Background-People living with HIV/AIDS (PLWHA) in Thailand face tremendous challenges, including HIV-related stigma, lack of social support, and mental health issues such as depression. This study aims to examine complex relationships among demographics, HIV-related stigma, and social support and their impact on depression among PLWHA in Thailand.

Rotavirus remains the most common cause of severe, dehydrating diarrhea among children worldwide. Several rotavirus vaccines are under development. Decisions about new vaccine introduction will require reliable data on disease impact. The Asian Rotavirus Surveillance Network, begun in 2000 to facilitate collection of these data, is a regional collaboration of 36 hospitals in nine countries or areas that conduct surveillance for rotavirus hospitalizations using a uniform World Health Organization protocol. We summarize the Network's organization and experience from August 2001 through July 2002. During this period, 45% of acute diarrheal hospitalizations among children 0–5 years were attributable to rotavirus, higher than previous estimates. Rotavirus was detected in all sites year-round. This network is a novel, regional approach to surveillance for vaccine-preventable diseases. Such a network should provide increased visibility and advocacy, enable more efficient data collection, facilitate training, and serve as the paradigm for rotavirus surveillance activities in other regions.

The importance of antiretroviral therapy adherence for patients living with HIV/AIDS has been well documented. Despite this critical need, many do not follow prescribed regimens. To examine the barriers that lead to non-adherence, we used cross-sectional survey data from a randomized controlled intervention trial in northern and north-eastern Thailand. Of the 507 patients that were enrolled in the trial, we analyzed 386 patients on antiretroviral therapy in order to examine the barriers to adherence. In addition to demographic characteristics, depressive symptoms, physical health, access to care, social support, and internalized shame, HIV disclosure and family communication were examined. The correlation analysis revealed that adherence is significantly associated with internalized shame, access to care, depressive symptoms, and family communication. Based on the multiple logistic regression analysis, depressive symptoms, access to care, HIV disclosure, and family communication were significant predictors of adherence. Having depressive symptoms remains a significant barrier to adherence, while access to care, HIV disclosure, and family communication play important positive roles. Our findings underscore the critical importance of addressing these various challenges that can influence adherence to antiretroviral therapy.

Diarrhea remains an important cause of morbidity and mortality among children in Thailand, with >1 million cases reported in 2002. In anticipation of the development of vaccines against rotavirus, we evaluated the disease burden associated with rotavirus infection in Thai children and evaluated the rotavirus serotypes now circulating in Thailand. Diarrhea surveillance was conducted at 6 Thai hospitals in different geographic areas. Community-based surveillance was conducted in Huaykrajao District, Kanchanaburi Province. During the 24 months of surveillance, 4057 children were admitted to the 6 participating hospitals, and 1950 stool samples were collected. Of these stool samples, 43% (838) were positive for rotavirus. All rotavirus-positive stool samples were evaluated to identify their serotypes; 54.8% of samples were of serotype G9, which was predominant each year. Other identified rotavirus serotypes included G2, G4, G1, and G3 (17.2%, 5.3%, 0.8%, and 0.1% of isolates, respectively). Approximately one-half of the children hospitalized with rotavirus diarrhea were <1 year old. Community surveillance showed the proportion of cases of rotavirus diarrhea in the community to be much lower than that in the hospitalized population (12.2% vs. 43.0%).

Objectives-. People living with HIV (PLH) in Thailand face multiple stressors. We examined findings from a randomized controlled intervention trial designed to improve the quality of life of PLH in Thailand. Methods-.A total of 507 PLH were recruited from four district hospitals in northern and northeastern Thailand and were randomized to an intervention group (n = 260) or a standard care group (n = 247). Computer-assisted personal interviews were administered at baseline, 6, and 12 months.Results-At baseline, the characteristics of PLH in the intervention and the standard care condition were comparable. The mixed effects models used to assess the effect of the intervention revealed that PLH in the intervention condition reported significant improvement in their general health (β = 2.51, P = .001) and mental health (β = 1.57, P = .02) over 12 months, compared to those in the standard care condition.Conclusions-We demonstrated successful efficacy of an intervention designed to improve the quality of life of PLH in Thailand. Interventions must be performed in a systematic, collaborative manner to ensure their cultural relevance, sustainability, and overall success.Corresponding Author: Li Li, PhD, UCLA Semel Institute, Center for Community Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024, USA, Phone: (310) 794-2446; Fax: (310) 794-8297; lililili@ucla.edu. About the AuthorsAt the time of the study, Li Li, Sung-Jae Lee, and Mary Jane Rotheram-Borus were with the University of California, Los Angeles, Semel Institute Center for Community Health. Chuleeporn Jiraphongsa, Siwaporn Khumtong, Sopon Iamsirithaworn, and Panithee Thammawijaya were with the Thai Ministry of Public Health, Bureau of Epidemiology, Nonthaburi, Thailand. Contact information for reprint requestsRequests for reprints should be sent to Li Li, University of California, Los Angeles, Semel Institute Center for Community Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024 (lililili@ucla.edu). ContributorsLi Li contributed to the conception and design of the study and led the study implementation and the writing of the article. Sung-Jae Lee contributed to the summarization and interpretation of study results and data analysis. Mary Jane Rotheram contributed to the conception and design of the study and the interpretation of the study results. Chuleeporn Jiraphongsa, Siwaporn Khumtong, Sopon Iamsirithaworn, and Panithee Thammawijaya contributed to the data collection activities in Thailand, and contributed to the interpretation of the study results. People living with HIV/AIDS (PLH) in Thailand face multiple challenges, including coping with HIV-related disclosure, stigma, and maintaining positive family relationships. HIV disclosure has been identified as a key stressor for PLH in Thailand, with disclosure to children being only 20%, 1 yet 85% to partners. 2,3 When PLH do not disclose their serostatus, the odds of becoming depressed increase threefold, similar to the rate when family members are ashamed of an HIV-positive...