Married women now make up the largest group of new HIV infections in Thailand, forcing health authorities to re-think prevention strategies.

Women engaging in unprotected sex with their infected husbands was behind the steep increase, Dr Sombat Tanprasertsuk, director of the Aids, Tuberculosis and Sexually Transmitted Diseases Bureau told the Bangkok Post Saturday.

More than 30 percent of the estimated 17,000 new HIV cases last year were wives, according to the Public Health Ministry, followed by men having sex with other men at 20 percent and intravenous drug users, who made up 10 percent of new infections. The remainder were teenagers and those buying sex services.

Sombat said the ministry was encouraging couples to have regular HIV tests, and up to five million condoms would be distributed to husbands and wives in a bid to control the rising infection rate.

Despite this alarming trend, Thailand has long been regarded as one of the most successful nations in fighting HIV/AIDS.

The health ministry said in January that 1,478 people died from AIDS between January and November in 2005, down from 6,593 for the same period in 2004.

The sharp drop in deaths was attributed to increasing access to antiretroviral drugs, which are available to more than 90 percent of those in need.

Global experts have called for urgent steps to fight deadly strains of drug-resistant tuberculosis which put HIV/AIDS sufferers at more risk and pose a worldwide threat.

"HIV has the potential to fast track XDR-TB (extreme drug resistant TB) into an uncontrollable epidemic," Karin Meyer, TB research director of the South African Medical Research Association said Thursday, after the opening of a two-day global conference here.

"Infection control precautions are needed now and must be scaled up without delays where HIV positive patients are brought together," she told a news conference.

"We need to act, and we need to act now."

The United Nations' World Health Organisation, South African health authorities and the US Centers for Disease Control are jointly hosting the conference in Johannesburg to enable world specialists to tackle the doomsday scenario.

The Geneva-based WHO has warned that alarm bells should be ringing worldwide because of the emerging threat posed by Multidrug Resistant Tuberculosis, or MDR-TB, which is able to fend off two longstanding frontline tuberculosis drugs.

Around 450,000 new MDR-TB cases are estimated to occur every year, according to the WHO -- a small but worrying trend among the nine million annual tuberculosis infections as a whole.

"Crucial to fighting drug-resistant TB will be rapid diagnostic tests -- with results available in days rather than months," said Ken Castro, director of the US Centers for Disease Control's tuberculosis unit.

He warned that it could spread rapidly if no action was taken, saying: "The occurence of XDR-TB knows no borders."

The experts underlined that TB and AIDS intervention campaigns would have to be merged to ward off the new threat.

The experts called for a seven-point action plan to be put in place immediately, including stepped-up surveillance, enhanced laboratory capacities and testing, infection control measures and more funding to develop new drugs.

Ernesto Jaramillo, head of the WHO's anti-drug resistance team, underscored the need for a "powerful, strong laboratory network to monitor trends... especially for surveillance," and a stronger "collaboration between TB and HIV" intervention efforts.

"These are the minimum actions that countries have to take," he said.

Castro said although "research in this area is lagging behind," a charity foundation set up by billionaire Microsoft founder Bill Gates was funding efforts to provide new medication to "ensure there is a pipeline of drugs."

"Four agents look very promising. We are trying to fast-track them," he said, adding that they were all in the phase-one trial mode.

Castro said better prevention measures were needed in hospitals and clinics to "avoid making patients or their healthcare workers sick with bacteria that they didn't have before they showed up in some of these places."

A recent outbreak in South Africa's AIDS-ravaged KwaZulu-Natal province saw 52 HIV-positive patients dying within an average of 25 days from the point when the resistant TB was first suspected.

At any given moment, about 330,000 South Africans have tuberculosis and about 6,000 have the multiple drug resistant (MDR) variant.

South Africa has the highest number of HIV sufferers in the world after India, with 5.5 million of the country's 47 million population affected by the disease.

A communique issued by the experts said that while the population prevalence of drug resistant tuberculosis was low in Africa, compared with eastern Europe and Asia, "drug resistance in the region is on the rise."

The South African government has defended its controversial approach to HIV/AIDS and sidestepped growing calls to axe Health Minister Manto Tshabalala-Msimang over her handling of the pandemic.

