The prevalence of HIV infection and the knowledge of AIDS among Thai labourers at Siriraj Hospital between 1994 and 1995.

From January 1994 to December 1995, a total of 71,249 patients (37,167 in 1994 and 34.082 in 1995) attended the clinic for labourers going abroad at Siriraj Hospital for a pre-assignment physical exam and mandatory blood screen for HIV antibody Of this total, 300 tested positive for HIV antibody (0.8 per cent) in 1994 and 244 (0.7 per cent) in 1995 respectively. The largest proportion of HIV positive persons were from the upper northern provinces of Thailand, Bangkok and Samutprakran (0.8 to 3.0 per cent). Of 614 labourers who volunteered to participate in an interview on the level of knowledge about AIDS, which was conducted by a clinic nurse, 13.6 per cent of the participants accepted that they were more likely to have had sexual intercourse with female commercial sex workers or other women, rather than their wives. Sexual intercourse appears to be the most plausible mode of HIV transmission for those Thai labourers who tested HIV transmission for those Thai labourers who tested HIV –positive, as none had history of injecting drugs. Therefore it is imperative to continue efforts to promote 100 per cent condom use in commercial sex as the norm. In addition, a notification link should be established between the Ministry of Labour and Social Welfare, job placement agencies, the AIDS division and the nearest provincial medical authority, in to provide post-test counseling and follow-up on regular basis to this group of Thai labourers as those who are infected may transmit HIV to others in their home provinces.

A comparative study of tuberculin skin test reactivity between asymptomatic HIV-1 seropositive subjects and healthy volunteers.

During November 1993-October 1994 tuberculin skin test reactivity (PPD-Thai Red Cross: 0.1 ml of 10 IU) was determined among 399 asymptomatic HIV-1 positive subjects and 405 healthy volunteers, 10% (40/399) had PPD-TRC induration 0-2 mm compared with 4.2% (17/405) (p = 0.001) and 43.4% (173/399) had induration > or = 10 mm compared with 53.8% (218/405) (p = 0.003) of healthy volunteers. However, the percentage of the PPD-TRC induration 5-9 mm was similar among HIV-1 seropositive subjects and healthy volunteers as 37.6% (150/399) vs 34.8% (141/405) (p = 0.4). The mean PPD-TRC reaction of HIV-seropositive subjects were 6.4 +/- 0.9 mm vs. 11.0 +/- 0.5 mm among those with CD4 lymphocyte counts 200-299 cells/mm3 compared with those > or = 300 cells/mm3 (p < 0.001). We provide support for use of induration of > or = 5 mm of PPD-TRC skin reaction for evidence of latent infection with Mycobacterium tuberculosis as the CDC recommendation in asymptomatic HIV-seropositive subjects. Consideration of tuberculosis chemoprophylaxis should have benefit, particularly in areas where M.tuberculosis is highly prevalent such as Thailand. However, among HIV-1 seropositive carriers with negative tuberculin (PPD-TRC) skin tests, there needs to be a careful evaluation and follow-up for evidence of tuberculous infection.

Risk factors for HIV infection among Thai laborers during 1992-1993.

From June 1992 to May 1993, 39,939 Thai men attended the clinic for laborers going abroad at Siriraj Hospital in Bangkok for a pre-assignment physical exam and mandatory blood screen for HIV and syphylis. Of this total, 438 tested positive for HIV antibody (1.1%). Of these, 215 men returned for post test interview and physical exam and were compared with 1,348 men randomly selected HIV-1 seronegative men. None of the HIV-1 seropositive had a history of injecting drug use or had received blood transfusion in the past seven years. HIV-1 seropositivity was associated with the TPHA serological marker for syphylis > 1.160 (p = 0.015, odd ratio 1.8), history of urethritis (p = 0.009, odd ratio 1.92) (Table 4). This study found that HIV-1 seropositive men were mostly single, were likely to be from the rural northern provinces of Thailand or Bangkok. History of purchase of low-fee commercial sex and less condom use were significantly associated with HIV-1 seropositivity as was a history of STD in the year prior to interview. Information on HIV disease and pre-test/post test counselling is needed for Thai laborers who are applying for work abroad to countries which require HIV and syphylis screening. In this effort, the Ministry of Labor and Social Welfare, the Ministry of Public Health and the clinic for laborers going abroad should join forces to provide this service. This will serve to increase awareness and self-determination among an increasingly vulnerable segment of the population who also have the potential to spread HIV infection to their spouse and other sex partners.(ABSTRACT TRUNCATED AT 250 WORDS)

HIV infection in male patients attending a sexually transmitted disease clinic.

Three hundred and fifty-two heterosexual males, attending a sexually transmitted disease clinic at Siriraj Hospital from December 1989 to February 1991 were studied for the prevalence of HIV infection. Of these, 334 men reported prostitutes as the main source of their sexually transmitted disease. No one had received blood transfusion in the last 5 years, and there was no history of intravenous drug use, homosexuality or bisexuality. HIV antibody was found in the sera of 24 men (6.8%). HIV seropositivity was associated with serologic makers of syphilis (P < 0.05) but was not associated with present genital ulcers on physical examination or other STDs. These data indicate the high rate of female prostitutes to male transmission of HIV infection in the presence of sexually transmitted disease and confirms the relationship between syphilis and HIV infection. HIV/AIDS educational programmes and campaigns to promote condom use among prostitutes and clients are an urgent need in Thailand.

A study on socioeconomic status of the Thai employee working abroad.

Descriptive epidemiology was applied to 1,000 Thai employee proposing to work abroad, during the period of February to April, 1987. 59.1% of the workers never traveled but another 40.9% experienced at least once. Mostly 92.5%, occupied within the age-group of 22-44, while the age-range was between 19-59. The male population was six times over the female, 72.4% married. Most of the worker (40.1%) lived in the North-east, rarely came from the South (0.6%). Agriculture (50.8%) was the common occupation. The previous average income was 8,794.66 Bahts per year. 92.3% of the destination was Saudi Arabia. Janpan, Iraq, Kuwait, Barhein and Singapore were respectively less popularity. Skilled labour (37.1%) was highly required for the male but house-wife (12%) for the females. The contract signed one year (28%) and two years (66%) for the period of employment. The monthly expected average income was 7,145.20 and 6,573.86 Bahts of the salary could be sent back home. Concerning the expense required from the agency, 30,000-40,000 Bahts was the sum (51.8%). Time spent for the arrangement (50.8%) was 1-4 months. 47.4% loaned from the bank, only 24.0% had their own financial support.

The experience of rabies prophylaxis in Siriraj Hospital 1980-1987.

Twenty two hundreds and thirty five records of patients receiving rabies vaccine prophylaxis between February 1980 and October 1987 were analyzed retrospectively in order to find out the epidemiological backgrounds of animals bite victims. These patients were 1,130 males and 1097 females with the ages raged from 9 months to 87 years. Most of the patients (1,486 case, 66.40%) were under the age of 25 while the most commonly found were between 5-9 years. The injuries occurred mostly around their residential areas. The rabies vaccine prophylaxis using the suckling mouse brain vaccine (SMV), Sample vaccine and human diploid cell vaccine (HDCV) were 1,626, 266 and 343 cases respectively. Primary suture of wounds and wound cleansing were carried out in 123 patients. No serious side effect was observed subsequent to the injection of rabies vaccine. However, skin rash was observed among patients receiving SMV and Sample vaccine in 14 and 7 cases respectively.