500,000 People with HIV. Now What, Thailand?

UNICEF latest report says 70% of all sexually transmitted HIV infection cases in Thailand are occurring among people between the ages of 15 to 24. It also goes to say that despite a gradual drop in the overall prevalence in the country during the past two decades, new infections are now rising. Thailand, once (almost) economically dominant in the region, and now with unexplained road-maps for development, is facing another round in a yo-yo up-and-down health crisis.

"Good for Me and Good for You" - condoms at SWING Pattaya drop-in centre

What's visibly absent from the current regime is its national strategies on HIV/AIDS, be it a multi-sectoral approach or its financial plan in meeting the specific targets as expressed in the United Nations' Millennium Development Goals. Nor do the mechanics of HIV/AIDS prevention, intervention programs have rights-based fundamentals. The MDG deadline is just around the corner, 2015 in fact. Similar to ASEAN's over-confidence for the creation of a "drug-free" region by 2015, the MDG itself is something of a bizarre neglect, particularly among the public. Pray tell, how many people know, understand the set of commitments? What's plain to see is the fashionable Thai culture of celebrities and social middle-class continuing, somewhat, in the art of wearing a red ribbon, when there's publicity and a desperate need to leave a mark in their public persona.

I'm not just concerned about Thailand's obvious lack of explanation to so-called integrated policies of treatment, care and support for people living/affected with HIV/AIDS, whether them being from the local, stateless or migrant populations. It seems that time-bound national targets are often highlighted extensively once, twice or if there's political mileage then three times a year. Its as if Thai civil society is not interested to nudge, or push, the authorities in being accountable and transparent. I have my reservation of some government-run agencies and their boasts of legitimate community representation, especially when they're financially motivated by the Thai politics of the day.

According to UNICEF and the department of public health, about 500,000 people are living with HIV in the kingdom. Even though young people learn about sexually transmitted infections from informal and formal education activities, and from their peers, it is obviously not enough, as prevalent behaviour seems to show that unsafe sex are still practised, and popular. And we have yet to touch on the concerns related to "ChemSex" (chemical sex, when substances/drugs taken before sex), among young people, whether those still in and out of school.

I believe in the element of participation, as is one's right to be involved in decision-making and problem-solving of national, provincial policies and even the direction of civil society. Are young people in Thailand an explicit part of the plans? And what of marginalized young people, those living in slums, rural districts, in rubber plantations, homeless, and from the sex worker, drug user, transgender communities? Of which many would forget young communities, such as stateless, migrants, Muslim and Buddhist youth living in the conflict-torn south and indigenous, most made vulnerable by societal dysfunctional tendencies. And the list continues.

Even if Thailand's militarized regime places high-political commitment to national HIV/AIDS situation, will the young marginalized population be involved in the development of district-province-national level strategies? Traditional flow, such as adults, officials and politicians subscribing to a form of moralistic behaviour in order to stop the spread of HIV, has failed in the past. Breeding such solutions do not generate empathy among young people nor empower them to equal participation.

For a start, the regime should focus on human rights and a rights-based approach to their road-maps with a prioritization in developing the skills of young people based on their issues, needs and concerns. Young people should be able to freely speak about their needs, from issues of confidential HIV testing, to life skills and most importantly their right to be heard, their right to be involved in shaping the programs to meet their needs.

A community-based Voluntary Counselling Testing (VCT) clinic run by an NGO called SWING: trained staff collecting samples, in a safe environment.

Staff taking a break at the drop-in centre, a program for female and gay sex workers. SWING is based in Bangkok, with a program in Pattaya.  

How I miss the sight of an NGO office.



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