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((Use dmy dates|date=December 2020))
((multiple issues|
((more citations needed|date=June 2013))
((Disputed|date=June 2013))
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Since [[HIV/AIDS]] was first reported in [[Thailand]] in 1984, 1,115,415 adults had been infected as of 2008, with 585,830 having died since 1984. 532,522 Thais were living with HIV/AIDS in 2008.<ref name="nationmultimedia.com">((cite news|title=More teenaged girls getting HIV infection|url=http://nationmultimedia.com/2008/11/25/national/national_30089295.php|access-date=17 June 2013|newspaper=The Nation|date=25 November 2008|author=Pongphon Sarnsamak|url-status=dead|archive-url=https://web.archive.org/web/20141126122625/http://nationmultimedia.com/2008/11/25/national/national_30089295.php|archive-date=26 November 2014))</ref> In 2009 the adult prevalence of HIV was 1.3%.<ref>((cite web|title=Thailand|url=http://www.unaids.org/en/regionscountries/countries/thailand/|work=HIV InSite|publisher=UCSF Center for HIV Information|access-date=17 June 2013|date=July 2009))((nonspecific|date=December 2018))</ref> As of 2016, Thailand had the highest prevalence of HIV in [[Southeast Asia]] at 1.1 percent, the 40th highest prevalence of 109 nations.<ref>((cite web |title=COUNTRY COMPARISON; HIV/AIDS((Snd)) ADULT PREVALENCE RATE |url=https://www.cia.gov/library/publications/the-world-factbook/rankorder/2155rank.html |archive-url=https://web.archive.org/web/20070613003325/https://www.cia.gov/library/publications/the-world-factbook/rankorder/2155rank.html |url-status=dead |archive-date=13 June 2007 |website=Central Intelligence Agency |access-date=2018-12-01))</ref><ref name="womensj">((Cite journal|last=Lines|first=Lisa|author-link=Lisa Lines|date=July 2015|title=Prostitution in Thailand: Representations in fiction and narrative non-fiction|url=https://www.capstoneediting.com.au/uploads/files/Prostitution%20in%20Thailand.pdf|journal=Journal of International Women's Studies|volume=16|issue=3|pages=86–100|access-date=21 March 2018))</ref>((RP|91))

A 2011 report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) identified Thailand among the eleven countries in the [[Asia-Pacific]] with a majority of the world's HIV-infected people.<ref>((cite news|title=HIV/AIDS: Pakistan has one of Asia's highest HIV prevalence rates|url=http://tribune.com.pk/story/240379/hivaids-pakistan-has-one-of-asias-highest-hiv-prevalence-rates/|access-date=17 June 2013|newspaper=The Express Tribune|date=27 August 2011))</ref>

==HIV/AIDS history and prevalence==
[[File:AIDS and HIV prevalence 2008.svg|thumb|280px|Estimated prevalence in % of HIV among young adults (15–49) per country as of 2011<ref>((cite web|title=AIDSinfo|url=http://www.unaids.org/en/dataanalysis/datatools/aidsinfo/|work=UNAIDS|access-date=4 March 2013))</ref>]]
After [[Thailand]]'s first case of [imported] AIDS was reported in 1984—in a Thai student who returned from college in the United States<ref>((cite web|title=Weniger BG. History of the Early HIV/AIDS Epidemic in Thailand and Highlights of the Country's Key Contributions to Global Prevention.|url=https://www.youtube.com/watch?v=H4QCczw-tvc&t=2368s |archive-url=https://ghostarchive.org/varchive/youtube/20211221/H4QCczw-tvc |archive-date=2021-12-21 |url-status=live|publisher=The Siam Society, Bangkok, Thailand (Lecture 2019-05-02 @Youtube)))((cbignore))</ref>—and after the first laboratory detection of HIV in 1985,<ref>((cite web|title=Wangroongsarb Y, Weniger BG, Wasi C, Traisupa A, Kunasol P, Rojanapithayakorn W, Fucharoen S. Prevalence of antibody to HTLV-III/LAV in selected populations in Thailand. |url=https://siamlotus.com/Pubs/WangroongsarbEtal-PrevHTLV-LAVThailand-SEAsiaJTropMedPH1985v16p517-520.pdf |archive-url=https://web.archive.org/web/20160120020324/https://siamlotus.com/Pubs/WangroongsarbEtal-PrevHTLV-LAVThailand-SEAsiaJTropMedPH1985v16p517-520.pdf |url-status=dead |archive-date=2016-01-20 |publisher=Southeast Asian Journal of Tropical Medicine and Public Health 1985;16(4):517-20.))</ref> starting in early 1988, HIV infection spread explosively in sequential waves in one risk group after another.<ref>((cite web|title=Weniger BG, Limpakarnjanarat K, Ungchusak K, Thanprasertsuk S, Choopanya K, Vanichseni S, Uneklabh T, Thongcharoen P, Wasi C. The epidemiology of HIV infection and AIDS in Thailand. |url=https://siamlotus.com/Pubs/WenigerEtal-EpiHIV-Thailand-AIDS1991v5s2ppS71-S85.pdf |archive-url=https://web.archive.org/web/20160131024704/https://siamlotus.com/Pubs/WenigerEtal-EpiHIV-Thailand-AIDS1991v5s2ppS71-S85.pdf |url-status=dead |archive-date=2016-01-31 |publisher=AIDS 1991;5(suppl2):S71-S85.))</ref>

