KEY POINTS• Thailand has one of the highest HIV prevalences in Asia and the Pacific, accounting for 9% of the region’s total population of people living with HIV.
• Although the epidemic is in decline, prevalence remain high among key affected groups.• Thailand is the first country to effectively eliminate mother to child transmissions, with a transmission rate of less than 2%.
• Thailand hopes to be one of the first countries to end AIDS by 2030.
However, to achieve this significantly more young people and key affected populations need to be reached.
Chiang Mai was the only city where testing had increased over time, from 22% in 2005 to 43% in 2014.28 There are a number of reasons transgender men and women are being left behind in prevention and treatment work.
Discriminatory heath systems, transphobia, family rejection and a lack of access to education and employment all discourage transgender people from seeking HIV services.29 Indeed, the 2015 UNICEF study mentioned above found only 32% of young transgender people had correct HIV knowledge.30 Within the first few years of Thailand’s epidemic, HIV prevalence among people who inject drugs (sometimes referred to as PWID) rose from 0 to 40%.
Of those people who know they are HIV positive, 75% were on treatment, 79% of whom were virally suppressed.
Globally, transgender people are the most at-risk group of sex workers, with HIV prevalence estimated to be on average nine times higher than for female sex workers and three times higher than for male sex workers.24 There are more than 75,600 transgender people living in Thailand.
For example, while the rate of new infections through injecting drug use steadily decreased between 19, the rate of new infections through male-to-male sex dramatically increased over the same period.9 Of all new infections in 2016, around 44% occurred among men who have sex with men, 10% among sex workers and their clients, and 11% among people who inject drugs, making these population groups a priority for prevention work.10 In Thailand 9.15% of men who have sex with men are living with HIV, although prevalence varies greatly depending on location.1112 For example, in Bangkok prevalence is estimated at 28.6%.13 Condom use among men who have sex with men is high, estimated at more than 82.1%.14 But, although the availability of prevention services has improved, new infections have not declined as much as intended.15 A 2015 study estimated there were 185,000 men who have sex with men living in metropolitan Bangkok, 60,000 of whom were at high risk of HIV infection.
It found that, while there are enough clinics and health personnel in Bangkok to support testing and treatment for all men who have sex with men at risk of HIV, there was limited take up of these services.
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