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13 Feb, 2012

As Thai Tourism Rebounds, An Old Crisis Lurks in the Shadows

BANGKOK – As Thailand’s tourism industry gets set to soar again, a regional meeting on the global AIDS pandemic organised here last week has refocussed attention on a rarely-discussed subject: the extent to which Thailand’s nightlife and entertainment industry contributes to the global spread of HIV/AIDS.

Although the Thai tourism industry robustly touts its contribution to economic growth, jobs and foreign exchange earnings, through copious statistics, far less forecast data is available about how more than 20 million visitors, especially those who will be here purely for the nightlife, could potentially worsen an already bleak situation.

Reports presented at the Asia-Pacific High-level Intergovernmental Meeting on the Assessment of Progress against Commitments in the Political Declaration on HIV/AIDS and the Millennium Development Goals made clear the link between prostitution and HIV epidemic.

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Said one of the background reports prepared for the meeting co-organised by the UN Economic and Social Commission for Asia-Pacific, “By some estimates, the number of men who have unprotected commercial sex is the single most important determinant of the potential size of the HIV epidemic in the region.

“On a regular basis, an estimated 10 million women sell and at least 75 million men — between 0.5 and 15 per cent of adult males — purchase sex in the region. Clients of female sex workers (FSW) make up the largest HIV-affected population group in Asia.”

According to the report, “The ongoing demand for commercial sex may explain why the HIV prevalence among sex workers approaches 20 per cent in some countries. In some countries in the region, more than 90 per cent of women acquired HIV from their husbands or male partners.”

It adds, “Given the strong link between a country’s HIV prevalence rate and commercial sex, the low level of HIV prevention coverage for sex workers in the region — estimated to reach only one third of all sex workers in Asia — poses a significant threat that countries have acknowledged must be addressed.”

The report notes that initial efforts to reduce the explosive rise of HIV among female sex workers focused almost exclusively on mandatory condom use by sex workers and their clients. “While these programmes had a significant and rapid impact, a number of critiques have subsequently arisen regarding the sustainability of such an approach,” the report said.

It added, “Most significantly, sex worker groups in some countries that have implemented 100 per cent condom use programmes have reported increased violence against sex workers by both clients and partners.”

Of the many crises that have struck the Thai travel & tourism industry over the years, the outbreak of HIV/AIDS pandemic in the 1980s-90s was the first. It was largely due to the leadership and anti-establishment courage of anti-AIDS campaigners such as Magsaysay award-winner Mechai Viraivaidhya, a former tourism minister, that Thailand’s tourism industry survived.

Over the years, however, the relationship between Thailand’s nightlife and the spread of HIV/AIDS has fallen off the radar screen and been replaced by the steady stream of other economic, geopolitical and environmental crisis. In terms of crisis priorities, it is way down on the pecking order.

But there is no doubt that increasing visitor numbers, especially from the “new boom markets” such as Russia, India and China, will mean more business for the nightlife and entertainment sector, especially as single males comprise a very high proportion of visitors from these markets. Indeed, it is not just Thailand that is facing a renewed threat — the growing number of casino and brothels are also an issue, especially at the border-crossing areas where there is both demand and, due to continued high levels of poverty and indebtedness, no shortage of supply.

At the UN meeting, the linkage between travel and commercial sex work was not discussed. The documentation and resolutions seek an end to the discrimination against travellers who are already HIV-positive; in the Asia-Pacific region, 16 countries impose travel bans on people living with HIV. However, the need to discourage travel for the sole purpose of sex was not covered.

The report warns that heterosexual commercial sex is not the only problem.

It says, “While there is significant variability, HIV prevalence among MSM (men who have sex with men) in the region is rising. In several countries in East Asia, male-to-male sex has become the dominant mode of transmission among newly diagnosed infections.

“Modelling projections presented by the Commission on AIDS in Asia in 2008 indicated that, unless prevention measures were strengthened and expanded, an increasing proportion of new HIV infections in the region would be among MSM, representing up to 50 per cent of new infections by 2020.

“Further, studies have shown that, in some countries, although the level of basic knowledge about HIV/AIDS was high among MSM, a high proportion of MSM perceive their risk of contracting HIV as low. While limited data is available, one study noted that less than 20 per cent of MSM know their status.”

The meeting discussed an action plan which calls for increased collaboration between government ministries, including health, justice, public security, police and drug control in genuine partnership with civil society and key affected populations including people who buy and sell sex, men who have sex with men, transgender populations and people who use drugs.

The participating representatives from 34 Asia-Pacific countries also called for the development of regional accountability mechanisms and financing modalities to enhance Asia-Pacific’s capacity to reach HIV targets and commitments. It was the first major intergovernmental meeting of its kind anywhere in the world after the historic adoption of the Political Declaration on HIV and AIDS by world leaders in June last year.