Information on the prevalence of AIDS in Thailand was initially suppressed due to the concern of affecting the economy of the tourist industry.<ref>Jackson, Peter A. ''Male homosexuality in Thailand: an interpretation of contemporary Thai sources''. Elmhurst, NY: Global Academic Publishers, 1989. Print.</ref> In 1991, the government adopted a strategy to combat the disease, and in recent years, the number of new infections has declined. According to [[Avert (HIV and AIDS organisation)|Avert]], the second-highest prevalence of HIV in Asia existed in Thailand in 2002, with a rate of 1.8 percent.<ref>((cite web|title=Timeline of AIDS in Asia|url=http://www.avert.org/asia-aids-timeline.htm|work=Avert|publisher=AVERT|access-date=17 June 2013|year=2013))</ref> HIV prevalence had remained the same from 2003 to 2005 (1.4 percent). By 2017 HIV prevalence had declined to 1.1 percent, with 75 percent having access to antiretroviral therapy (ART).<ref name="Nation-20181201">((cite news |last1=Saengpassa |first1=Chularat |title=Sharpened focus in Aids battle |url=http://www.nationmultimedia.com/detail/national/30359629 |access-date=2018-12-01 |work=The Nation |date=2018-12-01 |archive-date=4 April 2019 |archive-url=https://web.archive.org/web/20190404224513/http://www.nationmultimedia.com/detail/national/30359629 |url-status=dead ))</ref>

Thailand's early cases of HIV/AIDS occurred primarily among gay men. The virus then spread rapidly to [[injecting drug user]]s (IDUs), followed by prostitutes. Between 2003 and 2005, there were increases in HIV prevalence from 17 to 28 percent among [[men who have sex with men]] in Bangkok. In addition, prevalence among IDUs still ranges from 30 to 50 percent.

In 2005, more than 40 percent of new infections were among women, the majority of whom were infected through intercourse with long-term lovers. Money and a low level of condom use due to women's activity in the illegal sex trade are factors responsible for the spread of HIV among this group. Although the prevalence of HIV/AIDS in Thailand has declined, the epidemic has moved to the general population and there is a greater need to match prevention efforts with recent changes in the epidemic.<ref name=usaid/>

As of 2011, IDUs in Thailand are among the most vulnerable to HIV/AIDS and number between 40,000 and 97,300.<ref>((cite web|title=Slideshow: The Need for Clean Needles in Thailand|url=http://www.worldbank.org/en/news/2011/11/30/slideshow-the-need-for-clean-needles-in-thailand|archive-url=https://web.archive.org/web/20120618223356/http://www.worldbank.org/en/news/2011/11/30/slideshow-the-need-for-clean-needles-in-thailand|url-status=dead|archive-date=18 June 2012|publisher=World Bank Thailand|access-date=29 August 2012))</ref>

