Rights Body Opposes Regulation Demanding HIV/Aids Tests: Thailand

[webfact]

Rights body opposes regulation demanding HIV/Aids tests

Pongphon Sarnsamak

The Nation

Aids rights advocates are pressing the government to jettison all regulations requiring blood tests for HIV/Aids.

According to a survey by the foundation in 2009, of 233 people who had undergone a mandatory blood test, 76 per cent said they were fired from their jobs after their employers came to know that they were HIV positive. About 19 per cent were refused medical treatment and 20 per cent were not allowed to get healthcare insurance. About 74 per cent said they did not want to lodge a complaint with relevant agencies as they did not want other people to know that they were HIV positive.

"Many people have lodged complaints with our organisation that they were forced to undergo a mandatory blood test for HIV/Aids to apply for work. If they didn't, they couldn't get the job," Supattra Nakhaphew, director of the Foundation for Aids Rights, said yesterday.

Many public and private agencies such as the National Police Office, the Office of the Attorney-General, Juridical Office, temples, supermarkets and airlines are still forcing their staff to get tested for HIV/Aids, she said.

Educational institutions require students to take a blood test before taking classes. Some hospitals have asked patients to receive a blood test before they undergo surgery or lasik operation for their eyes.

Pregnant women have been told to accept a mandatory blood test before they receive prenatal care.

"Mandatory blood tests and human rights violations still exist in our society," she said.

A Cabinet resolution in 2007 had barred state agencies from conducting mandatory blood tests on their employees for HIV/Aids, but to date this regulation has never been implemented.

"We have to accept that HIV/Aids blood testing is a big issue for our society. That's why the mandatory blood test for HIV/Aids is still around," said John Ungpakorn, an Aids rights activist and former senator.

The government and the public must normalise their perceptions of HIV/Aids like other diseases such as diabetes, he said.

This could eliminate the stigma of people living with HIV, and the HIV/Aids blood tests will become a normal healthcare service that anyone can access.

"Mandatory blood tests for HIV/Aids should only be conducted on patients who cannot help themselves and need the test for diagnosis and for women who have been raped," he said.

Dr Praphan Phanuphak, an official with the Thai Red Cross Aids Research Centre, said the mandatory blood tests for HIV/Aids have affected not only the subjects of the test but also their relatives due to the stigma against people living with HIV/Aids.

According to the Foundation for Aids Rights, some people were attacked after their community learned that they were HIV. Some with HIV were not allow to join the community's events or ceremonies.

-- The Nation 2011-10-05

[geriatrickid]

Notice that there is no mention of the testing of sex workers? Hands up, those of you that think the sex trade worker testing program is still in place? Sorry, but it is not to the extent that it once was. The program doesn't get the funding it needs to test those workers.

Hands up anyone that thinks there is a national testing program where patient's confidentiality is respected, i.e. anonymous testing by outside visiting healthcare workers? Nope.

Hands up anyone if they think rural adolescents can access confidential treatment and counseling? Not for the majority of Thai adolescents.

In a country where hiring requirements are still discriminatory based upon age and sex criteria, is it any wonder there is a problem with HIV+ subjects experiencing this problem?

[jonclark]

Notice that there is no mention of the testing of sex workers? Hands up, those of you that think the sex trade worker testing program is still in place? Sorry, but it is not to the extent that it once was. The program doesn't get the funding it needs to test those workers.

Hands up anyone that thinks there is a national testing program where patient's confidentiality is respected, i.e. anonymous testing by outside visiting healthcare workers? Nope.

Hands up anyone if they think rural adolescents can access confidential treatment and counseling? Not for the majority of Thai adolescents.

In a country where hiring requirements are still discriminatory based upon age and sex criteria, is it any wonder there is a problem with HIV+ subjects experiencing this problem?

Hands up if you think Thai kids are educated properly on how to prevent infection?

[dean999]

Notice that there is no mention of the testing of sex workers? Hands up, those of you that think the sex trade worker testing program is still in place? Sorry, but it is not to the extent that it once was. The program doesn't get the funding it needs to test those workers.

Hands up anyone that thinks there is a national testing program where patient's confidentiality is respected, i.e. anonymous testing by outside visiting healthcare workers? Nope.

Hands up anyone if they think rural adolescents can access confidential treatment and counseling? Not for the majority of Thai adolescents.

In a country where hiring requirements are still discriminatory based upon age and sex criteria, is it any wonder there is a problem with HIV+ subjects experiencing this problem?

Hands up if you think Thai kids are educated properly on how to prevent infection?

Hands up if you think the sex worker with HIV will just move bars before she has to take the test.

[Beetlejuice]

Hands up all those that think those that keep saying hands up is getting boring.

[TAWP]

Notice that there is no mention of the testing of sex workers? Hands up, those of you that think the sex trade worker testing program is still in place? Sorry, but it is not to the extent that it once was. The program doesn't get the funding it needs to test those workers.

Lots of places, gogo's and especially massage places, have required tests of all staff regularly.

[steveromagnino]

Notice that there is no mention of the testing of sex workers? Hands up, those of you that think the sex trade worker testing program is still in place? Sorry, but it is not to the extent that it once was. The program doesn't get the funding it needs to test those workers.

Lots of places, gogo's and especially massage places, have required tests of all staff regularly.

