HIV/AIDS Prevention Programs

The case study discussed last night focused on preventing HIV/AIDS and STI’s in Thailand. HIV/AIDS cases in Thailand increased dramatically in the late 1980’s among injecting drug users and sex workers. The young military population was also seeing an increase in cases. When investigated further, a connection between young military men and the frequent use of sex establishments was found. The intervention was first pioneered in the province of Ratchaburi and then expanded throughout the entire country. After watching the TEDX event featuring Mr. Condom, I questioned how effective this program could be if used in other countries.

Mechai Viravaidya, also know as Mr. Condom, has been the leader of the family planning movement in Thailand since the 1970’s. He founded the Population and Community Development Association, aimed at slowing Thailand’s rapid population growth. As a public health advocate, Viravaidya did not just plan interventions strictly by the books, theory and research. Humor was one of the most essential parts of his effort.  In one interview, Viravaidya said “You cannot win people with embarrassment and shame.” Viravaidya has reached the Thai population through school campaigns, restaurants, markets and other popular public arenas. The Thai people do not need to search for condoms or information related to HIV, STI’s and family planning. Instead, they can simply walk out their doors and down the street to the local market or restaurant to find condoms.

My first reaction to this public health campaign was astonishment. In America, where sex is talked about or alluded to on almost every single television station, we are still very “conservative” in our sex education. During my practicum this past summer, I worked in the STD clinic of a health department. After many, many years of fighting to get into the school system, the health department’s STD staff had finally been able to break through the school board and will begin a sexual education course this fall. After watching the TEDX video, I had wondered how many setbacks Viravaidya had to endure during the implementation of this campaign. My search online did not come back with much information on the setbacks, only on the successes.

I question how many other countries would be able to adopt a program such as this one? With many countries deeply rooted in spirituality and/or religion, it would seem nearly impossible for the government and gatekeepers to allow such open discussion about sex and condom use. It is evident the Thailand campaign was extremely successful, as seen by the 90% reduction in new HIV/AIDS cases. However, this may not be enough evidence for other countries to accept.

I believe one of the next steps in this war against HIV/AIDS in Thailand would be the implementation of a surveillance system. The pioneer program briefly mentioned the use of contact tracing, by identifying the partners of infected men and women. From what I learned during my practicum, this is an essential part in breaking the chain. The case study mentioned the lack of focus on noncommercial sex. Implementing a surveillance system and hiring Disease Intervention Specialists to interview and track down partners, especially those taking part in noncommercial sex would be extremely beneficial.