HIV/AIDS In Thailand

By: Savanna Brown & Abby Sebastian

Brief Pathophysiology of HIV and Aids:

 How it’s spread:

• HIV is a retrovirus spread through bodily fluids (blood, semen, vaginal and rectal fluids, breast milk) not through casual contact
• Sexual contact is the most frequent mode of transmission
• Once in the body, HIV body attacks T cells (which are key component of the immune system), incorporating its DNA into the cell’s DNA, which then enables the cells to reproduce large amounts of HIV into the blood

 Course of infection

• Primary acute HIV infection – virus is beginning to replicate, individual experiences flu-like symptoms
• Latency – no signs or symptoms present (people with the infection, however, are still capable of spreading the virus)
• AIDS – a person is considered to have AIDS when their T-cell count falls below 200 (normal levels are between 500-1200)
• As the number of T-cells falls, the immune system is severely weakened making individuals susceptible to opportunistic infections
• These are infections that would typically not cause death in healthy individuals, but because of the weakened conditions of HIV/AIDS patients, they are unable to fight them off and therefore more susceptible to death
• In the end, it is not the HIV or the AIDS that kills the individual, but other infections like Pneumonia, Alzheimer’s, Tuberculosis, and various types of cancer

Why Thailand?

In the 1990s there was a lot of prevention campaigns regarding HIV prevention strategies. In the 1990s there was a decrease in HIV visits by commercial sex workers by half. This decrease was due to raised condom usage which achieved substantial reductions in new HIV infections, and decreased the prevalence of STDs. HIV newly diagnosed infections dropped from 143,000 in 1991 to 9,700 in 2011. However, there hasn’t been an effort and funding to keep up with new generation on HIV education and only a small portion of the national HIV/AIDS budget has been designated to Thailand, and a lot of it is used on treatment rather than prevention.  Three populations at large risk for HIV in Thailand are the younger generation, IV drug users, men who have sex with men, and sex workers.

The younger generation is at high risk for HIV due to their inadequate HIV knowledge, multiple sex partners, and inconsistent condom use. There was an effort to reach out to adolescents using a TV commercial regarding safe sex, however, some had no means of obtaining the information and other Thai residents believed it damaged the Thai culture by encouraging sexual activity.

IV drug users (IDU) are also at a great risk for HIV in Thailand. Currently there are 40,300 IDUs in Thailand and 22% of them have HIV. Thailand has CHAMPION-IDU

Project which includes peer educators travelling to hard to reach drug users and teaching them on prevention methods and providing them with resources for treatment.

Men who have sex with men (MSM) account for a large portion of HIV in Thailand.  41 percent of HIV infections in Thailand are due to MSM and a majority in bangkok, known as the “explosive epidemic.”

(2014 May Term students visiting HIV/AIDS Hospice)

Prevention vs Treatment: Thailands focus is on treatment rather than prevention. They used to administer antiretroviral drugs at CD4 (which is found on our immune cells) levels less than of <350 cells/mm3, rather than the previous 200 cells/mm3, so they have let the disease progress before treating it. To decrease the mortality rate of HIV/AIDS, Thailand should initiate treatment before CD4 count get below <350 cells/mm3  and treat even if there are slight indications that the person may be ill. Antiretroviral drugs are used to manage HIV by lowering the viral load, fighting infections, and improving quality of life.

References

“HIV & AIDS in Thailand.” HIV & AIDS in Thailand. N.p., n.d. Web. 5 Apr. 2015.

“Stages of HIV Infection.” AIDS.gov. N.p., 19 Dec. 2013. Web. 3 Apr. 2015.

Porth, Carol, and Ruth A. Hannon. Porth Pathophysiology: Concepts of Altered Health States. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2010. Print.

Somnuek Sungkanuparph. “Thai National Guidelines for Antiretroviral Therapy in HIV-1 Infected Adults and Adolescents 2010.” Asian Biomedicine4 (2010): n. pag. Web.

AIDS, HIV Medicatios Chart: Brands, Uses, Effects, Dosage, & More (WebMD)