Hiv Testing and Treatment In Los - Doctors, Meds, Costs

[Sheryl]

The information below has been compiled from past threads and updates provided by TV members. If you have anything to add to it, please PM one of the Moderators.

This information is for the benefit of persons who are HIV positive and living in Thailand. If you are concerned that you might have contacted HIV but do not know, an inexpensive HIV test can be performed at any hospital (government or private) as well as at any government Health Center. It can also be done at the Red Cross Clinic.

Please note that the internet contains some very inaccurate (and out of date) misinformation/"conspiracy theories" regarding HIV.FOr a discussio nof same and TV position on it see https://www.thaivisa.com/forum/topic/169704-hiv-aids-and-conspiracy-theories/


1. Doctors specializing in HIV:

There are a large number of HIV specialists in Thailand, including many who have trained in the West. As with other specialties, they are disproportionately found in Bangkok with much slimmer pickings elsewhere. As HIV is a chronic problem requiring life long management, it is important to find a doctor with whom you are comfortable and who is a good "fit" to your temperament and stage of illness. Priorities tend to change with time; someone newly diagnosed as HIV positive may need considerably more hand-holding and emotional support and prefer a doctor who is nurturing and highly directive in approach, whereas people who have been living with HIV for some time often prefer a more matter-of-fact and collegial decision-making approach. Given the wide range of choice, at least in Bangkok, do not hesitate to change doctors if the first one you try doesn't feel right. Doctors also vary greatly in their consultation fees, even within the same hospital and among doctors of more or less equivalent qualifications.

The HIV specialists listed below have all been recommended by at least one TV member. They are not listed in any particular order, and the list is by no means exhaustive; there are many other well qualified HIV specialists whom we just do not happen to have any feedback on.

Bumrungrad Hospital

Dr. Asda Vibhagool - US trained and US Board certified. The only doc on this list I have personally met, I found him very knowldgable, collegial in approach, frank and direct. "I would reccommend Dr Asada above all others! He cares for a dear friend of mine and we are all most happy with his service/knowledge! " (jdinasia) "I decided to change Doctors to Dr. Asda and the change is amazing," (private PM)

Dr Mondej Sookpranee." He has been treating me for the past 2 years, and I find him truly excellent" (Slimdog)

Dr. Anuwat. " He seemed nice and competent. He was aware of the anon clinic and wrote down what tests he wanted done" .

Bangkok Hospital
Dr Paitoon Boonma " I've seen him for 8 years now. He is very knowledgeable and kind." (Orchis)

Outside Bangkok
Pattaya

Dr Phillipe Seur " he is an excellent HIV resource for Pattaya Patients. He does excellent work providing ARV treatments to Local Thais and a few Farangs through his NGO http://www.heartt2000.org/ his email address is [email protected]" (private PM)

Chiang Mai
Dr. Phanumet at Sripet (Suan Doc) Chiang Mai University Hosp

2. Medications
Most of the HIV meds used in the West are available in Thailand and in some cases, they are available in an inexpensive local generic form. Local generics include AZT and 3 TC separately as well as an AZT/3TC combo (equivalent to Combivir or Combid), named Zilarvir..

ARVs are prescription only in Thailand. If cost is a constraint for you (1) frankly tell your doctor this, so that he can work that into the equation when deciding on a regimen and also be sure to provide generics where applicable; (2) for lowest price, ARV, have the doctor write the prescription and fill it at the Red Cross Anonymous Clinic (Bangkok) or at the Love Foundation clinic in CM.

Thai Red Cross · Anonymous Clinic
104 Ratchadamri Road
Pathumwan, Bangkok 10330.
Tel. 02-252-2568-9

It is located between the Sala Daeng and Radchadamri Road

The following are costs recently reported by TV members for a one month supply of Lamivudine @ 300 mg/day, (nevirapine) @ 400 mg/day and Viread @ 300 mg/day:
Bangkok Hospital = 6,060 B, Bumrungrad 5,190 B, and the Thai Red Cross clinic 2,580 Baht. I do not have a quote for costs at any of the non-profit private hospitals (e.g. St Luis, Bkk Christian, Camellian etc) but would expect them to be fall somewhere between these extremes.

The Thai Red Cross Clinic has doctors able to prescribe but they are available only some days of the week and limited in the number of clients they can accept, often with a waiting list. However the clinic will fill prescriptions, and perform blood tests (inc. CD4, VL) on written request from any doctor, no special form required, just the prescription/tests requested, your name, and doctor's name and signature. Private hospitals naturally prefer that patients purchase meds at their pharmacy and have labs done in their lab. Doctors vary in how they respond to this preference on the part of hospital administrators. Some treat it as an ironclad rule, some utterly disregard it if not in the patient's best interests, and some fall into the middle. This variation will be found among doctors at the same hospital. If you need to buy your meds at the Anon Clinic due to financial constraints and the doctor you see balks at writing a prescription, change doctors until you find one who is prepared to work with you. Legally and ethically, hospitals do not have the right to require you to use their pharmacy or their lab.

