How does a Thai National get HIV treatment?

[GordonP]

How does a Thai National get HIV treatment?

I’ll try and make this short. My TGF has a niece who was diagnosed HIV+ about 6 years ago. The niece’s friend had been diagnosed sometime earlier as HIV+ and we suspect that both were infected by the same Thai guy from another nearby village who has since died at a relatively young age.

The niece’s friend was diagnosed by the local (Issan) hospital, began treatment, however word got out in the village, she was ostracised and tragically took her own life. By a quirk of circumstance, the niece was holidaying and staying with us in Pattaya when she was taken ill and we took her to Pattaya Memorial Hospital whereupon she was diagnosed HIV+ and has been receiving ATRIPLA medication and generally is maintaining good health.

The issue is threefold. One, the niece has to come to Pattaya to be checked out and obtain prescription. This is usually 5 or 6 times a year. Secondly the cost of the medication (which I am covering) has risen from THB 90 a day to THB 130 and probably will go up again this year and thirdly she understandably refuses to go anywhere near a local hospital in Issan.

Question, is it possible for her to transfer to a Thai scheme and subsidised medication?

[Sheryl]

Yes, but probably not at Pattaya Memorial.

 

Is she employed and under Social Security? If so then she has a choice of hospitals but likely limited to the area where she works, should find out from the local SS office if there are other hospitals she can switch to.

 

If she is under the universal (AKA "30 baht") scheme then get her listed on a tabian ban in Pattaya (yours or anyone else's doesn't really matter, but she will then have to come off the tabian ban where she lives) and then she can get free treatment at the local government hospital. The only catch to this (aside form some initial red tape to get through) is that she will then have to use that same Pattaya hospital for all her health needs unless in an emergency.

 

I don't think the Thai Red Cross Anonymous Clinic in Bangkok (which is excellent) can treat patients from other parts of the country for free under the universal health scheme but I could be wrong, would be worth calling them to ask. They will certainly be familiar with this sort of problem . Have your wife or other Thai speaker call  Tel. 02-252-2568-9

 

I also strongly suggest you have your niece call this Foundation which helps Thais navigate the health system and have her tell them what happened to her friend and hospital name.

 

http://www.thaiplus.net/

 

They may not take any specific action on that incident but they are engaged in high level advocacy issues with the Ministry of Public Health and it is important they know about hospitals will issues like this as it points to a broader issue of insufficient training and supervision by MoPH of service providers on matters of confidentialty.

 

Actually the dead girl's family should lodge a formal complaint (and that foundation can help them do so) but given the stigma they might not want to draw attention to themselves. . Would help others if they did, though.

[hobobo]

Most Thai government hospitals will provide free treatment, in addition to several NGOs which are either free, or affordable to most Thais (certainly well under 130 baht a day). Very sad about niece's friend - almost 35 years after the virus was first discovered, there is NO ROOM for that kind of ostracism, but unfortunately some people prefer to remain ignorant.

[Grumpy Duck]

Wow, a post with replies that are not critical, hateful or blaming. Full of helpful suggestions. Thanks for putting a smile on my face this morning. 

Edited August 17, 2017 by Grumpy Duck
Elderly 555

[GordonP]

Thank you all.

Solid information and excellent pointers. We are on the case.

No, she is not "officially" employed, just working on building sites when members of the family have a contracy.

They are just back from PMH where they discussed the cost issue with the doctor (same one that has always been treating her). He appears to understand and is preparing some documents (medical records perhaps) to enable her to transfer to a government hospital. I will update with progress.

 

With reference to the other girl who took her own life, her near family certainly didn't know that she had been diagnosed HIV+ and to this day can't really understand why she took her life. They wouldn't ever envisage taking any action agianst a Doctor or Hospital.

[thailand49]

17 hours ago, Sheryl said:

Yes, but probably not at Pattaya Memorial.

