Thread: Soi Cowboy : Nirmal Ghosh on the challenges of HIV-Aids

from the blogworld ...............................


Michel Sidibe’s fight against prejudice
Nirmal Ghosh
February 15, 2011

Nirmal Ghosh on the challenges of HIV-Aids Soi Cowboy is a tiny lane off Sukhumvit in Bangkok, probably around 80 metres in length, crammed with go-go bars catering almost exclusively to foreign customers.

At night it becomes a loud, screeching, crowded place pounding with music, grotesquely drenched in coloured lights. But it is also a focus for much economic activity – and not just the sex trade.

Food vendors do brisk business from their carts. Others sell roses. Some sell fake watches and handicrafts.

On Monday evening – Valentine’s Day – I turned up at Soi Cowboy to meet UNAIDS executive director Michel Sidibé, who is in Bangkok to meet with Thai government officials on a mission to get Thailand to spend more on prevention of HIV-AIDS.

PHOTO: NIRMAL GHOSH

As they do on most Valentine’s Days on Soi Cowboy – and in Pattaya – the non-government safe sex activist group SWING Foundation (SWING Foundation ) was laying on a show to promote the use of condoms.

SWING co-founder Chamrong Phaengnongyang was dressed in a tiny gold bikini-like outfit and prancing up and down the street with a wireless microphone constantly exhorting everyone to practice safe sex.


PHOTO: NIRMAL GHOSH

A gifted and frenetic communicator, he has the talent to engage, entertain and raise a laugh from almost anyone.

Behind him, a band pounded out rousing, thumping music from the north-eastern Isan region. Many of the young women in the trade here are from Isan, a relatively poor region.

SWING organised their famous condom fashion show as well, with models dressed in clothes made from condoms.

They floated and pranced along a red carpet holding boards advocating safe sex. Nearby, more SWING volunteers stood with trays of free condoms. I saw several young bar workers taking handfuls.

PHOTO: NIRMAL GHOSH

MISSION IN THAILAND

I asked Sidibé, what his mission is in Thailand, and what his challenges are globally, in terms of his vision of 'zero new infections, zero discrimination and zero deaths from HIV.'

'First of all, Thailand is a successful country...we have been able to demonstrate in Thailand that we can virtually eliminate transmission from mother to child,' he said above the din of the crowd and the music.

'They are not having any more babies born with HIV. They have managed to reach universal access on treatment.'

'But prevention remains a major problem, particularly prevention among sex workers, men who have sex with men (MSM), drug users and illegal migrants.'

'This visit is to push up the prevention agenda, to make sure the government can invest more resources in the revolution in prevention I am calling for.'

'We are seeing a growing epidemic among MSM, and among sex workers - not in brothels, but in the streets. I will meet the Prime Minister and the governor of Bangkok. I want to have zero new infection in Bangkok. It is possible.'

Rising rates of infection in high-risk groups create a reservoir of the virus which then spills over into the general population. The groups do not live in isolation, he pointed out.

In Thailand, less than 20 per cent of the budget for HIV-AIDS is allocated to prevention – critical elements of which are wide availability of condoms and sterile needles for intravenous drug users.

But despite a tolerant culture, there remains prejudice in some areas – which undermines efforts to address some high-risk groups.

PHOTO: NIRMAL GHOSH

The Mali-born Sidibé has much experience in Francophone Africa, and is no stranger to issues like prejudice.

'I am fighting the prejudice, stigma, and discrimination that prevent people from using services,' he said.

'I’m fighting prejudice against most of the at-risk population throughout the world.'

'Eighty countries have homophobic laws; six countries consider they (homosexuals) deserve the death sentence.'

blogs.straitstimes.com

Originally Posted by Mid
SWING co-founder Chamrong Phaengnongyang was dressed in a tiny gold bikini-like outfit and prancing up and down the street with a wireless microphone constantly exhorting everyone to practice safe sex.
A gifted and frenetic communicator, he has the talent to engage, entertain and raise a laugh from almost anyone.

