Gay rights activists in Thailand say a unique combination of muted discrimination and cultural mainstreaming of the gay and transgender community is to blame for a dangerous lack of knowledge about HIV among gay and transgender persons, especially the youth.
"There are no discrimination laws here against gay people, so a young gay Thai may feel like, 'My life is free, I can do anything I want,' when in reality, most gay people here live a double life, both with a straight male identity and with a gay identity," said Narupon Duangwises, a cultural anthropologist who works as a consultant with Bangkok Rainbow, an NGO that supports the gay community.
Teenagers who identify as gay and transgender seamlessly blend with Bangkok's mainstream youth culture, spending their days at the city's popular, glitzy malls. At home, however, many find entertainment on the video chat service CamFrog, which they use to meet other young gay Thais, and sometimes as a platform to sell or buy sexual services.
"Young people cannot go to bars, so they go on CamFrog. They don't know about HIV, because they don't learn [about it] in school," Nikorn Arthit, president of Bangkok Rainbow, which has begun an online HIV-educational campaign through CamFrog. "They are excited to be meeting people but they don't know how to protect themselves."
CamFrog says it has more than 30 million users, mainly in Asia.
Duangwises expressed concern that not enough was being done to address the HIV needs of young gay people. "The gay organizations don't know what has happened with this health situation. The community is not well organized," he said. "We think HIV infections may be much higher than we realize. We need to instil a sense of social responsibility among gay Thais. We can't just be passing out condoms."
Thai health workers say a similar lack of knowledge is also caused by the disparity between the levels of HIV programming for male and female sex workers. According to Noi Apisuk, director of the Empower Foundation, an NGO for sex workers, Bangkok's female sex workers know all about safe sex and can always find multiple sizes of condoms at Empower’s office.
Nicha Jitjang, programme officer for the male and transgender sex worker rights' group Service Workers In Group, or SWING, estimates that most seasoned male and transgender sex workers know to use a condom when engaging in sexual activity, but the same cannot be said for newbies.
Her colleague, Nanokporn Sukprasert, a transgender former sex worker, remembers first learning about HIV two or three years after she began working at a bar.
"I sometimes used condoms and I sometimes didn't use them," she said. "I didn't know about HIV and STIs [sexually transmitted infections]; I saw many of my friends get HIV, but I thought they were different because they were MSM."
"We focus now on talking with new people who come every day and think they can get HIV from sharing food or from swimming in the same pool," she explained. "It's a perspective we are trying to change."
|Young people cannot go to bars so they go on CamFrog. They do not know about HIV, because they do not learn [about it] in school|
SWING regularly connects with more than 5,000 male and transgender sex workers.
On a typical night, Sukprasert will visit about 50 bars, dropping off boxes of condoms for male and transgender sex workers; if a bar is missed out, the owner may telephone, complaining that his employees are waiting.
"We give them knowledge, condoms and lubricants every day – one box of condoms per bar and people share with their friends," she said. "In the past they didn't want to talk about HIV with us because it is a personal issue, but now people know us and they are more open."
Approximately 16.7 percent of Thai male sex workers were found to be HIV positive in 2010, according to Bangkok Rainbow, compared with 3 percent of Thailand's estimated 200,000 female sex workers known to be living with HIV, according to Apisuk.
An estimated 1.3 percent of Thai adults aged 15 and older are HIV-positive, according to UNAIDS.