Warning signals and a quick response

In 1989, as evidence of a heterosexual HIV epidemic mounted, Thailand carried out a national survey of sexual behaviour. It showed that a high proportion of men had sex before and outside marriage, mostly with sex workers. The results of this survey were widely publicized; government officials and the general public were made aware that Thailand might well be headed for a major HIV epidemic.

Again, the government and society reacted quickly. The Prime Minister took direct responsibility for the National AIDS Committee, and the state decided to finance a comprehensive response. By 1996, the government was spending US$ 80 million a year on education, prevention, care and impact alleviation.

Many communities, including those living with HIV, as well as private business, contributed to the national effort. Among the most dynamic responses was that of the sex work community, which took action under pressure from state authorities. To reduce transmission in what the evidence suggested was a focal point for infection in Thailand, brothel owners and sex workers began to enforce a policy of 100% condom use. At the same time, free condoms were provided by the government for commercial sex and television and radio spots stressed that men should use condoms with prostitutes.

Thailand's efforts resulted in behavioural change, and that behavioural change can be strongly linked to a decrease in new infections.