Thailand has been quite successful at improving its economy for the last three decades. It now has an abundant workforce and the standard of living is greatly improved – 11 percent of the population lives in poverty, down from 57 percent in 1962.
But in spite of its economic strengths and a move toward universal health care, Thailand posts significant HIV transmission rates among at-risk populations, notably injecting drug users and men who have sex with men.
PSI began Thailand operations to focus on HIV prevention and opened the O-Zone Drop-In Center to promote healthier behaviors for injection drug users in Chiang Mai in 2003. The O-Zone program has measurably improved healthy behaviors among IDUs. Those who were significantly exposed to the program reduced needle sharing from 18.58 percent in 2004 to 8.8 percent in 2006 – effectively reducing the risk of the transmission for this group.
Past successes helped PSI/Thailand secure funding from The Global Fund to Fight AIDS, Tuberculosis and Malaria. A five-year (2009-2014) grant is helping fund a nationwide promotion of PSI/Thailand’s injecting drug users and transgender programs.
Thailand reduced HIV incidence in the 1990s with programs that targeted the commercial sex industry. However, risk remains high for Thai IDUs and Transgenders. PSI/Thailand provides HIV prevention products, services and communications for these vulnerable groups through the O-Zone project for IDUs and the Sisters project for Transgenders.
With support from the Global Fund to Fight AIDS, TB and Malaria, PSI Thailand, in its role as principal recipient, will support the implementation of outreach activities to IDUs through fifteen drop-in centers around Thailand. These will be managed by O-Zone and project implementing partners. PSI Thailand will also expand activities and services to Transgenders in Pattaya through its Sisters program.
Communications are tailored to promote healthy behaviors to each group. High-quality, affordable or freely-distributed products and services include:
- Water-based lubricants.
- Sterile injecting equipment.
- Voluntary counseling and testing.
- A comprehensive system of referrals for care and treatment.
PSI has a strong focus on measuring results and uses annual tracking surveys to closely monitor HIV risk behaviors among the populations it serves. Tracking surveys found that current and former IDUs and Transgenders use the O-Zone and Sisters Drop-in Centers for social support to maintain healthy behaviors, as well as to access quality health products and services.
- The Global Fund To Fight AIDS, Tuberculosis and Malaria
- Thailand government
- U.S. Agency for International Development
- United Kingdom Department for International Development
- U.S. Centers for Disease Control and Prevention
- Thai Ministry of Public Health
- Health Department of Bangkok Metropolitan Administration
- Raks Thai Foundation (CARE International)
- Malaria Testing and Treatment Markets on the Thai-Myanmar and Thai-Cambodia Borders
A 2016 outlet survey was conducted in Thailand with 2 study domains: Thai-Myanmar and Thai-Cambodia border areas. Availability of malaria blood testing was high in the public sector, but antimalarial availability was variable. Overall, over half of malaria clinics/posts and hospitals had ASMQ or DHA PPQ, CQ, PQ and malaria blood testing available, indicating moderate readiness to test for and treat both P. falciparum and P. vivax malaria. The gap in readiness in the public sector suggests that patients may need to be referred to a different facility to receive appropriate care.
- Providing Community Level Methadone Maintenance Therapy: An Evidence-Based Report on Effective and Sustaining Treatment for Opioid Substance Users
In Santikhiri, Thailand, access to health care services is a challenge. Transportation to the village is poor, different languages are spoken and the socio-economic status of the villagers is below the national average. These factors, coupled with the lack of access to health care services, has caused many to turn to illicit drugs for alleviation of pains and illnesses and, as a result, has cause many people in the community to become drug dependent.
- Santikhiri Best Practice Report
- Servicing Communities with Opioid Overdose Prevention: Lessons Learned from Thailand
- CHAMPION-IDU: Innovations, Best Practices and Lessons Learned
This report was created to document innovations, best practices and lessons learned during the the implementation of the CHAMPION-IDU project, a critical component of the national response to HIV among people who inject drugs in Thailand.
- “I’m Proud of My Courage to Test:” Improving HIV Testing and Counseling Among Transgender People in Pattaya, Thailand
In Thailand, PSI's Sisters program works to increase HIV testing and counseling among transgender women. This case study presents evidence that exposure to the program is associated with increased HIV testing in this population.
- Factors Associated with Use of Sterile Needles Among People Who Inject Drugs in Thailand
In Vietnam and Thailand, we conducted research to identify factors associated with needle and syringe sharing among PWID. The results of PSI/Thailand's research were presented at the 2013 Harm Reduction International Conference, while PSI/Vietnam presented at the 2014 International AIDS Conference:
- Using Coarsened Exact Matching to Strengthen Casual Inference for Program Evaluation: Findings From China, Laos, Thailand and Vietnam
This panel presents four applications of coarsened exact matching (CEM) used to strengthen evaluation of social marketing programs implemented by Population Services International (PSI) in Southeast Asia. As part of its strategy to improve causal inference in program evaluation, PSI research teams developed these evaluations to measure program effectiveness through cross-sectional behavioral surveys. . Reviewing examples from Vietnam, Thailand, Laos and southwestern China, the session illustrates the practical value of CEM in settings where other experimental and quasi-experimental approaches may not be possible. The Thailand, Laos and China interventions operate through models of community based outreach and service provision with transgender people and people who inject drugs whilst the Vietnam program markets specially branded clinics providing voluntary counseling and testing. The panel will highlight both the application of CEM, and how findings are being interpreted and used for HIV prevention and harm reduction programming.
- Assessing the Impact of a HIV Prevention Program Among Transgender People in Thailand Using Coarsened Exact Matching
PSI/Thailand targets transgender people with HIV prevention services through peer outreach and drop-in centers. This study was designed to evaluate the impact of the program on HIV testing and consistent condom use.
- Reducing HIV Risk among Transgender Women in Thailand: A Quasi-Experimental Evaluation of the Sisters Program
Transgender women are particularly at risk of HIV infection, but little evidence exists on effective HIV prevention strategies with this population. We evaluated whether Sisters, a peer-led program for transgender women, could reduce HIV risks in Pattaya, Thailand. The study used time-location sampling to recruit 308 transgender women in Pattaya into a behavioral survey in 2011. Coarsened exact matching was used to create statistically equivalent groups of program participants and non-participants, based on factors influencing likelihood of program participation.