HIV was a serious epidemic for Thailand in the 80's and early 90's. Towards the late 90's, Thailand's government began an aggressive HIV/AIDS awareness campaign, and at the time, it seemed to slow the spread of HIV down nationally. Thailand enjoyed considerable attention for their success and were commended by many organizations with their progress. However, in recent years researchers have seen the epidemic growing again, as Thailand's government and health services have seemed to have dropped the ball when it comes to promoting awareness. Thailand is statistically higher than most countries when it comes to per capita HIV infection, and 80% of those infected are heterosexuals. This is completely different than in countries like the United States and the UK, where only around 10% are heterosexual. This is believed to be because the type of HIV in Thailand is different than the type found in those countries. In Thailand, the most common HIV strain is Subtype-E, while in the west, it's Subtype-B. Travelers to Thailand should understand that Subtype-E infects people differently (more easily through heterosexual sex), and is much easier to catch than Subtype-B. Extra precautions should be taken to try to avoid contracting it while in Thailand. Tourists can sometimes get themselves into situations that even average citizens normally wouldn't. So if you plan to visit The Land of Smiles in the near future, there's a few things you should be aware of when it comes to Thailand and HIV/AIDS.
Places to Avoid
Probably the best way to avoid HIV in Thailand, is to stay away from the brothels, go-go's, bars, and places where you have a greater chance of having sex with a complete stranger. This isn't to say that you can't go to Thailand and have a good time in these places. I've been in many of them and I'm very familiar with how hard they are to avoid if you want to have some fun and enjoy the nightlife. But you should at least be aware of the increased risks you are taking by venturing into these types of places where you are more likely to meet somebody who is infected with HIV. Even if you make a commitment to yourself and tell yourself that you are just going for a few drinks and nothing else, you never know what can happen once you are drunk and less inhibited. Especially when a beautiful half-dressed woman approaches you and grabs your hand or flirts with you. While many bars and go-gos claim that they test their employees and bar girls (and bar boys) for HIV on a regular basis, this doesn't eliminate the risk at all. After infection, it can take 3 to 6 months for a standard HIV test to detect the HIV antibodies in a person's body. This is called the "window period" and it renders any routine testing methods useless. What good is it for a bar to test it's girls, if they can't get accurate results for 3 to 6 months? Let's say a girl is infected in January, and is tested in February or March and tests negative. Then a tourist walks into her bar in April or May and ends up having sexual relations with her, assuming she is working there because she is clean of any STD's. She is then tested again and tests positive for having HIV, as well as the man she just gave it too and however many other customers walked into that bar and went home with her. While most of Thailand's HIV epidemic is centered in the North, where condoms are not regularly used as much in the brothels, the risk is still there in places like Pattaya, Patong, and Patpong.
Imagine all the men in their 50's and 60's who retire to Thailand and couldn't care less about wearing a condom because they've already lived most of their life and could care less. Imagine all the people coming from Africa to work in Thailand's mining businesses and gemstone companies, that have the potential to carry other strains of HIV over from a place where people are dying by the thousands every day from AIDS related complications. There are entire neighborhoods in Thailand that are filled with people who have traveled from Africa to take advantage of work opportunities in Thailand. Not everybody who is from Africa has HIV/AIDS and we shouldn't stereotype. But we can't ignore the large number that do either. All it takes is one sex tourist, to spread it to one girl, who then goes on to spread it to 10 other people. In 2004, a one-legged 56 year old German man by the name of Hans-Otto Schiemann made headlines across the world for allegedly infecting over 400 girls and women in the area around Chaiyaphum, Thailand. The man was supposedly infected by his thai wife, and as revenge for what she did to him, he went around town and had sex with as many women as he could. He claimed that he even offered to pay most of them to have sex without a condom on, and most agreed. He had overstayed his visa, so Thai authorities arrested him for that, but they couldn't charge him for intentionally spreading HIV since Thailand has no laws against doing that. He was eventually deported and seemed to have disappeared from the face of the earth. He probably went to Cambodia or any other neighboring country. But what if he came back to Thailand? What if he's walking around in Bangkok or in some rural area, or even Pattaya? There are probably many selfish people out there like him, who have become infected with HIV in Thailand and continue to pass it on to others without even thinking about the lives they are affecting.
For westerners who travel to Thailand who engage in the sex industry, either accidentally or intentionally, there doesn't seem to be many reliable condoms designed for them. It's been proven by many studies that Asians, on average, are smaller in their love making area than their western counterparts. Because of this, many condom makers in Thailand make their rubbers in a smaller size than you would find in a country like the USA. Even Durex and Trojan condoms in Thailand, have a reputation for breaking when used by many westerners. It's ironic that Thailand, being the world's largest exporter of condoms, doesn't seem to have many in their own market that are geared towards the average size of foreigners. There is one brand, Body Guard, that is especially made for larger men. But I don't know if I would feel comfortable using them, because they aren't exactly FDA approved and they are only sold in Thailand, so who knows what type of track record they have. If you are traveling to the Land of Smiles and think there's a chance you may end up physically involved with someone, you should bring a large supply of condoms from your home country that you are comfortable with and have used before. Even if you don't anticipate meeting anyone, you should bring a supply of them anyways, just in case.
In addition the avoiding the bars and brothels to be on the safe side, you should especially make sure you don't engage in any kind of sexual relations with any girls you find walking the streets outside of these areas. Researchers believe these groups of men and women are three times as likely to have HIV or AIDS than the ones in the bars and brothels, because they are often those who were turned down for employment in those establishments after failing an HIV test. They may also loiter in malls, looking for foreigners or people they think they can possibly get money or a relationship from. This doesn't mean you should treat every stranger you meet as a potential HIV case, but it never hurts to be cautious and you should never let your guard down when dealing with strangers.
If You Suspect Infection
If you believe you've been infected with HIV, or that someone you've encountered has it, there are many clinics that can test you for free, as well as most hospitals (though they may charge a small amount). You should be aware of the fact that HIV Subtype-E in Thailand is believed to be more virulent than Subtype-B when it's left untreated. This means that it has the potential to progress to AIDS in less time if a person is not taking medication for it. So even if you have only a small suspicion that you or someone you know has been infected, it's important that you get yourself tested immediately so that you can begin medication as soon as possible if you end up testing positive. Researchers stress that it's important to get started as soon as possible, because the first few months of medication can make all the difference when it comes to keeping the infection in check.
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