Thailand makes progress in the fight against AIDS, but the stigma remains

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The stigma associated with AIDS in Thailand remains strong

This article was previously published in Equal Times

AIDS in Thailand - A patient on Phra Baht Nam Phu Monastery awaits the nurses who take care of him. Photo by Antolín Avezuela 

A patient on Phra Baht Nam Phu Monastery awaits the nurses who take care of him. Photo by Antolín Avezuela

AIDS in Thailand

Pon was devastated by the news that he was carrying the human immunodeficiency virus (HIV) and suffering from AIDS following a routine medical check-up eight years ago. On hearing it, he decided to leave home, without telling his relatives about his illness. Since then, he has been living in hiding in Phra Baht Nam Phu, a temple, 150 kilometres from Bangkok, that has set up a hospice to care for HIV/AIDS patients.

“My family does not know where I am, nor that I have AIDS. I divorced my wife and I left,” Pon tells Equal Times.

The stigma associated with this disease remains strong in Thailand, pushing many to travel to the monastery on their own initiative, from all over the country. Others are simply abandoned there by their relatives.

“I used to go and visit patients in hospital from time to time, then in 1991 some began to come and visit me here. I was an alternative for them,” says doctor Alongkot Dikkapanya, the head monk leading this project, which now takes care of over 1,500 men, women and mostly orphaned children.

There are 141 patients in the centre’s intensive care unit at the moment. When their health improves, they can stay in the small bungalows fitted out at the monastery, where employees, as well as monks and volunteers, continue to take care of them.

Thailand’s response to HIV/AIDS has been widely applauded for having achieved one of the best success rates internationally, bringing down the number of people newly-infected with HIV from 24,000 in 2001 to 6,900 in 2015.

Thailand’s case is highly significant, being one of the first countries, along with South Africa and Cameroon, to introduce free antiretroviral treatment against HIV. The treatment (commonly known as ART) helps HIV-positive people to live a longer and healthier life.

Stigma claiming more lives

But in spite of the advances, people diagnosed with HIV/AIDS in Thailand continue to be denied the employment opportunities they need to lead a normal life and are generally rejected by the people in their immediate circle.

Negative perceptions of the virus, the disease, its carriers and patients, permeate Thai society, making it much harder to eradicate HIV, since the virus is related to the sex trade or drug use, illegal activities that are frowned upon in the country, as in many others.

“Such attitudes take a long time to change,” Tatiana Shoumilina, director of the UNAIDS project in Thailand, tells Equal Times.

It is a vicious circle, as what often happens – as a result of the negative perceptions – is that many of the people infected with HIV are afraid of learning they have the virus through a medical check-up, which means they enter the health system later and, consequently, the antiretroviral treatment is delayed.

The consequences of this delay can be extremely serious : when a person with HIV takes antiretroviral drugs, the risk of developing AIDS (the final, most advanced phase of the chronic HIV infection) falls considerably.

Most of the patients in the monastery have been abandoned by their relatives.

“When new patients arrive, we have them fill in a form and they have to mark with a cross what should be done with their body when they die, because their families don’t come for them,” Thong (not his real name, he prefers to remain anonymous) tells Equal Times.

One option is for the body to be mummified and exhibited in a room a few metres from the clinic, an idea suggested by patients themselves, as a way of raising awareness about the lethal nature of the disease.

“When it is left up to us to decide what to do with their bodies, we cremate them,” explains Thong.

The temple of AIDS patients

A visit to Phra Baht Nam Phu is not for the faint-hearted. Some of the patients have been living here for years and are very debilitated by the disease ; they cannot eat, go to the bathroom or change their own incontinence pads. Others lie almost naked and covered in talcum powder because of the tropical heat, without the strength to cover a body they barely recognise. All are in complete solitude.

Rachen, a former heroine addict, was disowned by his community on becoming infected with the virus after sharing a needle with another addict. But HIV is mostly commonly contracted (and spread) through unprotected sex.

Pon contracted HIV after having sex with a prostitute.

Alia represents the other side of the story : she caught it from her husband and was then abandoned at the monastery.

“[Since I arrived at the monastery] no one [from my family] takes care of me,” she tells Equal Times.

Around 10,000 people have taken their last breath at the centre since it began receiving patients in the early 1990s.

According to UNAIDS estimates from 2015, around 440,000 people are living with HIV in Thailand (180,000 women, 250,000 men – over age15 – and 4,100 children – newborns to age 14), in a country with a population of 67 million.

People with HIV have access to medication in Thailand without having to pay prohibitive medical fees. However, the World Health Organization (WHO) announced in June 2016, that Thailand has become the first Asian country to eradicate mother-to-child transmission of HIV. Its eradication is defined as a reduction in its transmission to such low levels that it no longer constitutes a public health problem.

The message of Dr Poonam Khetrapal Singh, head of the WHO for south-east Asia, is optimistic : “Thailand has demonstrated to the world that HIV can be defeated,” she said recently in an official press release. To make this a reality, she said, it is crucial that no one is left behind in the fight to end an epidemic that has claimed thousands of lives.