 

Is she employed and under Social Security? If so then she has a choice of hospitals but likely limited to the area where she works, should find out from the local SS office if there are other hospitals she can switch to.

 

If she is under the universal (AKA "30 baht") scheme then get her listed on a tabian ban in Pattaya (yours or anyone else's doesn't really matter, but she will then have to come off the tabian ban where she lives) and then she can get free treatment at the local government hospital. The only catch to this (aside form some initial red tape to get through) is that she will then have to use that same Pattaya hospital for all her health needs unless in an emergency.

 

I don't think the Thai Red Cross Anonymous Clinic in Bangkok (which is excellent) can treat patients from other parts of the country for free under the universal health scheme but I could be wrong, would be worth calling them to ask. They will certainly be familiar with this sort of problem . Have your wife or other Thai speaker call  Tel. 02-252-2568-9

 

I also strongly suggest you have your niece call this Foundation which helps Thais navigate the health system and have her tell them what happened to her friend and hospital name.

 

http://www.thaiplus.net/

 

They may not take any specific action on that incident but they are engaged in high level advocacy issues with the Ministry of Public Health and it is important they know about hospitals will issues like this as it points to a broader issue of insufficient training and supervision by MoPH of service providers on matters of confidentialty.

 

Actually the dead girl's family should lodge a formal complaint (and that foundation can help them do so) but given the stigma they might not want to draw attention to themselves. . Would help others if they did, though.

The information you provide is really priceless as always!

This was a number of years when I heard them together to speak at a Expat meeting in Pattaya.

 

There is also a foundation www.heart2000.org

Dr. Philippe Seur   [email protected]

 

Ass.Prof Dr. Jureerat Bowonwatanuwong

Chief of Internal medicine department of Chon Buri, Provincial and Regional Public hospital.

 

If both are around both explain how to get into the program. Since the person is Thai, I suggest you take her to see the Doctor at Chon Buri.

 

Sadly, when it comes to Thailand regardless of the progress I fully understand why she doesn't want to be be treated in her hometown. I've heard lots of Thais do this travel far to a place no one knows them because of the ignorance. And if they have kids it is a death sentence for them too when people know.

 

Good luck

Edited August 17, 2017 by thailand49

[Sheryl]

An ill-informed and unhelpful post and replies to it have been removed

[cooked]

As a sad anecdote, my wife knows of two girls that came back to the village  with STDs that didn't even know what an STD was. She had to discretely get them to the appropriate hospital department.

One girl died here refusing to admit she had AIDS. We don't know why they all confided in my wife, although she isn't one of the gossiping crowd.

[ericthai]

Sorry to hear this. My wifes sister has HIV, got it from a Thai guy who knew he had HIV. Of course nobody in the village knows. She goes to another province for care so nobody finds out. Sad it has to be this way.

[RBOP]

She can go to the Thai Red Cross Anonymous (Walk-In) Clinic in Bangkok.   They have access to generic ARVs such as TEEVIR which a generic equivalent of ATIPLA at 35baht/day. There's other options too such as Rilpivirine + TENO-EM at 21.75baht/day. 

Edited August 21, 2017 by RBOP

[Sheryl]

Indeed she can get the meds at less cost at TRC, but she can also get them altogether free through the govt system.

 

It is to the OP's credit that he has stepped in to bankroll this but no need for him to do so indefinitely, even at lower TRC prices. It may take some phone calls and switching if house registration but she can get what she needs, free of charge, through the system and without risking the people back home finding out.

[GordonP]

Just an update, after a very long debate and many changes of mind and heart, she has decided that she it is preferable to stay local(ish) and will try the major(ish) hospital in the next town/city rather than the local one where her friend went. Due to drive her there early next week. Will update when there is somthing to add. Many thanks again for the input, pointers and general confidence building received as a result of my original post.

Edited September 15, 2017 by GordonP

[GordonP]

Further update. Hospital in nearby District refused point blank to consider even seeing her and stated that she had to be treated within the area she is registered/lives.

