Thailand's Nightlife Industry and the Global Spread of HIV/AIDS

[Guest fountainhall]

I missed this article in the Bangkok Post when it was printed a week ago. It basically summarises the findings of a regional Conference on the global AIDS pandemic held in Bangkok the previous week. This seems to have refocused attention on a topic which has in recent years rarely been discussed: “the extent to which Thailand's nightlife and entertainment industry contributes to the global spread of HIV/AIDS.”

 

With around 20 million visitors a year, one of the background reports for the Conference, co-organised by the UN Economic and Social Commission for Asia-Pacific, stated –

 

". . . the number of men who have unprotected commercial sex is the single most important determinant of the potential size of the HIV epidemic in the region.

 

"On a regular basis, an estimated 10 million women sell and at least 75 million men – between 0.5% and 15% of adult males – purchase sex in the region. Clients of female sex workers (FSW) make up the largest HIV-affected population group in Asia."

 

Referencing Thailand, it adds –

 

Of the many crises that have struck the Thai travel & tourism industry over the years, the outbreak of HIV/AIDS pandemic in the 1980s-90s was the first. It was largely due to the leadership and anti-establishment courage of anti-AIDS campaigners such as Mechai Viraivaidhya, a former tourism minister, that Thailand's tourism industry survived.

 

Over the years, however, the relationship between Thailand's nightlife and the spread of HIV/AIDS has fallen off the radar screen and been replaced by the steady stream of other economic, geopolitical and environmental crisis. In terms of priorities, it is way down on the pecking order.

 

But there is no doubt that increasing visitor numbers, especially from the "new boom markets" such as Russia, India and China, will mean more business for the nightlife and entertainment sector, especially as single males comprise a very high proportion of visitors from these markets.

 

The report warns that heterosexual commercial sex is not the only issue at stake.

 

It says: "While there is significant variability, HIV prevalence among MSM (men who have sex with men) in the region is rising. In several countries in East Asia, male-to-male sex has become the dominant mode of transmission among newly diagnosed infections.

 

"Modelling projections presented by the Commission on AIDS in Asia in 2008 indicated that, unless prevention measures were strengthened and expanded, an increasing proportion of new HIV infections in the region would be among MSM, representing up to 50% of new infections by 2020.

 

"Further, studies have shown that, in some countries, although the level of basic knowledge about HIV/AIDS was high among MSM, a high proportion of MSM perceive their risk of contracting HIV as low. While limited data is available, one study noted that less than 20% of MSM know their status."

 

http://www.bangkokpo...s-may-resurface

 

My only surprise is that this issue has been allowed to “fall off the radar”. With another earlier study suggesting that 24.7% of MSM in Thailand were infected with HIV in 2009 and that the rate of infection amongst MSM is “far higher than in the general population,” complacency and the continuing lack of public education campaigns about the dangers of unprotected sex is surely now taking its toll.

 

http://www.avert.org...nd-aids-hiv.htm

[Rogie]

With another earlier study suggesting that 24.7% of MSM in Thailand were infected with HIV in 2009 and that the rate of infection amongst MSM is “far higher than in the general population,” complacency and the continuing lack of public education campaigns about the dangers of unprotected sex is surely now taking its toll.

 

That's one very good reason why message boards such as this play a vital role. The importance of hammering home the safe sex message cannot be emphasised enough.

[Guest fountainhall]

I know this has been written about in at least one other thread in the past, but I make no excuse for raising it again. With the huge drop in the number of government safe-sex and anti-HIV campaigns, I am not surprised that rates of MSM HIV are at such a high level in this country.

 

There are probably lots of other reasons, but my Thai friends have told me that in the new Thai-for-Thai (sometimes Asian-for-Asian) saunas which have mushroomed in Bangkok in the last few years, unprotected sex seems to be the norm. I have also noticed on gayromeo quite a few members (mostly farang) advertising for bareback sex. It's almost as though, with the death sentence having been taken out of AIDS as a result of antiviral drug therapies, the 'fear' factor has disappeared. Yet we know from occasional posts on other Boards that Thai guys are still returning to their villages to die, either because they had not been regularly tested or they were in some kind of denial.

[Guest badcdn]

I have also noticed on gayromeo quite a few members (mostly farang) advertising for bareback sex. It's almost as though, with the death sentence having been taken out of AIDS as a result of antiviral drug therapies, the 'fear' factor has disappeared.

 

I was going to say the same, HIV is no longer a death sentence. With the treatment available today, for those who can afford or access treatment, it's considered a manageable disease.

