Countries in Asia and the Pacific can help curb the HIV/AIDS epidemic by tackling the spread of the disease in injecting drugs users but must act speedily, UN officials have said.

The UN Office on Drugs and Crime's South Asia representative, Gary Lewis, said Wednesday the virus was still contained in some nations within high risk groups like injecting drug users, but countries had to seize the "window of opportunity".

"That's why it's important to act now, while there is still a degree of containment in high risk groups," Lewis told AFP.

"If we can work to target infections with these communities, we have a real opportunity to contain the spread of the HIV virus into the general population," he said.

Lewis was speaking after a two-day UN-coordinated regional task force meeting in Kuala Lumpur on HIV/AIDS amongst injecting drug users (IDUs).

The task force, which includes UN agencies, government representatives and civil society groups, is acting as an advisory group on tackling the spread of the disease amongst that population.

UN officials say the HIV/AIDS epidemic is still concentrated among IDUs in some countries such as Malaysia and Vietnam in Southeast Asia, and Nepal and Bangladesh in South Asia.

The UN estimates that there are between 1.3 and 5.3 million injecting drug users in South and Southeast Asia.

The task force coordinator, Guillaume Le Hegarat, said the group was promoting the "scaling up" of public health services, currently reaching less than five percent of injecting drug users in most countries.

Services include education and needle exchange programs, and treatment options including substitution -- using drugs such as methadone to replace illicit drugs, he said.

"Unless we are able to reach at least 50 to 80 percent of the drug user population with these comprehensive services we will have saved lives, but we will not have made a difference in containing and reversing the HIV epidemic," he told AFP.

Le Hegarat said countries had to reach a "critical mass" of injecting drug users to break the transmission of the virus.

"We need to achieve a critical mass in order to make a difference. And not only do we need to reach this critical mass, but we need to do that very quickly, within the next three to five years," he said.

"The epidemic is not waiting for us," he added.

The numbers in India are frightening: In a country of more than 1 billion people, some 5.7 million are infected with HIV/AIDS. That makes India home to more victims of the disease than any other country in the world.

Set against those statistics is an army of people trying to fight the virus. Backing some of them are hundreds of millions of dollars from the world's deepest philanthropical pockets — The Bill and Melinda Gates Foundation.

The foundation's AIDS prevention effort in India, known as "Ahavan" — a Sanskrit word meaning "call to action" — has a $200 million five-year grant to operate an HIV prevention program on a scale never done before. But in a country as vast as India, it could do with more.

The AIDS fight here could easily cost $1.5 billion a year, said Ashok Alexander, the foundation's India director, citing recent U.S. government figures.

The challenge is complex. Often the sex trade — a main transmission route for AIDS — is nearly invisible, with prostitutes working out of truck stops, or even in small village homes. Some sex workers are highly mobile, moving from city to city.

One of India's hardest-hit areas, its remote northeast, has an entirely different problem. There, most HIV transmissions come from needles shared by thousands of heroin addicts, a problem fueled by the region's proximity to the poppy fields of the Golden Triangle.

Logistics can also be nightmarish in rural areas that often lack basic infrastructure.

All these problems are confounded by the stigma attached to AIDS in a very conservative country.

Ahavan's strategy has been to adopt a business-style structure. The product is prevention, and the foundation formed a pyramid structure to get it to consumers. It contracted 15 other organizations that, in turn, work with about 150 grass-roots groups. They employ some 5,000 prostitutes, many of them HIV-positive, to get the message out.

"I talk to women about condoms and how they must insist even their regular clients wear condoms," said Vijaymala, a fruit seller who supplements her income by working as a prostitute without her family's knowledge.

She has a third job working as a "peer counselor" at Saathi, a tiny Gates-funded clinic nestled among the shantytown brothels in Turbhe, an industrial area on Bombay's outskirts.

Employing prostitutes means feedback comes quickly when there are problems.

"In talking with sex workers, our team found that the women felt the condoms available in the market did not suit them," said Sanjeev Gaikwad of Family Health International, which runs the Saathi clinic.

So they went to a condom manufacturer to produce the stronger, better-lubricated ones they now distribute.

Alexander said that after three years of work, it's too soon to evaluate how successful Ahavan has been, but he is positive. "We started off with a five-year grant, but I think we will be here as long as it takes," he said.