On to the local hospital with much trepidation and after a six hour wait was eventually seen by a nurse who has taken just one page of the copius notes originally provided by PMH and told her to come back on 1st October (a Sunday!?) where it appears she will be interviewed by a panel to see if she is eligible. Needless to say none of us are inspired. I didn't attend either hospital as it was generally thought that having a "farang" on the scene would probably be disadvantageous especially with medical records coming from an international hospital.

 

One other bit of information that has been brought to my notice and further muddies the thought process of the poor lady who is the subject of this post. It seems that when talking to the doctorat PMH he made a point that other free or less expensive medications may not be as effective and could have serious side effects.

 

I had forgotten that the original diagnosis came about through serious illness and the fact that the subject had developed TB and had to have a lump removed from her collar bone area. Subsequent treatment and the eventual stability in her health took a good while with some serious side effects including hair loss, weight loss (30%+). Naturally, none of us what to take a retrograde step in what has been a positive story to date.

 

Watch this space!

[frodo77]

My hiv+ Thai partner is on Teevir provided by Banglamung Hospital. He has just told me that the Thai Government has not yet ordered more supplies for next year, and if they do not do it will run out at end of October. What are the options if Teevir is not available at the hospital. Teevir costs just over 1000 baht for one month's supply, but where to buy it? Also can anyone recommend an alternative to Teevir?

[jeab1980]

Luckily enough we live in a non judgement village where HIV/aids has reared its ugly head.

The Goverment hospital in KK treated and continues to treat the patient. I would say the person is a guy. Who was just in the wrong place at the wrong time it would seem. 

To the OP she needs to be strong and use the Hospitals around her. There will come a time where going to Pattaya will be out of reeach for her. Give her my best please.

[Aussieroaming]

Yeah its a tragedy for all who get infected. My lovely sister-in-law got HIV from some bloke as well. The fear of rejection is so great that my wife had trepidation about telling me. When she did i just asked her how we could help out. Luckily for the SIL all family members are supportive and she isnt treated any differently to anyone else. I couldnt ask for a better SIL to be frank. Good luck with the meds, but dont forget the family support aspect, its important.

[GordonP]

Further update - Patient spent all of last Sunday and Monday at local hospital getting more and more paranoid about being identified by others waiting to see a doctor. Eventually had blood taken for tests. She is awaiting phone call with results, but now running very low on existing meds. We are now contemplating returning to PMH. Watch this space.

[GordonP]

Final update - Job done eventually. As Sheryl suugested in her original post there was a lot of red tape and so many attendances at the local hospital who kept her asking her to return the next day, until finally when she had no more existing medication left, then gave her a single months supply. My view is that the entire procedure is somewhat shambolic and anonymity is continously compromised. We await the procedure for renewal which should be next week.

 

A BIG thanks to all who contributed with guidance and advice. Hopefully, these contributions will be of help to others.

[Sheryl]

This is all very typical, all dealings with govt hospitals tend to be like this. Gets a little better on follow up visits but will still be time intensive.

 

I end up giving up and going private almost every time I try to use a govt facility, because for me time is money, making even the most expensive private hospital still actually cheaper when it is just an OPD consultation.

 

For lifelong HIV meds, of course, the hassle is well worth it.

 

Anonymity is indeed a problem in small local hospitals where people know each other on sight. Unfortunately the system has made no adjustments for that and people are still required to use the hospital where they are registered.

[jinners]

I am just about to embark on this in Pattaya. A very near and dear one has been diagnosed. She was taken ill in the UK and is now back in LOS with a plentiful supply of meds. I want to get her in to the local system asap for checks and continued supply of meds. 

Any ideas or suggestions really appreciated.

[frodo77]

Take her to Banglamung Public Hospital. They have a special HIV section.

[BritManToo]

On 10/4/2017 at 3:42 AM, Aussieroaming said:

The fear of rejection is so great that my wife had trepidation about telling me.

