ABSTRACT
This paper provides a brief history of sexually transmitted diseases (STDs) in Thailand. The presentation is divided into three main sections: the period up to the 1930s; the period from the 1930s until the end of the early 1980s; and the period from the early 1980s until the present, the so-called 'AIDS Era'. The discussion in each of these sections focuses, as far as sources permit, on the epidemiological picture, as well as describing public and official responses to these diseases. In the final part of the paper consideration is given to these findings in relation to the present situation in Thailand regarding the HIV/AIDS epidemic.
PIP: Sexually transmitted diseases (STDs) have afflicted Thais since premodern times. Medical descriptions of STDs in the 1800s addressed the link between prostitution and STDs. During 1910-1925, STD rates in Bangkok were estimated to be 75-80% of adult males. Movement of people across the borders of China and Laos contributed to the spread of STDs in the early 1900s, as it does today. In 1908, Thailand enacted a law which required all female prostitutes to undergo a regular medical examination to become registered. It also set up brothels. Policymakers wanted to prevent STD transmission from prostitutes to men. They did not address male clients' responsibility. They were not concerned with the women. This official pattern persists. Beginning in 1930, Bank Rak Hospital housed the Control Unit to Reduce Venereal Diseases. The 1908 law was still in force during 1930-1949 despite attempts to ban sex work. In 1952, the UN provided Thailand assistance for STD education for students. During 1950-1965, businessmen and government officials profited from prostitution. In 1960, Thailand passed a law banning prostitution. In the late 1960s and early to mid 1970s, US military personnel in Thailand sought prostitutes, resulting in expansion of illegal prostitution. At the same time, Thailand was promoting itself as a tourist destination. One high-profile deputy premier, banker, and businessman asked provincial governors to promote sex tourism. In the mid 1980s, STDs spread rapidly in Thailand. The first AIDS case was in 1984. In 1987, there were 8 AIDS cases and 112 HIV-positive cases, most of whom were gay males (50% foreigners). It took just a few months for about 100,000 IV drug users to be HIV infected. In one year, the HIV infection rate among prostitutes in Chiang Rai Province jumped from 1 to 37%. HIV/AIDS is expected to reach all population groups by 2000. The official response to the AIDS epidemic was first denial, then active monitoring and public education, and now increased community support for sufferers and multisectoral development programs.