New HIV Cases In Thailand Down To Under 11,000 This Year

[webfact]

New HIV cases down to under 11,000 this year

By Pongphon Sarnsamak

The Nation

More than a million Thais had caught HIV since the first case was reported in 1984 and two thirds of these - some 644,128 people - had died of Aids, the Public Health Ministry revealed yesterday.

This year there have been 10,853 new infections among adults and children. Gay men remain the group most affected by HIV, officials said.

In a bid to curb the spread of HIV throughout the country, the Health Ministry has teamed up with the private sector to launch a massive campaign with the slogan "Light for Rights" to raise public awareness about the rights of people living with HIV.

Minister Jurin Laksanawisit said the ministry expected to halve infection rates next year. The ministry also will extend medical treatment to cover all people living with HIV.

The ministry set a goal that 80 per cent of patients with HIV and their families should get access to government social welfare without discrimination.

To date, about 60 million around the world have HIV, and 25 million of these have died.

In Thailand, 1,161,244 people are recorded as having caught HIV with just over half of them having died (644,128).

Of the 10,853 diagnosed with HIV this year, most are men who have sex with men (33 per cent), followed by housewives infected by their husbands (28 per cent).

The government healthcare scheme provides drugs and medical treatment to 214,661 people living with HIV who registered with the National Health Security Office and 80,000 people with HIV under the Social Security Fund. It also provides healthcare to about 2,700 migrant workers.

The Thai Red Cross' Aids research centre director Dr Praphan Panuphak said the rate of new infections had decreased from20,000 cases in several past years to 10,000 cases this year as most people with HIV have been able to access anti-retroviral drugs at an early stage of disease, which cuts the chances of the disease being spread to others.

-- The Nation 2010-11-25

[supaprik]

Only 10,000 more cases this year? That is the reported ones. I wonder how many new cases were "given" to visitors here, my guess would be thousands upon thousands.....

Only 10,000 new cases is an improvement on past years but in global terms so far as results are concerned another PATHETIC failure for the Thai authorities...

[DP25]

Amazing public health accomplishment. In the early 1990s yearly infections were over 150,000 per year, now they are down to 10,000. Infection rate is roughly on level with the US with their 56,000 per year according to the CDC, and only going to get even lower.

[peridot]

This seems like one more government PR announcement, not related to the facts. I have read from several reliable sources that 33% of people tested in Bangkok test positive for HIV. There is barely any HIV education, safe sex education, or even basic sex education in Thailand. After starting as an example to the world, things have slid to a stop, as usual. I think there is probably not much push for testing anymore, because no one wants to have any evidence of the real numbers.

My personal experience with Thai men is that about half of them don't use condoms unless pushed into it. Denial, or misunderstanding of the risks involved? I am not sure, but if my small sample is any indication of what is happening elsewhere, the number 11,000 cannot be real.

Edited November 25, 2010 by peridot

[DP25]

I have read from several reliable sources that 33% of people tested in Bangkok test positive for HIV.

If you mean "1/3rd of homosexual prostitutes in Silom" then maybe

Other wise your post is completely off the rails

[jonclark]

"Of the 10,853 diagnosed with HIV this year, ......followed by housewives infected by their husbands (28 per cent)."

So who infected the husbands and where are they (the husbands) included in the results. Surely we need to add an additional 28% (+) to these stats under the heading of; men infecteded by visits to hookers and massage parlours.

Don't want to be a cynic, but for the amount of whoring and the social acceptance of men having many wives or girlfriends i'm sure the rate is far higher, especially if you consider that HIV can remain dormant for between 10 - 15 years before sufferers show tangible symptoms.

How often would a married man go to get a HIV test given the social stigma??

[craigt3365]

You can go to a clinic, pay a few baht more, and get a report saying you don't have HIV. You don't even have to have your blood tested....

I don't believe these stats...

[geriatrickid]

One can only diagnose HIV is there is a test. My understanding is that the testing has been curtailed. Ipso facto, the number of those diagnosed will also decrease. Of greater concern are the following two statements;

1. The ministry set a goal that 80 per cent of patients with HIV and their families should get access to government social welfare without discrimination.

This is a reflection of the fact that HIV treatment and access to care is directly related to poverty. Despite those foreigners that say otherwise, the fact of the matter is that the poor, particularly the rural poor have a difficult time in accessing treatment. Proper HIV care is much more than popping multiple pills.

