is mainstay of fight
Media report source: via
The Planned Parenthood
Association of Thailand works with fishermen in Pattani, near the Malaysian
The condom has
been the mainstay of the fight against HIV/AIDS and widespread distribution
of free condoms by local family planning clinics has succeeded in a massive
reduction in the spread of the virus.
Thailand in particular,
has set an example to the rest of the developing world for the effectiveness
of its HIV prevention work, which started in 1984 when the first case of
AIDS was reported.
A "100 % condom
campaign" targeting behaviour change in men has achieved exceptional results
with rates of sexually transmitted infections falling by more than 90%
between 1989 and 1997.
Eight years ago,
with rates of HIV/AIDS running at about 3% among conscripts, the Planned
Parenthood Association of Thailand persuaded the Royal Thai Air Force to
take on an HIV prevention programme. They argued that the strength of the
country was at stake and encouraged instructors to give out free condoms
and use games and straight talking to help airmen understand the dangers
of AIDS. Conscripts now pass on what they've learnt to at least three other
While the air force's
programme ensures many of the male population are reached, at risk groups
such as fishermen, intravenous drug users and sex workers have also been
On a boat moored
in the harbour at Pattani in southern Thailand, a PPAT worker tells the
fishermen about the dangers of AIDS and describes some of the prevention
methods available. One of the men strikes up on guitar and sings a song
he's composed about AIDS. Then follows a demonstration of how to put on
a condom, using a wooden model.
Lek, 28, from Ubonrajatani,
north east of Bangkok, has been a fisherman for eight years and lives on
board. "We go out for 15 to 20 days and come home to port for a couple
of days. When I come back, I go out drinking, partying and flirting with
girls," he said. "It's good for the crew to know how to protect themselves
- it's useful."
The Planned Parenthood
Association of Thailand has been working with the fishermen for some years
but also targets commercial sex workers in the town. Throughout the country
there is now virtually 100% condom use among sex establishments. Weekly
check ups, free condoms and health promotion campaigns have clearly paid
Linda*, 25, from
northern Thailand, works to pay for her two sisters' education as well
as supporting her parents. She earns about 400 dollars a month and sees
roughly three clients a day. She says she won't have sex without using
But while the condom
campaign has been successful in the brothels and massage parlours, sex
workers tend not to use condoms with regular clients, partners and friends.
is also concerned that the programme has not reached what they call indirect
sex workers, those who work in restaurants where sex is offered clandestinely
and may be denied by the owner.
In other countries
in the region, the prevalence of HIV is rising alarmingly. Cambodia had
the highest prevalence rate in Asia with 4.04 per cent of the sexually
active population estimated to be HIV positive, according to a UNAIDS report
at the end of 1999. The epidemic is mostly among the heterosexual population
whereas in Vietnam, China and Malaysia, the HIV transmission is mainly
among intravenous drug users, although heterosexual transmission is also
In Myanmar, HIV
infection among sex workers rose from 4 per cent in 1992 to over 20 per
cent in 1996, while close to two thirds of injecting drug users are infected.
In India there are now 3.5m people living with HIV, the largest number
in the world after South Africa.
from Thailand's success is now becoming essential for other countries around
the world. Recently a twenty-strong delegation from six family planning
associations in Africa, South and South East Asia took part in an HIV advocacy
workshop organised by the Planned Parenthood Association of Thailand and
funded by the Japanese Government Trust Fund.
Key lessons learned
included adopting clear objectives, being prepared with up-to-date information
and adopting a pro-active approach to key leaders and the media. Using
existing networks as well as a multi-sectoral approach, ensuring sustainability
by involving the community, and last but not least perseverance!
As Steven Kraus,
programme and external relations advisor with UNAIDS in Thailand put it,
"HIV/AIDS rates in South East Asia are what they were in Africa ten years
ago. The big question is - will Asia get on top of the epidemic or not?"
* Name changed
to protect identity
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