Swing seems to be a hell of a character and passionate about what he does, it still amazes me just how many educated farang refuse to use condoms, I can't get to
grips with why anyone would take the chance of contracting any STD or be so cold as to pass one on.

Tackling rural poverty in Thailand would be the first step to controlling the spread of HIV and S.T.D's as 95% of the sex workers come from up-country and that ain't rocket science.

Or maybe just a massive awareness campaign directed at that part of the population might be a good start, awareness capaigns do work if they are sustained and co-ordinated.

Getting rid of poverty is just not going to happen so this programme has positive effects. It is in many peoples interest for the poor to remain poor providing cheap labor and rice.Have you noticed how so many things that were manufactured previously in Thailand are now made in China.At least sex education like this will make more aware of the dangers and hopefully minimize the spread of this terrible disease.

Originally Posted by Sdigit

awareness capaigns do work if they are sustained and co-ordinated.

Based upon my experiences and discussions with the working girls most girls know about the risks but if a punter refuses to suit up the money temptation overrides their better judgement.

Sad but true.

Originally Posted by Aussie Tigger

Getting rid of poverty is just not going to happen

I agree but lives can be improved if the government can control the rampant corruption that is stealing money from the everyday Thai particularly the farmers and poor.

Strike the disease at it's source and all this talking about it will not improve the situation.

Good piece by Chiang Mai Citylife about a westerner living in thailand with HIV.

Chiang Mai Citylife: The Secret Illness by James Austin Farrell

Mark, like many men here in Thailand, came on holiday for a few weeks and ended up falling in love with the country and the people (mostly the girls he admits). He took a TEFL course, found a job in Bangkok at a government school and was suddenly thrust into what he thought was temporal heaven. Somewhat nervous and apprehensive he takes a seat with me outside a coffee shop on Sukhumvit Soi 3. A large framed man, he could be mistaken for a body builder; I was, for obvious, if not ignorant reasons, expecting a sickly, frail man. Mark has been HIV positive for five years.

"Maybe I was just unlucky, I can only remember sleeping with three girls without a condom the whole time I was here. In hindsight I do remember falling quite ill after I'd slept with one girl, the last unprotected sex I ever had with a casual partner," Mark tells me, glancing upwards into his thought bubble as if still trying to locate the very night he contracted the disease. Once you are infected your immune system weakens after about two to six weeks and symptoms can include a flu-like illness (primary HIV infection); after that your immune system revitalises to control the HIV virus. "Years later I never even thought about that night, I had a regular girlfriend and things were going well. But about four years later I started to feel lethargic on a regular basis, and then I discovered lumps on the glands under my armpits. I knew nothing about HIV at the time, and other than that I felt in good shape. Still, to be sure I went for a medical." Mark explained that his medical reported that he was in fine health, although his immune system indicators showed a slight sign of abnormality. So it was after this, and talking to a friend, that Mark decided to get a HIV test.

"When the nurse came down to give me my results she said they would have to test again, I wasn't really sure why, then two hours later another nurse approached me smiling and handed me an envelope. As I was walking through the door I opened it, not really thinking I'd be infected - the nurse seemed so happy - then I saw the word POSITIVE. Strangely enough, at the time, I just thought positive, yeah, that must be a good thing. I was fooling myself - my heart started beating and I felt pretty light headed. I walked back inside and asked her, 'Does this mean I have HIV?' she told me yes, it does, and referred me to a doctor."

Mark's consultation with the doctor consisted of very little, only that the results were 95% accurate. Mark informed me that there was no counselling, no advice and zero support so he returned to the UK where he received comprehensive advice from his GP. "I guess in Thailand it's not such a big deal," said Mark passively, "Funny thing is I accepted it quite quickly, in fact, after I found out I had the best night's sleep in a long time. I think somewhere in my mind I always knew something was wrong . . . the worst thing by far was telling my girlfriend. We'd been together about a year and she'd lost her virginity to me. She'd trusted me, had been sleeping with me, and I thought for sure I must have given it to her."