A cabinet meeting on Wednesday "rejected, unreservedly, all the unfounded claims that we don't have a comprehensive programme to fight the pandemic," government spokesman Themba Maseko told reporters in Cape Town.

"Our programme is probably the largest and most comprehensive in the world."

President Thabo Mbeki this week received a letter signed by more than 80 scientists and a Nobel laureate asking him to dismiss Tshabalala-Msimang who has advocated a diet of beetroot, olive oil, garlic and African potatoes to help fight AIDS.

Similar calls have come from opposition political parties at home, as well as the country's largest AIDS lobby group, the Treatment Action Campaign.

Tshabalala-Msimang and the government were recently lampooned by the United Nations' top envoy for AIDS in Africa, Stephen Lewis, for harbouring "theories more worthy of a lunatic fringe than of a concerned and compassionate state".

Maseko said the budget allocation to the government's HIV/AIDS programme "has grown by no less than a hundred-fold over the past twelve years".

"This is an indication that this government is indeed serious about the fight against HIV and AIDS and that anything to the contrary is nothing more than a misrepresentation of facts."

The cabinet did not talk about Tshabalala-Msimang's axing, Maseko said, nor was he aware of any discussion in the government about it.

More than 80 scientists and a Nobel laureate have written to South African President Thabo Mbeki asking him to sack his controversial health minister for dragging her feet on AIDS, the presidency has said.

"We received the letter yesterday but the president has not been able to see it as he is busy with President Vladimir Putin," the first Kremlin leader to visit the country, spokesman Mukoni Ratshitanga told AFP.

The scathing letter -- signed by 81 people including Nobel laureate David Baltimore, an American biologist and Robert Gallo, the developer of the first HIV blood test -- said Health Minister Manto Tshabalala-Msimang was an "embarrassment" for a country with one of the world's heaviest caseloads.

"To promote ineffective, immoral policies on HIV/AIDS endangers lives; to have as health minister a person who now has no international respect is an embarrassment to the South African government," it said.

"We therefore call for the immediate removal of Dr Tshabalala-Msimang as minister of health, and for an end to the disastrous, pseudo-scientific policies that have characterised the South African government's response to HIV/AIDS."

Msimang, dubbed "Dr Beetroot" for her championing of vegetables and olive oil in the fight against AIDS, is facing growing calls to quit, both at home and abroad.

International frustration at the government's policies in a country where 5.5 million are infected with HIV, boiled over spectacularly last month when the UN's top envoy for AIDS in Africa denounced what he called "theories more worthy of a lunatic fringe than of a concerned and compassionate state".

Stephen Lewis's criticism came at an international AIDS conference in Canada, where he accused the South African government of being "obtuse, dilatory and negligent" in its distribution of anti-retroviral drugs (ARVs).

The joint letter said Msimang was neglecting the rollout of ARVs, crucial in the fight against the pandemic.

"According to the best estimates of South African actuaries, over 500,000 people without access to antiretrovirals have reached the stage of HIV-disease when they now require these medicines to save their lives," it said.

It said a government plan released in November 2003 "committed to treating over 380,000 people by this time in the public health sector. Unfortunately, fewer than half of that target number are currently receiving treatment in the public sector. Many people are therefore dying unnecessarily."

"We are also deeply concerned by the proliferation of unproven remedies being marketed in South Africa, some of them with the implicit or even explicit support of the minister of health," it added.

The letter said "slick marketing practices cause people not to take proven medications, or at best to waste money on false hopes. We condemn all those who profit from this type of quackery, at the expense of the sick and dying."

The health minister has rejected the criticism aimed at her by Lewis "with contempt" and said she will not step down.

"My resignation? I haven't thought of it and I am not just about to think of it," she said in a defiant press conference recently.

The government says that 175,000 people are benefiting from the free distribution of ARVs, a programme launched in 2004 after long years of delays.

But according to South Africa's Treatment Action Campaign main AIDS lobby group, more than 700,000 people are in need of ARVs in a country where 800 people die every day as a result of AIDS.

