The Hiv Scam

[Jingthing]

There is AFAIK no plausible physiological reason to believe that western men per se (independent of circumcision status) would be any less at risk than Thai men given unprotected sex with the same infected women.

That's a bit like saying 'there is no plausible reason to believe foreigners are more likely to die in a motorbike accident than thai's (independent of whether or not they wore a helmet) given they were driving on the same road with the same motorbike.

Circumcision has a dramatic effect. And most of the Thai men who have AIDS are likely gay anyway.

Aids in Thailand is overwhelmingly a HETEROSEXUAL disease. The situation here is much more similar to AFRICA than the west.

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

About 80% of HIV transmission in Thailand is heterosexual, as compared to about 10% in the USA and some other western countries.

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.

BTW, you and your friends who are having lots of unprotected sex in Thailand, are you all cut? I agree with you being cut really helps. However, I still think it is crazy to sleep around in Thailand without condoms, cut or not.

Edited January 10, 2010 by Jingthing

[richm7]

Hookers in Thailand get HIV from their Thai boyfriends. I hope that is not news to anyone. 99% of hookers in Thailand have Thai boyfriends and I also hope that is not news to anyone.

Few bars test for HIV. A couple do. Some get a doctor to come in monthly and a couple have the girls go to clinics weekly. Monthly they test for HIV and weekly for vaginal problems.

I have seen numerous occasions when the girls had to clear out of the bar because of a positive test. It is sad. Then the ladies go to another bar and get a job that doesn't require a test.

The hookers sleep with boys who work in gay bars. The guys who work in gay bars will do anything with anyone from anywhere.

I was going to say all of this but you beat me to it.

You also leave out, that a large portion of working girls will take their hard earned money and head to the male karaoke bars and pay Thai boys to have sex with them. As you stated, it is no surprise to know these guys also many times service men. Many of the girls have boyfriends who work in these same bars. It's a mess.

i dont doubt much of this

and these are excellent points

but when i read:

that a large portion of working girls will take their hard earned money and head to the male karaoke bars and pay Thai boys to have sex with them

i am thinking arrii wha??????

jing jing law?????

why would a (thai working) gal pay a (thai) man to have sex?

pardon me for looking for a logical reason

Simple. Because this forum, like all forums, has posters who are complete idiots and write whatever comes into their alcohol addled puny minds. Or, they have an agenda, or they want to excuse what they do, or a whole host of other reasons. Whatever the reason, they are generally (I'll be nice) grabbing "facts" out of thin air and spewing them all over the unwary who either fret about it or take the bait and write an equally uninformed response. Forget anything as emotive as HIV/AIDS, ask the bloody capital of Florida and you'll get 50 different opinions, most of which (well, it would be 99%, of course - I have to throw a number in to prove my point) are boll*cks. Sometimes you'll get good information here, and we all know who the sensible, intelligent, informed posters are. The rest, reader beware. Idiots love these forums because in real life every time they open their mouths they're told to shut the <deleted> up.

It's Tallahassee by the way. Well, I'm 99% sure it is.

Edited January 10, 2010 by richm7

[Jingthing]

Here in Pattaya, everyone knows that many bar girls have sex with bar boys. Most bar boys are gay for pay, not really gay. No news there. And yes sometimes they find it big fun to pay for that action. It can be empowering for prostitutes to hire other prostitutes, its a psychological reversal for them. I can't say what percentage are paid versus free, I would say mostly free.

Edited January 10, 2010 by Jingthing

[DegenFarang]

We are all American's so I would imagine the others are cut too, though I've never asked.

I still have yet to see a source quoted that I would trust. ThailandGuru.com? Looks like a high school kid made that site in 1999. At least my Christian Missionary propaganda cited the UN.

If your source is dubious your information is worthless.

Awaiting the next person to give us irrefutable evidence from ThailandSucks-Balls.info about how prevalent AIDS is among bar girls.