2. The Thai Red Cross' Aids research centre director Dr Praphan Panuphak said the rate of new infections had decreased from20,000 cases in several past years to 10,000 cases this year as most people with HIV have been able to access anti-retroviral drugs at an early stage of disease, which cuts the chances of the disease being spread to others.

I believe that Dr. Praphan Panuphak has been misquoted or taken out of context. The statement can create the incorrect belief that medication will protect the sex partners of infected people. In respect to the general population, the HIV medication available in Thailand does not "cut the chances of the disease being spread to others" . There has been no definitive proof of that. Perhaps someone has confused one distinct group of patients, pregnant women where it is true, with the general population. There is a recent NEJM article on the impact of pre exposure prophylaxis using emtricitabine and tenofovir. A study published in the New England Journal of Medicine on Nov. 23, reported the results from the Preexposure Prophylaxis Initiative (iPrEx) Trial, which found that drugs could reduce new infections by 43.8 percent in high-risk men who have sex with men (MSM) and transgender persons. (There was also a positive trial conducted in Thailand in 2005.) The downside of all these medications is the appearance of drug resistant strains.

There has indeed been a positive movement in the treatment of HIV and for that a great deal of gratitude is owed to the U.S. government, the Clinton Foundation and the Bill and Melinda Gates Foundation which has generously funded research and treatment programs. However, the number of HIV carriers in Thailand still presents a very deadly reservoir of disease. 11,000 new cases is still grim news as is a population of approx. 1% of Thailand's total population believed to be living with HIV.

[Bakseedaa]

"Of the 10,853 diagnosed with HIV this year, ......followed by housewives infected by their husbands (28 per cent)."

So who infected the husbands and where are they (the husbands) included in the results. Surely we need to add an additional 28% (+) to these stats under the heading of; men infecteded by visits to hookers and massage parlours.

Don't want to be a cynic, but for the amount of whoring and the social acceptance of men having many wives or girlfriends i'm sure the rate is far higher, especially if you consider that HIV can remain dormant for between 10 - 15 years before sufferers show tangible symptoms.

How often would a married man go to get a HIV test given the social stigma??

99% of these married men are Bi-sexual and caught the disease from another man.... also a big rise in the number of African prostitutes working Sukomvik area and about 60% of these girls have HIV... Same figure for African males who seem to take many Thai hookers for girlfriends , Condoms always.... is the best prevention... or just say No to hookers... Masterbate and save money..!!

[peridot]

I have read from several reliable sources that 33% of people tested in Bangkok test positive for HIV.

If you mean "1/3rd of homosexual prostitutes in Silom" then maybe

Other wise your post is completely off the rails

No, I mean what I wrote -- 30% of those tested. That may itself be a self-selecting group, because most people never get tested.

[peridot]

2. The Thai Red Cross' Aids research centre director Dr Praphan Panuphak said the rate of new infections had decreased from20,000 cases in several past years to 10,000 cases this year as most people with HIV have been able to access anti-retroviral drugs at an early stage of disease, which cuts the chances of the disease being spread to others.

I believe that Dr. Praphan Panuphak has been misquoted or taken out of context. The statement can create the incorrect belief that medication will protect the sex partners of infected people. In respect to the general population, the HIV medication available in Thailand does not "cut the chances of the disease being spread to others" . There has been no definitive proof of that.

I think you are incorrect here. Treatment has definitely been shown to decrease the spread of HIV to others. "Treatment as prevention" is catching on more and more in America, and other western countries. Switzerland made it official policy more than two years ago that serodiscordant couples in a monogamous relationship who are on treatment and have had no viral load for a certain period (six months to two years) no longer need to use protection when having sex. Their studies found no passing of the virus in these circumstances. People with other STDs in addition to HIV, or people who don't adhere to their medicine schedules, may possibly infect others. But the incidence of passing the virus is greatly decreased by treatment.

[DP25]

No, I mean what I wrote -- 30% of those tested. That may itself be a self-selecting group, because most people never get tested.

And you have absolutely no source for that, and it's ridiculous if you even think about how the numbers would work. I would believe 30% of homosexual prostitutes in Silom tested at one specific clinic were positive. In the entire city of 15 million people, where hospitals can test you without even asking, that is completely absurd. Remember, in the early 1990s they were finding 150,000 positives test results PER YEAR. They are testing WAY more people now than they were 20 years ago, and they found less than 11,000. The new positive rate outside of a few groups is now very low.

