Skip to main content Accessibility help
  • Print publication year: 2005
  • Online publication date: June 2012

7 - Making the Right Choices in the Asia-Pacific Region: Protecting Children and Young People from HIV and Its Impacts


The situation of orphans and vulnerable children in Asia and the Pacific, in particular children affected by AIDS, has received far less study and attention than has the situation in Africa. HIV/AIDS epidemics in the Asia-Pacific region began much later and have not yet risen to sub-Saharan Africa levels. As a consequence, the overall number of children orphaned by AIDS is much lower, below the threshold of most policymakers' concerns. The current low prevalence, however, also means that the most effective method of reducing the problems of children orphaned and affected by AIDS in the region is primary prevention of HIV infection. If countries respond effectively now, the problems of most children who would be affected by HIV in the absence of strong national responses can be averted. Acting now will also keep the magnitude of the problem small enough that available resources and institutions will be better able to address it.

Even with low prevalence, however, the number of affected children in Asia is substantial, owing to the fact that the region has over half the world's population and almost four times as many children (1.2 billion) as sub-Saharan Africa (350 million) (USAID, UNICEF, and UNAIDS 2004: 9). Almost two million Asian children have already lost at least one parent to AIDS, and many more have been or will be directly affected by the epidemic. Millions more children in the region are rendered vulnerable through poverty, prostitution, child labor, and trafficking.

Association François-Xavier Bagnoud. n.d. Orphan alert 2: Children of the HIV/AIDS pandemic; The challenge for India.
Balk, D., Cruz, G., and Brown, T.. 1997. HIV/AIDS risk in the Philippines: Focus on adolescents and young adults. Working Papers, Population series no. 93. Honolulu: East-West Center
Bamji, M., Thea, D. M., Weedon, J., Krasinski, K., Matheson, P. B., Thomas, P., Lambert, G., Abrams, E. J., Steketee, R., and Heagarty, M.. 1996. Prospective study of human immunodeficiency virus 1-related disease among 512 infants born to infected women in New York City. The New York City Perinatal HIV Transmission Collaborative Study Group. Pediatrics Infectious Disease Journal 15 (10): 891–8
Barnett, T., and Blaikie, P.. 1992. AIDS in Africa: Its present and future impact. London: Belhaven Press
Barnhart, H. X., Caldwell, M. B., and Thomas, P.. 1996. Natural history of human immunodeficiency virus disease in perinatally infected children: An analysis from the Pediatric Spectrum of Disease Project. Pediatrics 97 (5): 710–16
Black, B., and Farrington, A. R.. 1997. Preventing HIV/AIDS by promoting life for Indonesian street children. AIDS captions 4(1) June
Blanche, S., Newell, M. L., Mayaux, M. J., Dunn, D. T., Teglas, J. P., Rouzioux, C., and Peckham, C. S.. 1997. Morbidity and mortality in European children vertically infected by HIV-1: The French Pediatric HIV Infection Study Group and European collaborative study. Journal of Acquired Immune Deficiency Syndromes 14 (5): 442–50
Brown, T. 2003. HIV/AIDS in Asia. Asia-Pacific Issues no. 68. Honolulu: East-West Center
Brown, T., and Peerapatanapokin, W.. 2004. The Asian Epidemic Model: A process model for exploring HIV policy and programme alternatives in Asia. Sexually Transmitted Infections 80 (suppl.): i19
Brown, T., and Sittitrai, W.. 1995. The impact of HIV on children in Thailand. Bangkok: Thai Red Cross Society
Busza, J. 1999. Literature review: Challenging HIV-related stigma and discrimination in Southeast Asia; Past successes and future priorities. New York: Population Council/Horizons.
Busza, J.. 2001. Promoting the positive: Responses to stigma and discrimination in Southeast Asia. AIDS Care 13 (4): 441–56
Chase, E., and Aggleton, P.. 2001. Stigma, HIV/AIDS, and prevention of mother-to-child transmission: A pilot study in Zambia, India, Ukraine, and Burkina Faso. London: UNICEF and the Panos Institute
Chearskul, S., Chotpitayasunondh, T., Simonds, R. J., Wanprapar, N., Waranawat, N., Punpanich, W., Chokephaibulkit, K., et al. 2002. Survival, disease manifestations, and early predictors of disease progression among children with perinatal human immunodeficiency virus infection in Thailand. Pediatrics 110 (2, pt. 1): e25
China HIV/AIDS Socio-Economic Impact Study Team. 2002. Limiting the future impact of HIV/AIDS on children in Yunnan (China). Chapter 9 of AIDS, public policy, and child well-being, ed. Cornia, G.. Florence: UNICEF.