Mark took her to a quiet spot that night and broke the news. She took it quite well, deciding there and then to get a test right away. "I remember waiting in the car . . . that was definitely the worst hour of my entire life; going through all the scenarios in my head of how we'd deal with this. We'd been having unprotected sex for a year, how could she not have it? When she got in the car she started crying and I thought it must be positive, but then she told me it was negative. In a way I think she was crying for me, that I'd have to go through this alone. I have to say, she's never once blamed me for what happened. She's always been there. We are still together now and things are going well. Of course we take all precautions when we have sex and she takes a test every three months."

Originally Posted by Loy Toy

Originally Posted by Sdigit

awareness capaigns do work if they are sustained and co-ordinated.

Based upon my experiences and discussions with the working girls most girls know about the risks but if a punter refuses to suit up the money temptation overrides their better judgement.

Sad but true.

Yes very sad that some guys do this to to the girl but it's as much the girls resposibillity as the punter, they need to be strong and determined, easy for me with no money worries to say I know but thems the cold hard facts, if they make it socially unacceptable to let the punter go in unbagged it will make a difference, it's a bit like smoking in Blighty, no longer a socially acceptable thing to do in public, the same mindset needs to happen in reguards to condom use.

Originally Posted by Sdigit

the cold hard facts

The cold hard facts are everyone has a price. Even a veteran hooker in Europe will for the right price go for a bareback ride. For poor Thai women, price in comparison is not much for your average punter to pay. Agree, bottom line it's up to the woman but men who put them in a position of having to make what could be a life threatening decision are the culprits. Further they being "educated" should know they are at risk themselves.

Originally Posted by Norton

The cold hard facts are everyone has a price.

Yep, two in fact > 1. With a condom+ 2. Without a condom ++.

Originally Posted by Chairman Mao

Good piece by Chiang Mai Citylife about a westerner living in thailand with HIV.

If you can beleive it! You have better of odds of winning a lottery.

To say it's extremely rare for a man to contract HIV through normal heterosexual activity is an huge understatement.

Gay sex and or sex with an IV drug user is the most common way of getting it.

Originally Posted by Mr Earl

To say it's extremely rare for a man to contract HIV through normal heterosexual activity is an huge understatement.

So I've heard. Extremely rare for someone to win the big lottery prize but someone does. Every month. All a matter of risk/benefit trade off. The risk side out weighs benefit for me.

The most common ways that people become infected with HIV are:

• having sexual intercourse with an infected partner.
• injecting drugs using a needle or syringe that has been used by someone who is infected.
• as a baby of an infected mother, during pregnancy, labour or delivery, or through breastfeeding.

http://www.avert.org/can-you-get-hiv-aids.htm

Originally Posted by Mr Earl

To say it's extremely rare for a man to contract HIV through normal heterosexual activity is an huge understatement.

Originally Posted by Mid

having sexual intercourse with an infected partner.

.....

Originally Posted by Norton

Originally Posted by Sdigit

the cold hard facts

The cold hard facts are everyone has a price. Even a veteran hooker in Europe will for the right price go for a bareback ride. For poor Thai women, price in comparison is not much for your average punter to pay. Agree, bottom line it's up to the woman but men who put them in a position of having to make what could be a life threatening decision are the culprits. Further they being "educated" should know they are at risk themselves.

Totally agree mate, there's lots of pressure on the girls to bring the money in and these bare back chancers who do know better and still put them in this possition really are scumbags, there just isn't an easy answer to this problem but any solution has got to start with the girls refusal to allow this practice.

Originally Posted by Mr Earl

Originally Posted by Chairman Mao

Good piece by Chiang Mai Citylife about a westerner living in thailand with HIV.

If you can beleive it! You have better of odds of winning a lottery.