[DegenFarang]

Here in Pattaya, everyone knows that many bar girls have sex with bar boys. Most bar boys are gay for pay, not really gay. No news there. And yes sometimes they find it big fun to pay for that action. It can be empowering for prostitutes to hire other prostitutes, its a psychological reversal for them. I can't say what percentage are paid versus free, I would say mostly free.

How is this relevant in any way? So high-risk women are having sex with even higher risk men and then having sex with us. Ok? What's that got to do with the fact that the odds of getting HIV from an HIV positive partner via vaginal sex is 1/2000?

If those numbers scare you then cut out bar girls and freelancers and all other brand of whore and bareback everybody else - cut your changes from the odds of dying from a plane crash to being struck by lightening - either one, none of the above is likely going to happen to any of us in our lifetimes.

[mrtoad]

We are all American's so I would imagine the others are cut too, though I've never asked.

I still have yet to see a source quoted that I would trust. ThailandGuru.com? Are you seriously dumb enough to get your information from a site like that? Looks like a high school kid made that site in 1999. At least my Christian Missionary propaganda cited the UN.

Didn't any of you go to college and take a course on research methods or critical thinking? If your source is dubious your information is worthless.

Awaiting the next person to give us irrefutable evidence from ThailandSucks-Balls.info about how prevalent AIDS is among bar girls.

Well, it may be difficult to have an accurate figure of the prevfelance of HIV or AIDS among bar girls, because to be fair the industry is largely unregualted and the BG population is pretty transient. Lets be fair here though, it doesn't take a genius to work out that prevelance is likely to be higher in said group than others, and certainly again there will be hotspots - I belive Ranong is one such area. I don't go into looking at just stats alone, you need to look at the bigger picture in relation to what the raw data actually tells you. As a health worker myself (not HIV/AIDS) I'd say that there are lots of mistruths about illness and disease - but burying your head in the sand about the risk of HIV and playing the numbers game really isn't worth it. Says a lot about the mentality of such a person.

Sadly this thread seems to be going in circles.

Edited January 10, 2010 by mrtoad

[Sheryl]

One post has been deleted and another edited to remove flaming and sweeping negative slurs.

All posters are reminded to keep it civil.

DeGenFarang, perfectly credible, research-backed sources have already been provided and abundant more are readily to be found online. You continue to make factually incorrect statements; you may like to believe these things, but they simply are not true. Most HIV positive men in Thailand are not gay, heterosexual sex is the main mode of HIV transmission in SE Asia, and there is not a fixed risk of transmission applicable to all sexcual ensounters with an HIV infected partner.

This thread has focused on HIV but it is worth remembering that unprotected sex also runs risks of Hepatitis B and C, as well as of other STDs.

[Jingthing]

Very well said, Sheryl. BTW, people should get the Hep A and Hep B vaccine. There is none for Hep C.

[Jingthing]

We are all American's so I would imagine the others are cut too, though I've never asked.

Yeah the majority of older Americans are cut. With younger American men, a lot more uncuts.

Well if you are too prudish to ask, you might be a good friend and remind your mates that if they happen to be uncut, they are taking an even BIGGER risk having unprotected sex here in Thailand than if they are cut. The foreskin cells are target cells for Thai strain HIV, the cells themselves, an opening isn't needed. In any case, Mazel Tov to you and all your friends ... as my gramps used to say to me, Good luck, you're going to need it!

Edited January 10, 2010 by Jingthing

[philliphn]

The moral of all this is DONT HAVE UNPROTECTED SEX WITH ANY ONE!

[chiangmaikelly]

I would imagine the reason that so many heterosexual men are exposed to HIV in Thailand is that heterosexual in Thailand includes ladyboys. It is my understanding that many young men have their first sexual experience with a ladyboy and this is not considered homosexual behavior and these men/boys do not consider themselves homosexual.

I think this pretty much goes along with the ThaiVisa gay concept that also does not consider men who like ladyboys homosexual.

However from a physical standpoint it has a bit in common with a homosexual experience.

