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HIV in Thailand
There are very few developing countries in the world
where public policy has been effective in preventing the spread of
HIV/AIDS on a national scale, but Thailand is an exception. A
massive program to control HIV has reduced visits to commercial sex
workers by half, raised condom usage, decreased STDs (Sexually
Transmitted Diseases) dramatically, and achieved substantial
reductions in new HIV infections.
Thailand, though, is also a reminder that success
can be relative. Its well funded, politically supported and
comprehensive prevention programmes have saved millions of lives,
reducing the number of new HIV infections from 140,000 in 1991 to
21,000 in 2003. None the less, one-in-100 Thais in this country of
65 million people is infected with HIV, and AIDS has become the
leading cause of death.
However, unless past efforts are sustained and new
sources of infection are addressed, the striking achievements made
in controlling the epidemic could now be put at risk. There is a
need in Thailand to continue strong HIV/AIDS prevention and
education efforts in the future, as well as providing treatment and
care for those living with HIV/AIDS
The first case of AIDS was reported in Thailand in
1984, and it is believed that widespread transmission began in the
late 1980s. In 1988-89 in the first major wave of the epidemic, HIV
infection exploded among injecting drug-users, rising from almost
nil to 40% in a single year. At almost the same time, a second wave
of infection spread among sex workers. In 1989, it was found that
44% of sex workers in Chiang Mai, in the north, were infected with
HIV. The rising infection level among sex workers launched
subsequent waves of the epidemic in the male clients of sex workers,
their wives and partners, and their children.
The initial policy response was limited as in the
1980s the prevailing view was that this was an epidemic brought from
abroad that would be confined to a few individuals in high-risk
groups, like gay men and injecting drug-users, and would not spread
more widely. A government official insisted that the situation was
under control and that
"Thai-to-Thai transmission is not in evidence."
and a group of Thai MPs proposed that all foreigners
should be required to pass an "AIDS test" before being admitted to
the country 8. In keeping with this view, the government spent only
$180,000 on HIV prevention in 1988.
It was not until 1991, with a new Prime Minister
Anand Panyarachun, that AIDS prevention and control became a
national priority at the highest level. The new prime minister took
several important steps that have since been credited with helping
to slow the epidemic. |
