By: Katherine Schwei and Amanda Warner
AIDS (acquired immunodeficiency syndrome) has been a prevalent topic of interest in Thailand due to the thousands of people who have either HIV or AIDS. To understand why so many people in Thailand have either HIV or its more threatening stage, AIDS, we need to understand what HIV/AIDS is and how it is transmitted before we can gain a better understanding of how HIV/AIDS is spreading throughout the Thailand population.
The AIDS virus was first isolated by researchers in France in 1983 and by researches in the United States in 1984. HIV is the beginning form of AIDS, and there are two known viruses of HIV: HIV-1 and HIV-2; HIV-2 occurs mainly in West Africa, and HIV-1 is the strand that occurs throughout the world. HIV infects the certain white blood cells, including the T-helper cells and macrophages (“AIDS” World) which are key components in the response of the immune system. The HIV enters the CD4 cells and inserts its own DNA into the cells reproductive system which causes the cell to produce more HIV as the cell reproduces. Ultimately, the CD4 cells die, and although the body makes millions of CD4 cells every day, the HIV destroys them as fast as they are produced.
The symptoms of HIV are the same as many other conditions and include “enlarged lymph glands, tiredness, fever, loss of appetite and weight, diarrhea, yeast infections of the mouth and vagina, and night sweats” (“AIDS” World). However, a person who has HIV will experience prolonged cases of these symptoms, and the symptoms, in most cases, will be more severe. A person becomes diagnosed as having AIDS when an onset of an opportunistic infection or one of several other severe illnesses happens or when there is a marked decline in the number of CD4 cells a person has (fewer than 200 CD4 cells per microliter of blood). The leading illness that defined AIDS in HIV-infected people was Tuberculosis in 2002 (“AIDS” World). There is no set time line for when a HIV-infected person will develop AIDS; it can happen anywhere from two to fifteen or more years after a person becomes infected. However, the growth of HIV can be decreased by medical treatments that preserve the immune system and delay the onset of opportunistic infections which will delay the development of AIDS (“AIDS” World). HIV has been identified as spreading through sexual intercourse, direct contact with infected blood, and through perinatal; though, the most common way of becoming infected is through sexual intercourse (“AIDS” World). However, the statistics, prevention, and spread of information about HIV throughout Thailand are a little different from the world in general.
The history of HIV/AIDS in Thailand broke out between the years of 1988 and 1989, when infection rates among injecting drug users rose alarmingly from zero to 40% over six months of time (“HIV & AIDS in Thailand”). Furthermore, in 1990, the national HIV surveillance system noticed that in the northern city of Chiang Mai there was another “alarming rate of HIV among 44% of commercial sex workers” (“HIV & AIDS in Thailand”). The commercial sex workers have a higher chance of contracting HIV because they have relatively high numbers of sex partners. With the use of condoms, however, the sex workers will more likely be protected despite the number of clients they have sex with. Nevertheless, in reality, the women are not given power to use a condom; the men have that power. In other cases, the client or clients may refuse to pay for their time if the woman is using a condom.
Mechai Viravaidya, son of physicians, became a leader in promoting extensive AIDS education in Thailand. Mechai worked for the National Economic Development Board which gave him a firsthand view of serious rural poverty (“Mechai”). He viewed Thailand’s rapidly growing populations as a major obstacle to the nation’s development which led to his role in making the government notice the AIDS problem in Thailand. Mechai launched the world’s most creative and dynamic campaign to promote contraceptive usage and transforming the condom into an acceptable, clean, and healthful product. Later, in 1989, Mechai took on the new challenge of convincing the Thai government to break its silence about the emerging AIDS problem that had potentially epidemic dimensions (“Mechai”).
In the year of 1991, a new prevention program of the disease came about to focus on more of a government and national level. The government took a huge step talking to the brothel owners. In addition, the new program enforced a 100% condom use in commercial sex establishments and made it illegal for clients to not use condoms (“HIV & AIDS in Thailand”). Therefore, the program did allow for free distribution of condoms to the brothels and the sex workers. Government officials even posed as clients to make sure that the brothels were using condoms. If any commercial sex establishment failed to use condoms, they were shut down. Moreover, the government partnered with NGOs, the business community, people living with AIDS, religious leaders, and community leaders to educate them about the prevention of HIV (“Thailand”).
Since this program has taken effect, there has been a great success in decreasing the rates of new HIV and STDs infections. The reported condom use in the brothels has increased from 14% in 1989 to over 90% by the year 1994 (“HIV & AIDS in Thailand”). Although the HIV prevalence has declined in commercial sex establishments to 4.3% with the increase of condom use, the prevalence of HIV among freelance sex workers if remaining higher than commercial sex establishments at 19% in Bangkok (“HIV & AIDS in Thailand”).
In addition, men who have sex with men are currently a major risk group for HIV in Thailand. In Bangkok, HIV prevalence among this group rose from 17% to 28% between 2003 and 2005. In 2009, the prevalence of HIV among this group was still high at 24.7% (“HIV & AIDS in Thailand”). The Rainbow Sky Association of Thailand is the first gay organization aimed at providing men who have sex with men education about HIV prevention programs.
In 2011, there were approximately 66,720,153 people living in Thailand, and the most recent statistics of 2009 estimates 530,000 people in Thailand were living with HIV; furthermore, 28,000 people died from AIDS in Thailand in 2009 (“HIV & AIDS in Thailand”). On the positive side, the number of new HIV infections decreased from 143,000 in 1991 to 19,000 in 2003 (“HIV & AIDS in Thailand”).
The government is trying to make a difference in treating people who have HIV. In 2001, the Thai government “committed to providing antiretroviral drugs (ARVs) free of charge to people living with HIV under the National Access to Antiretroviral treatment program for People Living with HIV/AIDS” (HIV & AIDS in Thailand”). The production of cheaper generic medications has let the Thai Government purchase the medications at much lower prices and has led to and eight-fold expansion in treatment between 2001 and 2003.