Taiwan's experience in fighting HIV/AIDS in vulnerable populations

After the first case reported in 1984, the cumulative number of native HIV cases reached 18,378 by the end of 2009 in Taiwan. HIV/AIDS patients are provided with free medical care by the government in Taiwan, including HAART which was introduced on 1 April 1997. It was estimated that 84% of persons living with HIV (PLHIV) sought HIV-related care and 46.6% of them receiving HAART in 2009. The case fatality rate of AIDS cases declined from 64% in 1996 to 5% in 2009. The cumulative number of PLHIV increased annually accompanied with the growth of medical expense, which increased from 4.2 million USD in 1997 to 63.1 million USD in 2009. This expenditure is not included in national health insurance program, but budgeted by Taiwan CDC separately. According to the estimation, this policy reduced the rate of HIV transmission by 53% in Taiwan. Before 2004, the majority (>80%) of HIV infection occurred through sexual transmission. An HIV epidemic among injecting drug users (IDU) started since 2005, represented a 124% increase than previous year. To deal with the problem, we adopted a harm reduction program which consists of three main parts: needle-syringe program, drug substitution treatment, and health education program. The program successfully reversed the growing trend of newly reported HIV case number by the end of 2006. Besides, the program improved the quality of life of participating IDUs and further increased their employment rate. However, the impact of HIV/AIDS on social and economic aspects is still challenging in Taiwan.