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HIV/AIDS IN THAILAND
AND ITS PREVENTION
Presented by
Mr. Md. Matiar Rahman
Ethics group
Course: Bioengineering and Environmental Health
INTRODUCTION
Definition:
HIV - continuum progressive damage to the immune system
and manifestation of severe immunological damage - AIDS
Background information:
 Initial identification of AIDS in 1981
 AIDS a killer disease in the world
 33 million of patients in the world in 1998
 40 million of patients likely to be in the world by 2000
16,000 new patients daily
 8.2 million children has mother or parents - 1998
 13 million children likely to be has no mother or parents by 2000
OVERVIEW OF HIV/AIDS IN THAILAND
 Position in the world - 3rd
 Starts on September 1984
 Total population 62 million
 Total HIV patients 1 million up to 1998
 Total AIDS patients 142,027 up to April 2000
 Total number of AIDS patients died 39,193 up to April 2000
 Approximate number of HIV patients 1028,000 by 2000
 Approximate number of AIDS patients 562,000 by 2000
‘AIDS IS A REGIONAL EPIDEMIC’ IN THAILAND
AS IN REST OF THE ASIA
 Long latency period of the disease
 Asian economic crisis - 50% of the young population are infected
among the new patients
 Geographically more in the northern part of country since 1989
 Government, political, community and religious leader overlooked
the significance of AIDS
 Public health problem increases due to high infection rates
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AIDS distribution in Thailand
Age and sexwise distribution of patients in the year 1998
Number of patients
6000
5403
Male
5000
4185
Female
4000
3000
1973
2000
1553
1203
318
1000
277
68
55
60 63
365
333
91
182
23
0
0-4 yr
5-9 yr 10-19 yr 20-29 yr 30-39 yr 40-49 yr 50-59 yr Above
Age group
60yr
Sexwise - male:female = 1:1
Age below 20yr 1:1, above 20 yrs 4:1
CAUSATIVE AGENT
 HIV virus (Human Immunodefficiency Virus)
Incubation period
 Less than 1 year to 20 years
AIDS survival time
 Onset of disease to death
MODE OF TRANSMISSION
 Heterosexual - 82.6%
 Drug users - 5.3%
 Mother to child - 5.03%
 Blood transfusion - 0.05%
 Unknown - 7.02%
COMMERCIAL SEX WORKER
AND THEIR STATUS
 Prostitution is illegal but continuing
 87% of all women and children in prostitution are HIV positive
 Among sexual infected HIV patients 97-98% are from C.S.W.
 Young adolescent girls prostitutes are at greater biological risk of
HIV infection
 Selection of CSW from village, hilly and border areas, who are not
able to understand the Thai Language
COFACTORS FOR
DISEASE PROGRESSION
 Genetic factor
 Discrimination
 Age
 Sexual inequality
 Sex
 Inadequate health and
 Route of HIV infection
social services
 Other infections
 Rapid urbanization
 Poverty and nutrition
 Inappropriate development
 Smoking
 Increased labour migration
HIV PREVENTION MEASURES
 HIV prevention programme is a multidisciplinary approach
combining behavioural science, social science and biological methods
to fight against the spread of HIV.
 Aims of HIV prevention - to benefit people with affected by or at
risk of HIV/AIDS, so that they received better care, greater respect
and more integration in the society.
GENERAL MEASURES
 Health policy relating to HIV/AIDS
 Education- medical education including responsibility and ethical
advice for health professional.
Promotion of education to the policy makers about ethical, social
policy and human rights of HIV/AIDS
Health education regarding safe sex, HIV prevention and sexual
health promotion to the public
GENERAL MEASURES
 Health development had to be adopted to economic, political and
social change
Health legislation reflects the principles of social, medical ethics
and human rights
 Broad social policy
GENERAL MEASURES (Continued)
‘Integrated approach for HIV prevention with care’
 Active community participation of different organizations and
social movements can change the attitudes and practices of the
people regarding risky sexual behaviour and injectable drug use.
 High level political commitment for prevention of HIV is of value
 In Thailand a policy aimed at 100% condom use in brothels was
initiated in 1989 by the Ministry of Public Health and lead to a
dramatic increase in condom use and causes a sharp decrease in
STD including HIV.
PREVENTION OF SEXUAL TRANSMISSION
 Promotion of safer sex
 100% use of condom of good quality
 Encouraging patient to seek care for disease
 Changing peoples behaviour related to sex by
comprehensive and early sex education and
training in prevention skill, safer sex etc.
 Providing confidential voluntary counseling and
testing of HIV
PREVENTION OF SEXUAL TRANSMISSION
 Illegal CSW industry should be stopped and
rehabilitation of CSW is needed
 Providing incentive to girls to complete
secondary education
 Provision of comprehensive service delivery and
medical care for HIV patients by medical and
paramedical professionals and community
workers.
Prevention of IDU:
 Needle exchange programme have cut HIV
transmission among IV drug users
Prevention of HIV through blood
transfusion:
 Blood screening technology has reduced
transmission of HIV through infected blood by
99%.
Prevention of transmission from mother to
child:
 Before pregnancy both mother and father should
be checked whether they have HIV infection or
not.
 Use of anti retroviral regimen has cut
perinatal transmission of HIV
GLOBAL HIV/AIDS EPIDEMIC REPORT-JUNE 2000
 People newly infected with HIV in 1999
Total - 5.4 millions
Adult - 4.7 millions
Women - 2.3 millions
Children (<15 years) - 620,000
 Number of people living with HIV/AIDS
Total - 34.3 millions
Adult - 33.0 millions
Women - 15.7 millions
Children (<15 years) - 1.3 millions
GLOBAL HIV/AIDS EPIDEMIC REPORT-JUNE 2000
(cont’d)
 AIDS death in 1999
Total - 2.8 millions
Adult - 2.3 millions
Women - 1.2 millions
Children (<15 years) - 500,000
 Total number of AIDS death since beginning of
the epidemic
Total - 18.8 millions
Adult - 15.0 millions
Women - 7.7 millions
Children (<15 years) - 3.8 millions
Total AIDS orphans since beginning- 13.2 million
GLOBAL HIV/AIDS EPIDEMIC REPORT-JUNE 2000
THAILAND
 Adult and Children
- 755,000
 Adult 15-49 years
- 740,000
 Women 15-49 years
- 305,000
 Children (<15 years)- 13,900
 AIDS orphans
- 75,000
 AIDS death
- 66,000
CONCLUSION
 Prevention is better than cure
 The drugs used in the treatment of AIDS has no
curative value rather than suppression and not
able to prevent the transmission of virus
 Preventive methods coupled with unsqueamish
public awareness campaigns to make those methods
widely known and adopted can turn the tide and
check the spread of this insidious disease.