Between 2010 and 2016, Asia and the Pacific registered one of the steepest declines in HIV infecti ons globally, with prevalence rates dropping by approximately 13%. Despite this overall reduction, HIV prevalence among people who inject drugs in  Southeast Asia remains among the world’s highest. Regionally, seven of the ten countries with the highest rates of HIV among people who inject drugs are member states of the Association of Southeast Asian Nations (ASEAN).

Between 2011 and 2015, HIV prevalence among people who inject drugs in Southeast Asia was highest in the Philippines (29%), Indonesia (28.8%), Myanmar (28.5%), Cambodia (24.8%), Thailand (19%), and Malaysia (16.6%).2017 data exhibited very little change from previous years, with the highest prevalence rates (where known) in the Philippines (29%), Indonesia (28.76%), Myanmar (26.3%), and Thailand (19.02%).

There is a direct correlation between the high prevalence rates found in ASEAN and the increased health, social, and policy/legal risks faced by people who inject drugs. The HIV-related risks associated with injecting drug use in Southeast Asia are exacerbated by the stigma, discrimination, and risk of criminalisation and punishment (including caning, compulsory reporting/registration, forced rehabilitation, detention, and imprisonment) faced by people who use drugs, as people who use drugs
are deterred from accessing HIV prevention, treatment and care, drug dependence treatment, and other health services. In addition, coverage of such services is inadequate, due in great part to a lack of government funding.

This paper analyses some of the most concerning risks, and offers recommendations for the consideration of policymakers in ASEAN.