Hiv medication for European with work permit

[kopite]

I have found that the main concern of many medical practices in Thailand is to sell you as many drugs as possible and for as long as possible , rather than to give you the correct medication .

I would be more worried about how often you get your bloodwork done if your HIV+ in thailand, and how thorough and effective the tests are. The generic medication is fine, it's just unfortunate there isn't as many meds available like the US/UK etc.

[sanemax]

39 minutes ago, PunkRockerGuy said:

This means all the girls who do BBJ are in danger of HIV infection and basically ALL oral sex would provide a highly effective route of transmission, yet very few ever get HIV. 

   Hiv doesnt enter the bloodstream through oral sex , even if the hiv virus get into the stomach , the acids in the stomach would kill the virus

[PunkRockerGuy]

Just now, sanemax said:

   Hiv doesnt enter the bloodstream through oral sex , even if the hiv virus get into the stomach , the acids in the stomach would kill the virus

I will politely agree to disagree.  Most humans have small tears in mucousal membranes that lead to the bloodstream.  Additionally, if HIV is so weak that low molecular weight stomach acids "kill" HIV, there is little proof it leads to AIDS.  I studied it quite thoroughly while in med school and admit I was the odd man out.  Are you aware of how many gay men in the US have the "symptoms" of AIDS, but NOT A SINGLE HIV marker?  

 

It's the drugs, alcoholism, poor hygiene and most likely a super bacteria that when added to promiscuity causes AIDS symptoms.  However, I am willing to admit I am in the minority with my opinion and research.  I'm telling you, after sex with perhaps 400-500 girls since I was 17 years old, and using a condom only when I lost my virginity, I must be the luckiest damn bastard on this planet ?

 

[scubascuba3]

But them stats are predominately for western countries. Once you factor in prostitution, alcohol and drugs, those odds change significantly. Having other STD's hugely increases the odds as well.

Those stats i posted state "low income countries" and "high income countries" plus based on having sex with an HIV+ person, so not predominately for western countries. They don't appear to differentiate if someone is also a prostitute and alcohol and drugs, maybe because they are HIV+ anyway. You also need to factor in if someone is circumcised and/or taking prep. Anyway, i find the risks put into numbers much more useful than someone saying low and high risk which is meaningless

[kopite]

Those stats i posted state "low income countries" and "high income countries" plus based on having sex with an HIV+ person, so not predominately for western countries. They don't appear to differentiate if someone is also a prostitute and alcohol and drugs, maybe because they are HIV+ anyway. You also need to factor in if someone is circumcised and/or taking prep. Anyway, i find the risks put into numbers much more useful than someone saying low and high risk which is meaningless

How many low income countries have a thriving sex industry like Thailand? In the UK new diagnoses where people got infected abroad, the numbers are 10 times higher for Thailand than any other country. That suggests that in Pattaya, Bangkok etc a high number of sex workers are HIV+ and passing on the virus. It isn't just as simple as saying it's only a 1-233 chance of getting infected. You have to add in the factor of other STDS, drugs/alcohol, having multiple partners daily and not knowing your status. The odds shorten everytime you start looking at what increases the odds of infection if your having unprotected sex with prostitutes in places like pattaya.

[scubascuba3]

How many low income countries have a thriving sex industry like Thailand? In the UK new diagnoses where people got infected abroad, the numbers are 10 times higher for Thailand than any other country. That suggests that in Pattaya, Bangkok etc a high number of sex workers are HIV+ and passing on the virus. It isn't just as simple as saying it's only a 1-233 chance of getting infected. You have to add in the factor of other STDS, drugs/alcohol, having multiple partners daily and not knowing your status. The odds shorten everytime you start looking at what increases the odds of infection if your having unprotected sex with prostitutes in places like pattaya.

