SHARE has been working with the Khemarat district hospital in the fields of HIV/AIDS prevention and care for multiple groups including MSM, migrant labor, youth, community resident, and PLWHA. SHARE Thailand places great value on human resource capacity development, especially the development of group and community leaders. The goal of this approach is to increase self-reliance so that groups and communities can solve future HIV/AIDS problems without SHARE’s assistance, and to instill in community leaders a sense of ownership and responsibility for personal and community well-being.
Since the first report of HIV infection in 1984, more than one million people have been infected with HIV in Thailand. Currently, about 530,000 people are estimated to be HIV-positive in 2009, and about 1.3% of the Thai population aged 15 to 49 are infected with HIV (UNAIDS). Although the number of those infected anew is decreasing over the years, deaths due to AIDS are 28,000 in Thailand in 2009. However, current new HIV patient is 10,097 in 2011 (MoPH). The government recently started offering free anti-retroviral agents, thus changing the treatment environment for HIV-positive patients. In 2011、65% of those requiring treatments in Thailand were able to access medical care. In the areas where SHARE carries out its activities, many workers migrate to cities or to fishing areas, and a number of them return home without realizing that they were infected with HIV. There are many cases of sexual transmission between partners and vertical HIV transmissions from mother to child. Mounting problems include discrimination and prejudice against HIV-positive people, orphans and bereaved families of AIDS patients, economic instability, and difficulty getting medical care for HIV-positive people. SHARE believes that the people themselves, including the people in PLWHA, should help deal with such AIDS-related problems, and thus offers education on HIV and campaigns against HIV. We also support PLWHA in forming mutual help groups to promote communities without discrimination and prejudice, and to teach people to respect one another whether or not they are infected with HIV. When such communities are attained, we will be able to overcome the AIDS-related problems.
2008 – Present
Khemarat District (Population: 80,000), Na tan District (Population: 35,000), Pho Sai District (Population: 42,000), Kut Khaopun District (Population:40,000), Warin Chamrap District (Population: 156,000) Ubonratchathani Province, Thailand
- PLWHA (People Living With HIV/AIDS)
- MSM (Men who have Sex with Men)
- Lao Migrant Workers/Sex Workers
- AIDS Prevention/Awareness Raising Campaign for community residents
Provincial and district health offices, district hospital, district administrative office, schools, village health clinics, village health volunteers. village administrative offices, military personnel, police, village temples.
In Khemarat district, the number of people who contract STDs, including HIV, will decrease, while access to holistic care (mental, social, physical) for PLWHA and those affected by HIV/AIDS will increase.
- Holistic care and support systems at Khemarat hospital will be developed for PLWHA and those affected by HIV/AIDS in collaboration with community leaders and health related sectors.
- MSM will have increased access to STD and HIV/AIDS information and prevention tools.
- Sex workers and immigrants will have increased access to health services, basic needs, and a safer working environment.
- Community residents will have the knowledge and skills to work together towards solving and preventing HIV/AIDS related health issues in their community.
1. PLWHA (People Living With HIV/AIDS)
Our aim is to create a society where people with or without HIV/AIDS can live in harmony
After TOT training, group leaders, in cooperation with SHARE and hospitals, are able to lead monthly meetings for members of Mitrapap Rim Khong (a PLWHA Self-help Group) and their families. At the meetings, HIV-positive members are given correct knowledge about AIDS regarding ways to maintain health, especially regarding the treatments and drugs that should be used. Members can also consult with each other about their problems. Hospital staff is always present to offer health examinations and counseling, and doctors’ examinations and anti-retroviral drugs are offered after the meeting. Meetings for AIDS-affected children (those infected with HIV, AIDS orphans, children of parent(s) with HIV/AIDS) are also held regularly on a continuing basis. By playing games, children make friends and are able to talk to each other about their problems.
