Alarm Over Rising Hiv Infection Among Gay Men

[george]

Alarm over rising HIV infection among gay men

BANGKOK: -- While the overall figure of people living with HIV/Aids is declining, new infections among men who have sex with men have been increasing drastically during the past few years, causing grave concern at the Public Health Ministry.

Dr Somchai Chakrabhand, directorgeneral of the Disease Control Department, said yesterday that a recent survey looking at the situation across the country of HIV/Aids among this group had found that the risk areas were concentrated in tourism centres such as Bangkok, Chiang Mai and Phuket.

He was speaking at the conclusion of a oneday conference on lessons learned from the project to develop a network of men who have sex with men. About 200 health activists and gayrights advocates attended the meeting.

In Bangkok, a survey of homosexual men found that the incidence of HIV infection had increased from 17 per cent in 2003 to 30 per cent last year. The rate of infection in Chiang Mai rose to 16.9 per cent last year from 15.3 per cent in 2005, while Phuket jumped from 5.5 per cent in 2005 to 20 per cent last year.

The survey also found that half of men in this group do not use condoms with their lovers or temporary partners.

Male sex workers formed a highrisk group for infections due to their unsafe sex behaviour and lack of knowledge on protecting themselves from getting the virus, Somchai said.

"Most of them have anal sex with their partners without using a condom and lubricant. This could cause deep damage to anal tissue and easy transmission of HIV," he said.

He admitted that one factor was that over the past few years the campaign for HIV infection prevention among men who have sex with men, especially raising awareness to use condoms during sex, was discontinued.

Manoon Jaikueankaew of the Disease Control Department's Unit 10 in Chiang Mai, said men who have sex with men could not gain access to public healthcare services and receive medication for HIV/Aids and other sexually transmitted diseases.

Most of them are suffering from gonococcal urethritis, gonorrhoea, syphilis or HIV/Aids. But they do not go to a general clinic or hospital to receive treatment, such as antiretroviral drugs, because they are afraid of presenting themselves to the doctor or do not want others to know about their symptoms.

There are not enough agencies and budget to support operations in local areas and provide knowledge about HIV/Aid prevention to men who have sex with men. Some of them even do not know about the use of condoms and lubricants. So they need a special clinic to provide medication and consultation about HIV/Aids infections.

"A onestop service is really needed to provide information and healthcare to them. This is the only way for them to protect themselves from HIV," he said.

Chatwut Wangwon, of a joint programme of the Public Health Ministry and the US Centres for Disease Control and Prevention, said that while working in Phuket for four years, he found that most men who have sex with men and become infected with HIV are students, of working age and single.

At least 27 per cent of them could have sex with men or women, which means they could transmit the disease also to women.

About 50 per cent of them do not use condoms while only 26 per cent do. Some of them do not use a lubricant but try other substances such as detergent, which could easy destroy a condom.

The best way to reduce HIV infections among this group is providing free condoms and lubricant, Chatwut said. The health authorities also have to raise their awareness of health checks for early warning signs of HIV infections so they can provide medication immediately.

"The best thing that we need to do is make them know earlier about the infection and their symptoms," he added.

-- The Nation 2008-10-31

[Scott]

Certainly not very encouraging news.

[jayjayjayjay]

Certainly not very encouraging news.

Edit, you are correct it is not encouraging, however, this is one of the best reports on the topic i have ever seen. Most reports from ministries or NGO's are claiming massive 50,000 plus deaths per province per year etc that turn you away. They just don't seem to be realistic which unfortunately makes the public more sceptical of the real problem. This article does not come across in a way to create public panic. It's to the point, and offers up a decent goal to acheive, better education and services to the grass roots(the infected and the high risk group and the cross-over risk group). It's not crying prohibition, jailing or shooting of perpetrators, it's just simple wise advise that I hope the gov, medical system and NGO's can put in place. Great article! No, excellent article.

Edited October 31, 2008 by jayjayjayjay

[animatic]

Well I must agree with you BOTH.

Bad news on the rise in infection.

Good news about a straight up report on the problem.

Now do we expect Kuhn Chalerm to do the RIGHT THING...

<deleted>, more bad, bad news...

[Ijustwannateach]

The data seem very suspect- even 17% seems high, but 30%??? That's equivalent to the worst hit parts of the entire world.. Furthermore, the fact that the data were collected in cities with major entertainment districts (Bangkok, Phuket, Chiang Mai) leads me to suppose- especially given the reference to male sex workers within the article itself- that this is another botched survey done on a very non-representative group such as urban sex workers and clients in bars or on the street.

