Bangkok HIV Rate is 20%?

[rcox81]

I came across a surprising piece of information, saying that 20% of female freelance sex-workers are infected with HIV. A link to the study can be found here:

http://www.ncbi.nlm.nih.gov/pubmed/23512512

Just anectodally, this does not match what I have seen. I know one girl whose sister (24 years old) is infected, but that is all I have ever heard in my own experience here. But if this study is accurate, the disease is probably far more prevalent than most people realize. I really do not understand how this does not get more attention. This basically means that walking around Nana and seeing the freelance girls is literally similar to walking into some African countries with an HIV epidemic. I would like to believe these numbers are not true, but its very hard to doubt the science.

[Tywais]

That paper seems to be published in 2013 but data collected in 2007. There is an earlier publication that shows much worse statistics from 2004-2006 so the trend is downward and current data, 2013, would be interesting to get a better picture.

ACCESS TO HIV TESTING FOR SEX WORKERS IN
BANGKOK, THAILAND: A HIGH PREVALENCE OF HIV
AMONG STREET-BASED SEX WORKERS

P Nhurod1, LJM Bollen2, P Smutraprapoot1, O Suksripanich2, U Siangphoe2,
R Lolekha2, P Manomaipiboon1, C Nandavisai2, R Anekvorapong1, S Supawitkul2,
W Subhachaturas1, P Akarasewi2 and KK Fox2

1Bangkok Metropolitan Administration, Bangkok, Thailand; 2Thailand MOPH - US
CDC Collaboration, Nonthaburi, Thailand

Abstract. We offered voluntary counseling and testing (VCT) for HIV and syphilis to women attending three public sexually transmitted infection (STI) clinics in Bangkok, Thailand from May 2004 to June 2006. The testing was performed at either one of three STI clinics in Bangkok or at mobile VCT in the same area as the outreach activity. Six-hundred eighty-four women were tested. The HIV prevalences among the street-based sex workers, brothel-based sex workers and other women in these areas not reporting sex work who tested in the clinics were 45.8% (38/83), 4.2% (10/236) and 9.9% (28/284), respectively. The prevalences of syphilis in these groups were 13.3%, 2.1%, and 2.6%, respectively. Street-based sex work and longer duration of sex work were independent risk factors for HIV infection (p<0.001 and p=0.02, respectively). HIV and syphilis prevalences were 21.0% and 3.7% among 81 street-based sex workers accepting mobile VCT. The streetbased sex workers in Bangkok had substantially higher HIV and syphilis prevalences than other sex workers. Street-based sex workers should be sampled during routine surveillance to obtain systematic information on disease prevalence.

Publication in pdf format here

[Jingthing]

The surprising part is that the rate isn't higher.

[rcox81]

The surprising part is that the rate isn't higher.

Do you come across mass numbers of people that are infected? I am very surprised the number is this high, and I don't see how it isn't a bigger story.

[Jingthing]

People don't wear a red A on their heads.

[rcox81]

That paper seems to be published in 2013 but data collected in 2007. There is an earlier publication that shows much worse statistics from 2004-2006 so the trend is downward and current data, 2013, would be interesting to get a better picture.

ACCESS TO HIV TESTING FOR SEX WORKERS IN

BANGKOK, THAILAND: A HIGH PREVALENCE OF HIV

AMONG STREET-BASED SEX WORKERS

P Nhurod1, LJM Bollen2, P Smutraprapoot1, O Suksripanich2, U Siangphoe2,

R Lolekha2, P Manomaipiboon1, C Nandavisai2, R Anekvorapong1, S Supawitkul2,

W Subhachaturas1, P Akarasewi2 and KK Fox2

1Bangkok Metropolitan Administration, Bangkok, Thailand; 2Thailand MOPH - US

CDC Collaboration, Nonthaburi, Thailand

Abstract. We offered voluntary counseling and testing (VCT) for HIV and syphilis to women attending three public sexually transmitted infection (STI) clinics in Bangkok, Thailand from May 2004 to June 2006. The testing was performed at either one of three STI clinics in Bangkok or at mobile VCT in the same area as the outreach activity. Six-hundred eighty-four women were tested. The HIV prevalences among the street-based sex workers, brothel-based sex workers and other women in these areas not reporting sex work who tested in the clinics were 45.8% (38/83), 4.2% (10/236) and 9.9% (28/284), respectively. The prevalences of syphilis in these groups were 13.3%, 2.1%, and 2.6%, respectively. Street-based sex work and longer duration of sex work were independent risk factors for HIV infection (p<0.001 and p=0.02, respectively). HIV and syphilis prevalences were 21.0% and 3.7% among 81 street-based sex workers accepting mobile VCT. The streetbased sex workers in Bangkok had substantially higher HIV and syphilis prevalences than other sex workers. Street-based sex workers should be sampled during routine surveillance to obtain systematic information on disease prevalence.

