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Welcome to Chiang Mai, Thailand. HIV / AIDS Situation in Thailand : How much we succeed !. Suwat Chariyalertsak , MD., Dr.PH Research Institute for Health Sciences, CMU Present to EAA Member Meeting in Chiang Mai, 21 Mar 2011. Chiang Mai University.
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HIV / AIDS Situation in Thailand: How much we succeed ! Suwat Chariyalertsak, MD., Dr.PH Research Institute for Health Sciences, CMU Present to EAA Member Meeting in Chiang Mai, 21 Mar 2011
Research Institute for Health Sciences (RIHES) Chiang Mai University, Thailand
Hey Guy ! Do you know where did HIV come from ? Shuu ! Be quiet, I did it by myself
Estimated HIV burden in South-East Asia Region, 2007 * Without Pacific Region Source: Reports of HIV estimates, National AIDS programs cited in HIV/AIDS in South-East Asia_WHO, 2009
HIV prevalence (%) in adults (15–49) in Asia Source: UNAIDS_epidemiological data, 2008
Reported HIV/AIDS cases by mode of transmissions in selected countries, 2008 * Unsafe sex includes MSM transmission Source: HIV/AIDS case reports by National AIDS programs cited in HIV/AIDS in South-East Asia_WHO, 2009
Prevalence distribution among MARPs in Asia Source: UNAIDS_Estimates and projections_P.Rao presentation in ICAPP, Bali, August 2009
Thailand Health Statistics WHO Report on Health Statistics, 2006
First AIDS Case Report in Thailand • 28 yeas old Thai male, studied in U.S. with history of homosexual exposure • In 1983, he was admitted at a hospital in USA with Pneumocystis Cariniipneumonia • In 1984, he was referred to Thailand for continuing treatment
What NEXT ! The HIV EpidemicTransition in Thailand Pregnant Women Male withMultiple Partners CommercialSex Workers IntravenousDrug Users Family Children Homosexual Teenage 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 -2004
Interventions Care and ART Focus on prevention AIDS in 2 men (homosexual contacts) Rapid spreadingamong IDUs “0%” “30%” Massive campaign with100% condom Report in blood transfusion Rapid spreading among FSW (44%) Generalized Epidemic:Children born to HIV+ women Thailand HIV/AIDS Epidemic First report Explosive Epidemic 1984 1989 1991 1987 1988 2000 2007 Concentrated epidemic (MSM, SW and IDUs) • 2007 AEM Estimation: • 14,000 new infections • 1,100,000 cumulative HIV+ • 550,000 Living with HIV
THE SUCCESS OF THE 100% CONDOM PROGRAMME IN THAILAND “Thailand’s “100% Condom Program” has been one of the world’s most successful condom promotion campaigns” (Lamb D. Despite economic crisis, Thailand continue bold fight against AIDS. Los Angeles Times, November 16, 1998)
HIV Prevalance among pregnant women by age groups, 1995-2007 year Source: Sentinel Sero-surveillance, Bureau of Epidemiology, Ministry of Public Health
Reported AIDS Cases by age, gender, Thailand 1984-2007 Number of cases Source: Bureau of Epidemiology,MOPH,Thailand data as of September 30, 2007
Reports of ever-had-sex among high school students, 1996-2006 % Male Female SAQ PASI Source: Bureau of Epidemiology, Department of Disease Control, MOPH Note SAQ = Self administered questionnaire PASI = Personal digital assisted self interviewing
Fig. 5 Proportion of male conscripts, male factory workers and male students who used condoms consistently with commercial sex workers from 1995 – 2005
Current Situation 2007 Estimation, 2008 Report on the global AIDS epidemic
110,824 65,046 99,871 AIDS Situation THAILAND Total 357,407 cases Dead 90,054 cases 43,521 38,016
23,856 12,729 3,273 3,466 1,690 22,738 5,368 10,367 AIDS Situation NORTH THAILAND 1,679
National HIV/AIDS ART Treatment Program National Access to ARV Treatment for PLHA (NAPHA) NationalHealthSecurityProgram Global Fund PMTCT national program SocialSecurity Civil servant fund ARV mono and dual therapy under research settings 2002 2003 2004 2005 2006 2007 1997-1998 2000 2001
Number of Currently Received ARV, Thailand Up to 130,000 PLHA accumulatively received treatmentin 2007 by different schemes of health care services
AIDS Symptmatic HIV CHIANGMAI AIDS Situation1988 – 30 September 2009 Asymptomatic HIV
How many people who are HIV+ but don’t know their HIV status ?
Anyone is susceptible to HIV regardless of race, gender or sexual orientation!!
More emphasize on risk groups • Youth • MSM • Drug users group (Inject and others) • Sex workers (Female, Male) • Migrants/Mobile people • Etc ???
HIV Prevalence among MSMIBBS using Time-Location Sampling, 2003-2007 % Sentinel provinces Thailand MOPH-U.S. CDC Collaboration
What we should do in the future but need to start now Scale up ART Scale up Prevention