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Fading Smiles: One Third of Thailand's Gays Threatened by HIV

THAILAND - Apr 13, 2008

The Thai Ministry of Public Health has released figures detailing the dramatic rise of HIV infection among MSM (men who have sex with men). Estimated at 28% in 2005, that number has increased to just under 31% in 2007.

This continuing spike in infection rates, mentioned only briefly in the Thai Press, has seemingly gone unnoticed; just as Thailand's sexual minority including gay and MSM communities has languished from seriously low levels of official funding and only limited research into AIDS prevention among them.

With a vibrant GLBT sub-culture, "The Land of Smiles" has annual pride parade celebrations in four major cities; with Phuket Island's tourist-pleasing festival marking its first decade. Achieved with minimal official support, these self-produced public events are often focused on AIDS/HIV awareness (Pattaya's annual parade coincides with World AIDS Day). Without support from the government, Thai gays have been left to sink or swim on their own; and they're sinking.

Despite Thailand's famous reputation for tolerance, its homosexuals and "third genders" are never-the-less subject to public bias and official discrimination: in 2004 a Culture Ministry Deputy declared war on open gays for being abnormal influences in the media; in 2007 a member of the assembly drafting Thailand's new constitution objected to including protections for GLBT because such people would "make Thai society weak." More damaging, a long term Moral Order campaign, begun under the former Taksin administration, saw officials raiding legal businesses and threatening arrests and closures when condoms were discovered on premises. Condoms, the most effective weapon that gay venues had in a public health crisis, vanished as they were deemed instant proof of wrongdoing.

Two decades ago, when homosexuals made up only 1% of Thailand's run-away HIV infections, gays began grass roots education to prevent the kind of scourge that had wracked communities in Europe and the US. Groups like The White Line Dance Troupe toured straight brothels and schools, in addition to gay bars and dance clubs, to spread the safer sex message to the larger society.

Despite being pioneers in AIDS/HIV prevention and continuing to highlight prevention messages in its public events, the gay community received little meaningful assistance or attention in Thailand's recent prevention efforts.

Since the U.S. Centers for Disease Control and Prevention Collaboration (TUC) showed HIV prevalence of 17.3% among MSM in Bangkok in 2003, that figure has nearly doubled in just four years. Last month the Commission on AIDS in Asia reported that MSM infection rates in Asia as a whole are estimated to more than double in the next decade.

To their credit, the Ministry of Public Health has significantly added its support to developing national strategies, with the community, for dealing with HIV among MSM. What is missing, at least since the 1997 economic crisis, is the political will at the highest levels of government.

Unless prevention efforts change dramatically -- and UNAIDS suggests that 80% of a sub-population at high risk must be reached directly with HIV prevention efforts including condom and lubricant distribution, to achieve at least a 60% change in risk behaviours -- HIV disease seems set to consume more smiles in Thailand's future.

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Citation for the 30.7% 2007 figure comes from: Pliplat T, Kladsawas K, van Griensven, Wimonsate W. 2008. Results of the HIV surveillance among men who have sex with men (MSM) in Bangkok, Chiangmai and Phuket. Proceeding for the Department of Disease Control Annual Conference, Ministry of Public Health, 11-13 February 2008, Bi-Tech Convention Centre.

MSM infection rates are averaged from locations where MSM socialize (as opposed to commercial sex venues), specifically: saunas, bars and dance clubs, and parks.

In 2005, the infection rate for Bangkok male sex workers was 15.4% for venue-based and 22.6% for street-based male sex workers. Both lower than the 28% for gay and bisexual men at non-commercial venues.

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