You are missing the main point that those risks have been calculated based on the person being HIV+ i.e. 100%. I read in this thread or another that its something like 20% HiV+ rate for Bangkok sex workers, i have no idea if that's true as usual no back up was provided

[kopite]

You are missing the main point that those risks have been calculated based on the person being HIV+ i.e. 100%. I read in this thread or another that its something like 20% HiV+ rate for Bangkok sex workers, i have no idea if that's true as usual no back up was provided

That was me that said that. That was an estimate given by Thai authorities. I'm not saying your wrong. I'm saying that the variables and odds increase the more you are exposed to HIV+ people who live carefree reckless lifes. Don't forget that in Thailand that would be both the person who is HIV+ and the person who is not. The odds you posted would be across low income countries as a whole. So some counties would have lower risk, others a higher risk. Thailand of course would be higher risk as the facts and statistics show as per the high amount of UK nationals who were infected there on there travels.

[geriatrickid]

On 6/9/2018 at 2:58 AM, kopite said:

Very worrying that people assume you can't get HIV from bargirls or via "normal" sex. The estimate in Bangkok is that 20% of sex workers are HIV positive.
There are many factors to consider. I would advise your friend to leave Thailand and return to the UK. The NHS and specialist HIV teams in the UK are some of the best in the world, especially if you live near to London, Manchester and Liverpool.
PM me if you would like some more info!

Sound advice. The NHS has competent experienced professionals who can help the patient successfully manage the infection and turn it from a certain death into a managed chronic disease.

Unfortunately, the 20% is for all of Bangkok. If one were to look at the key farang sex districts, the % would be higher.

 

16 hours ago, kopite said:

16 hours ago, jenny2017 said:

I thought all prostitutes have to be tested from time to time/ 

By who? The bars? That's just a myth

There was a testing program, but that fell by the wayside. Successive budget cuts.

There was support and interest when the WHO, USA and some EU countries provided the funds.

 

16 hours ago, jenny2017 said:

Back in the old days, I've met quite a few girls who had to go for an HIV test and needed a stamp on a card that they were negative. 

It was a pink booklet  ?

 

12 hours ago, PunkRockerGuy said:

I did 2 years medical school at YALE after my Doctorate in Law, but stopped studying for my MD

You are not qualified to offer an assessment of the factors involved in the transmission of a communicable disease. The common transmission mechanism of the virus is known and the common attachment points are known. Your "theory" was dismissed because it was based upon your personal supposition and not supported by clinical evidence.  Contracting an infectious disease involves an interplay of multiple factors. However, it's rather obvious that those who serro convert subsequent to contact with a carrier in places like Pattaya, are distinguished by their damaged immune systems due to smoking, drinking in excess, recreational drug use, age, underlying medical condition and concurrent STIs. It's a game of odds where the odds are in favour of the infection when the subject  has a high risk lifestyle.

[kopite]

There is also the fact that the main strain of HIV found in Thailand is subtype E.

 

"In Thailand, the primary means of transmission of HIV is by heterosexual sex, overwhelmingly HIV subtype E. A second group is intravenous drug users (IDU's), most of whom are infected with HIV subtype B, the subtype most common in western homosexuals and IDU's, and which is apparently difficult to transmit heterosexually.

In the west, the prevalent HIV subtype B has as its primary means of transmission: anal sex (due to the abrasions of an unlubricated and tight tract which give the virus access to the blood), intravenous drug use (needle sharing between drug users), blood transfusions, hemophilia (people who need blood transfusions and who got donated blood with HIV before the hospitals could detect HIV), and with heterosexual transmission accounting for only about 10% of all cases. Subtype E is found in only a tiny minority of cases in the west, and is often traceable to travellers from Thailand.

For more than 20 years, Thailand has had HIV subtypes B and E. However, it is subtype E which has taken off in the heterosexual population. This has suggested that there are significantly different degrees of contagiousness between the two subtypes as regards heterosexual transmission.

It might be a common deadly mistake by western men to have unprotected sex with prostitutes in Thailand based on a lack of education and understanding of the difference between HIV subtype B in the west and HIV subtype E in southeast Asia."

 

This would tie in with what was found in the UK by citizens who were infected in Thailand. 70% reported having unprotected heterosexual contact.

 

 

 

[scubascuba3]

 
"In Thailand, the primary means of transmission of HIV is by heterosexual sex 
 

Can you provide back up? Isn't it better to provide backup everytime so people can read up on it rather than take yours or anyone elses word for it

[kopite]

Can you provide back up? Isn't it better to provide backup everytime so people can read up on it rather than take yours or anyone elses word for it

The paragraph I quoted is from the following article, he/she gives links at the bottom of the page to where he got the information. However a quick Google search of "subtype E HIV" will give you multiple academic studies.

http://www.thailandguru.com/hiv-aids-thailand.html

This is a screenshot of a wikipedia entry regarding the subtypes.

