Where is the AIDS/HIV in Thailand?

I want to start off this post with a very strong disclaimer: The goal of this post is not to minimize the risks of unprotected sex in any way. The goal is to look at facts and attempt to determine what is true and what is a myth in regards to AIDS/HIV in Thailand. Wear a condom. Always!

With that out of the way, let me give you some background. I’ve been reading various websites over the years and the people constantly mention the high HIV infection rate, especially in girls involved in prostitution. At the same time, Stickman has been quoted as saying that a large number of people he knows engage in unsafe sex (I believe I remember reading he said it was close to 50%). Rumors abound that many working girls will go without a condom for an extra tip. Stick also warns that there are several girls who are well known to be HIV positive and are still working.

If all of this is true; why isn’t there an AIDS/HIV epidemic in the farang community? With the amount of sex that goes on in Patpong, Soi Cowboy, Nana, Pattaya, Patong, and so on why are there so few stories about large numbers of farang men testing positive for HIV?

Now some might claim that the Thai authorities keep it hushed up or that someone who tests HIV positive isn’t likely to broadcast their status to all their friends. But that doesn’t explain why large numbers of men aren’t simply dropping out of the Thailand scene never to be heard from again as their AIDS begins to take hold. Surely people would notice this trend and comment on it, no? Nor does it explain why US, UK, other European, and Australian health officials aren’t sounding a loud bell warning the world about a large spike in cases from tourists recently returned from Thailand.

I don’t mean to propose that people aren’t contracting HIV in Thailand. I’m just asking why the societal impacts don’t seem to match up to the risk being reported.

First off, not everything may be as it seems. Do a large number of women go with farangs without requiring a condom? I don’t think anybody is ever going to be able to do reliable stats on that but my anecdotal evidence is that I’ve met not a single go-go dancer or bar girl who will let you party without a hat. I’ll even joke around and ask how much and not a one ever went for any reasonable offer (up to 1000 baht extra – over that and I guess people will do anything for money but I doubt few regulars to the scene are shelling out that kind of cash per session). By the way, I ask them both for educational purposes and to weed out anyone who would.

Of course my evidence is anecdotal as is Stick’s and others who make this claim so the only thing we can take away from this is maybe I’m too optimistic and the others are too pessimistic and the truth lies somewhere between.

Likewise I don’t know anybody who has ever told me they like to sleep with bargirls without protection. I’m sure some of my friends have done it from time to time or might make a habit out of it but they’ve never discussed it with me. Again, I think my anecdotal evidence runs the opposite end of the spectrum from others so somewhere between our two groups of friends must be the norm.

Lastly, when we see all of these numbers published about HIV/AIDS in Thailand and especially when the numbers concern women engaged in prostitution there is no distinction made between farang prostitution and Thai prostitution which may give misleading numbers. Just due to the sex education available to farangs back home they are far, far less likely to have sex without a condom than say a Thai army conscript who is losing his virginity in a brothel. For that and many other reasons (such as better outreach programs and regular testing) I think it would be safe to assume that sex workers servicing Thai clients are much more likely to contract and spread HIV than those servicing farang customers. So when you hear numbers being thrown around like “X% of Thai sex workers are HIV positive” it doesn’t necessarily mean that that X% of girls working on Soi Cowboy or Nana are HIV positive.

For instance, according to the WHO:

However, problems remain. Infection rates among injecting drug users remain high at 20%-45% nationwide. And in rural areas, HIV infection rates among sex workers have increased. In 1997, 20% of sex workers in rural areas were HIV-positive compared with only 7% in Bangkok. To make matters worse, studies carried out in rural areas reveal that only 50% of men who visit sex workers consistently use condoms. And as risk behaviour increasingly shifts from commercial sex to unprotected casual sex, efforts will be needed to sustain reduced infection rates.