The Indian government — notoriously testy about accepting help from outsiders and often at odds with AIDS activist groups, accusing them in the past of exaggerating the numbers — has nothing but praise for the Gates Foundation.

"They are playing a very critical role. The foundation is one of our major partners in helping us reduce the transmission of the disease," said Sujata Rao, director general of the government's National AIDS Control Organization.

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Vietnam will launch a project funded by the Asian Development Bank (ADB) to fight the spread of AIDS among its young people, the Philippines-based lender said.

The information campaign would "boost access and use of condoms and knowledge of HIV/AIDS among youth, and fight dangerous practices such as needle sharing among drug users," said Lisa Studdert, a Vietnam-based ADB health specialist.

Hanoi's population commission is to produce a television drama series over three years to support the program, which would also enlist sports and entertainment personalities to influence youth behavior, an ADB statement said.

From fewer than 4,000 reported cases in 1995, the official number of cases of AIDS and HIV have risen to more than 104,000 by March 2006, with the actual number possibly "three times that figure," it said.

The virus impairs the body's immune system, rendering it practically defenseless against infection.

Injecting drug use accounted for 57 percent of Vietnam's HIV cases, with sexual contact with prostitutes also a key mode of transmission, the bank said.

HIV infections among the 15-24 age group accounted for about 40 percent of all newly reported cases, it said.

"Young men and their high-risk behavior, including drug use, alcohol consumption and unsafe sex are a driving force of Vietnam's epidemic," Studdert said.

The campaign could potentially save 34,000 people from HIV infection over 20 years, she said.

People who spread HIV can be held legally responsible even if they didn't know they had the deadly sexually transmitted disease, California's top court said in an unprecedented ruling.

The four-to-three decision by the California Supreme Court cleared the way for a woman to dig into the sexual history of her husband, who reportedly hid a risky gay lifestyle behind a facade of feigned monogamy.

In a civil suit filed in a Los Angeles court, each spouse blames the other with infecting them with HIV.

"This is a sad case," Justice Marvin Baxter wrote in the opening sentence of the ruling issued on Monday.

"We conclude that the tort of negligent transmission of HIV does not depend solely on actual knowledge of HIV infection and would extend at least to those situations where the actor, under the totality of the circumstances, has reason to know of the infection."

The ruling was described by rival attorneys as a groundbreaking shift to holding people legally responsible for spreading the AIDS virus without "actual knowledge" such as test results.

"Simply put, it means that even though you didn't know, you should have known," the wife's lawyer, Roland Wrinkle, told AFP on Wednesday.

"If you act negligently while driving and injure someone...the negligent person bears the burden. Why should it be different with a disease?"

The husband and wife, identified in Los Angeles County court paperwork only as John B. and Bridget B. for privacy reasons, began dating in 1998 and married in July of 2000.

John B. told his bride that he was monogamous and disease free, according to the suit. The husband has contended in court that he tested negative for HIV during a physical exam in August of 2000 for a life insurance policy.

John B. was diagnosed with full-blown AIDS the following year, a fact that Wrinkle said indicates he was HIV-positive prior to the marriage.

Saying they wanted to balance the wife's right to pursue her case with the husband's privacy, the justices limited her "discovery" regarding his sexual escapades to the six months prior to his negative HIV test.

The court based its reasoning on US Centers for Disease Control and Prevention findings that HIV infection will show up in medical tests within six months of infection.

The court ruled that Bridget B. would be able to dig deeper into her husband's past if she could provide a basis to doubt the reliability or accuracy of the test.

After they both were diagnosed with AIDS, John B. admitted to his wife he had sex, at times unprotected, with men prior to their marriage, the justices noted in their decision.

Bridget B. charged in her suit that her husband continued the practice after they wed and used the Internet to arrange dates with men.

A "should-have-known" standard regarding HIV is likely to encourage people to get tested and staunch the spread of the disease, the justices reasoned.

"The judges believed it enforces responsibility so this epidemic gets cut back," Wrinkle said. "There is no question in my mind the should-have-known standard will have a salutary effect."

"To the extent people thought they could be reckless and irresponsible in these types of situations and would not be held accountable for that behavior - that is no longer the case," Wrinkle said.

The case would be sent back to the lower court in Los Angeles later this year to resume the evidence-gathering phase under the guidelines set by the justices.