[SoNowWhat]

On 6/7/2018 at 8:53 PM, sfokevin said:

A second issue if your friend is going to use the Government SS system... Research the HIV meds they want to prescribe... They may prescribe the cheaper older drugs - Some of which have a long term side effect of facial/body wasting... Be firm and ask for the newer drugs such as generic Atripla...

#1 The side effects of wasting/humps (lypodystrophy) are basically non existent with the medicines available today. Of course with any medication including aspirin there are possible side effects after taking them long term. However now HIV medications are extremely well tolerated and safe. 

#2 ATRIPLA/generic or otherwise is not new it is now 12 years old. It is the workhorse of medications being cheap, effective, and forgiving with it's dosage. There are many newer medications available now in Bangkok however ATRIPLA is still most widely prescribed.

#3 As for being 'firm with the doctor ' there is nothing much cheaper than ATRIPLA, except RILPIVIRINE/TDF by about 200 baht or less, the older drugs are now used when there are other problems present within the patient such as tuberculosis or other confections presently needing medications that might make for possible drug interactions or for some special  cases that have rare drug resistant  HIV strains. 

[SoNowWhat]

18 hours ago, kopite said:

18 hours ago, scubascuba3 said:

That's most likely incorrect about a few weeks. I'm pretty confident the Thai Red Cross would test very quickly

I won't copy and paste someone else's posts from a different forum, but after diagnosis in which his wife was hospitalized they didn't check the viral load. They then paid for it and it took 3 weeks to get the results.

Unless this happened years ago or someplace far far far removed from a city, no doctor would be able to prescribe medication without a viral load test. As she was hospitalized I assume then she was quite ill. Your friend might have been confused with genetic resistance testing which is not routinely done here and takes 2-3 weeks for results. In Bangkok a viral load tests typically is reported within 5-10 days as there are only a few labs that do this work.

[theguyfromanotherforum]

17 hours ago, PunkRockerGuy said:

All I can say is this, before meeting my wife, I had hundreds of one-night stands since I was 17 and I think HIV awareness can around when I was about 18-years old.  I used a condom ONE time which was my first sexual experience at 17 years of age.  It was so awful, I never used a condom again, and that was 1979.  I am now 56 and due to my superbike injury, I have gone through 14-16 surgeries at Ramathibodi where they insist on HIV testing be included with the regular bloodwork.  Also, as I take a LOT of meds for pain, joint problems, for neuropathic pain in my right shoulder that no longer has soft tissue left, etc., so the doctors insist on bloodwork every 3-6 months and I always ask them to throw in an HIV test with the kidney, liver, and RBC counts.  Have always tested negative .... yet, I slept with really questionable girls.

 

If sexual contact or exchange of bodily fluids really, truly, 100% caused HIV infection and subsequently AIDS, I WOULD be dead by now.  This means all the girls who do BBJ are in danger of HIV infection and basically ALL oral sex would provide a highly effective route of transmission, yet very few ever get HIV.  Thus, either I have some awesome immune system, despite being plagued with IBS since I was about 20, easily get travelers diarrhea for many years, and suffer from extreme anxiety (controlled by meds) due to a severe Type A personality and always talking 5-6 projects at a time.  

 

I did 2 years medical school at YALE after my Doctorate in Law, but stopped studying for my MD as my salary at my Japanese company I started while in Law School was doing so well, I knew I could never go be a resident at a hospital until I commanded even 20% of my Japanese company salary where we worked for Black&Decker, DeWalt, Bosch, Stanley Tools, ESTWING hammers, and most of the large American power and hand tool companies opening their first sales offices in Japan in the 90's and importing and warehousing their tools.  So, it's not like I am medically ignorant.  However, I do have my doubts about the transmission of HIV and so does Dr. Rosenberg at UCLA medical school.

 

However, back to the thread: I work with the Thai Red Cross on a project basis and have had friends ask me about their friends or relatives in Thailand obtaining HIV meds at Thai Red Cross.  The previous poster is correct.  If you believe the HIV drug therapy is required, it is very inexpensive to obtain your meds at the Thai Red Cross. 

