since the peak of the epidemic in 2000, the study said.

In 2011, there were 490,000 people living with HIV in Thailand and 23,000 died from AIDS, according to UNAIDS, the United Nations agency for HIV/AIDS. The IHME says HIV/AIDS is responsible for 4.4 percent of all deaths in Thailand.

Thailand has reduced HIV infections among sex workers through its 100 percent condom campaign in brothels, but has had less success in controlling HIV among two other at-risk groups: intravenous drug users and male homosexuals.

The IHME said there were “no intervention efforts directed” at drug users. The prevalence of HIV among gay men in the Thai capital Bangkok has risen from around 17 percent in 2003 to almost 30 percent in 2011.

“Thailand has made good progress in reducing HIV/AIDS deaths but there’s more to be done,” Dr. Theo Vos, Professor of Global Health at IHME, said in a statement.

The IHME said HIV/AIDS is the leading cause of disease in 21 countries concentrated in four regions: Eastern and Southern Africa, Central Africa, the Caribbean, and Thailand.

REGION’S MAJOR HEALTH CHALLENGE

“HIV is on the rise for a number of countries in Southeast Asia,” Katrina F. Ortblad, IHME researcher and lead author of the study, told Thomson Reuters Foundation.

Five of the 12 Southeast Asian countries with HIV/AIDS epidemics – Indonesia, Laos, the Philippines, Sri Lanka and Vietnam – have rising HIV/AIDS death rates, she said.

Most of the countries “have historically had very small outbreaks, and not full-blown epidemics”, she said. “These countries would be wise to ramp up prevention strategies now, before the epidemic becomes more widespread.”

According to UNAIDS, nearly 5 million people in Asia were living with HIV in 2011, of whom 4 million are in South and Southeast Asia.

In most Southeast Asian countries, the epidemic is concentrated in particular populations, and UNAIDS says injecting drug users, men who have sex with men and sex workers and their clients have accounted for most of the new infections.

Yet national AIDS programmes in Asia often fail to prioritise those most at risk of infection, activists say, even as ongoing transmission to the female partners of drug users and the clients of sex workers is becoming apparent.

The study said the number of AIDS deaths increased in 98 countries from 2006 to 2010.

“Although many of these countries have small epidemic burdens, greater attention and allocation of resources may need to be directed in these settings,” it said.

“Despite progress, the message is clear: HIV/AIDS is not gone.”