PLWHAs leaders support PLWHAs by home visit
Twice weekly, leaders of three PLWHA groups take the initiative to visit group members who did not attend the monthly meetings, or who were not feeling well, at their homes. Leaders measure their blood pressures and give them advice regarding their health, especially about taking anti-retroviral drugs. The leaders explain the proper steps for taking medication to family members who do not know how to take proper care of the patient infected with HIV. If HIV-positive people continue taking anti-retroviral drugs for AIDS control, they may not develop AIDS. However, it is sometimes very difficult to continue taking such drugs because of intense adverse effects and because they must keep taking drugs at predetermined times for extended periods of time. Thanks to active home visits by the leaders, in the areas where SHARE is carrying out its activities PLWHAs maintains a high ratio for the number of people who properly take their medication.
2. MSM (Men who have Sex with Men)
MSM GROUPS CONVEY AIDS INFORMATION TO COMMUNITY PEOPLE
As MSM groups are at high risk of HIV infection, the Thai Government attaches importance to the prevention of HIV infection in MSM groups. In urban areas such as Bangkok and Chiang Mai, NGOs are actively deploying anti-AIDS campaigns for MSM, but there are few MSM groups that are engaged in AIDS-related activities in smaller provinces. In the Khemarat District, there were no NGOs or MSM groups engaged in such activities.
SHARE has undertaken training for MSM group leaders so that they will be able to take the initiative in AIDS-related activities. MSMs interested in learning more about AIDS were gathered, and those that wished to involve themselves in anti-AIDS activities on a continued basis organized groups. Leaders who would foster MSM group activities with SHARE were selected to receive leadership training so that they would be able to convey their knowledge about AIDS to other MSMs and community people.
3. Lao Migrant Workers/Sex Workers
ONE SHOULD OBTAIN CORRECT INFORMATION ON SEXUALLY TRANSMITTED DISEASES INCLUDING HIV – TO LEAD HEALTHY LIFE
The Khemarat District faces the border with the Lao People’s Democratic Republic and there are about 20 Karaoke bars frequented by Thai clients in the area. Many Lao women are employed as sex workers in Karaoke bars in this district. Most do not have proper knowledge or information concerning AIDS. SHARE offers information to Lao workers and their employers regarding the prevention of infection with HIV and other STDs (sexually transmitted diseases), as well as information regarding the mechanisms of the female body. As Lao workers have little access to medical care, with cooperation from the bar managers and hospital staff, mobile clinics have been offered at Karaoke bars. Therefore, we are able to hold health examinations, blood tests and HIV antibody screenings. We shall build a system for improving migrant workers’ access to medical care in cooperation with hospitals. We plan to convey messages for prevention of HIV infection to clients as well as managers and workers at the Karaoke bars.
In northeastern Thailand, many teenagers become pregnant at early ages and are at risk of STD/HIV infection due to a lack of knowledge regarding STDs/HIV, pregnancy, and methods of prevention. More than 50% of the HIV-positive population are between 25 and 34 years old. Most HIV-positive patients use public health services and are identified as HIV-positive after experiencing symptoms of AIDS, which are estimated to occur 10 years after initial infection. It is therefore clear that youth are in danger of STD/HIV infection.
SHARE provides sex education for youth at schools and community venues so that they can obtain correct information and protect their personal health in the future. Additionally, SHARE strengthens community team work by increasing human resource capacity development in youth and community leaders, village health volunteers, etc… to build future self-reliance.
5. AIDS Prevention/Awareness Raising Campaign for community residents
At village events and on World AIDS Day when many people gather, local authorities lend a hand to anti-AIDS campaigns by cooperating with AIDS volunteer groups, HIV-positive support groups, MSM groups, and Lao migrant workers working in Karaoke bars. Some walked about the village holding banners with handwritten messages about AIDS, some distributed condoms to prevent HIV infection, and others took part in school and other events to appeal to people about the importance of HIV prevention and lessening discriminations against AIDS.