by Mechai Viravaidya

The first AIDS case in Thailand was diagnosed in 1984. Since that time, the country has been able to identify HIV-positive cases before they have developed into full-fledged AIDS. But in an ironic twist, convincing policymakers—let alone the public—that a deadly disease still threatens the country has been exceedingly difficult.

Reports from the World Health Organization and from Thailand's Ministry of Public Health have not helped. Both sources report fewer than 100 cases of AIDS in Thailand and about 25,000 HIV-positive individuals.

These numbers, however, tally only those who have been tested through surveillance surveys or through diagnosis. When the figures are projected to the entire Thai population, a conservative estimate is 125,000 HIV—positive individuals—more than the total number of hospital beds in Thailand.

Estimates go as high as 400,000, partly because no one can agree on the number of prostitutes and IV-drug users in Thailand. In mid-1990, a nationwide survey by the military and based on a group of 32,000 men, ages 20 to 22, indicated that 1.7 percent are HIV-positive. In two northern Thailand provinces, the figure reached 11 percent. Surveys of commercial sex workers show that 40 to 72 percent of them were HIV positive.

Government and business hesitate to confront the linkage between AIDS and Thailand's prostitute problem because it threatens tourist spending, which has helped fuel the country's double-digit economic growth rate-Asia's highest. And, Thailand's widespread acceptance of prostitution exacerbates the problem. Many countries speak of sub-groups of their population at risk, but Thai males' usage of prostitution puts the entire culture at risk.

Thailand will not be alone in Asia in experiencing the coming deluge of people with AIDS. Both Burmese fishermen visiting prostitutes in Thai ports and Burmese women working as prostitutes in Thailand have taken AIDS home. India has recorded a significant number of AIDS cases and China, Malaysia and the Philippines are not immune.

As things now stand, events will play themselves out like recordings of the African experience. While the past five years have belonged to economic progress and development in Thailand, the next decade could very likely belong to AIDS.

Excerpt from Healthlink, April 1991.