Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

Reuters NewMedia - Friday, November 28, 2003
Chawadee Nualkhair

"It seems the people who have it are getting fewer and the people I hang out with are not the kind who would get it," the 27-year-old clothing designer says, swirling the drink in her hand at a nightclub. "Sometimes you just have to live your life."

As countries prepare to mark World AIDS Day on Dec. 1, young Thais are flirting with danger in a nation seen as a rare bright spot in the battle against the disease.

At the same time, the government is cutting spending on prevention programs, only a decade after Thailand successfully checked a crisis that had threatened to run rampant.

"Human nature dictates that if we were successful, we would be lulled into a sense of complacency. Unfortunately HIV/AIDS is something different," former prime minister and anti-AIDS activist Anand Panyarachun told Reuters.

"If we are complacent, I can envisage a recurrence of the epidemic in the foreseeable future. If we come to that situation we have only ourselves to blame."

FAINT MEMORY

Experts say the specter of AIDS -- which has killed around 400,000 Thais and robbed the economy of up to $9 billion -- is a faint memory for many young people.

The disease first appeared nearly 20 years ago, only to be dismissed as a scourge from abroad affecting only minority groups such as homosexuals.

It hit epidemic proportions by the early 1990s, infecting nearly half of Thai sex workers. Infection rates among needle-using drug addicts jumped to 40 percent from zero in one year.

Thailand hit back with a battery of prevention measures centered on its main tool, the condom. The steps it took included mandatory one-minute AIDS education ads every hour on TV and radio and free boxes of condoms for prostitutes.

Behavior patterns have changed drastically since. Up to 98 percent of Thai men, previously seen as averse to using condoms, now use them at brothels, up from 15 percent before the efforts to promote safe sex began, the government says.

At a time when Asia threatens to become the next AIDS epicenter after southern Africa, new cases in Thailand have dropped to just over 20,000 last year from 140,000 in 1991.

But transmission modes are now changing, experts say, and Thai attitudes have failed to keep pace.

The Health Ministry says young people are now the largest component of new HIV infections. A survey of 14-year-old boys found only a quarter use condoms.

"Young Thais feel the AIDS problem is not close to them," said Pattarawan Ucharatna of the Population and Communication Development Association (PDA), a nongovernmental group.

"They think it's a commercial sex workers' problem, so when they have sex with their friends, they don't practice safe sex."

Women are also increasingly affected, experts say, partly because wives are taking the repercussions of the unprotected sex their husbands had with prostitutes.

But social workers say many of the women getting infected are from the ranks of the very young.

"We are seeing higher infection rates of women under 20 than boys, and that is alarming," said Suteera Thompson, president of the Gender and Development Research Institute.

PREVENTION BETTER

More worrying, the government has scaled back prevention efforts and free condom programs at the same time that attitudes toward AIDS are becoming lax, activists say.

The PDA says spending on prevention has more than halved since 1997, and Ministry of Health figures show funding for all AIDS programs has dropped 60 percent since the 1997-98 Asian economic crisis to $765 million this year.

Activists also say the government has put the fight against AIDS on the back burner symbolically.

Thailand's prime minister has traditionally chaired the government's AIDS committee since the early 1990s.

But incumbent Thaksin Shinawatra has handed that duty to the health minister, who does not give the problem the same political weight, activists say.

The government says it will step up spending next year to help provide antiretroviral drugs to 50,000 Thais next year from 10,000 now and fund AIDS education at the grassroots level, it said.

"Prevention is still prioritized," the Health Ministry said in a statement faxed to Reuters. "The strategies ... have been changed from focusing on mass media to personal media through community-based activities which can reach and influence people."
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