Thailand's Response to the HIV Epidemic: Yesterday, Today, and Tomorrow

Abstract

Thailand's comprehensive national response to the HIV/AIDS epidemic has been extensively documented since the beginning of epidemic. Substantial progress in the fight against HIV/AIDS has been made because awareness of the problem was raised. Top-level political commitment and multisectoral strategies mobilized funds and human resources to implement the control program at all levels. Behavioral change resulting in increased condom use in brothels on a national scale rose from virtually nil to more than 95%. This was accompanied by a 90% reduction of the sexually transmitted disease rate. In parallel, the rate of new HIV infections dropped by 80%. Despite these achievements, there remains an urgent need to continue efforts to ensure universal and unfailing condom use. Further, Thailand needs to establish pragmatic innovative approaches to reduce transmission, especially among injection drug users, women, and youth, as well as to develop effective strategies for implementation of antiretroviral treatment. Further strategies also need to consider the changing cultural, social, and economic characteristics of the Thai populations.

Grand challenges in chronic non-communicable diseases

“…An estimated 45% of injecting drug users attending treatment clinics have been found to be infected with HIV (Punpanich et al, 2004), and an estimated 3%-10% of injecting drug users in Thailand are estimated to be newly infected with HIV each year (Kawichai et al, 2006). This is due chiefly to the large proportion of injecting drug users who use contaminated injecting equipment (some 35%, according to one recent study) (Longfield et al, 2006).…”

Structural Interventions: Concepts, Challenges and Opportunities for Research

“…The 100% condom programs in Cambodia and Thailand exemplify the massive multisectoral collaboration that structural interventions require. [38][39][40][41] In his description of the response to HIV in Thailand, Phoolcharoen describes the critical roles played by government (including the divisions of social services, public health, STD clinics, economics, culture, military, education), the media, sex workers, researchers/scientists, sex establishment owners, people living with HIV/ AIDS, financial industry and international agencies. 39 …”

Survival of an AIDS cohort in Thailand (2000–2005)

“…Older patients may have other chronic health conditions co-existing with HIV that may reduce their chances of survival, while younger patients may be in denial about their infection resulting in late diagnosis. Young people continue to bear the brunt of the global HIV/AIDS epidemic with those between the ages of 15 and 24 being particularly hard hit, especially women who comprise the majority of young people living with the disease that could become a driving force for the future spread of the epidemic (Punpanich et al, 2004).…”

“…Indeed, the young population in the 15Á 24-year age group is emerging as a new group at risk, not just the commercial sex workers as in the past decade (Allen et al, 2003;UNDP, 2004). A shift in the behavior of Thai youth toward an increase in unsafe pre-marital sex at earlier ages, commercial sex and drug use (Punpanich, Ungchusak, & Detels, 2004), has exposed them to morbidity and death, thereby depriving the Thai society of a potentially productive workforce. Research on the AIDS epidemic among young adults in Thailand has predominantly focused on sexual behavior, and the knowledge and perception of risks (Allen et al, 2003;Ford & Kittisuksathit, 1994;Morrison, 2004;Sweat et al, 1995;Thianthai, 2004).…”