Choe, M. K. n.d. Risk-taking among Asian youth: Findings from the AYARR Project, Asian Young Adult Reproductive Risk. PowerPoint presentation. Available at
Choe, M., H.-S. Lin, C. Podhisita, and C. Raymundo. 2001. Sex and marriage: How closely are they related in the Philippines, Taiwan, and Thailand? Research brief 12 presented at AYARR International Conference, Taipei, November 26–29.
Choe, M. K., Hatmadji, S. H., Podhisita, C., Raymundo, C., and Thapa, S.. 2004. Substance use and premarital sex among adolescents in Indonesia, Nepal, the Philippines, and Thailand. Asia-Pacific Population Journal 19(1): 5–26
Devine, S. 2001. A multi-sectoral approach to planning services for AIDS orphans: Sanpatong district, Chiangmai. Bangkok: UNICEF Office for Thailand
Diaz, C., Hanson, C., Cooper, E. R., Read, J. S., Watson, J., Mendez, H. A., Pitt, J., Rich, K., Smeriglio, V., and Lew, J. F.. 1998. Disease progression in a cohort of infants with vertically acquired HIV infection observed from birth: The Women and Infants Transmission Study (WITS). Journal of Acquired Immune Deficiency Syndromes 18 (3): 221–28
Ennew, J., Gopal, K., Heeran, J., and Montgomery, H.. 1996. Children and prostitution: How can we measure and monitor the commercial sexual exploitation of children? Literature review and annotated bibliography., Cambridge: Centre for Family Research; Oslo, Norway: Childwatch International
Galli, L., Martino, M., Tovo, P. A., Gabiano, C., Zappa, M., Giaquinto, C., Tulisso, S., et al. 1995. Onset of clinical signs in children with HIV-1 perinatal infection: Italian Register for HIV Infection in Children. AIDS 9 (5): 455–61
Gleghorn, A. A., Marx, R., Vittinghoff, E., and Katz, M. H.. 1998. Association between drug use patterns and HIV risks among homeless, runaway, and street youth in northern California. Drug and Alcohol Dependency 51 (3): 219–27
Gordon, J., Bessell, S., Borrell, B., Coombs, G., Jones, T., Horton-Stephens, K., Mauldon, R., Ranck, S., and Warner, B. 1999. Impact of the Asia crisis on children: Issues for social safety nets. Canberra: Centre for International Economics.
Hennessey, C. 2001. Research on available and potential support systems for children infected/affected by HIV/AIDS in Thailand. Bangkok: Save the Children UK
Janjaroen, W., and S. Khamman. 2004. Perinatal AIDS mortality and orphanhood in the aftermath of the successful control of the HIV epidemics: The case of Thailand. Chap. 7 of AIDS, public policy, and child well-being, ed. Cornia, G.. Florence: UNICEF.
Kamakura, M., M. Kihara, and R. Komatsu. 2001. The current status, trends, and determinants of the HIV epidemics in Japan. Paper presented at Mapping the AIDS Pandemic Network meeting, Melbourne, October
Kanshana, S., and Simonds, R. J.. 2002. National program for preventing mother-child HIV transmission in Thailand: Successful implementation and lessons learned. AIDS 16 (7): 953–9
KHANA (Khmer HIV/AIDS NGO Alliance). 2000. KHANA appraisal of needs and resources for children affected by HIV/AIDS in Cambodia.
Knodel, J., and W. Im-em. 2003. The economic consequences for parents of losing an adult child to AIDS: Evidence from Thailand (revised). PSC Research report no. 02-504. Population Studies Center at the Institute for Social Research, University of Michigan, October.
Knodel, J., W. Im-em, C. Saengtienchai, M. VanLandingham, and J. Kespichayawattana. 2002. The impact of an adult child's death due to AIDS on older-aged parents: Results from a direct interview survey. PSC Research report no. 02-498. Population Studies Center at the Institute for Social Research, University of Michigan, April.
Laidler, K. A. J. (with Hodson, D. and Traver, H.). 2000. The Hong Kong drug market: A report for UNICRI on the UNDCP Global Study in Illicit Drug Markets. Hong Kong: Centre for Criminology, University of Hong Kong.
