Laos temple. Photo: L Natoli
The Burnet Institute has been operational in the Lao People’s Democratic Republic (Lao PDR) since 1998 and has offices in Vientiane Capital and Champasak Province. In the last eight years, our work has steadily increased in both diversity and scale. Our work includes increasing local capacity to respond to the HIV epidemic through the delivery of critical training and provision of ongoing technical and financial support; building capacity in information gathering for health program management; and building capacity in government health departments to improve the health status of the population. We work with Government staff, mass organisation officials (nationally, provincially and at the district level), health workers, pharmacists, youth, the military and police, truck drivers, and commercial sex workers and their clients.
Lao PDR is one of the poorest countries in South East Asia with more than half the population living below the poverty line. UNAIDS classifies it as a low HIV-prevalence country with an infection rate of 0.04 per cent within the general population and higher among high-risk groups such as sex workers, where rates are around 0.9 per cent. The Lao Government has acknowledged however, that infection rates are probably much higher than the official figures, in both the general population and among the high-risk groups. UNAIDS estimated in 2005 there were 3700 people living with HIV in Laos.
A finding in the UNAIDS national second-generation surveillance in 2000-2001 showed that six out of 811 (0.9 per cent) female sex workers in entertainment sites were HIV positive. Another study involving 108 female sex workers showed a total STI infection rate of 54 per cent which is higher than reported anywhere else in South East Asia. The sex industry is rapidly expanding, with low condom use rates and widespread abuse of alcohol and amphetamines. In 2001, 96 per cent of infections were acquired heterosexually, and as such, mobile populations and sex workers are the most vulnerable groups.
The increasing mobility of the Lao population is only likely to lead to growing rates of HIV infection throughout the entire country. Population mobility has been identified as one of the key causal factors in the spread of HIV.