Do you remember the HIV vaccine story from last year? Over 16,000 people under 30 in Chonburi (where Pattaya is) were given a vaccine or placebo and tested every 6 months for several years, only 120 tested positive at the end. That's a little bit less than 1/3rd. The fact is Thailand halted what would have been an African level epidemic had things continued at the rates in the early 90s, and reduced new infections to the level in the US.

[pacovl46]

Only 10,000 more cases this year? That is the reported ones. I wonder how many new cases were "given" to visitors here, my guess would be thousands upon thousands.....

Only 10,000 new cases is an improvement on past years but in global terms so far as results are concerned another PATHETIC failure for the Thai authorities...

u mean how many were caught by visitors because they insisted on not using a condom. no sympathy for non-safe sex practitioners!!!

[jonclark]

"Of the 10,853 diagnosed with HIV this year, ......followed by housewives infected by their husbands (28 per cent)."

So who infected the husbands and where are they (the husbands) included in the results. Surely we need to add an additional 28% (+) to these stats under the heading of; men infecteded by visits to hookers and massage parlours.

Don't want to be a cynic, but for the amount of whoring and the social acceptance of men having many wives or girlfriends i'm sure the rate is far higher, especially if you consider that HIV can remain dormant for between 10 - 15 years before sufferers show tangible symptoms.

How often would a married man go to get a HIV test given the social stigma??

99% of these married men are Bi-sexual and caught the disease from another man.... also a big rise in the number of African prostitutes working Sukomvik area and about 60% of these girls have HIV... Same figure for African males who seem to take many Thai hookers for girlfriends , Condoms always.... is the best prevention... or just say No to hookers... Masterbate and save money..!!

Sorry 99% of married men are infected through sex with another man, and your source for such a statement is.....? and the 60% of African hookers on sukhumvit being HIV positive, again a source would be nice or is 60% just a random number pulled from the air.

I think that your statements are indicative of the Thai way of thinking that it HIV doesn't affect 'normal people' and that outsiders are to blame for the spread. The fact is in Thailand Thais are responsible for the spread of HIV in this country.

But as for saving money part- gotta agree :jap:

[peridot]

No, I mean what I wrote -- 30% of those tested. That may itself be a self-selecting group, because most people never get tested.

And you have absolutely no source for that

"Put together by the United Nations Development Programme (UNDP), Asia Pacific Coalition on Male Sexual Health (APCPM) and the University of Hong Kong's Center for Comparative and Public Law, the report said HIV prevalence among gay and bisexual men has been rising in many Asian countries.

For example, HIV prevalence among gay and bisexual men in Bangkok was now 30.8 percent compared to 1.4 percent in the adult population in Thailand. "

This number could indeed mean many things. It could mean those who self-identified and went for an HIV test. It could mean those who were identified by hospitals or doctors as gay/bi with HIV. It could mean the percentage of those treated by goverment sources. I cannot verify exactly what the 30.8% means. Several accounts say it means 30.8% of those who went for voluntary testing in Bangkok.

[DP25]

I cannot verify exactly what the 30.8% means.

Looks like it means what it says it means, it's a study about gay HIV prevalence in Asia and they found 30% of gay males tested in Bangkok were positive. And how did they even test this, recruit a few dozen volunteers from gay gogo bars in Bangkok? The rate could easily be wrong depending how they tested it

I think the 125 positives out of 16,395 under 30s (high rate of new infection) in Chonburi (has Pattaya so highest rate of new infection) tested for years in an international study is closer for the general population http://news.bbc.co.uk/2/hi/8272113.stm

Can add another 20 positive to that total if the drug did anything over the placebo, which it most likely didn't. It's nothing close to 30% tested either way

[HerbalEd]

This seems like one more government PR announcement, not related to the facts. I have read from several reliable sources that 33% of people tested in Bangkok test positive for HIV. There is barely any HIV education, safe sex education, or even basic sex education in Thailand. After starting as an example to the world, things have slid to a stop, as usual. I think there is probably not much push for testing anymore, because no one wants to have any evidence of the real numbers.

My personal experience with Thai men is that about half of them don't use condoms unless pushed into it. Denial, or misunderstanding of the risks involved? I am not sure, but if my small sample is any indication of what is happening elsewhere, the number 11,000 cannot be real.

