HIV and Syphilis Rates Rise in BKK

[Guest fountainhall]

This article from the Bangkok Post 10 days ago seems to have gone unnoticed. Sadly, it bears bad news.

According to data released by US Centers for Disease Control and Thai Health authorities, the rates of HIV and syphilis amongst gay msm in Bangkok are rising - fast! The syphilis rate has increased from 5% in 2005 to 12.5% in 2011. For some years it has been assumed that the rates of HIV infection had peaked at just under 25%. However, the new data shows that the rate has jumped from 24.5% in 2005 to 29.4% in 2011.
 

The data came from the Silom Community Clinic, located in a central Bangkok hospital and near entertainment venues for gay men.

The clinic was founded in 2005 by a joint collaboration between the the Public Health Ministry and the US CDC, offering free and confidential tests in an environment "receptive to the health and concerns of the MSM community."

When the team first began collecting data about HIV infections in gay men in Bangkok in 2003, the HIV prevalence was 17%.

 

 

http://www.bangkokpost.com/news/asia/357441/hiv-syphilis-rise-among-gay-men-in-bangkok

 

The article makes clear that the data is based on on limited sample. It adds that those who seek out testing and re-testing tend to engage in "higher levels of risky behaviour". But since all the data comes from the same clinic, there is surely a reasonable probability that the rate of increase is itself reasonably accurate for much of the wider msm population.

 

There have been several threads on this Board about the high rates of HIV in Bangkok. It must surely now be crystal clear to the public health authorities and the government that the major reductions in spending on HIV-AIDS awareness campaigns that coincided with the election of the first Thaksin government have been a spectacular disaster. 

 

Anyone who reads a variety of gay Boards in this country knows perfectly well that many young Thais are totally unaware of the seriousness of the safe sex message. Unsafe sex in the many new saunas attracting younger Thais that have mushroomed in the city in recent years is, it seems, the norm. And increasingly I notice on sites like gayromeo young Thais ticking the 'Safe Sex needs Discussion' box in their profiles. Sadly, too, there are visiting farang who seek out young Thais prepared to have unsafe sex.

 

Most sad of all, I suggest, is the lack of a gay lobby in this country to force the government to be far more proactive in its public education messages.

[Guest fountainhall]

A follow-up article to the one quoted in the op appeared in the Bangkok Post a week ago. This cleared up a number of factors re the recent Report about the alarming rise in HIV cases, a Report that terms the spread of the virus in Bangkok an “explosive eidemic”.

The first is that the majority of those visiting the clinic which supplied the data were not sex workers – they were white-collar workers.
 

Despite the perception that those visiting the clinic were restricted to sex workers and their cruising clients, Timothy Holtz, director of the Health Ministry's HIV/STD Research Programme, said many of them were regular men. "From 2005 to 2012, we had 6,526 clients who made 23,600 visits to our clinic," Dr Holtz said. "This group of MSM people, who are regular white collar people ... come to the clinic for free HIV testing as well as other kinds of sexually transmitted diseases, counselling and treatment support."

 

The second is the growing use of metamphetamine (crystal ice) to prolong the sexual experience.
 

The drug was not injected, as reported in MSM communities in the US and Australia, but smoked and taken along with stimulants . . . "Drug impairment may lead to inconsistent condom use and ultimately HIV transmission," the Report said.

 

Third, as I suggested above, the highest risk group for new infections comprises men under 24 and the lack of public education about HIV transmission.
 

Dr Holtz said this was due to factors such as living away from a family home, having more sex than older men, drug taking for sexual pleasure and inconsistent condom use. Lack of education about safe sex is another problem.

"We worry about the young MSMs," Dr Holtz said. "Another problem is that they have multiple sexual partners.”

http://www.bangkokpost.com/news/investigation/358720/hiv-epidemic-hits-white-collar-workers

[Rogie]

Good that the BP has published these reports.

 

But what about the Thai-language press, newspapers and magazines? 

 

One hears the odd derogatory comment thrown in the direction of the Thai educational system, but I would imagine many white collar workers are avid readers. If the Thai press are printing the same articles as the BP any MSM reading it will be aware of the risks he is taking. These risks include STD's such as syphilis (mentioned in the OP). 

 

That's all very well for me to conjecture, but do Thai-language newspapers print this kind of article? Assuming they do, does the target audience of 'young Thais' read them? How about magazines which specifically target young readers? I would say they have a big responsibility to spell it out in plain language. The plainer the better, and if it involves the use of crude terminology (which as you all know, I don't like under normal circumstances) then do it! 

 

Maybe any of our members reading this, who feel comfortable discussing it with their young educated Thai friends, can ask them if the kind of stuff they read, or leaflets they come across, carry these blunt messages. Don't forget we're talking about white collar workers here, not simple (meant in a nice way) country boys.

[Guest fountainhall]

I have been impressed that almost all the guys I have met brought up the issue of condoms. I don't know who attends the many Thai-for-Thai/Asian saunas and I suspect that many are students with some money to spare. But even if they are aware of the need for condom use, as the Report points out, when you combine the use of drugs and/or alcohol with all the hormones racing around young bodies craving sex, the safe sex message will quite easily drop down their list of priorities.

