HIV/AIDS – Thailand has made great progress but social stigma and ignorance remain a worry

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HIV/AIDS – Thailand has made great progress but social stigma and ignorance remain a worry

 

 

BANGKOK: -- The first cases of HIV/AIDs were detected in Thailand in 1984 and many doom and gloom merchants were predicting the end of the world for people with the condition.

 

While many if not most did die in the early years before there was any medicine to control the virus and though people continue to die today for various reasons, some great strides have been made in the kingdom coupled with ever improving drug regimens being developed worldwide.

 

But problems still remain and many of these revolve around the public’s perception of HIV/AIDS and the stigma that still remains and is the cause of great hardship, and can even lead to death itself, for the sufferers of the condition.

 

These days there are just shy of 500,000 people known to have HIV/AIDS in Thailand. But the real figure for those infected could be many more. There are many reasons for this not least of all that some people feel they would rather not know. Some have no inkling that they are infected because though many suffer a burst of fever in the early days of infection, this soon passes and the virus can lie in the victim for a decade or more with no symptoms.

 

Then, with a compromised immune system, it can sometimes be too late to get adequate treatment. For those with the kind of lifestyle that means they have a high likelihood that they could have acquired the virus, checking blood periodically is a wise precaution.

 

For those who suspect partners might have the virus but who are not having treatment then a check would also be a good idea. The best way to combat HIV is to face up to it.

 

The first drug treatments were available around the mid-90s and these have now been honed and added to so that today’s medications – that are all cocktails of several drugs – can suppress the virus to such a point that most clinicians have deemed people on successful treatment to be no longer infectious.

 

And the chance of such individuals living to a ripe old age – no matter when they were infected in their life – is now an increasingly accepted reality.

 

Individuals who are diagnosed with HIV will immediately have their T-cells checked. These are the cells that fight disease in the blood and in a normal healthy person with a strong immune system can be 800 per milliliter of blood up to around 1,500. After infection a sufferer’s disease fighter cells – known as the CD4 count – will generally be on a slow but sure direction down.

 

In the past most Thai doctors waited until a patient’s CD4 level dropped to around 350 before beginning treatment but these days many favor beginning treatment as soon as infection is confirmed and certainly at levels below 500.

 

Doctors in the USA considered that a CD4 level of less than 250 could lead to complications and infections that could give a patient a diagnosis of AIDS.

 

Those who have found out that they are infected and whose CD4 levels have dropped below 250 still have a great chance of making a full recovery, however. The key is that treatment must be started and adhered to rigidly.

 

Most HIV/AIDS patients take tablets once or even twice a day. Some can take just one pill that is a combination of drugs, others take separate medication. The treatment is called anti-retroviral therapy. Sometimes it is referred to as highly active anti-retroviral therapy or HAART.

 

Adherence is the key and for most people who take what is known as the “first line” of drugs they can achieve dramatic improvements in their immune systems within months or even weeks.

 

For HIV/AIDS sufferers the aim is to achieve what is known as an undetectable viral load. The viral load is the number of copies of the HIV virus that is in the blood. For someone recently infected this can be tens of thousands per milliliter.

 

For those on successful therapy they are deemed to have less than 30 copies per milliliter – this is known as the undetectable viral load. The reality is the virus is still in the individual but it can’t be measured because it is so low.

 

Several years ago a statement came out of Switzerland that was known as the Swiss Statement. This stated that individuals with an undetectable viral load were no longer infectious.

 

For many in the health field this has been confirmed by clinical studies. So much so that within the last year a conference heard that in relationships where one person was HIV positive and the other not, there was no chance of the infected partner passing on the virus no matter what their sexual practices or quantity thereof.

 

The majority of doctors at the conference did feel they should still recommend safe sex practices to these people, however, despite being told by a keynote speaker there was zero chance of infection.

 

Drugs in Thailand have consistently improved and come down in price. For Thai people there is now free treatment available for all. Non-Thais living with the virus are able to buy cheap drugs and attend bargain price clinics for regular or annual check-ups as necessary.

 

The Government Pharmaceutical Organisation (GPO) markets several front line drugs that can be bought at their pharmacies on prescription.

 

Some drugs are still not made here so for some HIV/AIDS patients with resistance or allergic reactions to some drugs they may need to buy imported medicine from places like Germany or India.