I know this is an old report but it demonstrates how using one infection rate across the entire country is flawed logic. Let’s say the combined total is 14% (since most of the population in Thailand is rural and places like Chiang Mai at one point had rates as high as 40%, I’m assuming the numbers skew to the high side). Saying you have a 14% chance of meeting an HIV positive sex worker in a brothel in Buriram is way too low and saying you have a 14% chance in Nana is double the rate for Bangkok as a whole.

Also, as mentioned before, even in the 7% Bangkok number there is no breakdown between sex workers who service Thais and farangs. I think it would be safe to assume that a Thai brothel is more likely to adopt the Thai casualness towards requiring condoms than would be a farang owned bar on Soi Cowboy. And seeing as that there are more sex workers working in the Thai sex industry than in the farang sex industry, again, assuming a 7% infection rate for your average Nana go-go is likely to be a huge overestimate.

And on top of all that, there’s the tendency to automatically assume a sex worker is a female. There is a vibrant transgender and gay prostitution industry in Bangkok as well. Unfortunately, most educational and awareness programs are aimed at women so, again, I think one would have to assume that HIV rates would run higher in the gay and transgender sex industry which would inflate the Bangkok numbers (the number of gay brothels outside of Bangkok is assumed to be very small compared to within Bangkok) as they too are sex workers.

We may never know the actual truth about what the infection rate is in farang sex venues. Nor is it likely that we will ever hear any sort of accurate numbers regarding how many farangs are contracting HIV from sleeping with Thai prostitutes. Actually we might if there was an alarming trend but barring that the NGOs and other groups who gather this type of data would be doing Thailand a disservice if they were to indicate that the chance of contracting HIV in farang oriented sex venues was relatively low. Better to report the overall number so as to put enough scare into potential customers that they either think twice about going with a prostitute or concerned enough to insist on using a condom.

Again, I would like to close by saying that none of this is meant to downplay the likelihood or the consequences of contracting HIV. If anything it is more for the person who normally practices safe sex and has a condom break during intercourse with a go-go dancer and is wondering what the real chances of him contracting HIV might be without all of the hype and also without all the crazy conspiracy theories that purport everything from you can’t catch HIV from heterosexual sex to there being no link between HIV and AIDS. After reading way too many threads and websites with people giving inaccurate data on both sides of the argument I simply wanted to take a neutral look at the subject and invite people who may have found better data sources than I was able to to comment and better educate people on this important topic.

Wear a condom. Always!

73 thoughts on “Where is the AIDS/HIV in Thailand?

  • July 9, 2012 at 4:48 pm
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    you worry because you dont know the difference between fuck and make love….

  • July 9, 2012 at 4:51 pm
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    I have never been sick in my life, dont drink and dont smoke, i run 20 kms or more almost everyday, i swim till 5 kms and i play tennis also when very hot and believe me, make love make me feel every year one year younger instead of older….but better condom and stop worry
    at my age i dont worry because i have always been healthy, not because old….enjoy and stop gossip||||||

  • July 9, 2012 at 4:57 pm
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    the real danger in thailand is if you marry a thai woman…..1000 times more dangerous than aids and you dont need a strong condom, but a very strong atm card…..not my problem hehehe

  • July 9, 2012 at 9:29 pm
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    I hear the ‘locally available’ condoms are a bit on the small side for European men and thus prone to bursting. Also if the girl is a bit ‘dry’ from lack of enthusiasm this can also cause the rubber to split. Maybe a splodge of KY jelly before you get started might be a good idea?

    Just thinking…….

  • July 9, 2012 at 9:33 pm
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    YES MAY BE BUY CONDOM FROM BRIDGSTONE, UNBREAKABLE…ARE USED ALSO BY CAR AT FORMULA ONE…..

    BESIDES IF YOU ARE UNDER 60, THAILAND IS NOT THE RIGHT COUNTRY FOR YOU….BEST AGE FOR YOUN THAI WOMEN ARE MEN OVER 80……

  • July 10, 2012 at 1:12 am
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    Thats it then ant… Bridgestone it is! Good grip even in the wet, lots of screeching and past the finishing in no time at all. Sounds good to me. 😉

  • July 10, 2012 at 4:51 am
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    make love soft and gently and no condom will break, may be you will break her heart

  • August 8, 2012 at 4:16 am
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    Thailand is for 2 weeks, HIV is for life, it’s not worth, remember the virus can remain undecetable for up to 3 months, that’s a long wait for one night of passion.