I am willing to agree that perhaps the massage places for the upmarket Thai market like Ratchada area do test as they are supposed to, but enough conversations with enough bar owners/staff/clients/AIDS NGOs would certainly suggest that the tests conducted in the tourist places are either not universal, not trustworthy or not done at all, as there are high proportions of HIV+ sex workers shown in almost every survey of the subject, particularly in the men to men market. There's also large parts of the market that aren't covered; as 2.30am in Nana indicates. I am not sure there was EVER a period that there was true mandatory testing of all facets of the sex industry here, and right now, we have seen probably a decade where HIV and AIDS have faded away somewhat in the public consciousness, maybe because people think it can be cured.

It is a long time since we saw the mass awareness campaigns of someone like Meechai who basically moved HIV to be front of mind. With the sidelining of some NGOs in the early 2000s both locally and as a result of reduced funding/support for abstinence in USA/abroad (where much of the funding comes from) also came a somewhat positive step locally of universal cost effective treatment (theoretically) albeit using medicines that are no longer recommended in the west due to some rather nasty side effects; the coup government also took a huge step forward in compulsory licensing, thankfully not rewound. However, while treatment access is improving, prevention and education is slumping.

There are some pretty big risks given the subtype of HIV here in Thailand which is particularly virulent; if a resistant strain starts to become prevalent due to non adherence in medication, then the average poorer Thai (or the orphanages I have been to) would really start to struggle to fund more expensive salvage/2nd line therapies. Prognosis is worse than the prevalent subtypes in Europe or USA and also than the HIV type in Africa.

Given the risks of some other extremely nasty bugs like hepatitis and various STDs, you'd think that protection would be widespread, but any visitor to Bangkok and Pattaya nightlife can probably find ways around protection. It's all pretty sad.

Watching the film Living With the Tiger, covers some of the issues relating to discrimination against HIV+ kids; pretty sad but given the requirement to submit photos for job applications, height and weight, questions about family and parents, it isn't perhaps unexpected.

Hate to say it, but as a doctor I would certainly want to know prior to treatment; not necessarily to not treat them, but definitely to take marginally more care....just as well I am not a doctor then! (well not a medical one, I am willing to be a doctor of massage for some extra sideline income).

Zero chance of getting health insurance is not so surprising or unexpected. Discrimination...well maybe something can be done.

[Lifer]

The other silly requirement is requiring a mandatory std blood test to get a work permit. Doesn't do a thing to enhance ones ability to perform their job. Negative today, positive tomorrow or the next day! Allows the medical people to get another fee for the test.

[TAWP]

Notice that there is no mention of the testing of sex workers? Hands up, those of you that think the sex trade worker testing program is still in place? Sorry, but it is not to the extent that it once was. The program doesn't get the funding it needs to test those workers.

Lots of places, gogo's and especially massage places, have required tests of all staff regularly.

I am willing to agree that perhaps the massage places for the upmarket Thai market like Ratchada area do test as they are supposed to, but enough conversations with enough bar owners/staff/clients/AIDS NGOs would certainly suggest that the tests conducted in the tourist places are either not universal, not trustworthy or not done at all, as there are high proportions of HIV+ sex workers shown in almost every survey of the subject, particularly in the men to men market. There's also large parts of the market that aren't covered; as 2.30am in Nana indicates.

/../

I would say that you are right, normal bargirls, streetwalkers etc are completely outside the organized tests, some better gogo's have, and all the better massage places have them - but again, smaller [and possible even less in Pattaya and Phuket] gogo's and massage places most likely have a much lower frequency of doing it right.

[Scott]

Several posts deleted. One for flaming, one for all caps and one for quoting a deleted post.

[Beetlejuice]

Notice that there is no mention of the testing of sex workers? Hands up, those of you that think the sex trade worker testing program is still in place? Sorry, but it is not to the extent that it once was. The program doesn't get the funding it needs to test those workers.

Lots of places, gogo's and especially massage places, have required tests of all staff regularly.

Would you stake your life on that?

[Boater]

even working for marriott you have to have an HIV test and STD test ! ..... and they make you take it , or you dont get the job !

[DP25]

Mandatory HIV testing may be a human rights violation, but it is part of the reason Thailand went from 150,000 new infections per year in the early 90s to under 10,000 per year now. For it to be contained people need to know if they have it to begin with, and most people avoid testing because they don't want to know or think they aren't at risk.

[bkkjames]

So test everyone they say, workers and so on - however while governments and some 3rd parties claim its neccessary, they remain quiet when it comes to travellers.

13 million people walk through the border of LOS every year untested, multiply this by every other country in the world that gets visitors and one can clearly see the hypocracy.

[Tokay]

Lots of places, gogo's and especially massage places, have required tests of all staff regularly.

If by "tests" you mean the ones done in the clinics for 500b, with cheap unreliable rapid tests from China, where the doctor can and often does stamp a clean bill of health for an extra 500b, then you are correct.

Very few (as in hardly any) places use an actual hospital who uses a real ELISA test.

[TAWP]

Lots of places, gogo's and especially massage places, have required tests of all staff regularly.

If by "tests" you mean the ones done in the clinics for 500b, with cheap unreliable rapid tests from China, where the doctor can and often does stamp a clean bill of health for an extra 500b, then you are correct.

Very few (as in hardly any) places use an actual hospital who uses a real ELISA test.

You are wrong in assuming that hardly any do real testing. But whatever...if it makes you stay away from them to be safe, the better I suppose.