Langston, C., Cooper, E. R., Goldfarb, J., Easley, K. A., Husak, S., Sunkle, S., Starc, T. J., and Colin, A. A.. 2001. Human immunodeficiency virus-related mortality in infants and children: Data from the pediatric pulmonary and cardiovascular complications of vertically transmitted HIV (P(2)C(2)) Study. Pediatrics 107 (2): 328–38
Life Skills Development Foundation, Chiangmai, Thailand. n.d. ‘Child-friendly’ community schools approach for promoting health, psychosocial development, and resilience in children and youth affected by AIDS. Report from the Child Friendly Schools project for AIDS affected children in three provinces of northern Thailand.
Mason, C. J., Markowitz, L. E., Kitsiripornchai, S., Jugsudee, A., Sirisopana, N., Torugsa, K., Carr, J. K., Michael, R. A., Nitayaphan, S., and McNeil, J. G.. 1995. Declining prevalence of HIV-1 infection in young Thai men. AIDS 9 (9): 1061–5
Measure DHS+ Indicators Database. Accessed Sept. 8, 2003
Methamphetamine use is heightening risks among gay youth: ‘Club drugs’ dull safe-sex sensibilities. 2002. AIDS Alert 17 (10): 121
Mielke, J. C. 1994. Child abandonment and HIV/AIDS in Northern Thailand: Implications for relocation of abandoned children into family and community networks. Ph.D. diss., University of Hawaii
Mitka, M. 2002. MTCT-Plus program has two goals: End maternal HIV transmission and treat mothers. Journal of the American Medical Association 288 (2): 153–4
Nelson, K. E., Eiumtrakul, S., Celentano, D. D., Beyrer, C., Galai, N., Kawichai, S., and Khamboonruang, C.. 2002. HIV infection in young men in northern Thailand, 1991–1998: Increasing role of injection drug use. Journal of Acquired Immune Deficiency Syndromes 29 (1): 62–8
Nemoto, T., Operario, D., and Soma, T.. 2002. Risk behaviors of Filipino methamphetamine users in San Francisco: Implications for prevention and treatment of drug use and HIV. Public Health Reports 117 (suppl. 1): S30–8
Newell, M. L. 2001. Prevention of mother-to-child transmission of HIV: Challenges for the current decade. Bulletin of the World Health Organization 79 (12): 1138–44
Nguyen, T. A., Hoang, L. T., Pham, V. Q., and Detels, R.. 2001. Risk factors for HIV-1 seropositivity in drug users under 30 years old in Haiphong, Vietnam. Addiction 96 (3): 405–13
Ono-Kihara, M., Kihara, M., and Yamazaki, H.. 2002. Sexual practices and the risk for HIV/STDs infection of youth in Japan. Japan Medical Association Journal 45 (12): 520–5
Pancharoen, C., J. Ananworanich, and U. Thisyakorn. n.d. Preventing Parent to Child Transmission & HIV: The Thai Experience.
Phalla, T., Leng, H. B., Mills, S., Bennett, A., Wienrawee, P., Gorbach, P., and Chin, J.. 1998. HIV and STD epidemiology, risk behaviors, and prevention and care response in Cambodia. AIDS 12 (suppl. B): S11–18
Phoolcharoen, W., Ungchusak, K., Sittitrai, W., and Brown, T.. 1998. Thailand: Lessons from a strong national response to HIV/AIDS. AIDS 12 (suppl. B): S123–35
Pisani, E., and Winitthama, B.. 2001. What drives HIV in Asia? A summary of trends in sexual and drug-taking behaviors. Bangkok: Family Health International
Pitayanon, S., S. Kongsin, and W. Janjareon. 1997. The economic impact of HIV/AIDS mortality on households in Thailand. In The Economics of HIV and AIDS: The Case of South and South East Asia, ed. Bloom, D. E. and Godwin, P., New Delhi: Oxford University Press
Podhisita, C., Xenos, P., and Varangrat, A.. 2001. The risk of premarital sex among Thai youth: Individual and family influences. Honolulu: East-West Center
Preble, E. A., and Piwoz, E. G.. 2002. Prevention of mother-to-child transmission in Asia: Practical guidance for programs. Washington, DC: Linkages Project
Rajkumar, V. 2000. Vulnerability and impact of HIV/AIDS on children in selected areas of Delhi, Rajasthan, Tamil Nadu, and Maharashtra. New Delhi: Save the Children UK
Rawson, R. A., Washton, A., Domier, C. P., and Reiber, C.. 2002. Drugs and sexual effects: Role of drug type and gender. Journal of Substance Abuse Treatment 22 (2): 103–8
Reid, G., and Costigan, G.. 2002. Revisiting “the hidden epidemic”: A situation assessment of drug use in Asia in the context of HIV/AIDS. Fairfield, Victoria: The Centre for Harm Reduction
Safman, R. 2002. Unto the thousandth generation? The reproduction of risk among Thai youth affected by HIV/AIDS.