There may be some rationale for this other than incompetent research practice- for example, to stir up a fuss so that more funding is available for the all-but-defunct government clinics and other programmes- but it isn't worth destroying research credibility or unfairly emphasizing the link between gay sex and HIV transmission, stigmatising a vast part of the gay population who are not represented in this 'research' and giving those who practice straight sex a false sense of security, in an environment where transmission by heterosexuals is becoming the fastest growing part of the epidemic. And who knows what is happening in the smaller cities, where there aren't even any gay 'centres' on which to focus research, representative or not?

To their credit, their prescription is spot on: government funding for sexual health clinics, public awareness, condoms, and prevention.

"S"

[animatic]

It definitely did NOT give those having straight sex a free pass.

Bar girls are known to frequent male sex workers also,

when they have had their fill of white buffaloe's too.

This gets to their normal customers and then maybe out to wives also.

It did look at one specific place with a huge rise in infection.

Better to look at the worst aspect, than try to generalize.

You are basically saying; well the epicenter makes no difference

let's generalize the whole gay population.

The earth quake only affected 1/25th of the country,

but we have to look at the whole country,

so we must spread earthquake aide around the country.

As opposed to

We have a serious problem at these points,

send aid there, and here's why.

The cure is correct, and should be used globally,

but the CDC says attack the primary or largest source in an outbreak

as well as contain it's vectors peripherally.

Edited October 31, 2008 by animatic

[Suzy]

It is high time the Ministry of Health worked together with the drugs companies and provided the equivalent range of HIV/AIDS antiretroviral drugs that are available in the West. PLUS reduce the prices to a range whereby lower income sufferers can afford the treatment. I do not agree that Thais suffering with HIV/AIDS are totally apprehensive about seeking medical advice. What is obvious is that the cost of treatment is far beyond the pocket of the average Thai. For HIV treatment I was quoted by Bumrungrad Hospital a cost of 30,000 Baht a month with some medication as yet not available to this hospital. This cost is certainly far beyond my pocket so what hope does the average Thai worker have of affording this treatment. Infection rates will continue to rise unless the government take more positive steps to help the country in this area. What percentage of those Thais afflicted with HIV/AIDS die per year as a result of not being able to afford the medication? I have had quite a few friends, both male and female, who have passed away and know of none who have shied away from seeking medical advice.

[Mitker]

This article does not come across in a way to create public panic. It's to the point, and offers up a decent goal to acheive, better education and services to the grass roots(the infected and the high risk group and the cross-over risk group). It's not crying prohibition, jailing or shooting of perpetrators, it's just simple wise advise that I hope the gov, medical system and NGO's can put in place. Great article! No, excellent article.

I do agree 100% with you.

Better prevention campaigns would make the difference both saving lives and reducing future burden on the health department; resulting -in fine- in better care for the ones infected.

Now, it is true that the country is not blessed with an outstanding government and we can just hope that some officials within the ministry will push for policies we hardly can expect from the top.

[Scott]

Suzy: I am not sure which drugs you are talking about. I have a close friend who is affected with AIDS and he used to pay 30,000 baht per month--but that was several years ago. (Basically, he only had money for medication). Then the country used compulsory licensing and he now pays around 3,000 baht per month.

[qwertie]

The above posts clearly indicate to me just how little attention people pay to the information they read. Guys, go over the report again - though put your brains into gear before you do!

The report comes from self-interested groups making outlandish claims backed up by highly dubious statistics. Think about it . . .

Are you really all SO gullible?

Bah!

[Ijustwannateach]

It definitely did NOT give those having straight sex a free pass.

Bar girls are known to frequent male sex workers also,

when they have had their fill of white buffaloe's too.

This gets to their normal customers and then maybe out to wives also.

It did look at one specific place with a huge rise in infection.

Better to look at the worst aspect, than try to generalize.

You are basically saying; well the epicenter makes no difference

let's generalize the whole gay population.

I am saying that their seeming manipulation of the statistics- either by, well, lying or by choosing a candidate population that is clearly not representative, while using it to apply to all gay men (which seems to be a sad habit in Thai HIV research)- invalidates the generality of their work.