Do you just make up your own facts and statistics? You say 1/3 of people tested in BKK are HIV positive. What are your "reliable sources" for this information? And what makes you an expert on the condom-use habits of Thai men? What is your "personal experience" about? How personal?

[bf2002]

Only 10,000 more cases this year? That is the reported ones. I wonder how many new cases were "given" to visitors here, my guess would be thousands upon thousands.....

Only 10,000 new cases is an improvement on past years but in global terms so far as results are concerned another PATHETIC failure for the Thai authorities...

Those infected sex tourists and visitors would be treated by their own countries' healthcare systems.

High risk behaviour with sex has a cost. More than one of the Thai women these men have contact with get it from the visitors too with no condom use, broken condoms, and infected men or women going around untreated and spreading it without knowing or even worst not caring and doing it intentionally.

[mommysboy]

The dramatic drop is just in line with the WHO revision of estimates world wide, and rather than admit error it's being trumpeted as a big success. Expect more 'big successes' in the future!

Even in school, we learn that stats. can be manipulated to serve whatever point you decide you want to prove, regardless of where the truth lies. Sadly with this AIDS phenomena we do not know what the true situation is, either regarding base statistics, or medical aspects such as transmission (it would appear to be a more 'rear end and drugs thing' though. I don't think they have successfully even phorographed the blasted thing (as I understand it the images we see are highly stylised computer representations).

All this doesn't hide the fact that this is a wretched ailment and the sooner a cure is found the better, let's hope the bandwagon finds some integrity, and works on a cure, as to my mind at least this is an area of incredible failure so far.

[peridot]

This seems like one more government PR announcement, not related to the facts. I have read from several reliable sources that 33% of people tested in Bangkok test positive for HIV. There is barely any HIV education, safe sex education, or even basic sex education in Thailand. After starting as an example to the world, things have slid to a stop, as usual. I think there is probably not much push for testing anymore, because no one wants to have any evidence of the real numbers.

My personal experience with Thai men is that about half of them don't use condoms unless pushed into it. Denial, or misunderstanding of the risks involved? I am not sure, but if my small sample is any indication of what is happening elsewhere, the number 11,000 cannot be real.

Do you just make up your own facts and statistics? You say 1/3 of people tested in BKK are HIV positive. What are your "reliable sources" for this information? And what makes you an expert on the condom-use habits of Thai men? What is your "personal experience" about? How personal?

See the post before yours for one source of my statistics. I misstated the statistic. It is 30.8% of "gay or bisexual men in Bangkok" that test postitive for HIV.

My personal experience is exactly that, personal. My experience. Between me and Thai men. What is vague about the word "personal"? I never claimed to be an expert, just someone who lives here and has sex with Thai men who don't work in the go go bars. Since I have worked with HIV for decades in America, I am quite interested in how HIV is handled here, and ask a lot of questions of people I interact with and health professionals. I have talked with several men who do work in go go bars about HIV education there, I have worked with a group that teaches English and adds HIV education to men and women in the sex industry, and have a friend who is the SE Asian representative for UNAIDS. Not an expert, but I have a lot of information to base my opinions on.

[mommysboy]

"Of the 10,853 diagnosed with HIV this year, ......followed by housewives infected by their husbands (28 per cent)."

So who infected the husbands and where are they (the husbands) included in the results. Surely we need to add an additional 28% (+) to these stats under the heading of; men infecteded by visits to hookers and massage parlours.

Don't want to be a cynic, but for the amount of whoring and the social acceptance of men having many wives or girlfriends i'm sure the rate is far higher, especially if you consider that HIV can remain dormant for between 10 - 15 years before sufferers show tangible symptoms.

How often would a married man go to get a HIV test given the social stigma??

Quite so, where are the ones that infected these women.

One other take is that the figs. are wrong.

Or that there is promiscuity on the scale of mating frogs. Usually, with viral diseases there is one super carrier who infects a lot of people, so it could be a few males are having there way with tons of bored housewives. Hmm! Wonder what odds you'd get at the bookies for that one.

Like I say, one other take is that the figs. are wrong.