To say it's extremely rare for a man to contract HIV through normal heterosexual activity is an huge understatement.

Gay sex and or sex with an IV drug user is the most common way of getting it.

You might want to read this....

HIV and AIDS in Thailand
Heterosexual Transmission in Thailand: HIV Subtype E in Thailand, and
<h4>Blood Tests About 80% of HIV transmission in Thailand is heterosexual, as compared to about 10% in the USA and some other western countries. So why is the heterosexual transmission rate by unprotected sex is much higher in Thailand than in western countries? One answer is because of a different subtype of HIV virus in Thailand. To understand this, read this section.

AIDS (Acquired Immune Deficiency Syndrome) is caused by the HIV-1 virus (Human Immunodeficiency Virus). However:

There are many sub-types of HIV virus, HIV subtype A, subtype B, and on thru subtype F, plus a subtype O, much like hepatitus has hep-A, hep-B, etc., and this may make HIV in Thailand significantly different from HIV in the west.
In general, it is common for a particular kind of virus (common flu viruses and others) to have different strains, some of which are much more easily transmitted than others.

In Thailand, the primary means of transmission of HIV is by heterosexual sex, overwhelmingly HIV subtype E. A second group is intravenous drug users (IDU's), most of whom are infected with HIV subtype B, the subtype most common in western homosexuals and IDU's, and which is apparently difficult to transmit heterosexually.

In the west, the prevalent HIV subtype B has as its primary means of transmission: anal sex (due to the abrasions of an unlubricated and tight tract which give the virus access to the blood), intravenous drug use (needle sharing between drug users), blood transfusions, hemophilia (people who need blood transfusions and who got donated blood with HIV before the hospitals could detect HIV), and with heterosexual transmission accounting for only about 10% of all cases. Subtype E is found in only a tiny minority of cases in the west, and is often traceable to travellers from Thailand.

For more than 20 years, Thailand has had HIV subtypes B and E. However, it is subtype E which has taken off in the heterosexual population. This has suggested that there are significantly different degrees of contagiousness between the two subtypes as regards heterosexual transmission.

It might be a common deadly mistake by western men to have unprotected sex with prostitutes in Thailand based on a lack of education and understanding of the difference between HIV subtype B in the west and HIV subtype E in southeast Asia.

Southeast Asia predominantly has subtype E, whereas other regions of the world have different predominant subtypes (the USA has subtype B, Africa has A, C and D, and so on). Thailand has a mix of two subtypes, subtype B and subtype E. Subtype B is mainly found in northern Thailand among intravenous drug users. Subtype E is what is predominantly found among prostitutes and heterosexuals. For example, a Chulalongkorn University clinic in Bangkok which had large numbers of HIV enrolled patients for studies found that 92% of male heterosexuals were infected with HIV subtype E, whereas 79% of intravenous drug users (IDU's) were infected with subtype B. (In both cases, practically all the rest were infected with the other subtype of HIV.)

HIV infection is highest in northern Thailand near the Golden Triangle, due to the opium and intravenous drug use in that area. Northern Thailand is also where the highest concentration of HIV subtype B can be found.

Subtype E actually appears to be a "recombinant" mutation, where a cell somewhere in the world was infected by two different strains of HIV at the same time, like "virus sex", resulting in genes "combined" from both. Subtype E is thought to be a combination of subtype A found in western Africa combined with another subtype, perhaps with subtype B which is dominant in North America, Europe, Australia, and Japan. (Subtype A is commonly found in other recombinant forms, too.)

Prostitution is rampant in many countries in Asia and the world, yet the percentage of the population in Thailand that are HIV carriers (approximately 2%) appears much higher than in other places with prostitution, after adjusting for per capita infection rates.

A research report at the University of New South Wales in Sydney, Australia, has an analysis that concludes: "it has been estimated that the heterosexual HIV transmission rate in Thailand (where subtype E predominates) is fifty-fold higher than that observed in USA and Europe (where subtype B predominates)."