Jingjing is absolutely correct in that anyone who lives in Pattaya knows bargirls pay barboys for sex. The girls who don't are made fun of by the girls who do. It's a status thing. The gay barboys look for women who don't want to have sex. I saw a fight at a club between two middle aged women over one gay bar boy. The one lady was a dancer and the other a business owner. I was sitting with the gay bar boy watching the fight. He was rooting for the dancer because she paid him and didn't require sex. She just liked to hang out with him and watch him sing and dance.

But the largest risks in Thailand are not in the bar towns like Pattaya. The largest risks are in Rayong and Chiang Mai.

Nevertheless there is risk everywhere. For me it's personal. I know Western men who have tested positive and I have seen a couple die, one in Pattaya. I have known at least 10 women who have tested Positive and all have continued working. I was dating a lady who worked at a bar that tested weekly and monthly so our social circle included women who could no longer work at the bar. I asked one bar owner who let one lady continue to work after she tested positive why. She said that the woman had too many customers to fire.

For me it's serial monogamy because I don't like condoms. Maybe the woman I am living with has a Thai boyfriend, I wouldn't be surprised but I hope not. If so it would not be the first time I have been fooled.

[DegenFarang]

The moral of all this is DONT HAVE UNPROTECTED SEX WITH ANY ONE!

Which thread did you read?

[Jingthing]

As the vast majority of HIV transmission in Thailand occurs via HETEROSEXUAL sex, I think it is false to single out sex with kathoeys or gays as being especially culpable. There is that old hat western Aids is gay disease stigma that is basically wrong here. Its a HUMAN disease.

[siggie2]

MODS

i thought we couldnt talk about prostitutes.Wil psned a couple of days reading the do,s and dont,cant do it now though,as i need some sleep in 3 hours

[chiangmaikelly]

As the vast majority of HIV transmission in Thailand occurs via HETEROSEXUAL sex, I think it is false to single out sex with kathoeys or gays as being especially culpable. There is that old hat western Aids is gay disease stigma that is basically wrong here. Its a HUMAN disease.

This is the health forum and I think we can talk about medical things here. Right?

Yes, Jingjing you are right and politically correct at the same time.

I am not a doctor although I have worked in hospitals for 10 years.

I am thinking about the blood thing. I know a couple kathoeys and they use sanitary napkins just like women because they have so much anal blood discharge. Although you would think they are in pain they don't seem to notice it.

I think with working night life kathoeys this is a common problem.

I think blood transmission is an easier way to become HIV positive than bodily fluid transmission but again I am not a doctor. I do know that is the way that hepatitis is transmitted and that would worry me.

I also know Kathoeys who hold regular jobs and I am sure this is not a problem for them at least I am not aware of it.

[deejah]

'Thai guys are better'

elaborate please

[Jingthing]

MODS

i thought we couldnt talk about prostitutes.Wil psned a couple of days reading the do,s and dont,cant do it now though,as i need some sleep in 3 hours

The mods will answer but I think it is clear in the health context we are discussing here we bloody well CAN discuss the connection between prostitution and HIV transmission.

[chiangmaikelly]

To be fair I should have mentioned the sponge egg. Most female Go go dancers and a lot of night workers use a sponge egg instead of a tampon or sanitary napkin which allows them to keep working during their period. When it gets full they go to the rest room and wash it out and re use it. I don’t really know any surefire way of detecting it. I would rather not have intercourse during that time of the month based on my irrational fear of blood but that’s probably just me.

[DegenFarang]

Pretty sure discussing prostitutes in this context does not violate the spirit of such a rule, even though it may violate the letter. That type of a rule is most likely meant to prevent discussing where to go to find them, the quality, being ripped off by them etc.

[b19bry]

Here in Pattaya, everyone knows that many bar girls have sex with bar boys. Most bar boys are gay for pay, not really gay. No news there. And yes sometimes they find it big fun to pay for that action. It can be empowering for prostitutes to hire other prostitutes, its a psychological reversal for them. I can't say what percentage are paid versus free, I would say mostly free.