== Dynamics ==
Several factors had put Thailand at risk of a resurgence of HIV/AIDS cases. Awareness of HIV status was low in 2006. For example, 80 percent of HIV-positive men who have sex with men (MSM) had never been tested or thought they were HIV-negative, according to a 2006 study cited by [[UNAIDS]]. By 2017, awareness of HIV status had risen to 98 percent.<ref name="Nation-20181201" /> A large portion of IDUs—35 percent according to one study—use non-sterile injecting equipment.<ref name=usaid/>

<!--This is largely plagiarized from https://web.archive.org/web/20080816045636/http://www.usaid.gov/our_work/global_health/aids/Countries/ane/thailand_profile.pdf-->Other research has noted an increased trend of erratic condom use by female prostitutes. In some cases, women selling sex reported using a condom in just over one half of [[commercial sex]] encounters. Finally, premarital sex, once taboo, is increasingly common among young Thais, only 20 to 30 percent of whom use condoms consistently, according to the [[United Nations Development Program]].<ref name=usaid/>

According to the [[World Health Organization]], Thailand has a high [[tuberculosis]] (TB) burden, with 63 new cases per 100,000 people in 2005. Approximately 7.6 percent of TB patients are also infected with HIV; HIV-TB co-infections pose a challenge to treatment provision and care for both diseases.<ref name="usaid">((cite web |url=https://www.usaid.gov/thailand/documents/country-profile |title=Thailand Country Profile |date=30 October 2017 |access-date=19 August 2021 |archive-date=16 August 2008 |archive-url=https://web.archive.org/web/20080816045636/http://www.usaid.gov/our_work/global_health/aids/Countries/ane/thailand_profile.pdf |url-status=dead ))((cite web |url=https://www.usaid.gov/our_work/global_health/aids/Countries/ane/thailand_profile.pdf |access-date=19 August 2021 |archive-url=https://web.archive.org/web/20081114144241/https://www.usaid.gov/our_work/global_health/aids/Countries/ane/thailand_profile.pdf |archive-date=14 November 2008 |title=Thailand HIV/AIDS Health Profile |date=March 2008 |publisher=USAID ))</ref>

==National response==
<!--This is largely plagiarized from https://web.archive.org/web/20080816045636/http://www.usaid.gov/our_work/global_health/aids/Countries/ane/thailand_profile.pdf-->
Thailand's initial response to the epidemic was weak.((citation needed|date=June 2013)) However, since the National AIDS Control Program was moved from the Ministry of Public Health to the Office of the Prime Minister in 1991, the country's HIV/AIDS prevention efforts have been recognized((By whom|date=June 2013)) as among the world's most successful. The Ninth National Economic and Social Development Plan (2002–2006) emphasized the adoption of a human-centered approach to bring about reform through the public health system, especially the health care system. Thailand's policy on AIDS has worked toward educating its citizens on HIV/AIDS and prevention measures; developing a system of medical, public health, social, and consultation services to improve the quality of life of persons living with HIV/AIDS (PLWHA); developing medical biotechnology, medicine, and AIDS vaccination research; and working with all parties involved, such as the government and private sector, to prevent and alleviate the HIV/AIDS situation.<ref name=usaid/>

Thailand's HIV/AIDS activities include conducting a public education campaign targeting the general public and most-at-risk populations (MARPs), improving sexually transmitted infection (STI) treatment, discouraging men from visiting sex workers, promoting condom use, and requiring sex workers to receive monthly STI tests and carry records of the test results.<ref name=usaid/><ref>((cite journal|last=Celetano|first=David D.|author2=Kenrad Nelson |author3=Cynthia Lyles |author4=Chris Beyner |author5=Sakol Eiumtrakal |author6=Vivian Go |author7=Surinda Kuntolbutra |author8=Chirasak Khamboonruang |title=Decreasing Incidence of HIV and Sexually Transmitted Disease in Young Thai Men: Evidence for Success of HIV/AIDS Control and Prevention Program.|journal=AIDS|year=1998|volume=12|issue=29|pages=29–36 |doi=10.1097/00002030-199805000-00004 |pmid=9543437|s2cid=39577722|doi-access=free))</ref> The Thai sex industry has become the major focus of campaigns aimed at HIV prevention and treatment due to the perception that prostitution has been responsible for the spread of AIDS.<ref name="womensj" />