One of the best medical web research sites (geared for physicians) has an in-depth research report conducted in Thailand, which reports: "One of the earliest studies suggesting differences in efficiency of transmission among HIV-1 subtypes was a cross-sectional seroprevalence study of HIV-1, presumed subtype E, in Thai military conscripts infected by commercial sex workers (CSWs).[52] Using mathematical modeling, researchers estimated that the probability of female-to-male HIV-1 transmission per sexual contact was approximately 1 in 30 to 50 contacts; previous estimates for HIV-1 subtype B were estimated at 1 in 500 to 1000 contacts. A second Thai study compared serodiscordance in couples in which the index case was either infected with subtype E from CSW contact or subtype B from intravenous drug use (IVDU). After controlling for factors known to affect transmissibility (eg, STDs, advanced disease), subtype E was associated with a much higher rate of seroconcordance, suggesting a difference in the intrinsic properties of the subtypes, with enhanced heterosexual transmission in HIV-1 subtype E.[53] One recently published report suggested that this apparent enhanced heterosexual transmission of subtype E may be due to increased replication in Langerhans' cells, which are located in the vaginal mucosa and may be the cell types that first become infected during heterosexual transmission of HIV-1.[54] The data from these studies, and the predominance of HIV-1 subtype B in the Americas and Europe where homosexuality/bisexuality is the major risk behavior, have led some investigators to conclude that subtype B is less efficiently transmitted heterosexually than the other subtypes, particularly subtype E." Reference: http://www.medscape.com/SCP/IIM/1997/v14.n09/m3170.brodine/m3170.brodine.html
Reports that analyzed only HIV in general, without specifying the subtype, are apparently not completely applicable to situations in Thailand.

Overall, in Bangkok, at a hospital which has the subtype statistics for more than 2000 HIV infected patients, approximately 82% have subtype E (95% of subtype E infections contracted heterosexually), and approximately 13% have subtype B (70% of subtype B infections contracted by intravenous drug use). (Reference: RetroConference 99.) Stated differently, non-IDU's (i.e., heterosexuals, homosexuals and hemophiliacs who do not inject drugs) accounted for approx. 30% (85/284) of subtype B infections, but approx. 95% (1723/1820) of subtype E infections.

Subsequent studies have confirmed that HIV subtype E is more contagious than subtype B for heterosexuals, and there doesn't seem to be any significant disagreement about that, but there is disagreement about how much more contagious subtype E is -- from less than twice as contagious to 50 times as contagious, or maybe something in-between.

It has been determined in general that HIV is more easily transmitted when another sexually transmitted disease is present. How much this applies to subtype B vs. subtype E is not clear to me at this point, since subtype B appears to need access to the blood more than subtype E, and thus may need to take advantage of herpes lesions, inflammation of the urethra due to other STD's such as chlamydia, NSU, or gonorrhea, scratches due to teeth during oral sex, etc.

In any case, to compare the chances of getting HIV by unprotected sex in the west vs. the chances in Thailand are not comparable due to factors including the following:

1. HIV subtype E vs. HIV subtype B
2. The higher percentage of HIV carriers in Thailand
3. The preponderance of other STD's such as NSU which increase transmissibility

The rate of spread of HIV in Thailand levelled off in the early 1990's, apparently due to diligent campaigns on condom use by the Thai government and certain NGO's. However, many ex-pats continue to "bareback" (i.e., have sex without a condom) with prostitutes, with more ex-pats doing so after consumption of alcohol.

Some studies estimate that the percentage of prostitutes infected with HIV is approximately 10% in the ex-pat areas of Bangkok. However, these studies have uncertainties due to the biases of their samplings.
A Chulalongkorn study found that "disguised prostitutes", that is, ladies who freelance in shopping malls and the like posing as non-prostitutes but who extract presents (fashion items, mobile phones, etc.) and spending money from quasi-boyfriends in an extrinsically motivated relationship, had HIV infection rates of around 30%. The Chulalongkorn study speculated that the higher rates may be due to lower condom use in these relationships. However, the Chulalongkorn study notes that this was an unexpected finding and based on a statistically small and arguably insignificant sampling.

