Sunday, October 23, 2016

A Sexual Health Lesson from Thailand

Because we did not have much time in class Tuesday to discuss it, I would like to take this blog post to comment more on Mechai Veravaidya’s Ted Talk, “How Mr. Condom Made Thailand a Better Place.”  There were many clear strengths in this program and it is a strong example of how to promote change in an individual behavior at a societal level.  As we discussed in class, many public health campaigns center their efforts around educating the individual on proper health behaviors, without looking at the confounding factors at the societal level that may make this behavior unpopular or infeasible.   Condom use, for example, is complicated by access to condoms, understanding of their effective use, and the consent of all involved people to use them.  Apart from these direct causes, other indirect causes affect their perception in the public sphere; these include religion, opinions about sexual behavior and sexual education dissemination, and social norms regarding sexual activity. 

The folks in Thailand clearly had a lot working against them, with a 3.3% growth rate in 1974 and a resurgence of sexual health issues when HIV/AIDS hit some years later.  Especially coming from a U.S. perspective where sex ed has been overtaken by abstinence-only programs, I must say that my single favorite part of Thailand’s program was their presence in the schools.  I believe this is a must for any public health campaign; children learn easily and can more quickly adapt their behaviors while adults may be more resistant due to lifelong habits.  As cliché as it sounds, children are also the future and even if behavior adoption is not 100% in the adult population, making an impact on the youth of a community can spell out great success later down the road, when they practice the desired health behavior and pass it on to their own children. 

The other great thing this program did was remove stigma by cementing the condom into popular culture.  They made art and t-shirts, board games and superheroes.  Condoms are available in coffee shops, not only in some corner aisle of the drug store where people are embarrassed to be seen as is the case here in the U.S.  Condoms in mini-bars at hotels is an ingenious idea, and also represent an honest perspective by acknowledging that alcohol use can lead to risky behaviors and that being prepared is a better strategy than pretending things like this don’t happen.


Because condoms are not 100% effective, I would be interested to see if Thailand has seen an increase in the use of other methods of birth control as well, such as the pill or implant, and what their policy on emergency contraception is.  It seems that since their condom program has been so effective, it may be easier to increase usage of other methods now that the stigma around sexual and reproductive health has been somewhat lifted.  I believe many other countries, including our own, have a lot to learn from this public health initiative.

2 comments:

  1. Hi Sydney,

    I think this campaign in Thailand has certainly been effective. What is needed to be examined further or perhaps considered in these campaigns is the region by region cultural and perceptual differences. For instance, in large populated areas such as Bangkok are more developed in terms of pop culture and hence, the acceptance towards condom usage can be well accepted. It is also important to note that tourism largely drives their economy and as such, people in these areas are usually foreigners who hold different views and ideologies towards sexual behaviors. I question how much of the population that is being exposed to such campaigns are locals. Also to spring off on this, because tourism is quite dominant of an industry, locals have been attempting to capitalize on this since the boom, developing many industries off of it such as sex trade and underground sex shops to provide for themselves and their families. Does this impact the change in their perceptions on condom usage as something that is being 'forced' onto them? These are all questions I have been thinking of since watching the TED talk after I saw your post. It would be interesting to see the success of campaigns in smaller regions not so influenced as of yet by western popular culture and behaviors.

    Taking it back to your question however, I think attempting to understand how other contraception methods are perceived and used would be interesting for sure. Also to compare this with other parts of the world would be something that I certainly have been thinking of in starting the Italy research!

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  2. Sydney,
    It is clear that the Mr. Condom program has been very successful in Thailand, and I honestly would love to see that kind of behavior and intervention in the States. One small attempt toward this sort of behavior is that Hotbox pizza here on campus will put a condom in the pizza box if you order or get delivery after a certain hour. I wonder if other companies or bars would be interested in implementing what Hotbox is already doing? That would be pretty cool, especially on a college campus.

    I am also curious to see Thailand's thoughts and policies toward other types of birth control. I was recently reading an article for another class about "dual-method" birth control, where an individual uses LARCs (long-acting reversible contraceptives, aka something like the pill) and condoms to better prevent both pregnancy AND STIs. I feel Thailand could easily incorporate this method into their pre-existing condom program as an enhancement to reducing both population growth and STIs. Awesome thought.

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