 

Blah, blah, blah... how did OP friend get it? Maybe Alex Jones send some UFO's his way and got probed.

[scubascuba3]

The paragraph I quoted is from the following article, he/she gives links at the bottom of the page to where he got the information. However a quick Google search of "subtype E HIV" will give you multiple academic studies.

http://www.thailandguru.com/hiv-aids-thailand.html

This is a screenshot of a wikipedia entry regarding the subtypes.

Interesting article, it was updated 2006, not much online more recently discussing sub type E in Thailand. You'd think if it was that clear cut there would be many articles and more recent.

[kopite]

Interesting article, it was updated 2006, not much online more recently discussing sub type E in Thailand. You'd think if it was that clear cut there would be many articles and more recent.

There are many articles and published research regarding subtype E. Most of the studies were done late 90s and early 2000s.

An example,

https://www.researchgate.net/publication/12903121_High_Rates_of_Transmission_of_Subtype_E_Human_Immunodeficiency_Virus_Type_1_among_Heterosexual_Couples_in_Northern_Thailand_Role_of_Sexually_Transmitted_Diseases_and_Immune_Compromise

[kopite]

Unless this happened years ago or someplace far far far removed from a city, no doctor would be able to prescribe medication without a viral load test. As she was hospitalized I assume then she was quite ill. Your friend might have been confused with genetic resistance testing which is not routinely done here and takes 2-3 weeks for results. In Bangkok a viral load tests typically is reported within 5-10 days as there are only a few labs that do this work.

I found it odd as well. Too be honest it is quite obvious that he isn't doing well with the diagnosis and is struggling with the language barrier.

[SoNowWhat]

2 minutes ago, scubascuba3 said:

1 hour ago, kopite said:

The paragraph I quoted is from the following article, he/she gives links at the bottom of the page to where he got the information. However a quick Google search of "subtype E HIV" will give you multiple academic studies.

http://www.thailandguru.com/hiv-aids-thailand.html

This is a screenshot of a wikipedia entry regarding the subtypes.

Interesting article, it was updated 2006, not much online more recently discussing sub type E in Thailand. You'd think if it was that clear cut there would be many articles and more recent.

Because unless you are an epidemiologist it has little relevance. In Thailand if you engage in mainly heterosexual contact you most probably will get infected with type E which has been reclassified under a new name...I can't recall...and if you engage in homosexual contact you most likely get type B. New HIV cases in Thailand are split roughly even at about 50% for gays and 50% straights with gay men. Regardless of the subtype, the outcome and treatment are the same. The subtype  and strains are a specialist academic point.

[scubascuba3]

There are many articles and published research regarding subtype E. Most of the studies were done late 90s and early 2000s.

An example,

https://www.researchgate.net/publication/12903121_High_Rates_of_Transmission_of_Subtype_E_Human_Immunodeficiency_Virus_Type_1_among_Heterosexual_Couples_in_Northern_Thailand_Role_of_Sexually_Transmitted_Diseases_and_Immune_Compromise

I'm just surprised they are all so old, nothing recent comes up, makes me wonder why. I'll be seeing my UK STI doctor tomorrow so I'll see her view on some of these figures

[SoNowWhat]

She will hardly be keeping up on that. It's extremely specialized and really of no consequence.  

[scubascuba3]

She will hardly be keeping up on that. It's extremely specialized and really of no consequence.  

But further up someone said most new UK HIV cases were from Thailand, if true you'd expect the UK doctors to keep up to date

[kopite]

But further up someone said most new UK HIV cases were from Thailand, if true you'd expect the UK doctors to keep up to date

What I said was, 15% of new HIV diagnoses were acquired whilst abroad. Most of these were acquired in Thailand. Almost 10 times more than any other country. That is probably due to the huge numbers of UK nationals that go to Thailand primarily for sex with prostitutes. The study also concluded that most of these individuals were older in age. I'm about to start my shift at work so will post the link later.

[SoNowWhat]

29 minutes ago, scubascuba3 said:

56 minutes ago, SoNowWhat said:

She will hardly be keeping up on that. It's extremely specialized and really of no consequence.  