As the vast majority of HIV transmission in Thailand occurs via HETEROSEXUAL sex, I think it is false to single out sex with kathoeys or gays as being especially culpable. There is that old hat western Aids is gay disease stigma that is basically wrong here. Its a HUMAN disease.

Surely male to female transmission is greater than vice versa ? And you may be strictly correct about the vast majority of HIV transmission being via heterosexual sex here, however if 'many' bar girls as you indicate, are paying for sex with 'pay for gay' bar boys that puts a different slant on things ?

[Jingthing]

Here in Pattaya, everyone knows that many bar girls have sex with bar boys. Most bar boys are gay for pay, not really gay. No news there. And yes sometimes they find it big fun to pay for that action. It can be empowering for prostitutes to hire other prostitutes, its a psychological reversal for them. I can't say what percentage are paid versus free, I would say mostly free.

As the vast majority of HIV transmission in Thailand occurs via HETEROSEXUAL sex, I think it is false to single out sex with kathoeys or gays as being especially culpable. There is that old hat western Aids is gay disease stigma that is basically wrong here. Its a HUMAN disease.

Surely male to female transmission is greater than vice versa ? And you may be strictly correct about the vast majority of HIV transmission being via heterosexual sex here, however if 'many' bar girls as you indicate, are paying for sex with 'pay for gay' bar boys that puts a different slant on things ?

Oh, geez! If you seriously think it is important to scapegoat some group or another about a VIRUS, go right ahead and be my guest. Also, most HIV transmission in Thailand has nothing to do with the Pattaya bar scene anyway!

As far as percentage of male to female vs. female to male, I think you need to look at the studies. Its really a chicken and egg thing. If you are going to blame the kathoey, maybe he got it from a straight man to begin with! If you back far enough, you will find a monkey (yes seriously). So who is to blame? If anyone, people who are promoting the idea of not using protection. In any case, I will repeat, in an environment like Thailand it is rather insane to not use protection regardless of your flavor choice.

Wiki suggests that risk of female to male is about half as male to female in high income countries. However in Thailand and Africa where the HIV strain directly goes for the foreskin I think it is fair to assume that would increase the risk of female to male here in Thailand.

This is one source. I am sure you can find many others.

http://en.wikipedia.org/wiki/HIV

Sexual

The majority of HIV infections are acquired through unprotected sexual relations. Sexual transmission can occur when infected sexual secretions of one partner come into contact with the genital, oral, or rectal mucous membranes of another. In high-income countries, the risk of female-to-male transmission is 0.04% per act and male-to-female transmission is 0.08% per act. For various reasons, these rates are 4 to 10 times higher in low-income countries.

Edited January 10, 2010 by Jingthing

[b19bry]

Here in Pattaya, everyone knows that many bar girls have sex with bar boys. Most bar boys are gay for pay, not really gay. No news there. And yes sometimes they find it big fun to pay for that action. It can be empowering for prostitutes to hire other prostitutes, its a psychological reversal for them. I can't say what percentage are paid versus free, I would say mostly free.

As the vast majority of HIV transmission in Thailand occurs via HETEROSEXUAL sex, I think it is false to single out sex with kathoeys or gays as being especially culpable. There is that old hat western Aids is gay disease stigma that is basically wrong here. Its a HUMAN disease.

Surely male to female transmission is greater than vice versa ? And you may be strictly correct about the vast majority of HIV transmission being via heterosexual sex here, however if 'many' bar girls as you indicate, are paying for sex with 'pay for gay' bar boys that puts a different slant on things ?

Oh, geez! If you seriously think it is important to scapegoat some group or another about a VIRUS, go right ahead and be my guest. Also, most HIV transmission in Thailand has nothing to do with the Pattaya bar scene anyway!

I'm not trying to scapegoat any group in particular, just pointing out what could be inconsistencies in your argument. Also you're the one who introduced and indicated the Pattaya bar scene had some relevance to the argument ?

[Jingthing]

I'm not trying to scapegoat any group in particular, just pointing out what could be inconsistencies in your argument. Also you're the one who introduced and indicated the Pattaya bar scene had some relevance to the argument ?