Finland is set to see a two-fold increase in AIDS cases in 2006, due in part to men contracting the disease while on holiday in Thailand, the Finnish government said.

More than 100 new HIV cases are expected before the end of the year, compared with 53 in 2001, out of a population of 5.2 million, according to a report published by the Finnish ministry of health.

"In a growing number of cases, people contract the disease abroad, particularly in Thailand," a favorite holiday destination of Finnish holidaymakers, health ministry advisor Merja Saarinen told AFP.

"What is especially worrying is the number of new cases transmitted sexually," Saarinen said.

Around three out of four of the carriers are male, a figure that has remained unchanged since the beginning of the 1980s, while the average age of infected men has risen from 33 to 40 since 2001.

A drop in the number of cases contracted through sexual contact in those below 25 was an "encouraging" trend, according to Saarinen.

Since AIDS emerged in the 1980s, 2,007 Finns have contracted the disease.

An 11-year-old girl who allegedly had sex with as many as 20 people as a 16-year-old girl watched and coached her has had HIV since birth, an alderman who met with the family said Friday. Alderman Mike McGee Jr. told The Associated Press that he met with the girl Thursday and described her as distraught.

"You can't expect her to be doing well," he said Friday.

McGee said the girl feels like she was misled by the 16-year-old.

"She now is trying to sort out who to trust and who not to," he said.

Her mother died of AIDS and the girl lives with family members, he said.

Also Friday, the 16-year-old's uncle, Freeman Gurley, 40, and Darnell Chaney, 17, were charged with two counts of first-degree sexual assault of a child in the incident, which authorities said took place Monday in a house on the city's north side.

The 16-year-old girl was charged Wednesday in juvenile court with four counts of being a party to first-degree sexual assault of a child. A 15-year-old boy was charged with two counts in juvenile court.

Court records say as many as 20 men and boys took part in the sex acts.

Police spokeswoman Anne E. Schwartz said Friday they were still seeking five others in the case.

No child can give legal consent for sex, District Attorney E. Michael McCann said in a statement Friday.

"Whether the 11-year-old child consented or not is utterly irrelevant," he said.

As of this summer, 338 Wisconsin residents under the age of 19 had reported having the AIDS virus since 1983, according to the state health Web site.

The likelihood of someone spreading the AIDS virus through a single sex act is not well known. A key factor is how much virus is in the infected person's blood, according to Johns Hopkins University researchers who have studied this topic. Treatment with AIDS drugs greatly reduces the amount of virus in the blood.

HIV is spread through blood, semen and vaginal fluids — not saliva. Cases of an infected woman passing HIV to a male partner solely through oral sex have been reported, but these are very rare. If the woman had bleeding gums or mouth sores, that could expose the recipient to her blood and increase the potential risk, according to the federal Centers for Disease Control and Prevention's web site.

As for vaginal sex between an infected female and an uninfected male, studies suggest the probability of getting HIV from a single act is far less than 1 percent.

According to the complaint filed Friday in adult court against Gurley and Chaney, the 11-year-old said the 16-year-old told her she should perform various sex acts on a number of young men at the house Monday and she agreed.

She was in a bedroom and began performing sex acts on a number of males, the complaint said.

When the uncle, Freeman Gurley, came home from work the teenage girl encouraged the 11-year-old to have sex with him, the complaint said. Initially, the 11-year-old refused but then gave in, the complaint said.

At one point the 11-year-old was performing oral sex on Chaney while Gurley was having intercourse with her, the complaint said.

Gurley admitted he had unprotected intercourse with the girl on the bed, the complaint said. In the juvenile court documents, Gurley said his niece coached the 11-year-old.

Chaney admitted the girl performed oral sex on him. He also told police the 16-year-old was directing the 11-year-old girl, the complaint said.

According to court records from the juvenile court case, the 11-year-old told police after the incident in the bedroom she went to the basement, where there were about 15 males and "began to choose who she wanted to perform oral sex on."

The 16-year-old denied encouraging her, court records said.

McGee said he handed out fliers Friday, letting people know about a reward for anyone who had information that would lead to an arrest in the case. Residents had donated $2,000, he said.