The best protection against HIV, besides abstinence, is condom use. Condoms are a highly effective protection against HIV.

The most often recommended condom is Durex, especially those with the N-11 spermicidal lubricant which may also help protect against some sexually transmitted diseases. However, some of the very thin and polyurethane ones have been reported by associates to break, including a Durex non-mainstream variety. A larger condom for ex-pats has recently arrived on the local market, often in the form of vending machines in ex-pat areas, and it is called BodyGuard. More information is on the ThailandGuru page on condoms.

Update in December 2006:

One thing I find interesting is that the more contagious subtypes found in Thailand and Africa don't seem to be spreading around the world as quickly as I would expect from travellers. Therefore, I wonder if there is more than one factor here.

Contrary to popular belief among many laymen, subtype E does NOT require blood-to-blood contact to transmit itself. Based on research studies, scientists have found that subtype E attacks the Langerhans cells (LC) exceptionally well, particularly those located on the penis foreskin and in genital mucosa, with HIV subtype E infecting and reproducing itself multiple times more quickly than other strains of HIV. Subtype B prevalent in the US and Europe doesn't seem to have ever had (or possibly lost) the same viral sequences as subtype E for transmission this way.

However, this may not entirely account for increased spread of subtype E in Thailand in view of the slow spread of subtype E to the outside of Thailand, similar to African HIV.

In Africa, there are widespread trends for ladies to dry their vagina before intercourse in order to create more friction for the man and presumably pleasure, rather than a well lubricated vagina. In fact, the ladies often insert powders and herbs and other things. These things can cause irritation and even bleeding, which could account for the increased transmission in Africa, not the particular strains of HIV there (which, again, differ from western countries).

Is there some custom in Thailand which could serve a similar role? I think maybe so, for reasons similar to those in Africa. ("Same-same but different" as is joked here.)

HIV seems to be transmitted mainly thru the prostitution community, not the mainstream Thai community nearly as much, even though many young Thais are promiscuous in their multiple romantic and casual relationships. What do prostitutes do which is different from mainstream Thai ladies? Talk to any guy who goes with prostitutes, whether they are picking up the lady from a bar, going to a massage place, or just a knocking shop. It's all the same -- the lady takes a shower and cleans herself first, and requires the man to do likewise. Unfortunately, this removes natural lubrication.

Of course, prostitutes having mercenary sex are generally not as naturally lubricated as a girlfriend with sincere sexual or emotional attraction to you. However, the cleaning just exacerbates this.

Never, not once, have I ever been with a mainstream Thai lady who stopped the action to go take a shower first, or require that I do so. Same thing with foreign ladies. I don't want to brag here, but for the sake of research and statistics, I've had sex with many foreign ladies and many mainstream Thai ladies, and none -- not one -- ever stopped to take a shower first or required me to do the same. I've rarely had any significant lubrication issues in these encounters.

I've also never had a broken condom, but I've heard of many cases of broken condoms in Thailand. I have spoken with these guys, including brand of condom, and one of the clear answers is that there wasn't enough lubrication for complete penetration before the condom broke. If there wasn't enough lubrication on the condom, then imagine penetration without a condom with the same lady and circumstances! That must be creating irritation, not only in the lady's vagina which makes her more susceptible to infection (and whereby she passes it on), but also to the man by pulling the sides of the front end of the penis so that its inner urethra & mucous membrane are not only exposed but seriously contacted in a way which just doesn't happen with well lubricated sex. That exposes any HIV viruses to the LC targets in the man.
That may be a major part of the answer.

Therefore, pack both condoms and a water based lubricant. Durex sells the lubricant all over Bangkok. There's also K-Y jel available at pharmacies and department stores all over, and it's water based.

