A UN Resident Coordinator blog

Six years ago, Thitiwatt Sirasjtakorn learned that he was HIV positive, a point in his life when he struggled to understand what this meant and had almost given up on life. However, this is where his story begins.

Mr. Sirasjtakorn managed to overcome stigma and discrimination and decided to publicly disclose his HIV-positive status on social media and educate people about HIV from his experiences, becoming today an influential voice in Thailand.

The network of people living with HIV is actively working alongside government and the UN to promote HIV testing, advocate for prevention campaigns and tackle discrimination. All of us can do more to support their efforts.

Thitiwatt Sirasjtakorn (centre) and other HIV activists, meet Gita Sabharwal, UN Resident Coordinator in Thailand (right), and Patchara Benjarattanaporn, (second from right) Thailand Country Director for UNAIDS in December 2020

Stigma, discrimination, and misconceptions

That begins with countering stigma and discrimination that still pervades all sectors of society. People living with HIV continue to face stigma and discrimination everywhere: at work, at school, at home, in health settings and in the community. Discrimination doesn’t just hurt individuals or groups of people – it hurts everyone.

Studies conducted in different countries around the world show that there are still people who do not want to buy food prepared by people living with HIV, or parents who do not want their children to attend school with students living with HIV. These ideas and attitudes are deeply founded in ignorance and put the lives of people living with HIV in danger. There is clear evidence that people do not access the health care they need because of stigma and discrimination.

To this day, there are still many misconceptions about HIV. The virus cannot be transmitted through saliva, tears or sweat and can only be found in body fluids, such as blood, semen, vaginal fluids and breast milk. For example, hugging, shaking hands, sharing toilets, sharing dishes and kissing do not transmit HIV. It is transmitted through penetrative sex, blood transfusion, the sharing of contaminated needles in health-care settings and drug use, and between mother and infant during pregnancy, childbirth and breastfeeding.

Several methods have proved highly effective in reducing the risk of HIV, including male and female condoms, the use of antiretroviral (ARV) medicines, and treatment of people living with HIV to reduce viral load and prevent onward transmission.

There are also misconceptions about the health situation for people living with HIV, with ARV treatment- having life-changing benefits. Treatment enables people living with HIV to stay healthy, maintain their quality of life and have a lifespan similar to those who are not living with HIV.

Successes and challenges

Thailand is at the forefront of the HIV response with a strong public health system that provides antiretroviral treatment (ART) covered by its universal health coverage scheme, extending to an estimated 80 per cent of people living with HIV. Among those receiving treatment, 97 per cent are virally suppressed.

Twenty years of evidence shows that HIV treatments are highly effective in reducing transmission, with clear findings that people who have an undetectable viral load cannot transmit HIV sexually. This is life-changing for people who feel liberated from stigma associated with living with HIV and can provide a strong sense of being agents of HIV prevention.

Thailand has also made considerable progress curbing mortality associated with HIV, with a 44 per cent decline of AIDS-related deaths from 2010 to 2019, from 25,000 to 14,000 respectively.

Yet considerable challenges remain. The country has one of the highest prevalence rates in the Asia-Pacific region, with an estimated half a million people living with HIV.