 

Chiang Mai:  This non-profit clinic is reported to offer services similiar to that of the TRC Clinic in Bangkok, including testing, low cost ART, PrEP etc.

 

Love Foundation

114/38 Greenpuls 1 Businesspark  Nungpakhung Muang Chiangmai. ( at business park. Next to Index Living Mall on the hightway. [18.796643, 99.023139] on google map.)
Tel. 052-001-119
Email : [email protected]
Website : www.lovefoundation.or.th
Facebook : https://www.facebook.com/Lovefoundationth/

Persons covered by Thai Social Security system may do best going to a government hospital. Any government hospital at provincial level up to tertiary can handle this and will often have a dedicated HIV clinic, but as with any other service at a govt hospital, long waits and limited English speaking by other than the doctors will be the norm.


3. Labs

The full gamut of lab tests, including viral loads, are available in Thailand although not in all hospitals. Costs vary across facilities in a manner similar to that described for meds.

A CD4 count = 300b at the Anonymous Clinic, around 1000 – 2000 at a private hospital. Viral Load = 1,500b at the Anonymous Clinic, about 6-7,000 at a private hospital.

in the Pattaya area, the Bangsaen clinic (tel 081-863-2934) is reported to be of acceptable quality and quite affordable. offers Viral load as well as CD4 and all standard blood tests. It is situated about 600 yards along Thanon Long Had (road 3137) on the right hand side coming from Road 3.

[Sheryl]

A member reports the following experience at the Thai Red Cross Anonymous Clinic, getting meds filled based on prescription from private doctor:

"Viread 300mg 90 tablets

Lamivudine 150mg 180 tablets

Nevirapine 200mg 180 tablets

Total cost 6660 baht.

The reception staff and other personnel were so pleasant, friendly ansd efficient that I dashed out and returned with a box of chocolates for them. The experience uplifted me for the rest of the day. "

[Sheryl]

Updated Prices of ARVs at Thai Red Cross Clinic Nov 2009:

1.ABC (Ziagenavir) 300mg 60 tablets 8490 THB

2.ATZ " REYATAZ 200mg 60 tablets 9750 THB

3.ATZ '' REYATAZ 300mg 30 tablets 8640 THB

4.Darunavir " PREZISTA 300mg 120 tablets 13800 THB

5.DDI " VIDEX*EC 250mg 30 tablets 2430 THB

6.DDI " VIDEX*EC 400mg 30 tablets 3750 THB

7.EFV " STROCIN 600mg 30 tablets 810 THB

8.IDV (CRIXIVAN) 180 tablets ราคา 2160 THB

9.3TC " LAMIVIR 60 tablets 570 THB

10. 3TC " LAMIVIR 30 tablets 570 THB

11.LPV/RTV " Aluvia 60 tablets 1440 THB

12.LPV/RTV " Kaletra 180 tablets 5400 THB

13.NVP " NERAVIR 60 tablets 960 THB

14.RTV " Norvia 84 tablets 3024 THB

15.SQV " Invirase 120 tablets 9360 THB

16.D4T " STAVIR 60 tablets 240 THB

17.TDF " Viread 30 tablets 1350 THB

18.AZT " ANTIVIR 100 tablets 650 THB

19.3TC+AZT " Zilavir 60 tablets 1230 THB

20.3TC+NVP+D4T" GPO vir S-30 60 tablets 990 THB

21.3TC+NVP+AZT ''GPO vir Z-250 60 tablets 1320 THB

[Sheryl]

Have received additional positive feedback on Dr. Soeur in Pattaya to the effect that he is extremely thorough and also quite affordable, with medication charges only “ a little more than those of the Thai Red Cross” and very modest consultation fees, making this probably the most affordable quality option for people living in or near Pattaya.

His hours are 1400 to 1600 and 1800 to 2000 on Mondays, Tuesdays, Thursdays and Fridays.

[Sheryl]

Update of location/phone of Thai Red Cross Anonymous Clinic:

Thai Red Cross · Anonymous Clinic

104 Ratchadamri Road, Pathumwan, Bangkok 10330.

Tel. 02 256 4107-8 x 208-9. No appointment required.

It is located on Rajadamri and is not part of the Chulalongkorn hospital complex. It is at the junction of Rajadamri and Sarasin, on the same side of the road as Chulalongkorn. If you are walking and you get to the Royal Bangkok Sports Club Exit 7, then you have gone too far and need to u-turn. The building looks like a large fat water tower, with red crosses interspersed on the exterior wall. The entrance is clearly marked 'ANONYMOUS CLINIC' in English.

