Abstract

PIP:

HIV infection is firmly established in the general population of Thailand and will soon exact substantial medical, social, and economic effects at the community and household levels. The primary risk behavior for infection in Thailand is heterosexual intercourse compounded by high levels of other sexually transmitted diseases (STD) and the general cultural acceptance of commercial sex. The June 1993 round of sentinel surveillance for HIV seroprevalence found median and provincial ranges as follows: 35.2% in the range of 13.3-70.8% among IV drug users, 28.7% in the range of 5.1-64.1% among direct sex workers, 7.6% in the range of 0.0-37.3% among indirect sex workers, 8.0% in the range of 0.0-33.0% among men attending STD clinics, 1.4% in the range of 0.0-7.6% among women attending antenatal clinics, and 0.74% in the range of 0.0-8.4% among blood donors. HIV seroprevalence was 4.0% among military conscripts in May 1993. Men and women in Thailand with no other risk factor than sex with a spouse are often at risk of infection with HIV. Urban/rural differentials are minimal, with HIV infection strewn across the country. HIV seroprevalence levels continue to climb despite some success with interventions in slowing the rate of infection among military conscripts and reducing the incidence and prevalence of STDs. Interventions, health care, and coping responses therefore need to be delivered at the community level throughout the country. Although much emphasis has been given to the prevalence of HIV infection in Northern Thailand, seroprevalence data show that other parts of the country will soon experience the same explosion of AIDS cases observed in the North over the past two years.