I don't see any inconsistency that you have pointed out, and frankly am not very interested in this line of discussion.

Regarding the bar scene in Pattaya, I was responding to someone else who brought up the topic of female bar workers paying for male ones. Also, I think you are either confused or acting to be confused. Transmission is primary heterosexual in Thailand. That is a fact. Transmission occurs at the exact time you have a risk act where the virus spreads from one human host to another. In Thailand the vast majority of those sexual transmission events are between males and females.

(BTW, before anyone suggests that stating the facts that most sexual HIV transmission in Thailand is heterosexual is scapegoating heterosexuals, I would like to say, that is ridiculous, you can't scapegoat a group of people that is most of the population! Scapegoating by definition involves minority groups (or even one person). If it was the TRUTH that most sexual transmission here was homosexual, there would be no problem with stating the scientific facts. When I used to live in San Francisco when the epidemic first emerged, that was indeed the case there.)

Edited January 10, 2010 by Jingthing

[moe666]

And in some countries if you have sex with a virgin it will cure you of aids.

[b19bry]

I'm not trying to scapegoat any group in particular, just pointing out what could be inconsistencies in your argument. Also you're the one who introduced and indicated the Pattaya bar scene had some relevance to the argument ?

I don't see any inconsistency that you have pointed out, and frankly am not very interested in this line of discussion.

Not really surprising.......it doesn't quite fit your agenda right ?

(BTW, before anyone suggests that stating the facts that most sexual HIV transmission in Thailand is heterosexual is scapegoating heterosexuals, I would like to say, that is ridiculous, you can't scapegoat a group of people that is most of the population!

You don't say !!

[moe666]

We could take to magic Johnson about Unprotected sex.

[gregb]

What surprises me is that after more than 30 years of studying the affliction, there are still questions like this. I honestly mean that. I'm intrigued.

and there is not a fixed risk of transmission applicable to all sexcual ensounters with an HIV infected partner.

Can you expand on this Sheryl? This comment didn't really seem to be well supported by the thread, but you kind of dropped this in here as a fact. It piqued my interest.

Why can't you assign a probability of transmission from an infected female to an uninfected (circumcised) male? I can understand there may be various criteria that come into play here, but over a large enough sample over a diverse group such a calculation should be possible.

Taking that as a given, what we are really discussing here is whether or not vaginal intercourse with Thai prostitutes contains a particular bias based on some unstated factor that makes use of the calculated statistic invalid. However, without even making an attempt at stating what things could possibly be factors, it is a very confusing statement.

I can think of a couple of factors. Quantity of fluid transferred during intercourse, presence of blood during intercourse, etc. It is not clear to me why a prostitute would be particularly biased in either of these areas vs. non prostitutes. The reproductive system doesn't work differently based on someone's choice of occupation. The one area that does seem to provide an opportunity for bias, percentage of infected individuals in the group, is irrelevant because you have specifically stated that the partner is assumed to be HIV+.

Once you have this number (and it should be available in the literature, but for some reason I don't ever see it published), then all you need to do is multiply by the probability of infection in your particular target group, whether that is your office staff or the local red light district. That number clearly is not available in the literature, so endless discussions on what it should be are just distracting.

Then, after N partners, the probability you are infected is simply 1 - (1-[partner infection probability] * [female/male transmission probability]) ^ N. This is approximated by N * [partner infection probability] * [female/male transmission probability] for extremely small probabilities and small N.

While I don't agree with Degan's conclusions from an emotional or moral point of view, from a mathematical perspective I can not find a fault with his logic.

The only thing you should have to guess at is the partner infection probability, and I can't imagine even in Thailand's seedier areas it is much above 10%. The key question is "what is the female/male transmission probability"? In 30 years, someone MUST have answered that question.

If we take Degan's number of 1/2000, and use 10% infection in the target group (and that is probably too large, but we'll go with it), we arrive at 13,862.6 sexual encounters to have a 50% probability of infection. That's a different partner every single day for about 38 years, and then it is only even money you are infected.