In other words, it is likely that the 'epicentre' they have 'discovered' is NOT among gay men but among a very small minority, most likely male sex workers. It would be hard to know for sure without looking at the data, but the outrageous claim of 30% is something that is simply not reflected in reality. As I recall from the recent literature of the Red Cross in Bangkok, the infection rate even among those who had come for testing (and thus self-reported and were worried, and so are ALSO not representative of the whole gay population) is still under 20%. The most recent data I could find (up to 2004) reports a 17.5% figure for the WHOLE population (not only gay men, so that is mis-cited if it is their source for the 17% in the article).

I seriously doubt that they would have found that the problem had increased so severely so quickly, or that it is any accident that their research focuses on 'major tourism centres.' I would take the report with a BIG grain of salt until I had seen how data is collected. Even if the data is actually based on the Thai Red Cross somehow- and if it were, I think they would say so- it will exaggerate the problem since those who select themselves for testing are likely to have engaged in risky behaviour and are thus not a random sample.

[qwertie]

Ijustwannateach says it all. Excellent post, I couldn't do better.

[Chang_paarp]

Dr Somchai Chakrabhand, directorgeneral of the Disease Control Department, said yesterday that a recent survey looking at the situation across the country of HIV/Aids among this group had found that the risk areas were concentrated in tourism centres such as Bangkok, Chiang Mai and Phuket.

For a pleasant change Pattaya did not rate a mention.

This could be because they did not look here, but hey Patters was left out of the scare campaign, or they forgot to include the stats because they were not as dramatic.

[animatic]

It definitely did NOT give those having straight sex a free pass.

Bar girls are known to frequent male sex workers also,

when they have had their fill of white buffaloe's too.

This gets to their normal customers and then maybe out to wives also.

It did look at one specific place with a huge rise in infection.

Better to look at the worst aspect, than try to generalize.

You are basically saying; well the epicenter makes no difference

let's generalize the whole gay population.

I am saying that their seeming manipulation of the statistics- either by, well, lying or by choosing a candidate population that is clearly not representative, while using it to apply to all gay men (which seems to be a sad habit in Thai HIV research)- invalidates the generality of their work.

In other words, it is likely that the 'epicentre' they have 'discovered' is NOT among gay men but among a very small minority, most likely male sex workers. It would be hard to know for sure without looking at the data, but the outrageous claim of 30% is something that is simply not reflected in reality. As I recall from the recent literature of the Red Cross in Bangkok, the infection rate even among those who had come for testing (and thus self-reported and were worried, and so are ALSO not representative of the whole gay population) is still under 20%. The most recent data I could find (up to 2004) reports a 17.5% figure for the WHOLE population (not only gay men, so that is mis-cited if it is their source for the 17% in the article).

I seriously doubt that they would have found that the problem had increased so severely so quickly, or that it is any accident that their research focuses on 'major tourism centres.' I would take the report with a BIG grain of salt until I had seen how data is collected. Even if the data is actually based on the Thai Red Cross somehow- and if it were, I think they would say so- it will exaggerate the problem since those who select themselves for testing are likely to have engaged in risky behaviour and are thus not a random sample.

With all respect you seem to be getting lost in figures after the original premise.

BANGKOK: -- While the overall figure of people living with HIV/Aids is declining,

Nothing alarming there, and it DOES address the general issue.

new infections among men who have sex with men have been increasing drastically during the past few years, causing grave concern at the Public Health Ministry.

This goes to the point they are trying to make. In most nations this is a recurring thing.

Dr Somchai Chakrabhand, director general of the Disease Control Department, said yesterday that

a recent survey looking at the situation across the country of HIV/Aids among this group

had found that the risk areas were concentrated in tourism centres such as Bangkok, Chiang Mai and Phuket.

A quite logical conclusion actually.

OK fine the target of discussion is narrowed to the trouble areas.

They then note the rise WITHIN that group,

and specifically target solutions for THAT group.

He admitted that one factor was that over the past few years

the campaign for HIV infection prevention among men who have sex with men,

especially raising awareness to use condoms during sex, was discontinued.

Simply put, he is making a correlation

between the information being stopped

and the rise in infection rates.

Something seen in other countries also.

ALL statistics are manipulated to give some relevant data to use.

It's what is done. They are useless otherwise. I don't see targeting a

demographically narrow group, as being particularly suspect,

just applying funds where the worst occurances happen.

The self-reporting are the more thoughtful ones,

What percentage are just oblivious to all but making the cash flow and food on the table?

What percentage went on the game AFTER the information on prevention was stopped?

The Red Cross is far from then only available reference,

and anecdotal evidence has some value also. Except for scientists and politicians.

