A plague in prostitution: HIV and AIDS in Thailand.

Religion, culture, socioeconomics, political factors, and even geography play important roles in the spread of HIV in Thailand. The author discusses these factors, emphasizing the role of Thailand's significant commercial sex trade. Politics, poverty, and geography together form much of the basis of the patterns of HIV's spread throughout Thailand. Although 80% of the Thai population lives in rural areas, the Thai government since the 1950s has invested disproportionately large amounts of resources in the urban sector at the expense of rural areas. Opportunities for economic gain and overall advancement are therefore greater in urban centers. Girls and young women of predominantly poor rural households therefore migrate to Thai cities to work in brothels. As prostitutes, they make, without education, better wages than they could working in factories. After buying what they need to accommodate their urban lifestyles, the women may send money in support of their rural-based families as well as to monasteries and temples. These latter contributions are made in keeping with Theravada Buddhism, the predominant faith, which regards female prostitutes are very low on the cosmological scale in the quest for nirvana both because they are women and they come from poor families. It is hoped that by contributing to the faith, one's karma will be improved, thus allowing return in the next lifetime as a man, preferably wealthy. There are an estimated 80,000-1,000,000 prostitutes in Thailand. Each may have sexual intercourse with up to twenty clients per day. Their clients include international tourists as well as local Thai men. At least 450,000 Thai men visit prostitutes daily, with at least 75% of Thai men having had paid sex at least once. One researcher found that 72% of the low-class prostitutes were HIV-seropositive, while another examination of a few brothels found all prostitutes to be infected. 50% of Thai men reported in a 1990 study that they never use a condom, 26% had multiple sex partners in the preceding six months, and 86% believed that there is only a small chance of contracting AIDS. This high prevalence of HIV infection among prostitutes, frequent sexual intercourse, and lack of condom use in Thailand is ideal for the continued spread of HIV throughout the population. Men from hill tribes who have sex with prostitutes and use IV drugs also help take HIV into the most remote areas of Thailand.