It seems to me then, we either have to refute Degan's number of 1/2000, or accept his conclusion. To refute the number, we need to state what the correct number really is, or else quantify what are the characteristics that make establishing such a number impossible. Seems to me a human reproductive system is a human reproductive system. If we accept that circumcision can bias this and limit the discussion only to circumcised males, can we still honestly claim that a scientific consensus on transmission probability is impossible? If not, what is the correct number if not 1/2000?

I'm truly curious about this. I'm happily married and have 0 interest in having unprotected sex with multiple partners, but it just seems to me the medical community has done an incredible disservice to the global population by not clarifying this area.

[Jingthing]

I'm not trying to scapegoat any group in particular, just pointing out what could be inconsistencies in your argument. Also you're the one who introduced and indicated the Pattaya bar scene had some relevance to the argument ?

I don't see any inconsistency that you have pointed out, and frankly am not very interested in this line of discussion.

Not really surprising.......it doesn't quite fit your agenda right ?

Hmmm. Instead of launching a thinly veiled personal attack against me, why don't you let us know what your opinion is on this topic (as your commenting on this would lead us to think you have one). Would you like to assign the "blame" for HIV transmission to a particular group of people here in Thailand? OK, so who and why?

BTW, I will repeat here again, I most certainly did NOT start a discussion about Pattaya sex workers.

Edited January 10, 2010 by Jingthing

[gregb]

Please see post #38.

Sorry Sheryl. Just realized you meant to say post 36. I looked at post 38 and got confused. In post 36, you mention a couple of factors that I did not consider.

1. Viral load. Of course concentration is a big one I didn't immediately think of, and it will be almost impossible to control for that. There is almost no way to retroactively guess this number after months or years.

2. Sores and genital lesions. Do you have any idea how prevalent this is in HIV+ females? We are presumably talking about internal lesions, because I think even Degen would not be crazy enough to have unprotected sex with a woman with open genital sores clearly visible. If this is a small number, it could be ignored. A large number would cast it into the same category as above, as again these can appear and disappear randomly.

Still however, even given the inability to control for the constraints above, it does not invalidate the idea of a transmission probability. In Degen's case he is having sex with possibly thousands of partners, and such a wide sampling would in all probability match the distribution of cases found in any other society. Presumably, people living with HIV, as long as they are still ambulatory and active, will fall into a distribution of viral loads that will be essentially constant. It may vary slightly based on ethnicity, so it may be wise to be careful when appropriating data from diverse regions.

However, even if the variance is substantial, it does not invalidate the idea of a transmission probability. A large number of independent studies should give us a range of values for the transmission probability. At least some of these should match any given profile, and the lowest numbers would likely give us a worst case estimate. We might not be able to get a perfect answer, but even an order of magnitude calculation would be helpful. For instance, if we found out that the transmission probability from infected oriental women ranged from 1/100 - 1/1000, we could at least tell Degen with a specified degree of confidence that in certain studies his lifestyle may lead to a 50% probability of infection with only 692.8 encounters.

That's less than 2 years. He might suddenly start to have second thoughts if there was reliable data to counter his belief.

I maintain the medical community has done a disservice to the global population by not trying to make these numbers and studies more accessible, if they were done at all. After 30+ years there should be thousands of such studies done globally, and everyone should know these values without having to question them on internet forums.

Without this kind of data, conspiracy theorists will make up their own numbers. And how are we supposed to tell them they are wrong?

[chiangmaikelly]

Scapegoating HIV. I guess we could scapegoat intravenous drug users as a high risk group for HIV transmission. Anyone have any problems with that?

Also I guess we could scapegoat people who receive anal sex as the risk as I understand it is 10 times greater.

I also think we could give a pass to people who have only oral sex as the risk is quite low but of course not zero.

The highest risk as far as I know is 1. Shared needles.

2. Shared blood as in blood sports or just blood around during sex.

3. The catcher in anal sex. 4. Vaginal sex.

I guess we could get into a thing about who has the most anal sex but I hardly think that productive as all those things are on a sliding price scale.