[hammered]

Oh god it probably means even more ridiculously annoying and stupid expats and sex tourists hand jobbing on in whore filled bars about how they never use a condom and never get tested, which would be amusing if it were not for the fact they could be personally passing on premature death sentences to many others

[geriatrickid]

I think you are incorrect here. Treatment has definitely been shown to decrease the spread of HIV to others. "Treatment as prevention" is catching on more and more in America, and other western countries. Switzerland made it official policy more than two years ago that serodiscordant couples in a monogamous relationship who are on treatment and have had no viral load for a certain period (six months to two years) no longer need to use protection when having sex. Their studies found no passing of the virus in these circumstances. People with other STDs in addition to HIV, or people who don't adhere to their medicine schedules, may possibly infect others. But the incidence of passing the virus is greatly decreased by treatment.

Sorry, but I disagree with you. Please cite the studies that support your position.

Until February of this year there were no definitive studies to back up the claim, There were hunches and suppositions derived from quantitative mathematical analysis (modeling for you engineers) that plotted the impact of patients with low or undetectable viral loads. February was when the Fred Hutchinson Cancer Research Center in Washington released its African study results on 3000+ heterosexual couples. The study was led by a dynamo of statistician named Debbie Donnell. The findings published in the Lancet were misquoted in the press. Even the Economist adopted an optimistic opinion and said similar to what the Nation wrote. However, if one reads the conclusions it says the following;

INTERPRETATION: Low CD4 cell counts and high plasma HIV-1 concentrations might guide use of ART to achieve an HIV-1 prevention benefit. Provision of ART to HIV-1 infected patients could be an effective strategy to achieve population-level reductions in HIV-1 transmission.

That's not a definitive statement, just a possibility. In the world of health science, this means that although the results are positive, more study is needed.

We then have the recent iPrEx study that was released by the New England Journal of Medicine this week that I referenced. This study does indeed support an HIV prevention approach called oral pre-exposure prophylaxis (PrEP), which involves the use of antiretrovirals (ARVs) by people who are HIV-negative and at high risk of infection. Note that the subjects are not infected. This is the first of the 5 trials testing oral PrEP to report results. However, I direct you to the following word of caution from the Microbicide Trials Network (MTN), As a trial involving one particular high-risk group - men who have sex with men - the iPrEx findings cannot be viewed as wholesale endorsement for the widespread use of PrEP at this time,. Until other studies are completed, definitive conclusions cannot be made about how PrEP should or should not be used and in whom it would be safe and effective.

This is the current public health position and is supported by the Red Cross. That is why I believe that the Dr. was misquoted or taken out of context. For all we know, he could have been referring to the treatment given pregnant women, which has been proven effective.

Your reference to the approach in Switzerland isn't relevant. (I'm not arrogantly dismissing your statement, as it is accurate, but it is not applicable to Thailand.) In any case, IMO the Swiss position seems to have been associated by a report published in 2008 in the Bulletin des médecins suisses that was signed off on by all the Swiss public health big wigs (some of which have now distanced themselves from the report if the interviews are reliable.) The heading of the report read; "After review of the medical literature and extensive discussion," the Swiss Federal Commission for HIV/AIDS resolves that, "An HIV-infected person on antiretroviral therapy with completely suppressed viremia ("effective ART") is not sexually infectious, i.e. cannot transmit HIV through sexual contact." This position was rejected outright by the leading experts at the time. The statement is still considered inappropriate. From a public health perspective as applied to counties like India, Thailand and elsewhere it is not applicable. The infection demographics and social characteristics are very different.

There are multiple ongoing trials in major North American cities in respect to a strategy public health workers call "Seek & Treat". Seek and Treat expands HIV treatment and improves testing, diagnosis, and linkage to care. This approach is very different than what is in place for Thailand which emphasizes treatment. The Canadian province of British Columbia is the only major jurisdiction in the world where it is now available as part of the health care delivery system. In February of this year the province funded ($C50MM) for a full scale 4 year pilot trial. Trials are planned for San Francisco, in New York and Washington DC,. Other trials are planned for France and the UK. There is a randomized trial already under way in nine countries which is testing whether early treatment leads to durable prevention of transmission within couples. That study will not report results for several years.

Therefore, I return to my main point that the statements attributed to the Red Cross representative are not believable. The declining numbers reported may mean that the infections are under reported. If the diagnostic work isn't done, the data is not reliable as an indicator. I retain my opinion that testing on high risk groups outside of major urban centers has decreased.

[asiawatcher]

No, I mean what I wrote -- 30% of those tested. That may itself be a self-selecting group, because most people never get tested.