 

As for Thai newspapers and magazines, again I can only speculate. I'm almost certain the articles will have been published, and I assume many Thais will read them - if they actually see them. I read both English newspapers most days of the week, but it so happens I missed both of the days when the two articles I quoted were published! I had to depend on another website to bring them to my attention.

 

But there's another issue. If you have not been brought up with the consequences of unsafe sex being constantly rammed home, I suspect such articles on their own are relatively meaningless. You read them - but then there's an almost automatic reaction "This is worrying, but it doesn't concern me!" Educating people to go against what they believe to be the natural way to have sex, like all education, cannot be taught in one article or one warning poster. 

 

What is so saddening about the epidemic now affecting this country is that it did not need to happen. 20 years ago Thailand was often quoted as the model other countries should copy in combatting HIV-AIDS. If successive governments had simply kept up the very successful safe sex/condom use public information campaigns that used to be run here, hundreds of thousands of young lives would not now be affected.

[Rogie]

You're right about young people's resistance to messages they don't want to hear or maybe don't understand in the first place. 

 

Smoking (no jokes please!) is an obvious instance where there are plenty of warnings NOT TO DO IT, but if you are blind to that message then you will ignore it (I am thinking of young people here who start smoking knowing the dangers which are clearly spelled out - or rather graphically displayed on the outside of the packet - I can sympathise with any of our older members and readers who have tried to quit and failed, as smoking was so all-pervasive back in the 60's and 70's and deemed quite acceptable, despite the price to be paid in health terms having been known since the Royal College of Physicians report in 1962). 

 

Now onto something I know very little about - drugs (apart from alcohol!). Methamphetamine is, quite frankly, a disgusting chemical which everybody should know about before they contemplate taking it. DON'T DO IT! If in doubt read up about it. This quote from wiki below confirms what FH reported above. The final two sentences are not so relevant to Bangkok as it seems it's more often smoked than injected.

 

Men who use methamphetamine, cocaine, MDMA, and ketamine, are twice as likely to have unprotected sex than those who do not use such drugs, according to British research. American psychologist Perry N. Halkitis performed an analysis using data collected from community-based participants among gay and bisexual men to examine the associations between their methamphetamine use and sexual risk taking behaviors. Methamphetamine use was found to be related to higher frequencies of unprotected sexual intercourse in both HIV-positive and unknown casual partners in the study population. The association between methamphetamine use and unprotected acts were also more pronounced in HIV-positive participants. These findings suggested that methamphetamine use and engagement in unprotected anal intercourse are co-occurring risk behaviors that potentially heighten the risk of HIV transmission among gay and bisexual men. Methamphetamine allows users of both sexes to engage in prolonged sexual activity, which may cause genital sores and abrasions. Methamphetamine can also cause sores and abrasions in the mouth via bruxism (teeth clenching and grinding), which can turn typically low-risk sex acts, such as oral sex, into high-risk sexual activity. As with the injection of any drug, if a group of users share a common needle, blood-borne diseases, such as HIV or hepatitis, can be transmitted. The level of needle sharing among methamphetamine users is similar to that among other drug injection users

 

 

http://en.wikipedia.org/wiki/Methamphetamine

 

Quite why any sensible person would risk their longterm health for the buzz of short-term kicks escapes me. Furthermore it's not just impressionable young Thais who take methamphetamine. Farangs in Thailand do so as well. I knew (note the past tense) an extremely well-educated ex-pat who took it for sex kicks. He described it to me in great detail once. Thankfully I said "no thanks I'm not putting that junk into my body". 

 

I suspect he would've been an ideal person to 'drop in and tune out' at this place: Incidentally it describes the difference between yaba and methamphetamine here:

 

Some people believe that yaba and methamphetamine is the same drug; in fact, there is a slight difference. Yaba means ‘crazy medicine' in Thai and comes in the form of a small round tablet. It is often red, but can be green, yellow, orange, or blue. Some have small logos on them while others may be grape, orange, or vanilla flavored. Yaba is a combination of methamphetamine and caffeine. It is most commonly consumed orally or smoked, but it can also be crushed and snorted or injected.

Methamphetamine is chemically made. The final result is a crystal or glass like substance which varies from white or blue. This must be crushed into a powder. From here, it is commonly smoked, snorted, or injected. In Thailand, Yaba is the preferred drug of choice, but methamphetamine use is on the rise.

 

 

http://www.thecabinchiangmai.com/archive/thailand___s_drug_problem__methamphetamine_and_yaba

 

Yaba and methamphetamine users in Thailand, and throughout the world for that matter, can get help. It may be difficult and will not happen overnight, but with proper treatment including therapy, education, and support, sobriety can be achieved.

The Cabin Chiang Mai is a private luxury rehab located in Chiang Mai Thailand. Due to our location, we are familiar with the devastating effects that yaba and methamphetamine has had throughout this beautiful country. We pride ourselves on being highly skilled with various techniques on how to treat yaba or methamphetamine addictions. Furthermore, we are dedicated to helping those individuals who are dependent upon these drugs.

[NIrishGuy]

I would question the ya ba being the drug of choice now, I know we (I) always assumed so and I actually had this conversation with a few guys in Bkk two weeks ago and they to a man told me now that Ice was by far the more common drug of choice across the board from sex workers to blue and white collar works as (in Bkk anyway) it was much easier to get apparently.