Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
Bangkok Post - Tuesday 26 February 2002
The data comes from an on-going study among army recruits during the 1990s. (The study continues, but confirmed results are possible only up to three years in the past, because of the slow onset of HIV.) Cases of sexually transmitted HIV fell from 11% of recruits over the period of 1991-93 to 2% in 1998. At the same time _ ``swimming against this positive tide'', in the words of the report _ use of injected drugs rose from 1% of the youths to 4%. Drug users had eight times more HIV infections in 1997, and 13 times more in 1998. One quarter of all HIV/Aids victims were users or abusers of injection drugs, generally meaning heroin.
More research is clearly needed. In the meantime, common sense indicates these young men are major risks to the community through their combination of drug abuse and infection. Similarly, their male and female peers, who are outside the military draft and thus unstudied, are either at risk themselves, endangering others or both.
The threat of Aids spreading through shared heroin needles has been long known. The American researchers, led by Dr Kenrad Nelson, suggest the successful Thai fight against Aids has focused too strongly on the single aspect of sexual transmission. It is difficult to fault anyone for this, if it is true. Heroin addiction has fallen significantly in the past generation. Suppression has rightly focused on big-time heroin dealers _ meaning the Burma-based cartels _ and on methamphetamine abuse and trafficking.
Dr Nelson's continuing study indicates that authorities must supplement the Aids fight in two important ways. The first is with a strong educational campaign aimed at drug users. Research indicates they are badly misinformed or uninformed of the danger they pose to themselves and others. Users inject heroin directly into their drug stream, and anyone who uses the needle also shares the blood. Most Thais know this is supremely dangerous. Users are unaware, uncaring or unable to feed their lamentable drug habit with personal needles.
The second necessary track is to step up efforts to wipe out the lingering heroin trade into, and through, Thailand. This trade has actually increased in the past year. The Burma-based drug baron Wei Hsueh-kang has increased production and sales of heroin. He has allied his Wa United State Army band with the formidable, international Chinese triad known as the 14K gang.
Authorities have launched successful drives in recent weeks. They have broken several Wei-backed drug factories and smuggling rings. They also have seized well over 300 million baht in cash and assets from the drug baron. They have arrested Taiwanese and Russians, serving notice it may not be safe to do business with Wei. Much more remains to be done, including convincing Burma to join the effort.
The increased infections and the growing use of heroin by young people should be a cause for alarm. The American research should send an urgent alarm to health, education and drug authorities alike.
The country's advance against HIV/Aids may be the talk of the world, but it is always at risk. Nothing can be taken for granted in battling this terrible epidemic. Authorities and local communities alike must step in, quickly, to address this problem. Thailand can defeat the HIV/Aids scourge only with an all-out effort, across the board.
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