 

A cocktail known as GPO-vir can be a one pill a day regime, at most two. Thai nationals can get this free though buying a month’s supply would be less than 15 baht a day. Even second line treatments utilizing foreign made drugs can be less than 30 baht a day.

 

Clinics like the Red Cross “Anonymous” clinic in the Rajdamri area of Bangkok are well run and efficient, dispensing drugs and helpful advice to people with HIV and those who think they may have contracted it or could be at risk. It is in the area of Chulalongkorn Hospital.

 

So much of the news for those who know they have the virus and who are on treatment is very positive, if you will pardon the pun.

The problems come when people have the virus but do not get tested. For one thing they can easily pass the virus on to others. For another if the virus is left untreated and a person becomes weakened to such a degree that AIDS sets in, it can be too late and people can still die from the condition.

 

Many are still dying needlessly in Thailand. Much of the reason for this is the stigma that exists. People still feel a great shame at having contracted the disease and want to keep it quiet from family members and neighbors. Despite the worthy efforts of many Thai and foreign NGO’s in the kingdom this stigma still exists.

 

Despite legislation forbidding the practice, employers still require many in certain fields to undergo blood tests. Workers found with the virus can and do lose their jobs getting only mandatory severance pay.

 

Most enlightened people know that the virus can only be passed on by sexual contact or transfer of blood but still there are those who would not, for example, want their children to share a swimming pool or cutlery with an infected person.

 

Some would still rather not even touch a person with HIV though the chances are that with perhaps two or three people in a hundred having the virus they might do that every day on a bus or in a crowd.

 

Many of these people would be astounded to know that HIV positive couples on successful treatment can even have healthy children. The chance of undetectable HIV+ couples passing on the virus to their children – especially when Caesarian birth is employed and mothers do not breast feed – is now very close to zero. This is without any other special measures like sperm washing.

 

Still, the NGOs recognize that stigma and lack of knowledge about HIV/AIDS is still one of the biggest problems in the fight against the condition that has seen so much success over the last thirty years.

 

Also problematical is the fact that HIV has dropped off many people’s radar as the dire headlines have subsided. This means that safe sex practices – especially in casual sexual contact or with sex workers – is often ignored these days. This attitude has seen a reemergence in some populations.

 

It is often worth remembering as well that unprotected sex can lead to other infections that can cause lesions on and inside the body that make the transfer of HIV significantly easier.

 

Thailand continues to fight a great fight and is often praised by international organizations for the progress made here.

 

But the stigma remains. Whereas cancer sufferers are always referred to as brave and putting up a great fight against the disease, HIV+ individuals often live in the shadows of fear. And it is that fear that can be more deadly than the virus in the fight against HIV/AIDS.

 

So if you suspect that you might have the virus have a check. If you think someone close to you may be infected encourage them to have a check. It is inexpensive and quick. Knowledge is power.

 

Realize that if the worst comes to the worst there are many treatment options available in Thailand. It can be treated like diabetes and is now referred to as no more than a chronic condition; HIV is no longer a death sentence in any way.

 

Stigma and ignorance are much more dangerous.

 

Source: http://www.inspirebangkok.com/lifestyle/hivaids-thailand-made-great-progress-social-stigma-ignorance-remain-worry/

 

-- © Copyright Inspire Bangkok 2016-11-30

[kamahele]

In addition, I understand the Red Cross clinic noted in this article does dispense (Prep) for those at high risk of contracting HIV. This medication can help prevent contracting HIV for those at high risk.

[jerojero]

Plenty of ignorance of basic medical issues and treatments among the population. Antibiotics common treatment for cold viruses! Totally useless.

[greenchair]

Gonnerea is easily cured with medication. We don't see newspaper reports telling people to make light of it and don't worry about contracting it . Relax you'll be fine. What about herpes. Are the doctors telling the community to embrace the prospect of herpes as it will not impact your life too much. Why does hiv have to be the golden disease. What they should be saying to young people, is ,---this is a serious disease that will have a profound effect on your entire life. 

That, this disease will have a profound effect on your entire family for the rest of their lives. 

That, once you contract this disease you can never ever change that situation. 

That, you should take every precaution available to not contract this disease in the first place.