 

Having said that, barebacking in porn has made a big comeback. Not that this would have a direct influence over attitues towards safe sex in Thailand, but I fear people have either let their guard down with the knowledge the virus won't kill them. Perhaps also todays generation didn't live through the AID's epidemic and watch their friends, family and community waste away and die.

[Guest]

I find it simply unbelievable that people go to saunas without wearing condoms.

Doesn't Thailand have some kind of public health body that is responsible for educating the public about such basics?

Even if they lack that, surely there would be some kind of independent media that can expose such poor attitudes by the governments?

[KhorTose]

I find it simply unbelievable that people go to saunas without wearing condoms.

 

So do I. I feel sorry for the Thais who do not receive a good HIV education, due to the neglect of their government, but I am totally agast at Westerners and educated Asians who practice unsafe sex. HIV may no longer be a death sentence, but it is still a serious illness often leading to lower life expectency. To be honest, I still think many gays in the West and elsewhere still have low self esteem that leads to risky (self-destrructive) behavior be it unprotected sex, drugs or alcohol.

[Guest fountainhall]


todays generation didn't live through the AID's epidemic and watch their friends, family and community waste away and die.


 

This is surely a key issue. Those of us who went through the fear which accompanied start of the HIV/AIDS pandemic and were then shocked by some of the dramatic public advertising campaigns, had the safe sex message pretty well drummed into us. Who could forget Australia’s Grim Reaper series? But governments now seem to have forgotten that today’s teenagers became aware of sex and sexuality long after these campaigns were felt not to be necessary, or were cut during the various economic crises.

 


I still think many gays in the West and elsewhere still have low self esteem that leads to risky (self-destrructive) behavior be it unprotected sex, drugs or alcohol.


 

I reckon this may only be a small part of the reason. More important, surely, is the point made in the article I quoted in the OP – “a high proportion of MSM perceive their risk of contracting HIV as low.” So those who seek out bareback sex have a sort of Terminator frame of mind – ‘Shoot what you like at me (apologies for the pun). I’ll just morph back. Nothing can harm me.’

 

When you think like that, you deem yourself invincible. But these guys are the epitome of selfishness. Whilst some of their partners may be aware of the risk, when they come to Thailand, Cambodia and other countries where the dangers have not been drilled into youngsters, some are unquestionably sowing the seeds of death.

 

I think we all should look back at the poll conducted on GB’s Board 16 months ago titled “When was your last HIV test?”

 

http://gaybuttonthai....php?f=7&t=1637

 

No matter that this is just a general poll, the findings are surely shocking! 75 posters responded. 22 had already tested positive. Only 8 had been tested within the previous 3 months, and a further 7 within the last year. More shockingly, 25 (33%) had not been tested between 2 and 10 years earlier. And most shockingly, 13 (17%) had never been tested at all!

 

There is no way to split the respondents between residents, visitors and those who have never been to Thailand - nor to know if the responses were the truth. However, if - and I stress ‘if’ – this is a representative sampling of farang who have sex with Thais here, it surely highlights the desperate need for the Thai government to re-start its public education programmes which were so effective in the late 1980s and early 90s.

[Guest Jovianmoon]

My experience led me to realise how widespread HIV may be among the Thai gay male population. Someone I've been involved with on my last two trips turned out to be positive. Not a go-go boy or freelancer, but a waiter (not that it matters really I suppose). After I learned his status (in a phone call back home) he mentioned another guy we both know who works in the same soi who is also positive (he ought not have told me that and of course I'll maintain the other guy's privacy).

 

The risks for the visiting and resident Western population also cannot be understated. The stats may be known, but the subconscious notion of 'it won't happen to me' seems to abound, especially for 'bulletproof' holidaymakers who deposit their brains in the quarantine bin after getting off the plane. I never thought that was my mentality, but that didn't stop the consequences of my overindulgence in booze (one or two of my friends would call it alcoholism) leading to two or three risky activities with my Thai friend which now beggar belief. I didn't know he was HIV positive then, but now I know we both are.

 

Still no ill feelings - it was a (drunken) choice we both made. No excuses either - I knew better, or should have known better no matter my state of mind, or lack thereof.

 

Anyway, I'll be seeing him again on an upcoming trip in a couple of weeks, and I intend to put it behind me while we enjoy our time together. Then starting on the antiretrovirals when I return from my holiday.

 

Let my experience at least be of some warning to those who may be tempted to think "it won't happen to me".

 

Cheers.

[Guest fountainhall]

Jovianmoon – thank you. Thank you for posting such an honest and well-written account of your experience. Nothing, I believe, hammers home the safe-sex message than hearing from someone who is HIV+ and of how that came about.