Don't understand the fear.

Pal of mine was recently diagnosed, so he went back to the UK, 2 pills a day for life, no other restrictions on his life.

Doesn't seem that big a deal (for older people who already had families), my former Mil with high blood pressure and diabetes has a much worse time of it with 15-20 pills a day and extreme dietary restrictions (they are the same age). 

 

Everyone has sex, so everyone is at risk.

Edited September 19, 2018 by BritManToo

[scubascuba3]

 
Everyone has sex, so everyone is at risk.

People can get tested pre relationship assuming going to be monogamous. Plus people at risk should take PrEP

[Sheryl]

4 hours ago, jinners said:

I am just about to embark on this in Pattaya. A very near and dear one has been diagnosed. She was taken ill in the UK and is now back in LOS with a plentiful supply of meds. I want to get her in to the local system asap for checks and continued supply of meds. 

Any ideas or suggestions really appreciated.

Where is she listed in a tabien ban? As to get free care she has to go to the govt hospital that covers that location.

[cleopatra2]

2 hours ago, Sheryl said:

Where is she listed in a tabien ban? As to get free care she has to go to the govt hospital that covers that location.

Sheryl , I know a number of Thais who travel from the province's to Bangkok for their HIV treatment. 

For Jinners did the person in question discuss with the UK doctor of her return to LoS. I ask because the Thai doctors are cautious where previous treatment and diagnosis has occurred elsewhere. The Thai doctors ideally would prefer to see the UK medical notes.

[Sheryl]

11 minutes ago, cleopatra2 said:

Sheryl , I know a number of Thais who travel from the province's to Bangkok for their HIV treatment. 

For Jinners did the person in question discuss with the UK doctor of her return to LoS. I ask because the Thai doctors are cautious where previous treatment and diagnosis has occurred elsewhere. The Thai doctors ideally would prefer to see the UK medical notes.

To do so free of charge they would have to have a letter of referral from the hospital where they are registered. Hospitals with their own HIV units will usually not provide this.

 

On a self pay basis then of course, can go anywhere, but for HIV tx this will add up to a lot of money over time.

[cooked]

On 9/19/2018 at 12:11 PM, BritManToo said:

Don't understand the fear.

Pal of mine was recently diagnosed, so he went back to the UK, 2 pills a day for life, no other restrictions on his life.

Doesn't seem that big a deal (for older people who already had families), my former Mil with high blood pressure and diabetes has a much worse time of it with 15-20 pills a day and extreme dietary restrictions (they are the same age). 

 

Everyone has sex, so everyone is at risk.

The fear is of social rejection and shame, in the villages at least, HIV still has the same status it had in Europe in the 80s. Even STDs are hidden.

My wife had to insist on taking a friend to the hospital to get treated, she didn't even know what an STD after she came back from Pattaya was  <deleted>.

Another girl in the village died from AIDS, she didn't tell anyone and wouldn't go for treatment, even though we all knew.

So bully for you and your friend, for myself I disagree that being HIV is no big deal.

[Sheryl]

Yes, the stigma in Thailand is still very strong. Leads to a lot of needless suffering and sometimes death.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[pbellanger1]

On 10/1/2017 at 9:13 AM, frodo77 said:

My hiv+ Thai partner is on Teevir provided by Banglamung Hospital. He has just told me that the Thai Government has not yet ordered more supplies for next year, and if they do not do it will run out at end of October. What are the options if Teevir is not available at the hospital. Teevir costs just over 1000 baht for one month's supply, but where to buy it? Also can anyone recommend an alternative to Teevir?

i am on teevir right now, do you if there are any other alternatives to teevir now

thank you

[scubascuba3]

i am on teevir right now, do you if there are any other alternatives to teevir now
thank you

Have you been to the Thai Red Cross in Bangkok? they supply my PrEP so they should have what you need at a relatively low cost