1. HIV/AIDS Prevention and Treatment in Thailand
Kittipong Vairojanavong M.D.
Nittaya Vairojanavong M.A.
National Council for Women, Thailand

2. Avert.org commented
There are very few developing countries in the world where public policy has been effective in preventing the spreads of HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndromes) on a national scale but Thailand is an exception.

3. History First case was found in 1984
Next few years, increase in incidence among
* gay men
* sex workers
* injecting drug users
* tourists
WHO reported that Thailand had the highest infected rate of 10 folds within a few years in FIGO Congress in Montreal 20 years ago.

4. HIV/AIDS Situation in Thailand
In March 2006, Total population = 63 millions
Infected cases= 288,672,
Death cases = 81,584
In 1991, there were 143,000 new cases but in 2003, there were only 19,000 new cases
Incidence rate declines during the last 7 consecutive years
Most common among people of years of age
Male to female = 2:1
At age 15 – 19 , more among female than male

5. HIV/AIDS Prevention
No sex without protection
Condom usage is a “MUST”

6. Prevention in General Population
Ministry of Public Health initiated “ 100 percent Condom Program” for general population
Condoms were distributed free of charge, NGOs provided strong support to this program
Raised condom usage had decreased the prevalence of sexual transmitted infections dramatically

7. Detection of HIV
In 2 – 3 weeks after infected, acute retroviral syndrome occurred: fever, sore throat enlarged lymph nodes, flu like illness, viremia,. Antigenemia, and later anti-HIV antibody.
Window period is the period prior to detect antibody, may last from 8 weeks to 6 months

8. HIV Check Up Blood and serum recipient Homosexual Unprotect sex
Have sex with HIV case
Sex with drug user
Multiple sexual partners
Sexual transmitted disease patient
Drug addicted
Pregnant women

9. Diagnosis of HIV/AIDS Detection of anti-HIV antibody:
Screening test: ELISA and GPA (gelatin particle agglutination)
Confirmatory test: immunoblot (western blot) and immuno fluorescent
Antigen (p24 antigen) assay (IFA)

10. HIV/AIDS Therapy 1987 AZT (had been used since)
Drugs used in the developing countries
Anti-infective agents to prevent opportunistic infections
Palliative drugs for physical and mental discomfort such as analgesics, tranquilizer.
Antiretrovirals (ARVs): to prevent and kill HIV prior to invade immune system and prevent HIV from mother to fetus

11. HIV/AIDS Therapy
Right procedure
Continuous
Regular

12. HIV Transmission from Mother to Fetus
During pregnancy, HIV penetrates placenta to fetus. This is hard to prevent
One to two weeks prior to delivery and intra-partum period are highly sensitive period of transmission up to percentใ Prevention by cleansing birth canal with antiviral antiseptics, reduce chance of contact of maternal blood during labor
HIV from maternal milk, incidence of 20 percent

13. Prevention of Transmission from Mother to Fetus
AZT (zidovidine) therapy at 36 weeks and during labor reduces the infection down 50 percent
AZT therapy to both mother and fetus reduces infection rate from 25-30% to 9.2%
AZT plus 3TC (lamivudine) for short period to mother from 34 weeks reduces infected rate down to 2.83 %, (three times lower)

14. HIV/AIDS Therapy
No drug to cure this disease yet but there are drugs to prevent progression of the disease
Side effects of the drugs are anemia, nausea and vomiting
Vaccines are in investigational periods ad may need more than 10 years to confirm the effectiveness of the vaccine

15. GPO-VIR Local made regimen Less expensive but effective
3 in 1 combination (stavudine + lamivudine + nevirapine)

16. GPO-VIR (Government Pharmaceutical Organization)
Combination of three antiviral drugs
Stavudine (Zerit) mg.
Lamivudine (Epivin) 150 mg.
Nevirapine (Viranme) 200 mg.
Dosage One tablet twice a day
Result: increase body weight, increase CD4 T-cell, decrease occurrence, no change of lipodystrophy (study in )

18. Thank You for Your Attention