Thailand has made strides in the fight against HIV, but must do more to directly prevent HIV transmission among men who have sex with men, transgender people, and sex workers. Midnight Poonkasetwattana, Executive Director of the Asia Pacific Coalition on Male Sexual Health (APCOM), says it is crucial that the government and healthcare providers create a more welcoming and supportive environment for high-risk groups.
Poonkasetwattana says that in Bangkok, one in three men who have sex with men (MSM) are HIV positive and that 40 percent of new cases in 2012 occurred among MSM. UNICEF reports that HIV infections are at 500,000 and are on the rise among men who have sex with men, transgender people, sex workers, and young people generally.
APCOM has launched a Test BKK campaign encouraging gay men in particular to get tested every three to six months. The Test BKK tagline is: “Suck F*#K Test Repeat.” The organization aims to destigmatize gay sex and instead promote a healthy sex life. The campaign emphasizes the importance of knowing one’s HIV status, and the Test BKK website reads, “casual disregard for HIV does not make the disease go away.” APCOM has tried to reach gay men through light-hearted, humorous videos such as a short titled “Birthday Surprise.” A young man flips through a scrapbook and finds a CD titled “Sex 101,” and when he plays it, finds it is a video of two men having sex. The young man’s family walks in with a birthday cake and party favors while he is masturbating to the video. The message: “There are more awkward things than getting tested.”
That’s really what Test BKK is all about — promoting a healthy sex life and understanding that “it’s not a bad thing to know your status,” Poonkasetwattana says.
Research shows that Thai men who have sex with men are concerned with protecting themselves against HIV. In one PLoS One study, 49.2 percent of men said they would “probably” consider using pre-exposure prophylaxis (PrEP) methods to prevent HIV, and 39.2 percent said they would “definitely” consider using it. The researchers who conducted the study concluded that, “Despite its multiple challenges, MSM in Thailand would be willing to take PrEP, even if they had to experience inconvenience and expense.”
Poonkasetwattana believes the key to getting more high-risk people tested regularly is to provide them with a safe and supportive environment in which to do so. The fear of social stigma is powerful, and Poonkasetwattana said that is what keeps many men from getting tested.
Test BKK is designed to direct MSM to supportive clinics, and to send the message, “Don’t be afraid.”
“We send them to centers that will be respectful of their lifestyles and orientation,” he said. If one person has a good experience at a clinic, they’re more likely to tell their friends and spread the word about being able to get tested without being judged or ridiculed. Poonkasetwattana notes that while transgender people appear to be culturally accepted in Thailand, prejudices remain below the surface. He criticizes the “lack of a supportive environment for gay men” and the disconnect between the cultural and legal realities for people in Thailand.
“There’s still a lot of work that needs to be done,” he says.
Thailand has made achievements in preventing HIV infection rates. The organization Avert describes Thailand as “an example of a developing country where public policy has been effective in preventing the transmission of HIV on a national scale.” However, Avert also stated that Thailand became “complacent” following successful campaigns to reduce and prevent infections. Resources often went to treatment rather than prevention programs. However, Thailand showed success when it came to providing anti-retroviral (ART) treatments to pregnant women and preventing mother-to-child transmission of HIV.
Prevention among young people generally is still a concern. As of 2011, Avert reported that condom use was falling among young people, there was a decrease in education about HIV, and more people were sleeping with multiple partners. The organization concluded that safe sex messages are not getting through to people in the 15-24-year-old bracket, putting them at greater risk for contracting HIV and other sexually transmitted diseases.
UNAIDS reported that as of 2013, 430,000 people in Thailand had HIV/AIDS and that 18,000 people died of the disease that year. As one of the most popular destinations for sex tourism in the world, Thailand has a strong incentive to campaign for better education and prevention, especially among high-risk communities. Of course, providing life-saving testing should not be viewed purely through an economic lens, but a humanitarian one.
Thailand has done well in the past with HIV-prevention initiatives, and must not turn a blind eye to destigmatizing and supporting high-risk communities such as MSM and transgender people.
By Casey Hynes
Source – Asia Correspondent