Shy reception for Beijing-backed gay chatroom, the world's new HIV capital, World Bank warns of potential AIDS boom in South Asia...

A government-backed gay chatroom has launched in Beijing aimed at encouraging safe sex - a major step in a country where homosexuality was not so long ago considered a mental disorder.

Conservative attitudes and an unwillingness to talk about sex mean ignorance about AIDS in China is shockingly high.

Around 85 percent of homosexual men interviewed in one Beijing survey did not realise they could catch HIV/AIDS, according to a 2005 U.N. report. Given that China estimates it has 10 million gay men, the potential for an epidemic is only too clear.

Although condoms are widely available in China thanks to the country's one-child policy, they are not generally promoted in connection with AIDS prevention.

Beijing's first officially sanctioned gay chatroom - hosted by Chaoyang district's disease prevention centre - certainly faces an uphill battle. So far, few people have posted messages apart from the website's managers, according to the Beijing Times.

Perhaps this has something to do with people's concerns about censorship or airing their views on an official site.

How to prevent the spread of AIDS in places like China will be a major focus at the 16th International AIDS Conference, which opened on Sunday in Toronto.

Here are a couple of other AIDS-related stories that caught our eye today:

A doctor shortage in Zambia - one of the countries hardest hit by AIDS - is so severe that non-doctors are being used to help hand out free medication to nearly 30,000 people in need of lifesaving drugs, according to the Toronto Star.

The same newspaper reports that celebrities such as U.S. Grammy winner Alicia Keys, actress Olympia Dukakis and British pop singer Elton John are throwing their weight behind the cause of African grandmothers who have lost their children to HIV/AIDS and are now having to raise their orphaned grandchildren.

The world's new HIV capital

So which country has the highest number of people infected with HIV? If you're thinking of somewhere in sub-Saharan Africa you'd be wrong.

Almost unnoticed, India recently overtook South Africa. It now has an estimated 5.7 million people living with HIV/AIDS.

And more than two thirds of these cases are in just eight states - Tamil Nadu, Karnataka and Andhra Pradesh in the south, Maharashtra and Goa in the west and Manipur, Nagaland and Mizoram in the northeast.

A new report by the World Bank on AIDS in South Asia points out that India's epidemic is just as advanced in many rural areas as in urban populations. Yet, almost all the prevention programmes focus on cities and towns.

In recognition of this, the government launched a plan this month to involve tens of thousands of rural politicians in the fight against HIV/AIDS.

The sex industry is the main factor behind the spread of HIV in most of India - but this is not confined to mega-cities like Mumbai. For example, in one region of Karnataka up to half the villages have at least 10 prostitutes working in them.

At the moment India is focussing its HIV education initiatives on migrant workers and truckers, targeting them at key haulage stops. The report says India should gear more anti-AIDS programmes towards reaching sex workers.

The picture is a little different in India's northeastern states where intravenous drug use is behind the epidemic's rapid growth. However an increasing number of women, many the widows of drug users who have died from HIV/AIDS, are turning to sex work - a pattern that will likely accelerate the disease's spread.

The World Bank study says there's also evidence that the role that high risk homosexual activity and gay prostitution plays in spreading HIV in India is greater than previously thought.

Amid all this dismal reading there is a small glimmer of hope. Recent research suggests HIV prevalence may be declining in some southern states. The drop is attributed to a big rise in condom use among men going to female sex workers.

What about the rest of South Asia?

The World Bank report, published to coincide with the Toronto conference, warns that South Asia's HIV/AIDS epidemic will likely boom, especially in India, unless HIV prevention work is dramatically stepped up.

AIDS first appeared in the region during the early 1980s but epidemics in the different countries have played out in remarkably different ways.

• NEPAL: India's sex industry is helping to fuel Nepal's HIV problem. Many poor Nepalese women work as prostitutes in India, especially in Mumbai. Intravenous drug use is also a major factor across Nepal.

• PAKISTAN: The epidemic is mainly among injecting drug users. There is also evidence of HIV increasingly spreading among men having sex with men and hijras, or transgendered men. HIV infection among sex workers is low.

• BANGLADESH: The pattern is the same as in Pakistan. The report warns the country is at high risk of a substantial epidemic if there is significant spread among drug user networks and their sexual partners.

• AFGHANISTAN: Evidence suggests increasing HIV transmission among clusters of intravenous drug users. Those returning from Iran, which has a significant problem of injecting drug use, are at high risk. The report says the country must act urgently to limit infection in this group.

• SRI LANKA: HIV infection remains low. The report says Sri Lanka has a golden opportunity to ensure this stays the case by introducing early, effective programmes for sex workers and gay men and monitoring for any increase in intravenous drug use.

Emma Batha
AlertNet journalist