But further up someone said most new UK HIV cases were from Thailand, if true you'd expect the UK doctors to keep up to date

Again the type doesn't matter in anyway. Different types are found in different communities...that is all.

[scubascuba3]

Again the type doesn't matter in anyway. Different types are found in different communities...that is all.

In post #72 the link does seem to say it does matter about type, for example "Subsequent studies have confirmed that HIV subtype E is more contagious than subtype B for heterosexuals, and there doesn't seem to be any significant disagreement about that"

[KiChakayan]

On 6/7/2018 at 8:19 PM, phitsanulokjohn said:

He just always enjoyed being single.Bar girl was the source as far ss I'm aware.

And what difference does it make? Just remember HIV is difficult to catch. Hence some people catch it. Make your own choices.

[kopite]

And what difference does it make? Just remember HIV is difficult to catch. Hence some people catch it. Make your own choices.

See this is the kind of post that infuriates me. It only takes one time to be infected by HIV. That's the only stat you have to remember. All the other odds are irrelevant as it doesn't wait until your 233rd time to infect you. It all depends on variables. In Thailand, in certain parts of country, within certain groups the odds go agaisnt your favour massively.

[gk10002000]

So he is a foreigner but can get into Thailand with Hiv?  Isn't that one the few tests a foreigner has to submit results for when applying for retirement visas?  So that doesn't happen for work permits and other types of visas? 

[scubascuba3]

So he is a foreigner but can get into Thailand with Hiv?  Isn't that one the few tests a foreigner has to submit results for when applying for retirement visas?  So that doesn't happen for work permits and other types of visas? 

HIV isn't on the medical report

[SoNowWhat]

7 hours ago, SoNowWhat said:

Again the type doesn't matter in anyway. Different types are found in different communities...that is all.

Again it is all based on geography and whom you are having sex with. The only reason you would be interested in this is if you are an epidemiologist or researcher. If you do a little more research you will find that-

 

#1 These articles you guys keep reaching for are quite old and things have moved on.

 

#2 The subtype B has been reclassified because it was misclassified and the reason for it being prevalent and more easily transmitted in the heterosexual community is unknown and apparently no one feels it necessary to research this more.

 

#3 Again your strain of HIV is immaterial and based largely on geography and sexual practices. The vast majority of people in Thailand have no idea of their HIV genotype because it is an expensive procedure and completely unnecessary, unless you have treatment failure or are in a research program.

 

So can anyone enlighten me as to why this is important?

 

What is important is regular HIV testing for  all sexually active people, no excuses just get it done. Those who are positive must adhere to their treatment to stay healthy and stop the spread of HIV. If you are going to engage in transactional sex protect yourself with condoms and or PrEP.

 

This nonsense of armchair epidemiology clouds the fact that HIV numbers in Thailand are not great and the change has to start with you. 

 

Oh sorry I have quoted myself...oops but you can guess what I meant.

 

[scubascuba3]

Again it is all based on geography and whom you are having sex with. The only reason you would be interested in this is if you are an epidemiologist or researcher. If you do a little more research you will find that-
 
#1 These articles you guys keep reaching for are quite old and things have moved on.
 
#2 The subtype B has been reclassified because it was misclassified and the reason for it being prevalent and more easily transmitted in the heterosexual community is unknown and apparently no one feels it necessary to research this more.
 
#3 Again your strain of HIV is immaterial and based largely on geography and sexual practices. The vast majority of people in Thailand have no idea of their HIV genotype because it is an expensive procedure and completely unnecessary, unless you have treatment failure or are in a research program.
 
So can anyone enlighten me as to why this is important?
 
What is important is regular HIV testing for  all sexually active people, no excuses just get it done. Those who are positive must adhere to their treatment to stay healthy and stop the spread of HIV. If you are going to engage in transactional sex protect yourself with condoms and or PrEP.
 
This nonsense of armchair epidemiology clouds the fact that HIV numbers in Thailand are not great and the change has to start with you. 
 
Oh sorry I have quoted myself...oops but you can guess what I meant.
 

Yes the link in post #71 Kopite was quoting from was very old, 2006 and earlier, i did wonder if it was legit and superseded