It's easy to slag ANY set of numbers as wrong from EITHER point of view.

WHAT'S HARD... is just getting things done using them as a jumping off point

on where to work on the problem. Think of the story not the hard numbers.

That's the real bottom line; the PEOPLE.

Edited October 31, 2008 by animatic

[Hairy]

Maybe some of you folks are too young to remember, but "the great heterosexual AIDS epidemic" has been eagerly anticipated by the media since the disease was discovered in the early 1980s. The fact remains that homosexual men are most at risk, and have been ignoring the issue, whether out of fear, or denial, or because they just hate condoms.

The single most significant thing to do to avoid HIV infection is to not be an asshol_e (so to speak). It's not easily transmissible by oral sex, and is less easily transmissible (certainly to men, probably to women as well) during ordinary sexual intercourse. The most dangerous route for transmission is receptive anal sex. Period. Get your partner to use a condom. They should print this on condom boxes: "Failure to use condom may result in death."

The whole "they're just stigmatizing gays!" crap is a sidestep to avoid the real issue. Sorry, guys, but this is your life at risk.

[Jingthing]

Maybe some of you folks are too young to remember, but "the great heterosexual AIDS epidemic" has been eagerly anticipated by the media since the disease was discovered in the early 1980s. The fact remains that homosexual men are most at risk, and have been ignoring the issue, whether out of fear, or denial, or because they just hate condoms.

This is misleading at best.

Yes, homosexual sex and IV drug use is high risk.

So is heterosexual. I don't know what your agenda is, but it really isn't helpful.

To wit:

http://www.kff.org/hivaids/upload/3030-05.pdf

The major route of HIV transmission worldwide is heterosexual

sex, but risk factors for HIV vary around the world.

30 percent of the HIV cases in South and SE Asia are WOMEN. I guess they have been having alot of male to male anal sex on the side, based on your weird logic.

Edited October 31, 2008 by Jingthing

[endure]

Alarm over rising HIV infection among gay men

BANGKOK: -- While the overall figure of people living with HIV/Aids is declining, new infections among men who have sex with men have been increasing drastically during the past few years, causing grave concern at the Public Health Ministry.

Dr Somchai Chakrabhand, directorgeneral of the Disease Control Department, said yesterday that a recent survey looking at the situation across the country of HIV/Aids among this group had found that the risk areas were concentrated in tourism centres such as Bangkok, Chiang Mai and Phuket.

He was speaking at the conclusion of a oneday conference on lessons learned from the project to develop a network of men who have sex with men. About 200 health activists and gayrights advocates attended the meeting.

In Bangkok, a survey of homosexual men found that the incidence of HIV infection had increased from 17 per cent in 2003 to 30 per cent last year. The rate of infection in Chiang Mai rose to 16.9 per cent last year from 15.3 per cent in 2005, while Phuket jumped from 5.5 per cent in 2005 to 20 per cent last year.

The survey also found that half of men in this group do not use condoms with their lovers or temporary partners.

Male sex workers formed a highrisk group for infections due to their unsafe sex behaviour and lack of knowledge on protecting themselves from getting the virus, Somchai said.

"Most of them have anal sex with their partners without using a condom and lubricant. This could cause deep damage to anal tissue and easy transmission of HIV," he said.

He admitted that one factor was that over the past few years the campaign for HIV infection prevention among men who have sex with men, especially raising awareness to use condoms during sex, was discontinued.

Manoon Jaikueankaew of the Disease Control Department's Unit 10 in Chiang Mai, said men who have sex with men could not gain access to public healthcare services and receive medication for HIV/Aids and other sexually transmitted diseases.

Most of them are suffering from gonococcal urethritis, gonorrhoea, syphilis or HIV/Aids. But they do not go to a general clinic or hospital to receive treatment, such as antiretroviral drugs, because they are afraid of presenting themselves to the doctor or do not want others to know about their symptoms.

Most of who? And what does he mean by 'most'?

There are not enough agencies and budget to support operations in local areas and provide knowledge about HIV/Aid prevention to men who have sex with men. Some of them even do not know about the use of condoms and lubricants. So they need a special clinic to provide medication and consultation about HIV/Aids infections.

"A onestop service is really needed to provide information and healthcare to them. This is the only way for them to protect themselves from HIV," he said.

Chatwut Wangwon, of a joint programme of the Public Health Ministry and the US Centres for Disease Control and Prevention, said that while working in Phuket for four years, he found that most men who have sex with men and become infected with HIV are students, of working age and single.