 

Despite all the warnings, I suspect most of us have once or twice found ourselves either in a similar situation as you on your visit - or very close to it. Even if brains are not dumped on entry to Thailand, an excess of ‘desire’ and ‘drink’ can easily make it seem that way. Those visiting Thailand need to be constantly made aware that the rate of HIV amongst Thai msm is a good deal higher than in most countries. Safe sex is the only way to protect both the visitor and his Thai partner. And since it seems that so many younger Thais are now less aware of how to protect themselves against HIV than was the case up to around 10 years ago, visitors can do a lot to ram home the message.

 

I am glad you will be seeing your Thai friend again. I am sure many others would simply say “no way!” I hope that he is already receiving treatment, or that you will be encouraging him, so that he does not become just another Thai boy statistic who goes back to his village eventually to die.

 

Have a great time on your holiday - and best wishes.

[Guest Jovianmoon]

Thanks Fountainhall.

 

I just hope my post will make some people think about their own risk-taking.

 

I was reluctant to post given that my avatar is actually a picture of me (might be recognised in Bangkok?), but I'm tired of all the secrecy. It's expected that HIV positive people will keep their mouths shut because of the stigma (which is real and one of the worst of many problems that come with being positive), but how does keeping quiet help with prevention of the spread of HIV? Quite the reverse.

 

I'm going to talk to my Thai friend about medication when I get to Thailand, because he told me on the phone that he tried them but couldn't keep up the regimen (knowing his personality, that figures). Like you said Fountainhall, I don't like to think of him returning to his village...

 

For any others reading, my basic advice echoes that of an Australian HIV-prevention TV commercial from years ago:

 

"Always use condoms. Always."

 

Cheers.

[Guest thaiworthy]

Hi Jovian,

 

These are just incredibly beautiful posts. I am greatly impressed by your candor and honest expressions. I can't remember anyone using his own likeness as his avatar and then sharing such experiences in such a frank and open manner. You deserve considerable credit for this and would well serve as an exemplary role model for farang and Thais alike. This speaks volumes for your personality and outlook on life, and you strike me as the kind of person who could handle just about anything that came your way. While that was not automatic, I'm sure you had to work at it. Had it been me, I would have wallowed in self-pity for years, far from the intelligent approach you have taken so evident in your attitude.

 

I wish you the best in the coming years and a long and healthy life. I think you are a great and wonderful human being. Keep up the courage, and best of luck to you and your friends.

 

--tw

[Guest Jovianmoon]

Thanks a lot Thaiworthy

 

While I'm really getting far more credit than I deserve, I do appreciate these supporting comments.

 

I did wallow in self-pity for a month or so. I was diagnosed in November 2011 after returning from Thailand in late October having suffered the well-known 'flu like symptoms. It certainly didn't take the textbook three months for me to seroconvert. But I came to know more about the treatments and my prognosis and started to feel a bit better about the future. Like you I had always previously thought that if ever I became positive I would be cut to pieces emotionally and lock myself in my room or something, or maybe worse... But I guess I realised that there's nothing I can do about it now but try to make the best of it. This is not the future I wanted, but what to do?

 

I suspect that had it really been you, you too would have found a way to cope.

 

I still don't quite know how I'll deal with this long-term. Do I become an activist? I've never really been that sort. I marched in Perth Gay Pride once years ago, but I've otherwise been quite conservative, like: "What do we want? Gradual change! When do we want it? In due course!" Well, ok, that's an embellishment. On the other hand, maybe my annoyance at other people's complacency might shake me into action... I guess that's where activism begins?

 

I'm ranting and a little drunk, so I'll stop now.

 

Cheers and thanks again for your kind words and encouragement.

[Guest fountainhall]

Jovianmoon - I just picked up a copy of the February issue of Desire Magazine, a gay publication written mostly in Thai and for Thais. I noticed there is a short article about The Poz Home Center. This exists as a means for Thai guys to obtain advice about how to prevent HIV and AIDS, and assistance in living with the virus. I just thought your friend/s might be interested in giving them a call, even just to have an anonymous chat. There is also a website - details below.

 

The article is on page 25. Unfortunately the website is in Thai and features the March issue, and so I cannot locate it on the site. But maybe your friend can.

 

http://www.bangkokdesire.com/

 

The Poz Home Center details are -

 

Tel: 02 747 5638/9

web: http://www.thepoz.org

[Guest Jovianmoon]

Thanks a lot for that Fountainhall, really appreciated. My friend has a smartphone and the hotel I'll be staying at has free wi-fi, so I'll get him to check it out. I've copied your message into an email draft for easy reference later.

 

Cheers.