[health menu] XI International Conference on AIDS
July 7-12, 1996

Robinson, Noah Jamie, Auvert B.
INSERM, France

Silarug N.
Ministry of Public Health, Thailand

Surasiengsunk S.
Chulalongkorn University, Thailand

Hanenberg R.
FHI, Thailand

Mo.C.904

Two Million HIV Infections
Prevented in Thailand:
Estimate of the Impact of Increased Condom Use

Objectives

To evaluate the impact on the spread of HIV infection of increased condom use between female commercial sex workers (CSWs) and their clients in Thailand since 1989, and to assess the future course of spread of HIV infection assuming condom use is maintained at current levels.

Methods

The objective was addressed by application of SimulAIDS, a simulation model of the transmission dynamics of HIV infection and of other sexually transmitted diseases (STD) in populations where HIV infection is predominately heterosexually transmitted. The model was employed to simulate the spread of HIV infection in the Thai population from its assumed introduction at the end of 1988 up until the year 2000. The percentage of sexual contacts between CSWs and their clients protected by condoms was assumed to increase from 14% before 1989 to 90% after 1991. Results of simulations between 1989 and 1995 reproduced important characteristics of the Thai epidemic; notably HIV prevalence among CSWs and among young men entering service with the Royal Thai Army, and a 90% decrease in STD incidence among men. For comparison, simulations were re-run from 1988 assuming condom use between CSWs and clients remained at 14%. Other factors were unchanged.

Results

The cumulative number of heterosexual HIV infections in Thailand was estimated at 600,000 by the end of 1995 and was projected to be 1 million by the year 2000. Having peaked at 3% in 1993, simulated HIV prevalence among men aged 20-24 stabilized at about 2.5%. However HIV prevalence among women aged 15-44 continued to increase up until the year 2000 (reaching 1.3%). For the comparison scenario, with condom use remaining at 14%, HIV prevalence among men aged 20-24 stabilized at over 20%, and cumulative number of HIV infections exceeded 3 million by the end of 1995 and was projected to exceed 6 million by the year 2000.

Conclusions

Although results are preliminary, they suggest that the 100% Condom Programme adopted by the Thai government may have already prevented more than 2 million HIV infections in Thailand. Prevention programs must continue to encourage condom use in all sexual contacts between CSWs and their clients.

Noah Jamie Robinson
INSERM U88
14 rue du Val d'Osne, 94415
Saint-Maurice, France
Tel: 331-45183870; Fax: 331-45183889
Email: robinson@citi2.fr

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Created: July 16, 1996
Last modified: July 17, 1996
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