At least 27 per cent of them could have sex with men or women, which means they could transmit the disease also to women.

About 50 per cent of them do not use condoms while only 26 per cent do. Some of them do not use a lubricant but try other substances such as detergent, which could easy destroy a condom.

What do the other 24% do?

The best way to reduce HIV infections among this group is providing free condoms and lubricant, Chatwut said. The health authorities also have to raise their awareness of health checks for early warning signs of HIV infections so they can provide medication immediately.

"The best thing that we need to do is make them know earlier about the infection and their symptoms," he added.

-- The Nation 2008-10-31

Sounds to me like someone is looking for some new funding and has just thrown together some vague fears and figures to justify it.

[Suzy]

Suzy: I am not sure which drugs you are talking about. I have a close friend who is affected with AIDS and he used to pay 30,000 baht per month--but that was several years ago. (Basically, he only had money for medication). Then the country used compulsory licensing and he now pays around 3,000 baht per month.

HIV DRUGS

EPIVIR 150 gm Lamivudine ฿218.00 2

ZIAGEN 300 gm Abacavir ฿347.00 2

VIREAD 245 gm Tenofovir 1 NOT AVAILABLE IN THAILAND

SUSTIVA 600 gm Efavirenz ฿184.00 1

LAPIVIR 40gm Statin ฿120.00 1 combats side effect of drugs that cause high Cholesterol

ATRIPLA 600gm Replaces VIREAD & SUSTIVA NOT AVAILABLE IN THAILAND

Daily dosage Totals: Bt1434 7

[sylviex]

Some numbers from another source:

Thailand Statistics³³

Estimated total population, 200865,493,000Estimated number of people living with HIV, end 2007610,000Adults (15+)600,000Women (15+)250,000Children (0-15)14,000Estimated adult HIV prevalence1.4%Estimated number of AIDS deaths in 200731,000

• The majority of Thailand’s HIV infections (around 80%) occur through heterosexual sex.³⁴
  
• HIV affects more men than women in Thailand; the male-female ratio is 7:5.³⁵
  
• HIV prevalence among pregnant women, which reached a peak of 2.35% in 1995, had fallen to 1.18% by 2003.³⁶
  
• An estimated 1 in 5 new HIV infections in Thailand are attributable to unprotected sex between men.³⁷
  

http://www.avert.org/aidsthai.htm

[sylviex]

In recent years, I have seen concern expressed particularly for teenagers, who missed the public education campaign, and also married women, esp. those whose husbands were migrant workers and/or users of prostitutes.

Also disconcerting is:

Although since 2005 the government of Thailand has been providing free Antiretroviral (ARV) treatment to Thai citizens, the ethnic minorities are not covered under this programme.

...

Statistics show that three times as many non-Thai speaking women don’t know how to prevent HIV, and 60% of non-Thai speakers hold common misconceptions about HIV transmission, nearly double the rate among Thai speakers. In addition, condom use is much lower among non-Thai speaking women, according to the Ministry.

Preliminary data of the NIMH-supported pilot of mobile VCT found that 1.4% of ethnic minorities tested positive for HIV. Assuming that roughly one third of the 1.3 million highland ethnic minorities are vulnerable to HIV, some 6,000-7,000 are likely to be HIV infected.

http://www.hdnet.org/V2/News/detail.asp?iD...p;nChannel=News

[PeaceBlondie]

The only gay or bisexual men in the world who are not aware of the hazards of AIDS/HIV must be hermits living in caves. And 99% of them know they should use condoms. Now, as for the remaining 90% of the world, please get your head out of the sand. Thank you. The life you save will probably be straight.

[Bagwan]

Costs of HIV drugs in Thailand.

AMIVIR (Lamivudine)

NERAVIR (Nevirapine)

VIREAD (Tenofovir)

28 days supply of these three totals at 5040 THB at Bumrungrad. A small price to pay to ensure the continued wellbeing of a dearly loved wife.

When I read Press reports that the Government Laboratory Organisation supplies hospitals with GPO-VIR at a cost of 1200 THB for a 28 days supply when the preeminent hospital in Pattaya was charging 2800 THB we walked away in disgust and will never return. Bear in mind that ancillary costs such as transport and storage are minimal and there are no advertising or marketing costs. Why does not the supposedly caring medical profession rise up in arms? I conclude that they don't give a dam_n. Scamming is a large part of Thailand's medical services much the same as everything else.