Sattah, M. V., Supawitkul, S., Dondero, T. J., Kilmarx, P. H., Young, N. L., Mastro, T. D., Chaikummao, S., Manopaiboon, C., and Griensven, F.. 2002. Prevalence of and risk factors for methamphetamine use in northern Thai youth: Results of an audio-computer-assisted self-interviewing survey with urine testing. Addiction 97 (7): 801–8
Shaffer, N., Chuachoowong, R., Mock, P. A., Bhadrakom, C., Siriwasin, W., Young, N. L., Chotpitayasunondh, T., et al. 1999. Short-course zidovudine for perinatal HIV-1 transmission in Bangkok, Thailand: A randomised controlled trial. Bangkok Collaborative Perinatal HIV Transmission Study Group. Lancet 353 (9155): 773–80
Sittitrai, W., Phanuphak, P., Barry, J., and Brown, T.. 1994. A survey of Thai sexual behaviour and risk of HIV infection [letter]. International Journal of STD and AIDS 5 (5): 377–8
Temmerman, M., Quaghebeur, A., Mwanyumba, F., and Mandaliya, K.. 2003. Mother-to-child HIV transmission in resource poor settings: How to improve coverage?AIDS 17(8): 1239–42
Thai Working Group on HIV/AIDS Projection. 2001. Projections for HIV/AIDS in Thailand: 2000–2020. Bangkok: Dept. of Communicable Disease Control, Ministry of Public Health
Thisyakorn, U., Khongphatthanayothin, M., Sirivichayakul, S., Rongkavilit, C., Poolcharoen, W., Kunanusont, C., Bien, D. D., and Phanuphak, P.. 2000. Thai Red Cross zidovudine donation program to prevent vertical transmission of HIV: The effect of the modified ACTG 076 regimen. AIDS 14 (18): 2921–7
UNAIDS (Joint United Nations Programme on HIV/AIDS). 1998. Expanding the global response to HIV/AIDS through focused action: Reducing risk and vulnerability; Definition, rationale, and pathways. Geneva: UNAIDS
UNAIDS (Joint United Nations Programme on HIV/AIDS). 1999. Reducing girls' vulnerability to HIV/AIDS: The Thai approach. Geneva: UNAIDS
UNAIDS (Joint United Nations Programme on HIV/AIDS). 2002. Report on the global HIV/AIDS epidemic. Geneva: UNAIDS
UNICEF, UNAIDS, and WHO (World Health Organization). 2002. Young people and HIV/AIDS: Opportunity in crisis. New York: UNICEF
United Nations Economic and Social Commission for Asia and the Pacific. 1999. Background document on the Mekong Project on Sexual Abuse and Sexual Exploitation of Children and Youth: Research and intervention phases. UNESCAP HRD course on psychosocial and medical services for sexually abused and sexually exploited children and youth. Bangkok: UNESCAP
United Nations Population Division. 2001. World population prospects: The 2000 revision. New York: United Nations
USAID (United States Agency for International Development), UNICEF, and UNAIDS. 2002. Children on the brink 2002: A joint report on orphan estimates and program strategies. Washington: TvT Associates/The Synergy Project, USAID.
USAID (United States Agency for International Development), UNICEF, and UNAIDS. 2004. Children on the brink 2004: A joint report of new orphan estimates and a framework for action. New York: USAID. Available at
U.S. Bureau of the Census, International Program Center, Population Division. 2004. HIV/AIDS Surveillance Database. 2004 edition. Washington, DC
Verma, R. K., S. Salil, V. Mendonca, S. K. Singh, R. Prasad, and R. B. Upadhyaya. 2002. HIV/AIDS and children in the Sangli district of Maharashtra (India). Chap. 8 of AIDS, public policy, and child well-being, ed. Cornia, G.. Florence: UNICEF.
Westley, S., and M. Choe. 2002. Asia's changing youth population. In The future of population in Asia, by East-West Center, 57–67. Honolulu: East-West Center
Wijngaarden, J., and S. Shaeffer. 2002. The impact of HIV/AIDS on children and young people: Reviewing research conducted and distilling implications for the education sector in Asia. Paper prepared for the workshop Anticipating the Impact of AIDS on the Education Sector in Asia, Bangkok, Thailand, December 12–14
Xenos, P., Achmad, S., Lin, H.-S., Luis, P.-K., Podhisita, C., Raymundo, C., and Thapa, S.. 2002. Marriage and sexual experience indicators for Asian youth: A graphical presentation. AYARR CD. Honolulu: East-West Center