And you have absolutely no source for that, and it's ridiculous if you even think about how the numbers would work. I would believe 30% of homosexual prostitutes in Silom tested at one specific clinic were positive. In the entire city of 15 million people, where hospitals can test you without even asking, that is completely absurd. Remember, in the early 1990s they were finding 150,000 positives test results PER YEAR. They are testing WAY more people now than they were 20 years ago, and they found less than 11,000. The new positive rate outside of a few groups is now very low.

Do you remember the HIV vaccine story from last year? Over 16,000 people under 30 in Chonburi (where Pattaya is) were given a vaccine or placebo and tested every 6 months for several years, only 120 tested positive at the end. That's a little bit less than 1/3rd. The fact is Thailand halted what would have been an African level epidemic had things continued at the rates in the early 90s, and reduced new infections to the level in the US.

There was also the campaign by Cabbages and Condoms owner and the Police - you may recall - very successful when they were on street corners handing out condoms. Their slogan "Cops and Rubbers" !!!

[sfm]

>Only 10,000 new cases is an improvement on past years but in global

>terms so far as results are concerned another PATHETIC failure for the

>Thai authorities...

10,000 in a country of 60.000.000 is one in 6.000 pr. year.

Which number, then, would not be a failure?

> I have read from several reliable sources that 33% of people tested

> in Bangkok test positive for HIV.

Can you link to such a source? I know several doctors that test people for HIV every day and

say that positives are not even found every month.

> You can go to a clinic, pay a few baht more, and get a report saying you don't have HIV.

> You don't even have to have your blood tested....

The report is based on hospital feedback on positive tests - not on what attest people may show up with

>> "...this year as most people with HIV have been able to access anti-retroviral drugs at an early stage

>> of disease, which cuts the chances of the disease being spread to others."

> I believe that Dr. Praphan Panuphak has been misquoted or taken out of context. The statement can create

> the incorrect belief that medication will protect the sex partners of infected people.

...

> the HIV medication available in Thailand does not "cut the chances of the disease being spread to others

...

> Until February of this year there were no definitive studies to back up the claim, There were hunches and

> suppositions derived from quantitative mathematical analysis (modeling for you engineers) that plotted

> the impact of patients with low or undetectable viral loads.

Wrong. There are many studies, some more than 10 years old, that confirms the corellation between viral

load and infection risk

This statement is from CDC, US:

"The risk of sexual HIV transmission is substantially reduced for individual couples in which the infected partner

is on effective ART and has achieved undetectable plasma HIV viral load, but is not completely eliminated."

and they do not take such statements likely.

How an individual with undetectable levels of HIV in the blood should be just as infectious as one with e.g. millions of

copies pr. cubic centimeter, would be a unique characteristic for HIV.

Studies have been made, here is one:

http://www.ncbi.nlm.nih.gov/pubmed/10738050

It is easy to find more information in Google, like

http://www.thebody.com/content/treat/art52828.html

[geriatrickid]

sfm, you state;

Wrong. There are many studies, some more than 10 years old, that confirms the corellation between viral load and infection risk

This statement is from CDC, US:

"The risk of sexual HIV transmission is substantially reduced for individual couples in which the infected partner is on effective ART and has achieved undetectable plasma HIV viral load, but is not completely eliminated."

and they do not take such statements likely.

How an individual with undetectable levels of HIV in the blood should be just as infectious as one with e.g. millions of copies pr. cubic centimeter, would be a unique characteristic for HIV.

Studies have been made, here is one:

http://www.ncbi.nlm....pubmed/10738050

It is easy to find more information in Google, like

http://www.thebody.c...t/art52828.html

You have not read these studies have you? You have also taken statements out of context. You are demonstrating wishful thinking. In the first link you cite, please go back and read the conclusion. It states only;

CONCLUSIONS: The viral load is the chief predictor of the risk of heterosexual transmission of HIV-1, and transmission is rare among persons with levels of less than 1500 copies of HIV-1 RNA per milliliter. This does not support any claim that treatment prevents new infections. It is a literature review statement. More studies were needed. That is why 5 studies were launched, only 1 of which has now reported. No conclusions can be drawn until the studies are published and the reviews made. Longterm public health policy is not made on early results.

You then link to an interview with Dr. Granich that is actually a discussion of the studies that I previously discussed in detail. What part do you not understand? Read the conclusion; So we must all think about ways to come together to do combined prevention. Our model used a combined prevention approach -- combined prevention that would include ART, but also many other interventions (like couple's counseling and male circumcision, for example) to get ahead of the epidemic, and prevent transmission

The article was written by a magazine that targets a readership that wants and needs good news. Treatment was one part of the approach.

