By
Reuters
Published:
01:01, 6 October 2014
|
Updated:
01:01, 6 October 2014
By Alisa Tang
BANGKOK, Oct 6 (Thomson Reuters Foundation) – Bare-chested
male models strutted through the glitzy ballroom in Bangkok to
the beat of house music while dozens of young gay men waited
anxiously, working up the nerve to have a blood test.
The mostly female health team taking samples seemed
incongruous next to the shirtless models circling the party, but
the health workers’ presence at the TestBKK event, Thailand’s
first mass HIV testing for gays, was sending a powerful message.
Over the past decade, HIV has spread rapidly among gay men,
transgender people and male sex workers in Bangkok to reach
epidemic levels, fuelled partly by greater use of illicit party
drugs that make people less cautious about sex, experts said.
Once touted as an HIV success story, Thailand is now faced
with infection rates in its gay population comparable to those
in Africa’s AIDS hot spots.
Waking up to the scale of the problem, Thai authorities have
embarked on a campaign to raise awareness about HIV and
encourage testing among those most at risk: men who have sex
with men and transgender people.
Frits van Griensven, an HIV researcher and adviser to the
Thai Red Cross, said the initiative to focus on this key group
was a positive step and long-awaited acknowledgement that
Thailand – which successfully tackled HIV/AIDS in the 1990s -
had failed to keep up with the spread of the virus into certain
communities.
“For the government to take a stand in this epidemic and
stand up for the rights of a minority population, I thought this
was a big move,” van Griensven told the Thomson Reuters
Foundation in an interview at his home in Bangkok.
He said it was only in the past year that Thai authorities
had started to take this seriously and focus on HIV (human
immunodeficiency virus) prevention in Thailand’s gay community.
Perhaps the biggest step in the campaign was in March last
year with the release of guidelines on how to prevent the spread
of HIV in men who have sex with men and transgender people. The
guidelines came nearly 30 years after the first AIDS case was
diagnosed in a gay Thai man.
“It’s a little late, but it’s better than never,” said van
Griensven, welcoming moves to take testing to gay communities.
RISE OF HIV
This month Thailand’s Ministry of Public Health began
offering free drugs to all HIV patients to expand treatment and
put them under the state’s monitoring system.
Data from 2013 estimates Thailand has 450,000 people living
with HIV/AIDS, but only 353,000 have access to life-saving
antiretroviral drugs.
Thailand’s large gay community, which officially numbers
about 560,000, or 3 percent of men aged 15 to 49, is now seen to
be at risk of HIV. Van Griensven believes this figure
underestimates the real number of gay men in the country, and
7.5 percent, or about 1 million of the 66 million population,
would be closer.
In 2003, while working with the U.S. Centers for Disease
Control and Prevention’s (CDC) unit in Thailand, van Griensven
collected data showing 17.3 percent of 1,121 Thai men in Bangkok
bars, saunas and pick-up spots tested positive for HIV.
The situation has worsened since with studies showing about
30 percent of all men who have sex with men in Bangkok are HIV
positive. In 2013, gays, transgender people and male sex workers
accounted for 41 percent of all new HIV infections in Thailand.
Timothy Holtz, director of an HIV-focused programme run
jointly by the CDC and Thai Ministry of Public Health, said the
HIV epidemic among gay men “really is an emergency situation”.
“The only place you really see high rates like that are in
the hardest hit areas among the generalised HIV epidemics in
sub-Saharan Africa,” Holtz said in an interview at the CDC-run
Silom Community Clinic at Mahidol University’s Hospital for
Tropical Diseases.
“It’s not quite as high as it is in some really high-risk
populations in southern Africa, such as in young women of
child-bearing age in South Africa, but it’s still very
alarming.”
According to UNAIDS, nearly one in five South Africans aged
15-49 are HIV positive.
IGNORANCE IS BLISS
Thailand was once considered to be in the vanguard of the
fight against HIV.
After the country’s first AIDS cases were diagnosed among
Thai and foreign gay and bisexual men in the mid-1980s, the
epidemic took off, spreading through the country’s massive sex
industry, their clients and then the men’s wives and babies.
In the 1990s, 35.5 percent of female sex workers across
Thailand had HIV.
Then Thailand launched a condom use campaign targeting
prostitutes and their clients, as well as antiretroviral
treatment to prevent HIV transmission from pregnant women to
their babies, which cut the estimated number of people infected
each year to 8,100 in 2013 from 143,000 in 1991.
But over the past decade the numbers have started to rise
again among certain groups, with many gay men unwilling to be
tested, believing ignorance is HIV-free bliss.
At Silom Community Clinic, the CDC’s voluntary counselling
and testing centre for men who have sex with men founded by van
Griensven, 46 percent of men who walk in have never been tested.
“That’s really high. When you’ve got roughly half of an
at-risk population who’s never been tested, that needs to
change,” Holtz said, adding that gay men in Thailand should get
tested at least once a year, if not more often.
Somsak Akksilp, deputy director general of the department of
disease control at the Thai health ministry, said spreading
awareness through traditional media does not work with younger
generations and outreach has to be clearly directed at gay men.
“They never watch television. They never read newspapers. So
how can they get messages from government or public services?”
Somsak said. “We should have more mobile clinics or outreach
units to serve them in the places convenient for them.”
Testing is critical because awareness has failed to slow the
epidemic, according to Piyathida Smutraprapoot, AIDS chief for
the Bangkok Metropolitan Authority.
“If people know their status, they can learn how to prevent
the spread to others,” she told the Thomson Reuters Foundation
at the TestBKK event that attracted about 100 people.
The Asia Pacific Coalition on Male Sexual Health (Apcom),
the Bangkok-based advocacy group behind TestBKK, later told
Thomson Reuters Foundation that eight out of 76 men tested at
the event were found to be HIV positive.
Van, a 24-year-old NGO staffer who asked to be identified
only by his nickname, had his third HIV test at the event. His
first test followed a casual hook-up. Van is now in a steady
relationship but remains unsure if he is safe from the virus.
“With my boyfriend, I trust him to an extent – 99 percent.
Even if he strays, I told him: ‘Please protect yourself’.”
(Reporting by Alisa Tang, Editing by Belinda Goldsmith.)
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