Publication in pdf format here

I am a finance guy, so I don't mean to sound like I know what I am talking about but I don't think these are similar studies. In your link, it looks like they were offering STD counseling and testing, so some of the population might have even known they had HIV already. Either way, I think we would all agree that prevalence didn't drop from from 45% to 20% in only 3 years.

[rcox81]

People don't wear a red A on their heads.

OK, I guess your are going for a joke there. But what I am really getting at is whether or not you hear people talking about their friends testing positive, etc. I literally have only come across one indirect example in my 2 years here.

[beano2274]

Do you think that people will go around saying they are HIV positive, within days the whole of their friends would know

[rcox81]

Do you think that people will go around saying they are HIV positive, within days the whole of their friends would know

This is all you are going to do to respond to the topic?

[Jingthing]

Studies and statistics aren't perfect but generally they are much better objective info than anecdotal personal stories.

[steamer]

Cant imagine the 'fresh meat' get tested. More so the habitual flesh peddlers. Skewes the results somewhat I would think.

[Jingthing]

Many of the sex workers aren't from Bangkok. If they get very sick, they go home. Mystery solved.

[wellred]

I think the infected rate is not surprising given it's a 3rd world country after all.

[rcox81]

Studies and statistics aren't perfect but generally they are much better objective info than anecdotal personal stories.

We were all aware of this.

[wolfmanjack]

I know a few sex workers that only go get tested if they have had sex without a condom. I would think that would skew the tests results based on any voluntary tests only.

[oldthaihand99]

That paper seems to be published in 2013 but data collected in 2007. There is an earlier publication that shows much worse statistics from 2004-2006 so the trend is downward and current data, 2013, would be interesting to get a better picture.

The overall trend has been downward again since 2007, according in the latest studies i've seen, which are up to 2011.

In 2007, the rate was 10% in Chang Mai amongst non venue FSW, so 50% of the BKK figure at that time. By 2010 the CM number was halved to 5%. No figure was given for BKK in 2010, but Phuket & Chonburi are listed at 1.4 & 1.2%.

Venued FSW HIV rates in Siam dropped from 3.8% in 2005 to 1.8% in 2011. BTW the overall estimate for the general population of the country is usually listed at around 1.0%. See pages 47-50 @

http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_th_narrative_report.pdf

[thepool]

The spread of HIV is demand lead

Mainly by Westerners

Enjoy your holiday guys !

Take home a "gift" for the wife or the boy/girl friend.

[oldthaihand99]

Do you come across mass numbers of people that are infected? I am very surprised the number is this high, and I don't see how it isn't a bigger story.

The overall FSW rate in LOS was estimated as 2.0% in 2011, compared to 1.0-1.2% for the entire general population aged 15-49.

Relative to many African nations that is excellent. Compared to much of the Western world it is quite inferior.

Although like in many other places in the world, the Thai rates remain relatively high for specific small groups such as MSM & IDU.

[rhythmworx]

Did the study mention the national ethnicities of the people infected and also the sexuality and gender of the sex workers?

For all we know 30% of the people in the study could have been of African origin 40% could have been Thai males.

[oldthaihand99]

Many of the sex workers aren't from Bangkok. If they get very sick, they go home. Mystery solved.

If they get sick from HIV complications, they may die or otherwise quit labour in the sex biz.

This factor works toward lowering the numbers of HIV infected hookers and therefore also the chance any random prostitute is infected.

Those who were tested HIV positive may also quit after learning of their result.

Even if they don't quit, if they insist on condom use or take HIV meds they will be safer to the public than they were before.

[Jingthing]

...

Even if they don't quit, if they insist on condom use or take HIV meds they will be safer to the public than they were before.

Hookers with a heart of gold, eh?

[oldthaihand99]

"With the current intervention responses, the results of the projection and estimation revealed that between 2012 and 2016, new infections among MSM, sex workers and clients and intravenous drug users will make up about two thirds of all new infections, while new infections through sex between husbands and wives and through casual sex will make up about one-third (Table 6)." [page 53]

http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_th_narrative_report.pdf

[rcox81]

I started the thread because these numbers are alarmingly high and I was curious to hear more anecdotal examples from people that actually live here.