Entering, on the right side is a curved large reception desk. Tell them you wish yo have some tests, they will hand you a form to fill out. On the form, you state what test you wish to have by ticking one of many boxes. The very first box reads 'HIV/AIDS'. Another says something like 'All STIs'. General health tests like cholesterol, CBC etc are also available. The second page of the form asks for the initials of your first and last name. You are may use your actual initials or any other that you like (but make them ones you can remember). You do not need to show ID at any point. The form will also have spaces for your mobile number and email address but these can be left blank if desired.

After completing the form you got to the cashier and purchase a membership card which has a uniquely numbered sticker. This number is the only thing that will appear on your blood samples and test results, in order to preserve your anonymity. Costs of the card as of February 2011 = only 20 baht.

Next you will be referred to a counselor who will, in a professional and non-judgemental manner, take a brief sexual history and discuss with you the planned tests to be sure they are appropriate for your specific situation. Any questions you have about the testing process or other health questions may be asked at this point. The counsellors speak English.

After that, you pay for the tests and the blood is drawn. The HIV test as of Feb 2011 costs under 200 Baht, as do most other tests.

Results are usually within an hour. Should the "rapid" HIV test be positive, they will perform additional tests which will require a longer wait. Do not panic if this happens.. the "rapid" test is used first because it is inexpensive and fast, and very rarely gives a false negative (unless the person is very newly infected), but it is known to give false positives in a certain percent of cases. Most people positive on the rapid test will prove to be negative on further testing. See post #7 for fuller discussion of this.

[Sheryl]

The Red Cross Anonymous Clinic (address above), which has long hjad support groups for thai speakers who are HIV+, now has one for English speakers.

2 to 5 PM on the 3rd saturday of each month 2 to 5 pm

[Sheryl]

Regarding HIV tests:

 

Update: The Thai Red Cross clinic is now doing a 4th generation combined antibody/antigen test that will detect 9% of infections 4 weeks after exposure. As with antibody-only tests, still necessary to do a repeat test later if negative.

 

 

The standard test is one that checks for antibodies. As these take sometime to form, this test is not useful immediately after exposure. About 90-95%% of people infected with HIV will be antibody positive by 6 weeks after exposure and virtually all will be by 12 weeks. Standard advice for anyone concerned about a recent possible exposure is to get an antibiody test at the 3 month mark, although it is perfectly reasonable to do one after 6 weeks and then (if negative) repeat at 12; you'll have the peace of mind of knowing sooner that you are almost surely not infected. A very small percentage -- less than 1%, but still some -- of people take more than 3 months to develop antibodies, so a repeat test at 6 months is sometimes advise for people negative at month 3.

Sometimes people are so worried that the idea of waiting for the antibody test is more than they can handle without stressing out, and sometimes there are medical reasons for needing to know sooner if exposure has taken place. In that instance there is a more complicated test called a PCR which can be done as early as 2 weeks post exposure. Unlike the antibody test, which is quite rapid, PCR results take several days to a week, and it is much more costly. The least expensive realiable place to obtain it with is the Anonymous Clinic at the Thai Red Cross, which charges only 1500 Baht. It is necessary to consult a doctor there first but the cost is minimal.

The Anonymous Clinic also tests for other STDs and offers very reasonably priced comprehensive check up packages inclusive of both HIV/STD and general health screening.

[Sheryl]

Update on HIV+ Support Group in Bkk for English Speakers:

Meetings are on the third Saturday of the month at the Red Cross Anonymous Clinic, left side water tower building at 2 pm. Most of the times an English doctor is present not for consultations but for counseling in the discussion. Other than that it's whatever anyone talks about.

Upcoming dates:

17 Mar 2012

21 Apr 2012

19 May 2012

for further info contact [email protected]

[Sheryl]

A valuable resource for HIV+ people having trouble navigating the Thai health system is the HIV Foundation Thailand http://www.thfthailand.org/the_foundation.html

tel 026340541

[Sheryl]

Also the AIDS Access Foundation which has a telephone hotline 1663

[Sheryl]

Thanks to @orchis

 

some updated prices at TRC clinic:

 

Efaviranz 600 (CAMBER -generic) = THB 135/bottle (30 tablets)
Efaviranz 600 (GPO -generic) = THB 195/bottle (30 tablets)
Efaviranz 600 (MSD original - STOCRIN) = THB 825/bottle (30 tablets)
Efaviranz 600 (MYLAN -generic - EFAMAT) = THB 270/bottle (30 tablets)

 

Tenofovir 300 +Emtricitabine 200 (GPO Generic - TENO-EM)= THB 630/bottle (30 tablets)
Tenofovir 300 +Emtricitabine 200 (CAMBER - TENOF EM)= THB 367.50/bottle (30 tablets)
Tenofovir 300 +Emtricitabine 200 (LFASIA original - TRUVADA)= THB 2,100/bottle (30 tablets)
Tenofovir 300 +Emtricitabine 200 (MYLAN Generic - Ricovir-EM)= THB 780/bottle (30 tablets)

[Sheryl]

Updated list of meds and prices at the Thai red Cross: