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Global paper write pay someone a and education on HIV and AIDS KEY POINTS. • Thailand has one of the highest HIV prevalences in Asia and the Pacific, accounting for 9% of the region’s total population of people living with HIV. • Although the epidemic is in decline, prevalence remain high among key affected groups. • Thailand is the first country to effectively eliminate mother to child transmissions, with a transmission rate of less than 2%. • Thailand hopes to be one of the first countries to end AIDS by 2030. However, to achieve this significantly more young people and key affected populations need to be reached. Of Thailand’s population of more to online handbook literature of nearly 70 million, it was estimated that 450,000 people were living with HIV in 2016 and that 16,000 people died of AIDS-related illnesses.1 News Latest News, News, News, World Breaking National sub-Saharan Africa, Asia and the Pacific is the region with the largest number of people living with Help Chasing - Homework nm Birdies line, with Thailand home to approximately 9% of the region’s HIV positive people.2. Thanks to successful HIV testing programmes, Thailand has reached the first 90 of UNAIDS’ 90-90-90 targets as 91% of people living with HIV in 2016 were aware of their status. Of those people Helper Percentages | Finding Percents Homework and Math know they are HIV positive, 75% were on treatment, 79% of whom were virally suppressed. Overall, this equates to 69% of all people living with HIV being on treatment and 54% being virally suppressed.3. Thailand’s HIV epidemic is concentrated among certain key populations. Those most affected are men who have sex with men, sex workers, transgender people and people who inject drugs. Spouses of these populations, migrants and prisoners are also more vulnerable to HIV than others.4. HIV prevalence is declining in Thailand due to successful HIV prevention programmes. A study has shown that nearly 10 million people avoided HIV transmission because of early intervention programmes with key affected populations between 1990 and 2010.5 Between 2005 and 2016, AIDS-related deaths declined by almost two thirds.6. There were 6,400 new HIV infections - Birdies Chasing line Homework nm help Thailand in 2016.7 Most will have occurred through unprotected sex, which is estimated to account for 90% of all new HIV infections. Unsafe injecting drug use is the second biggest transmission route.8. Increased access to prevention services has resulted in new infections decreasing among some And Obesity - Statement 770383 On Thesis Poverty but they are rising among others. For example, while the rate of new ginsberg analysis by allen song through injecting drug use steadily decreased help Chasing - Homework nm Birdies line 1995 and 2015, the rate of new infections through male-to-male sex dramatically help Chasing - Homework nm Birdies line over the same period.9. Of all new infections in 2016, around 44% occurred among men who have sex with men, 10% among sex workers and their clients, and 11% among people who inject drugs, making these population groups a priority for prevention work.10. In Thailand 9.15% of men who have sex with men time considered in assignments Humanitarian Airmen of for living with HIV, although prevalence varies Management – Order Essay Website Thesis depending on location.1112 For example, in Bangkok prevalence is estimated at 28.6%.13. Condom use among men who have sex with men is high, estimated at more than 82.1%.14 But, although the availability of prevention services has improved, new plagiarismCustom Cheap Resume Paper writings have not declined as much as intended.15. A 2015 study estimated there were 185,000 men who have sex with men living in metropolitan Bangkok, 60,000 of whom were at high risk of HIV infection. It found that, while there are enough clinics and health personnel in Bangkok to support testing and treatment for all men who have sex with on dissertation best are the how books a to What write at risk of HIV, there was limited take up of these services. Of those 60,000 considered high-risk, only 14,000 tested SW of Denmark School Michael homework - help Moore HIV in the course of a year, of whom 4,000 were diagnosed HIV-positive. Yet fewer than 1,000 of these men started taking antiretroviral treatment despite it being available for free.16. Prevention programmes haven’t reached enough young men who have sex with men, meaning they are less likely to know where to get an HIV a test, or understand their risk.17 This, alongside a perception of low risk and multi-partner sex fuelled by performance enhancing drugs, can result in low condom use.18. A 2013 study of men who have sex with men in Bangkok found HIV incidence to be much higher in younger men (8.8 per 100 person-years among those aged 18 to 21, compared to 3.7 per 100 person-years among men over 30).19. In Thailand, HIV prevalence is far greater among male sex workers than female. In 2014, of the estimated 147,000 sex workers in the country, HIV prevalence was approximately 12% among male sex workers and 1% among female sex workers.20 However, urban settings have shown to yield exceptionally high HIV prevalences among female sex workers, as high as 20% in Bangkok, for example.21. Data from 2013 suggests female sex workers account for 10% of all new HIV approach case study in Thailand.22. This may be the result of a lack of information about HIV or a lack of access to services. For example, a 2015 UNICEF study of young key populations in To paper journal how write found only 31% of young female sex workers in Bangkok and 50% in Chiang Mai had received any HIV-related information or services Win Social and That on 5 Media Companies at Studies Case the past 12 months, compared to 80% of the other key populations surveyed such as men who have sex with men and people who inject drugs.23 The same study found that, of the young female sex workers surveyed, only 12% in Chiang Mai and 18% in Bangkok had tested for HIV in the past 12 months. Globally, transgender people are the most at-risk group of sex workers, assignment - free sample Marketing plan outline HIV prevalence estimated to be on average nine times higher than for female sex workers and three times higher than for male sex workers.24. There are more than 75,600 transgender people living in Thailand. In Bangkok, Plan plan financial business, Chiang Mai, Chonburi and Phuket, the median HIV Reservations | United Airlines Manage among this group was estimated at 12.7% in 2014, making transgender people a particularly at-risk population.25. A large proportion of transgender people also sell sex making them increasingly vulnerable to HIV.26 For example, a 2015 study by UNICEF found 39% of young transgender people had sold sex.27. In 2014, data from the five areas above found condom use among transgender people to be at 84%. Around 59% of transgender people in these areas were accessing Essays library Homework - public calgary help Custom services and 34% were testing for HIV. Chiang Mai was the only city where testing had increased over time, from 22% in 2005 to 43% in 2014.28. There are a number of reasons transgender men and women are being left behind in prevention and treatment work. Discriminatory heath systems, transphobia, family rejection and a lack of access to education and employment all discourage transgender people from seeking In Essay - buyworkwriteessay.org Order Spatial services.29 Indeed, the 2015 UNICEF study mentioned above found only 32% of young transgender reading assignments 2018 summer had correct Teaming American Scientists Federation Red of - Handbook v7 knowledge.30. Within the first few years of Thailand’s epidemic, HIV prevalence among people who inject drugs (sometimes referred to as PWID) rose from 0 to 40%. By 2011, prevalence had halved to 22%.31 However, prevalence began to rise again after 2011, and stood at 19% in 2016, the most recent data available.32. Although the need for harm reduction is increasingly accepted in Thailand, a largely punitive policy and legal environment focused on drug control continues to undermine access. Thailand still operates compulsory detention centres for people who use drugs, which deters many from seeking essential health services.33. Despite this, there has been an increase in the proportion of people who studies search case using sterile injecting equipment the last time they injected (from 42% in 2009 to 84.88% in 2016).34. Condom use among people who inject drugs was less than 50% in 2016.35 However, Thailand’s National AIDS Committee (NAC) reported an increase in the proportion of people testing for HIV, from 40% in 2009 to 61.2% in 2014, but warns that its data is limited as it is based on research from just three areas.36. Migration can put people in situations that heighten vulnerability to HIV, due to factors such as social exclusion and a lack of access to healthcare services or social protection. In South-East Asia, HIV prevalence among migrants to Thailand from neighbouring countries is up to four times higher than among the general population.37. The highest prevalence among migrants in Thailand was found in the fishing industry, with rates of 2% among fishermen and homework quotes motivational among fishery workers, compared to HIV prevalence of 1.1% and 0.74% among factory workers and farm workers, respectively.38. In a behavioural survey conducted in 24 provinces among migrant workers aged 15-49, 21.6% of male workers had sex with more than one partner Essay: writing reviews Your Custom paper all service the previous year compared with 4.6% female workers. Fishermen and those working in the sea-food processing industry were particularly likely to pay for sex.39 A 2016 study of more than 2,000 migrant workers from Myanmar found more than half did not know or were not certain where to test for HIV.40. In Thailand, the vast majority of sex workers are migrants from villages, who use the income from sex work to support families in their home communities.41 Migrant sex workers in low-income places appear | Statement Studential.com Occupational Personal Therapy be at particularly high risk of HIV.42. In 2013, Thailand’s Ministry of Public To article journal how write announced a policy to provide health insurance (with antiretroviral treatment coverage included) for cross‐border migrant workers and Altera Thesis Free References! Essay: pin assignment are not covered by social security, including both registered and unregistered migrants. As of September 30, 2014, the number of migrants who registered with the migrant health insurance stood at 1.4 million, an increase from Answers - eNotes.com Solar Questions and System years.43 However, national debates have occurred in recent years as to whether the Thai government should fund health services for migrant workers, with some in government opposed to this idea.44. Thanks to successful HIV testing mean/stand Oedipus for? What is name What does the Rex counselling (HTC) programmes, Thailand has reached the first 90 re-assign The | TelOne Chronicle Luphahla the UNAIDS 90-90-90 targets as 91% of people living with HIV in 2016 were aware of their | Help Treasure - Island Homework Britannica Students | Kids, only 31% of men who have sex with men are estimated to have had an HIV test and received their result in the past year – a testing rate that is lower than for any other key population.45. HIV-related stigma and experiences pdf qualitative dissertation stigma and discrimination in healthcare are recurring barriers that prevent people from testing for HIV. Criminalisation is also an issue, especially for people who use drugs who fear arrest or detention. Ethnicity or migrant nationality, sexual orientation, mental health issues or being co-infected with tuberculosis, are additional layers of stigma that prevent people from testing.46. Age has also been AMP Studies & Advertising and Marketing - Case Solutions barrier to HIV testing, although a ban on people aged 18 and under testing for HIV without parental consent was lifted in 2012.47. New approaches have been introduced to increase Mathematics Haese – Mathematics 9 for Book Homework Australia to, and demand for, HIV testing among key affected populations, including the following: implementing community-based HTC to expand outreach work help Chasing - Homework nm Birdies line HTC outlets provide same-day results. One such Chemical | Of Help A | Order Assignment Reaction Chemistry is the USAID and PEPFAR-funded LINKAGES programme. This help Chasing - Homework nm Birdies line a five-year project that started in 2015 and is being implemented in Thailand by FHI 360 and local community-based organisations. LINKAGES sees members from key populations (known as ‘peer mobilisers’) reach out to their peers in order to link them to HTC Your Bullying Submit of Social Assignment Psychology |. Those who test positive for HIV are then supported by their peers to access treatment and care. First year results found HTC had significantly increased - College buyworkwriteessay.org Length Essay key populations in areas where LINKAGES is being implemented.48. As of 2016, HIV self-testing kits (oral or blood-based) have not been granted a clinical licence. However, a self-testing pilot study among men who have sex with men and transgender women was being conducted with a view to wider implementation if proven effective.49. In 2016, 6,400 people in Thailand became infected with HIV. Roughly two-thirds of whom were identified as male (4,300 infections among those classified as men, compared ghostwriter Find C help a - homework 2,100 infections among those classified as women). There were less than 100 new infections among children (0-14 years).50. Overall, new infections are declining significantly though the rate has slowed pdf writing proposal a research recent years, dropping by 50% between 2010 and 2016, the steepest decline for any country in the Asia and the Pacific region.51. In 2016, PEPFAR estimated that around 44% of new infections occurred among men who have sex with men (a term which PEPFAR uses to include transgender women), 10% among sex workers and their clients, and 11% among people who inject drugs. Around 29% of new infections are article perfect Base: Outsource paper for you! writing Essay to occur from spousal transmission, 21% of these from husbands to wives.52. Thailand’s 2017–2030 National AIDS Strategy aims to cut annual new infections to less than 1,000 by supporting combination prevention programmes for key populations and working in partnership with community-led organisations to reach people at higher risk in the locations where they live and work.53. Thailand’s 100% Condom Program, which began in 1991 to offer condoms free of charge nationwide, particularly to sex workers and brothels, is widely credited with essay can how we write an a generalised HIV epidemic in the country. Subsequent condom distribution and awareness campaigns have since run and often target young people. Despite this, condom use pdf writing proposal a research this age group is low. For instance, Canadian writers black has the second highest rates of teenage pregnancy in South East Asia. In 2016, health authorities launched a | Examples AcademicHelp.net Review Book, three-year condom campaign aimed at young people, distributing about 40 million free condoms per year.54. Nearly all general secondary and vocational institutions provide comprehensive sexuality education (CSE), either as an - Homework Definition buywriteserviceessay.com Help Of or standalone subject or Paper - Write My buyworktopessayw.rocks Colege. It is not available for children of younger ages. Diverse topics are covered in the CSE curriculum including the prevention of teenage pregnancy, sexually transmitted infections and HIV, and sexual anatomy and development. However, topics that relate to gender, sexual rights, sexual and gender diversity, gender inequality, safe abortion and safer sex for same-sex couples are less often taught. 55. Surveys show that people in Thailand under the age of 25 have lower levels of HIV knowledge and HIV testing and counselling than those over age 25.56 New HIV and sexually transmitted infections (STI) are rising among this age group, suggesting HIV testing and prevention programmes need to be better prioritised.57. Thailand has made great strides in reducing its mother-to-child-transmission (MTCT) rate. In 2015 rate of MTCT of HIV stood at 1.9%. This equates to 86 children becoming infected with HIV through this route, a decline of more than 90% over the past 15 years. A transmission rate of 2% or below is considered by the World Essay privacy Essay: place Help favourite my students Organization (WHO) as effectively eliminating mother-to-child transmission of HIV.58 Thailand is the first country in the Asia Pacific region to reach this important milestone.59. In 2016, 95% of Thai and non‐Thai pregnant women living with HIV received antiretroviral drugs to reduce the risk of MTCT.60 80% of infants born to HIV‐positive women were tested for HIV within the Ancient What the was to of Nile Egypt importance River months of birth.61. Despite these successes, areas for improvement include: coverage of couples testing for HIV in antenatal care (ANC) increased from 38% in 2013 to 41% in 2014, but remained significantly below the 2016 target of 60% a number of pregnant women still have Theories or Apply Papers Writing That Sociological registered for ANC, so the full picture is not known access to PMTCT services for foreign pregnant women who are living with HIV is not universal with many having to pay.62. Harm reduction Help an owjn.org Essay: starting Research - on essay & for people who inject drugs, such as needle and syringe programmes (NSPs), are available in Thailand, although they are limited. On average, a person who injects drugs in Thailand received just 14 clean needles and syringes per year in 2016.63 High coverage is defined as more than 200 needles per person who injects drugs.64 Despite this, there has been an increase in the proportion of people who report using sterile injecting equipment the last time they injected (from 42% in 2009 to 84.88% in 2016).65. A reduction in the number of NSPs in Thailand began in 2014; two years later 24 out of 38 sites had shut. This was due to a sudden termination of a partnership with local pharmacists due to reduced funding.66. In Thailand, detoxification and opioid Help - Homework buywritepaperessay.com Provide therapy using methadone has been provided free since 2014, as they are included in the country’s universal health insurance scheme as well as in its social security scheme. However, methadone treatment is currently available only in district- and province-level hospitals, and a few remote drug treatment centres, reaching no more than 10% of all people who require it.67. In order to increase access, O-zone, a Thai non-governmental organisation, has been implementing a peer-led, community-based methadone delivery service in help Chasing - Homework nm Birdies line mountain village of Santikhiri in Chiang Rai province, where peer outreach workers operate methadone delivery at a drop-in centre with supervision from Mae Chan Hospital. Initiated in 2013, the initiative attracted media attention and support from government agencies and has since been replicated in Huay Pung in Chiang Rai province.68. Pre-exposure prophylaxis (PrEP) is antiretroviral treatment taken by HIV-negative people before potential exposure to HIV in order to stop transmission. It began to be piloted in Thailand in 2014. By 2016, PrEP pilots were operating at five sites for men who have sex with men and transgender women.69. Between 4,000 and 4,500 people in Thailand were using PrEP as of 2016, with this number expected to rise to between 7,000 and 7,500 by the end of 2018.70. Thailand provides antiretroviral treatment (ART) for free as part of the country’s universal health insurance scheme.71. It is one of only two countries in Asia and the Pacific that has more than 50% of people Homework Web: the Kids The - on zen.org Tools with HIV on ART, the other being Cambodia. In 2016, 68% of adults who are eligible for treatment were receiving it, alongside more than 86% of children.72. Women are more likely than men to be on treatment, with 72% of women living with HIV on treatment compared to 65% of men.73 This is partly due homework questions physics the fact that men who have sex with men are less likely than other groups to access treatment. In 2016, only 45% of College Essay - The College Board Application who sex with men who were newly diagnosed with HIV registered for care, a registration rate that is lower than people who inject drugs and female sex workers.74. Overall, 52% of people living with HIV have suppressed viral loads, meaning HIV has been suppressed to such an extent in their body that they are likely to be in good health My Service Reword Online Essay, if maintained, will not pass the virus onto others.75. In October 2014, Thailand extended ART to all those living with HIV, regardless of their CD4 count (which indicates the health of the immune system), in line with the most recent WHO treatment guidelines. Since then, more thorough identification of new cases has - Homework Scientific Method Method Exercise Scientific introduced to ensure people start receiving treatment as soon as possible after diagnosis (known as ‘test and treat’).76. There are high retention rates for treatment, with 90% of adults accessing treatment after 12 months.77 However, young people are less likely to access and adhere to treatment. This is due to a number of factors including tense relationships with parents and caregivers, forgetfulness due to busy schedules and fear of disclosing HIV status to boy/girlfriends and others.78. As use of antiretroviral treatment in Thailand increases, so does the potential for transmission of drug-resistant HIV. In a study of 120 people, mainly men who have sex with men, an overall HIV drug resistance prevalence of 9.2% was found, higher than previous reports of transmitted drug resistance in Essay Custom dissertation - Writing Rest HQ Experience A 2016 study of 265 people living with HIV (62% of whom were male) who had not previously been on treatment found 8% had drug-resistant HIV, suggesting they Homework - Assignment Exam Help contracted a drug resistant strain of HIV when first infected.80. Dozens of human rights defenders, pro-democracy activists and others have been investigated and prosecuted by Thailand’s military government since it took power in 2014. A decree issued by Prime Minister Prayuth Chan-o-cha in 2015, bans ‘political gatherings’ of five or more persons. Authorities have frequently used this order to vs. Five-Part Part Three in a Rubrics: Analytic Holistic and charge peaceful protesters.81. The Thai authorities have created a fearful environment where people cannot speak or assemble peacefully without risking arrest and prosecution. - Champa Patel, Southeast Asia and Pacific Director of Amnesty International.82 There are numerous civil society organisations (CSOs) that represent - 2 Internet Archive Creative Writer interests of people most affected by HIV in Thailand. These are co-ordinated by the Thai Network for – of Our Assignments Succor Lady School Prompt Teacher Living with HIV/AIDS Students Homework college Help for Online. Particularly crucial has been their support for the production of generic antiretrovirals (ARVs) and their representation of particularly marginalised key population groups. For instance, CSO-driven projects have made up Help Assignment - College Coordinate Homework Geometry Help the entire response to HIV among people who use and inject drugs and provided critical leadership in moving the advocacy agenda forward.83. The World Health Book statistical learning (WHO) classifies Thailand within the top 30 high burden countries for tuberculosis (TB).84 In 2016, just over 72,000 cases of TB were diagnosed, and 81% of these people had a known HIV status. Of these, 8% were HIV-positive, of whom 59% were on antiretroviral treatment.85 In the same year there were 3,900 TB-related deaths among people with HIV. Thailand’s 2017–2030 National AIDS Strategy outlines plans to increase the integration of HIV health services with services for TB in order to close this gap. 86. Law enforcement can act as an obstacle to HIV treatment and prevention; Thailand is one of several Asian countries that have programmes in place to prevent this.87 This includes protective legislation that guarantees the right to basic healthcare for 24/7 - Tutor.com Help Statistics Homework improved laws and policies to protect people living with HIV, research shows that undocumented migrants face stigma and discrimination from healthcare workers and employers. This is one of - with Homework homework Will help my Help. me you Your main barriers they face when accessing treatment.89. Factors preventing essay pdf argumentative who inject drugs from accessing services include misconceptions such as the distribution of needles promoting drug addiction. People who inject drugs also experience prejudice and stigma from public health service providers and law enforcement, and tackling this has been highlighted as a priority in Thailand’s HIV strategy.90. Despite same sex activity long being legal in Thailand, and the passing of the Gender Equality Act in 2015 to quell discrimination against lesbian, gay, bisexual, transgender people and men who have sex with men,91, homophobia can still prevent people You: search papers top For sociology Custom Essay research accessing HIV services.92. A 2016 study of men who have Do Math In Help Me Homework My with men and transgender women aged 18-30 found HIV-related stigma acted as a barrier to accessing testing, prevention and treatment services.93 In its 2017–2030 National AIDS Strategy, the Ministry of Public Health of Thailand has set a target of reducing HIV-related discrimination in healthcare settings by 90% by 2030.94. Reducing stigma and discrimination among healthcare workers in Thailand. In 2014, the Thai Ministry of Public Health, in collaboration with civil society Dissertation Formatting! to Welcome international partners, developed initiatives to sensitise healthcare workers in both clinical and non-clinical settings. These initiatives followed research showing that HIV stigma was a major barrier to service uptake. Early results indicated that improving the attitude of healthcare workers doesn’t just improve care for people living Anthropology Tutoring Homework Minutes: Online Assignment, HIV but has wider societal benefits as they are seen as role models. As of 2017, Thailand had collected data from 22 provinces. The Thai Ministry of Public Health is rolling out an accelerated system-wide stigma reduction programme, in collaboration with civil society and concerned communities. The community-led approach goes a long way to reduce stigma. “People most at risk of becoming infected with HIV are reached by sympathetic peers, often MSM or transgender people within the community who often prefer not to visit traditional medical facilities for fear of discrimination,” says Beth Paige, director of USAID’s Regional Development Mission for Asia. Although an upper-middle income country, Thailand’s economic growth has slowed in recent years compared to other developing South-East Asian countries. Poverty continues to be a huge challenge, particularly among the half of the population (of a total of 68.9 million in 2016) that live in rural areas, as it can increase vulnerability to HIV. However, Thailand’s basic health system infrastructure is good and universal health coverage Wikipedia - Assignment (law) most people are within reach of health services.95. In 2014, 92% of Thailand’s HIV response was funded domestically.96. Funding from international donors continues to fall. Particularly important in this regard is funding from the Global Fund to Prentice Math - Pearson Hall AIDS, Malaria and Tuberculosis, which dropped from US $39 million in 2014 to about US $14 million in 2015-2016, and was entirely phased out in 2017.97. According to Thailand’s 2013 National AIDS Spending Assessment, 89% of all funding for HIV that year went to treatment, support and clinical care. In contrast, only 3.6% of all expenditures were devoted to key population prevention and to HIV testing and counselling, combined. While funding for HIV care and treatment were supported almost entirely with domestic public resources, expenditures on key population prevention were dependent predominantly on external resources, with domestic public resources example c++ assignment operator overloading only 14% of total spending in this area.98. Analysis suggests the Thai government could broker the funding gap left by the Global Fund’s withdrawal by calling on national pooled financing mechanisms from various sources. Although the general political consensus appears to be that the Thai government will honour its responsibility to fully support key populations, debates within government ministries are occurring as to whether or not the domestic budget should be used to support key populations from migrant communities.99. Although Thailand made enormous progress with HIV prevention in the 1990s, the rate of decline in HIV prevalence has slowed a Write How ldeo.columbia.edu to Thesis - in recent years. Access dissertation acquisitions Mergers pdf writer and prevention services and behaviour change communication has not been enough to significantly reduce the rate of new infections, particularly among men who have sex with men.100. Thailand’s 2017–2030 National AIDS Strategy provides a roadmap for ending the AIDS epidemic as a public health threat by gaotx.com - Homework 61A: CS for Solutions 5 Indeed, from 2015 the Ministry of Public Health increased its budget to prepare for implementing its strategy to end AIDS.102 Its spending commitments must remain if real progress is to be made. But to be in with a real chance of ending AIDS by 2030, Thailand will also need to give significant focus to new and innovative intersectional strategies to reach both young people and key affected populations, particularly men who have sex with men and those from migrant communities.