In 2004, Thailand received a third-round grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria to prevent HIV/AIDS among IDUs and increase care and support for them. Objectives of the grant are to train peer leaders within IDU communities; create harm-reduction centers; educate health care providers, police, prison staff, and policymakers; and provide peer-based outreach, education, counseling, referral services, and HIV testing support. The US Government provides one-third of the Global Fund's contributions.<ref name=usaid/>

Since the change of government in 2006, Thailand has reinvigorated its HIV/AIDS prevention and control efforts. In 2007, Thailand adopted a three-year strategic plan that focuses on scaling up HIV prevention efforts, particularly for people most likely to be exposed to HIV and for difficult-to-reach populations. Thus, the government continues to strive for achieving universal access to treatment. As of the end of 2006, 88 percent of HIV-infected people were receiving ART, according to UNAIDS.<ref name=usaid/>

Early in 2007, the government announced that it would, if necessary, break patents on drugs to treat HIV. Thailand's [[Government Pharmaceutical Organization]] will produce the antiretroviral drug [[efavirenz]] after receiving [[World Health Organization|WHO]] approval in 2018. GPO's product costs 180 [[Thai baht|baht]] per bottle of thirty 600&nbsp;mg tablets. The imported version retails for more than 1,000 baht per bottle. GPO will devote 2.5 percent of its manufacturing capacity to make 42 million efavirenz pills in 2018, allowing it to serve export markets as well as domestic.<ref name=BP-20181103>((cite news |last1=Wipatayotin |first1=Apinya |title=Thailand gets nod to make HIV/Aids drug |url=https://www.bangkokpost.com/news/general/1569426/thailand-gets-nod-to-make-hiv-aids-drug |access-date=3 November 2018 |work=Bangkok Post |date=3 November 2018))</ref>

Despite the efforts put into anti-HIV strategies, it is estimated that condom use remains quite low: in 2010, the Department of Disease Control (DDC) estimated that 60 percent of sexually active teenagers, more than 50 percent of MSM and 40 percent of sex workers do not regularly use condoms.((Citation needed|date=June 2013))

==Research==
The American [[Centers for Disease Control and Prevention]] (CDC) conducted a study in partnership with the [[Ministry of Public Health (Thailand)|Thailand Ministry of Public Health]] to ascertain the effectiveness of providing people who inject drugs illicitly with daily doses of the anti-retroviral drug Tenofovir as a prevention measure. The results of the study were released in mid-June 2013 and revealed a 48.9% reduced incidence of the virus among the group of subjects who received the drug, in comparison to the control group who received a placebo. The Principal Investigator of the study stated in the ''Lancet'' medical journal: "We now know that pre-exposure prophylaxis can be a potentially vital option for HIV prevention in people at very high risk for infection, whether through sexual transmission or injecting drug use."<ref>((cite web|title=Preventive drug could reduce HIV transmission among injecting drug users|url=https://theconversation.com/preventive-drug-could-reduce-hiv-transmission-among-injecting-drug-users-15166|work=The Conversation Australia|publisher=The Conversation Media Group|access-date=17 June 2013|author=Emma Bourke|date=14 June 2013))</ref>

A study done by [[AIDS Care]] investigated substance use of HIV risk behaviors among kathoey sex workers in [[Bangkok]], Thailand.<ref>Nemoto, Tooru, Mariko Iwamoto, Usaneya Perngparn, Chitlada Areesantichai, Emiko Kamitani, and Maria Sakata. "HIV-related Risk Behaviors among Kathoey (male-to-female Transgender) Sex Workers in Bangkok, Thailand." ''AIDS Care'' (2011): 1-10. Web.</ref>

==See also==
* [[Prostitution in Thailand]]
* [[Health in Thailand]]
* [[List of HIV/AIDS cases and deaths registered by region]]

==References==
((reflist))

((Asia topic|HIV/AIDS in))
((AIDS))

((DEFAULTSORT:HIV AIDS in Thailand))
[[Category:1984 establishments in Thailand]]
[[Category:HIV/AIDS by country|Thailand]]
[[Category:Health in Thailand]]

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