As an aside, the male circumcision aspect referenced has already been demonstrated by the great Dr. Bailey (one of the most brilliant and courageous scientists around who had to face threats from wackos subsequent to the release of the multiple longterm circumcision studies.) One need only look at the resistance expressed by some to some very explicit data to understand that there is a long journey between study results and application to a population.

The Thai approach has focused mostly on medication. Counseling, intervention, and testing are not lead components of the Thai strategy because these are expensive. When you have limited resources you don't have many options. Thailand opted to emphasize on one component of a multi pronged response and now risks creating a reservoir of resistant HIV strains. That's an aspect of the story that isn't discussed either. Nor is the fact that medication has adverse reactions. Sometimes the cure is worse than the original disease.

Edited November 26, 2010 by geriatrickid

[housepainter]

Aids and Thailand.

I've read the Thai academic studies on the spread of the desease in Thailand. It makes interesting reading and the findings run very much against what may be wrongly assumed by many people.

The highest concentration of HIV identified persons remains within the Chiang Rai province. Furthermore, within the studies specific villages, Tambons and Ampurs are named. I do not wish to identify them here. I will however, go some way to explaining the finding through explaining that those places have the highest number of returning migrant workers who bring the desease with them.

There follows the infection of partners. The resulting numbers are mainly across heterosexual couples and overwhelming it is the returning male who infects the partner female.

Studies in other areas, for example Pattaya, do present a clear distortion to those figures that show the introduction and establishment of aids / HIV in Thailand.

The lack of effective sex education, treatment for HIV or accepted safe sex practices amongst the population goes some way to explaining the resulting PH figures. The accuracy of such statistics remains questionable as the birth rate within Thailand has shown no discernable reduction despite what we are told is the increased condom usage.

Simply, put: you can't have one without the other but the PH Department in this case asserts you can. I think therein is found the lie.

There is some information that I do not wish to share but would pose the following question. Firstly, I would like to add that I have always considered the contracting of AIDS to be rather difficult. For those of you who are some what puzzled by that statement, please consider the following: with a disease that is contracted through unprotected sex wouldn't you think that the spread of it, 40 years ago, would have engulfed the entire world almost over night?

Those many years ago, the Western world's females used no contraception or the pill; the rest of the world used withdrawal, abstinace or the rythm method.

If it were at all easy to contract the disease then we'd all be a sexual or dead by now.

So the question is does anyone know of the statistical variances for the contraction of AIDS via heterosexual sex; gay or lesbian sex; and all the anal permutations thereof. You see, part of the answer lies in identifying that there is a difference in rates of contraction [ as there would be] between vaginal and anal sex.

Furthermore, in assessing the value of any PH statistics one has to apply a rule of thumb methodolgy and also give due credence for one's own knowledge, behaviour and anecdotal evidence. After all, such statistics were merely derived by asking / testing a coort of persons.

One should consider whether one's own condom usage is infallible, meticulously maintained. Experinces garnered from one's peers may also be enlightening regarding the oversight when failing to use a condom. This would need to be measured against the chances of infection. That is whether it is an easy or a more elusive disease to contract.

In summation, I would suggest that time is the measure of the infection rates. It is all too easy for such deaths to be recorded as 'heart failure', which they are technically, and hence the figures are clearly manipulated downwards. But the sad fact remains that if a westerner found they were infected they would fly home and receive treatment. The BKK elite would pay for it. The rural people would be denied it unless they too could pay, which they overwhelmingly could not.

I have witnessed such cases. I have witnessed such deaths. I have seen patients sent home. I have seen them returned to the same hospital when their relations could offer nothing other than a place to die, with out medication other than a well meant but ill informed neighbour offering Tiffy.

I have witnessed the innocent rural poor who never strayed further than the Chiang Rai village struck down by an infection borne by a returning husband.

I have witnessed the laboured death of a Pattaya bar girl as she protected her hand bags belongings held firm as the pillow beneath her head.

Neither was a sight I shall ever forget.

There needs to be a human face to this topic. This is it. We need to act responsibly and speak responsibly. Those of us on here have no excuses for our attitudes, which are informed or our behaviour, which is a product of our education.

That is something we can claim. Many Thais can not.

[eurasianthai]

This is just a joke, a bad joke.

AIDS is like abortion in Thailand, something you can not talk about.