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Preventing HIV-AIDS and Sexually Transmitted Infections in Thailand

The population at the highest risk of HIV/AIDs infection in Thailand consists of; commercial sex workers, their clients, drug users particularly those using intravenous drugs, and those engaging in casual non-commercial sex. The intervention targeted the sex workers and their clients. This was after a resolution that even though commercial sex is illegal in Thailand, the campaign to control HIV infection was a higher-ranked priority than illegalizing prostitution. From the case, we can see that Thailand’s commercial sex industry is quite organized. The sex workers do not stand independently as freelancers; the majority of these workers are members of some establishment. The workers are employees of some other person who owns a sex establishment. The authorities know the direct or indirect establishments and have a list of the owners’ contacts. This means that it was easy for the authorities to contact the establishment owners and ask them to co-operate to make the intervention successful. The condom distribution, sensitization and awareness campaigns, are easily administered when the target groups are organized. The nation had a well-established STI surveillance and treatment network. This network was used as a platform of service delivery for offering treatment and advice to the sex workers and their clients. It was, therefore, easy to introduce the concept of HIV awareness into the already existing STI control program. The STI program was housed in the efficiently functional health sector. This meant that experienced and qualified staff members in the different fields were already available at the inception of the HIV awareness program. The program could have been difficult to establish without this workforce.

Considering the success of this intervention, this was clearly visible in the significantly high drop rate in HIV infection, other countries ought to replicate this in their efforts to curb HIV/AIDs menace. The 100% condom use initiative was replicated in neighboring Cambodia which has a very high population percentage engaging in commercial sex. The campaign was first initiated in the Sihanoukville Province which had a high prevalence of HIV infection among establishment-based sex workers. The program picked up almost immediately with the cooperation of establishment owners. The 100% condom use campaign was strengthened further by following up with the establishment owners. This ensured that they supplied condoms. Those who were not co-operating were nabbed by mystery clients. These were volunteers who posed as clients with the aim of getting information on condom use in the establishments. Random STI testing also encouraged condom usage because a positive test to STI means that one has had unprotected sex. The program has since been scaled up to the national level with the aid of funds donated by external donors.

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Although the 100% condom use has born fruits amongst commercial sex workers, the people engaging in casual but non commercial sex have not been sensitized on the importance of using condoms. This group is also at a very high risk of HIV infection. It will be very profitable if the program is replicated in this setting. The drug users also need to be educated on the dangers involved in sharing of needles and syringes. Also, they need to be enlightened on the higher chances of having sex irresponsibly under the influence of such drugs.

The work load is still heavy on the authorities involved in this fight. However, if the authorities collaborate, the desired results will be achieved.