[exexpat]

"The only gay or bisexual men in the world who are not aware of the hazards of AIDS/HIV must be hermits living in caves. And 99% of them know they should use condoms. Now, as for the remaining 90% of the world, please get your head out of the sand. Thank you. The life you save will probably be straight. "

I agree, but you do realize when people take ya baa, or crystal meth, or ecstasy, or whatever new drug, they don't really think straight. They should, but they don't. Also, sticking their head in the sand is what Asians do best. Add on the fact that that commercial sex workers will do anything for extra baht, including not using condoms. You there have a recipe for disaster.

I don't think the statistics are lying, I just think that the sampling was small. I wouldn't be suprised at all if the trend was on the rise, gay men tend to be very stupid, and fuc_k everything that moves. That includes women.

[PeaceBlondie]

"..The life you save will probably be straight. "

I agree, but you do realize when people take ya baa, or crystal meth, or ecstasy, or whatever new drug, they don't really think straight. They should, but they don't. Also, sticking their head in the sand is what Asians do best. Add on the fact that that commercial sex workers will do anything for extra baht, including not using condoms. You there have a recipe for disaster.

I don't think the statistics are lying, I just think that the sampling was small. I wouldn't be suprised at all if the trend was on the rise, gay men tend to be very stupid, and fuc_k everything that moves. That includes women.

Would you agree that STRAIGHT FARANG MEN TEND TO BE VERY STUPID, AND F EVERYTHING THAT MOVES. THAT INCLUDES WOMEN.?

[chrisyork]

Replying to post no 15 above from Hairy - Thailand is very badly placed to sucumb to a hetersexual crossover because of the large number of basically heterosexual Thai men who have no hang ups about indulging in gay sex when it's on offer - which it is a large amount of the time! I don't know if Thailand is unique in this - I would imagine the Phillipines at least has a similar propensity - but it is certainly a very serious risk that Westerners are culturally prone to underestimate. This makes it extremely important for Thailand to tackle the "high risk" groups identified.

As to whether the statistics are exaggerated or manipulated to make a point - this is where anecdotal evidence is genuinly useful. My initial reaction to the 30% infection rate figure quoted for Bangkok gay sex workers was disbelief. I know socially quite a number of these guys and my impression has been that they are generally untypically intelligent - university educated or the like - and also very well educated and clear about protection. Then I had a pause and a think - these guys are generally the cream of the bunch who can work in flashy and expensive bars - there's a whole other level out there of lads lurking about on mall stairwells and cruising Lumbini park. I guess the natural order of things would imply at least a 10 to 1 ratio to the sort of guys I've had direct contact with. In that light the figures are perhaps worryingly credible.

Overall a highly worthwhile report. Lets hope some notice and action are taken.

Chris

[animatic]

If it gets more money to where it's needed,

I could care less how thy massage the numbers to get it.

Most politicians try for 50% or more OVER what they expect to get,

just so opposing people can back them down and think they won a battle.

[BarryM]

Among my shags in BKk and Pattaya I find most insist on condoms, if I mention the subject. Once they get "warmed up" this drops to about half.

30% sounds about right. Most of them see HIV as a disease you get from sex with farang and low class people (ho's etc). They still haven't yet figured that nice middle class and hi so boys carry germs too......lol.

Amongst the bar ho's in Pattaya, few seem to worry about condoms, unless you make an issue of it.

[Ijustwannateach]

While I am poo-pooing the specific statistics quoted, awareness of safer sex and HIV and other STDs is shockingly limited in younger Thai people these days, even gays. Generally the 30+ generation seem to know about it, but the 20yo's (and presumably those who are younger) seem to have missed the boat in their health education/government programmes. Maybe this is a good time to post a link to the Safe Sexual Practices In the Thai Gay Community survey thread, where I invite our gay members to report on attitudes of their recent partners.

[ulath]

Have to say, that the case is similar in Australia were I live (work in a gay night club) and most of the younger people tend to have missed the boat here for the sexual health message add that to the mix of of drugs (which basically makes then do anything, know people who have woken up in bed with multiple other people and cant remeber anything)doesnt make for a good picture in the next 10 to 20 years. Also I think they havent seen what it can do as they were not around when lots of people were dieing from it. The drugs extend living periods greatly now as well so its not so in ya face.

[endure]

If it gets more money to where it's needed,

I could care less how thy massage the numbers to get it.

The problem with that argument is that when the people/institutions/governments who provide the funding find that they've been lied to they tend to withdraw the funding.