Another thing I've found out from talking with guys is that a lot of them who don't like to use condoms (and try not to) will take an antibiotic prior to visiting prostitutes and immediately after, in order to prevent infection by gonorrhea, chlamydia, and other things -- the same broad spectrum antibiotic that is given to cure these diseases, with the theory being that just a little bit will prevent infection by a small number of bacteria, rather than curing a full blown infection several days later. They take these antibiotics shortly before and immediately after sex, but don't need to take them for long, and apparently that works from their reports.

Besides the unrelated issue of developing antibiotic resistant strains due to not completing an antibiotic regimen, I also wonder if attempts to decrease bacterial infection may increase HIV infection.

In the West, heterosexual HIV transmission tends to occur much more frequently when another sexually transmitted disease (STD) is present in the recipient. This infection could result in more LC's being available as part of the body's natural defense against the bacterial STD.

If someone takes antibiotics, they artificially raise the number of infection-fighting T-Cells. This creates more targets for the HIV virus to find in the same places that other STDs come in. Does this cause a significant increase in one's chances of contracting HIV somehow? I don't know, and I've never seen this "prophylactic antibiotic usage" issue researched.

Other STDs may be another

Maybe I'm wrong about all of this, but I've never seen these two issues really analyzed and addressed. If I'm right, then a few lives could be saved here. I welcome comments and critiques.

(However, please don't send emails about HIV not being the cause of AIDS, a common sort of feedback I receive. I'm aware of that small minority school of thought at www.virusmyth.net/aids, and I have read those hypotheses and find them full of one-sided arguments which totally ignore the overwhelming evidence otherwise. These people say HIV doesn't cause AIDS, and many of their believers in Thailand don't use condoms as a result, using this as a rationalization. Let natural selection takes its course. Google the keywords [AIDS HIV myth] and you'll find further discussion as well as thorough refutation of these claims.)
</h4>

I have known personally 2 people who have tested positive for HIV.

One is a prick relation who is a homosexual and he has been infected for the last 20 years and the other a Scandinavian friend who was into anything including drugs and some suspect orgies.

Both are still alive and fighting fit when I spoke with them just recently.

I honestly have never met a Thai bar girl who has contracted the disease but then again quite a few of them have gone missing.

Originally Posted by StrontiumDog

HIV infection is highest in northern Thailand near the Golden Triangle, due to the opium and intravenous drug use in that area. Northern Thailand is also where the highest concentration of HIV subtype B can be found.

I know for a fact that an Aussie Missionary who was working in that area was found to be HIV positive but protested his innocence and with regard to remaining celebrant.

The Church sent him back to Australia and after many tests it was found he had some rare form of Malaria virus which when first found triggered the HIV alarm.

I wonder how many of these people who are HIV positive really have this same virus and the testing methods in Thailand are just out of date.

Confessions of an HIV-positive prostitute
8/11/2009

Bangkok Post : Confessions of an HIV-positive prostitute

Originally Posted by Loy Toy

I honestly have never met a Thai bar girl who has contracted the disease but then again quite a few of them have gone missing.

I've known two. One died a few years back in a hostel near Yasothorn. The other simply disappeared. Off to Nakorn Nowhere to die I suppose. Pitiful and sad to say the least.

If you see a woman has disappeared from a bar and no one knows where she is you can be pretty sure she may have HIV. Sure the manager or other bargirls know but they won't be telling a customer where she went if HIV. Bad for business.

what a non article
the OP headline screams
''fight against PREJUDICE''
then the paragraphs come and go ,and lots of them ,but with no mention of the word,
ie why prejudice needs to be fought to stop aids spreading

right at the end the author throws the word in several times , but still does not address how gays Africans and Arabs not wearing condoms ,and causing aids to spread ,connects to any kind of prejudice ?

guess you should not expect too much from this African guy , who is no doubt getting rich from it somehow .