  • August 10, 2012 at 7:37 pm
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    i think i will play lottery then, because last time i had sex in thailand was last november and before that i was with over 50 thai women and now after over 6 month i took another blood test and was …..happy results hehehe
    but I don’t want to challenge my luck and in future…no sex in Thailand, luck could decid to abbandon me…

  • August 17, 2012 at 2:29 pm
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    Thailand sounds like a great place. But I do have concern about farangs contracting HIV in Thailand. I’ve been living with HIV for sometime now and although it doesn’t bother me as much as it once did; I’ve grown to concern myself with the stigma and disassociation of those living with HIV, by those who are not infected. Anyone living with HIV is a victim, someone infected us. Therefore, cease the ignorance and use a condom.

    In the meantime, your can find my books HIV in Thailand and Let’s Talk About HIV on http://bangkokbooks.com & http://hivdisclosuremission.org

    B.L.Fowler

  • September 10, 2012 at 2:27 am
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    I wouldn’t worry about the subtype E fear mongering in posts here.

    This is a 2009 comment from one of the world’s foremost STI experts:

    “That this HIV subtype is more transmissible through heterosexual exposure is controversial, supported by some studies and not confirmed others. Little or no research on this concept has been reported in the past 10 years. If some HIV strains are more transmissible sexually than others, the difference is likely small and not particularly relevant to individual risk assessment. It is much more important that vaginal sex is an inherently inefficient transmission mechansism and that HIV is now uncommon in most Thai sex workers.”

    “Avert.org, an HIV prevention organization in the UK, has an excellent summary of HIV subtypes and their significance. See http://www.avert.org/hiv-types.htm.”

    “…Although HIV was once common in Thai sex workers, it’s much less frequent than 15 years ago, largely due to excellent government sponsored HIV prevention programs in that country…My understanding is that well under 5% of Thai sex workers have HIV, probably less than 1% in most parts of the country.

    http://www.medhelp.org/posts/HIV—Prevention/Unprotected-sex-with-thai-sex-worker/show/1079780

    http://www.washington.edu/news/archive/id/56166

  • September 13, 2012 at 11:34 am
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    yes thai women love sex and do it very easy and superficial naively, because most of them dont even think about condom and farangs in that moment are too excited to use it if not find it in that moment,,,,,
    I think we should not challange our luck and think seriously about it…..
    on my opinion best would be to have only one partner and have both hiv test and if ok, enjoy sex only with her….
    but to have sex with only one woman in thailand is like to go to oktoberfest in munich.germany and drink only one beer…….

  • September 14, 2012 at 4:13 am
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    I don’t waste my money on go-go girls, but most of the Pattaya bargirls and even more of the beach road girls will happily fuck without a condom

  • September 14, 2012 at 5:11 pm
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    yes i agree, most of thai women love sex more than farangs and they also get paid to have fun…..
    at least 90 per cent of them dont use condom according to my experience and dont worry a little bit…..I dont know what kind of prevention the government has taken…i think nothing….
    thai women married with old farangs who is not so active anymore, love sez very much and have it with other thai men and farangs are too naive to discover, but if a farang only look at nice girl while walking, his 30 years younger wife, play jalous and the problems is that her farang husband believe it

  • September 14, 2012 at 6:10 pm
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    So having sex with a bar girl/prostitute without using a condom is ‘cool’? It beggars belief and simply perpetuates the HIV problem throughout the world.

    Laughable that we in a civilised society condemn the African nations for being ‘ignorant’ about the spread of AIDS?