As I said before, I have been here more than 2 years, and I have only come across one person (indirectly) that is infected with HIV. She was doing sex work, so she would fall into that category. Only 24 years old when she took her test.

I am just surprised I have not heard more stories because if this study is accurate, picking up a street girl in Nana is just as risky as going into some of the epidemic countries in Africa. I think there are a lot of people that don't realize this.

[Jingthing]

Just use protection every time and assume every new partner you meet may be positive ... they would be smart to assume the same about you.

[MrHammer]

Seems like people can't read the study.

They tested those who voluntarily showed up. That means you will get a larger subset of those who may think they are at risk including drug users.

44% of all street based prostitutes had HIV. 4% only of brothel based prostitues and again only those who went voluntarily. Very low number and then a proper study should discount IV drug users to get sexually transmitted HIV.

I hope most guys are smart enough to realize that street prostitutes are there for a reason, most likely because they are drug users and therefore can't work in bars or brothels. IV transmission is by far the most 'effective'.

But yeah, I hope some of the guys who are happy to pick up a 500 baht whore from Beach Road realize the risks.

[oldthaihand99]

I started the thread because these numbers are alarmingly high and I was curious to hear more anecdotal examples from people that actually live here.

As I said before, I have been here more than 2 years, and I have only come across one person (indirectly) that is infected with HIV. She was doing sex work, so she would fall into that category. Only 24 years old when she took her test.

I am just surprised I have not heard more stories because if this study is accurate, picking up a street girl in Nana is just as risky as going into some of the epidemic countries in Africa. I think there are a lot of people that don't realize this.

Your study, even if accurate, has no application to today. It was from 2007, not 2014, so it's 7 years out of date.

Moreover more recent studies have shown far different figures, as i've already posted, referenced & explained.

Furthermore 7 years is a long time in the sex trade biz. Girls come & go, retire quickly, and turnover is very high.

So i'd say the 2007 study, even if accurate, does not support your statement that today "picking up a street girl in Nana is just as risky as going into some of the epidemic countries in Africa".

As far as anecdotal evidence or hearing stories is concerned, Stickman mentioned some gogo or bar girls still working while knowing they were infected. Also at least one news report claimed to have interviewed a street working girl in BKK who alleged to be HIV positive & willing to forgo condom use. I've also heard from street girls themselves who claim to know of 2 of their co-workers who had the disease, one who quit soon after knowing of her infection and the other still working last i heard. Of 10 street walkers i've seen the Bumrungrad HIV results for in the last 3 years, 100% of them tested negative.

[oldthaihand99]

I hope most guys are smart enough to realize that street prostitutes are there for a reason, most likely because they are drug users and therefore can't work in bars or brothels. IV transmission is by far the most 'effective'.

But yeah, I hope some of the guys who are happy to pick up a 500 baht whore from Beach Road realize the risks.

IMO a small minority of street sex workers in BKK are drug addicts. It's nothing like a skid row in the USA or Canada, such as in Vancouver, BC where almost every hooker is addicted to crack, heroin or both.

As for drug use, what is that, drinking coffee, alcohol, meds, recreational MJ, pills, nicotine?

Drug abuse & addiction is well known to occur amongst venue sex workers in BKK, not just street girls. Yabba & ice, for example.

These ladies generally work on the street, or as other types of freelancers, because they prefer this over the other options where they are under a boss.

[wellred]

Do you come across mass numbers of people that are infected? I am very surprised the number is this high, and I don't see how it isn't a bigger story.

The overall FSW rate in LOS was estimated as 2.0% in 2011, compared to 1.0-1.2% for the entire general population aged 15-49.

Relative to many African nations that is excellent. Compared to much of the Western world it is quite inferior.

Although like in many other places in the world, the Thai rates remain relatively high for specific small groups such as MSM & IDU.

What is MSM?

[Jingthing]

MSM is the clinical medical term for Men who have Sex with Men.

It used because not all men having such sex identify as gay. For example, on the down low, gay for pay, prison sex, etc.

[Dumbkid]

Thanks for the topic and helping people to gain morre knowledge

I have a question, thx girls in soapy massage aka brothel are they safer than street hookers?

1- Do they get tested like their brothel claim or its just bullshit

2- And if customer didnt want to use a condom ,will they accept ?

3- And if they were infected ,do they use their meds to reduce the viral load so she doesnt spread hiv and be healthier ?