  • September 14, 2012 at 8:59 pm
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    yes very very sad about what manny has written.
    But not only aids is a problem in africa where we should be ashamed….look how much food we trow away in western world and we complain about economy getting worse, but we throw hundred of tons of food every year…
    also in Thailand is the same , even worse about eat and throw away half of food like many clients in restaurants do…..
    I have been in at least 100 governments partyes -so boring- in thailand and so much food, really very very much food is brought- also beers and whiskeys- and really at least half of it will go to recicler…..-but alchol not-
    with full stomach and cheerfully drunk is very difficult to think about poor africans starving all life…
    besides, ask most of thai people where africa is, they really dont know….i asked atleast 20 teachers at a school near nong khai of where Brazil is and believe me, none knew….but one of them seemed to be more intelligent than the other and told me: …Brazil is far…..

  • September 24, 2012 at 1:22 am
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    UK….1000 to 1 in thailand drops to 100 to 1 still good odds if ur a betting man or woman!!

  • April 19, 2013 at 4:16 pm
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    does just a single intercourse (just a single thrust) make you infected?

  • March 31, 2014 at 10:44 pm
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    I just had an unprotected sex with a hooker in thailand,it cant be called a 1 nught stand or something,but yeah I used condom…. But after I while I made my biggest mistake in my entire life for I took it off and fucked her,the hooker complained,but I came to my senses and stopped immediately. That was 45mins average that I was Inside her without condom. Now I am paranoid not sleeping well,m anticipating the symptoms to appear,it happened march 21,2014,and now its 10days after that. Been feeling weak and loss of appetite,had night sweats but not the one that soaks the bed sheets,no fever though. And they say symptoms start at 2 to 4 weeks exposure. So i am anticipating it. Am I infected? I am a seaman and that was my first time aside from my wife. Just one sexual act.

  • March 31, 2014 at 10:48 pm
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    Sorry I mean one night stand,i was in a hurry at that time and I need to go for my night watch,this are the girls who board the vessels anchored in kosichang,and the mamasan said she’s clean. I have my doubts though. But then again.. Her sister told me she’s clean. Am I just being paranoid?

  • August 18, 2014 at 3:04 am
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    I alwaz wear two condoms for xtra protection..

  • August 28, 2016 at 10:32 pm
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    Condom does not protect you from hiv, only reduce 80% the probabilities. If you look the updated table of risks , in spanish, sorry
    http://gtt-vih.org/actualizate/la_noticia_del_dia/12-06-14
    Will see the risk is low. Does not obssesionate Reonjuanico, keep calm. You can make a test in 28 days. 90 % of persons can detect on that time. Then another test at 3 months, and then at 6 months.
    But including taking all the precautions, there is no guarranty of safe sex. You have more probabilities to have an accident of car. Just decide nivel of risk you can accept, and relax

  • May 4, 2017 at 1:23 pm
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    I want to give people on here a bit of advice: I have lived in both China and Thailand. Sometimes ( not often ) I had unprotected sex with Chinese women. Two my GF’s , a one night stand, and with a prostitute. After unprotected sex when I was a bit drunk with a Chinese hooker I did not have sex with anyone for six weeks, then STD tests, negative for syphilis, HIV, Hep A and B.

    I still often visit Pattaya. One time I picked up a girl at LK Metro, was using a condom, it burst. Three months later, STD tests, and HIV negative. Also was drunk about six weeks ago, had sex without condom
    with a bar girl. Will get tested next week, after seven weeks. Not really panicking, but a bit anxious.
    Usually I always wear a condom for straight sex. For oral I think the risk is low, so I don’t bother with protection getting or receiving oral, but use Listerene straight after if you do oral on a Thai girl, and gargle it. It is in most decent hotels in Pattaya.

    If your HIV test is negative after six weeks it’s extremely unlikely you are infected. Still, better to go back a month later and have another test to make sure, but you should wait at least five weeks of “window” before a first test.

    The biggest problem is not accidents when drunk or burst condoms, it guys who deliberately have sex with Asian bar girls bareback multiple times: those people who deliberately NEVER use condoms.

    So, yes, always try to remember to use condoms, and don’t get too drunk, that’s when shit happens, accidents, forget, etc.

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