Working in public health brings me close to the stories of brave patients and dedicated medical staff. Very often we also conduct quantitative and qualitative assessments of case studies. In recent years, our work in Malaysia engages a public health concern that has gripped the world – HIV. Our findings have given us hope of winning the fight against the disease.
The days that I spent on the Big Cities project taught me how to handle different people from all walks of life, who were diagnosed HIV positive. Working there, I learned that HIV/AIDS does not choose its victims, whether rich or poor.
One of them happened to be my close friend. I really didn’t know how to tell him about his HIV status. It was hard… really hard to be his HIV counselor. It was difficult putting myself in his shoes, for example, when this diagnosis must’ve felt like the end of the world for him. But I knew that I had to be strong for my friend.
I wondered how I could help him if I wasn’t strong myself, so I promised him that I would do my best to support him, which was similar to what I do for other people living with HIV.
ประเทศไทยยังคงเป็นหนึ่งในกลุ่มประเทศที่ได้รับผลกระทบจากการระบาดของเชื้อเอชไอวีมากที่สุดในทวีปเอเชีย ในปัจจุบันประชากรจำนวน 440,000 คนในประเทศติดเชื้อเอชไอวี และจำนวนผู้เสียชีวิตจากโรคฉวยโอกาสมีประมาณ 1,250 คน ต่อปี
แม้ว่าประเทศไทยเองจะได้รับการยกย่องในความพยายามที่จะควบคุมการแพร่ระบาดของเชื้อเอชไอวีในหมู่ผู้ขายและผู้ใช้บริการทางเพศ โดยเฉพาะอย่างยิ่งจากโครงการ 100% Condom Use แต่การตอบสนองต่อเรื่องนี้จากกลุ่มชายที่มีเพศสัมพันธ์กับชาย ยังคงจำกัดอยู่ในวงแคบ
In Asia, Thailand remains one of the countries hardest hit by the HIV epidemic. Currently, 440,000 people are living with HIV and approximately 1,250 people die each year from HIV-related causes.
Although the country is often praised for its highly successful efforts to curb the spread of HIV among sex workers and their clients, particularly through the world-renowned 100% Condom Use Program, its response to HIV among men who have sex with men (MSM) has been limited.
At 44%, the HIV infection rate is high among men who have sex with men (MSM) in Thailand. Despite efforts to promote safe sex, HIV infection rate will rise from 30% now to 59% by 2030 if there is no radical intervention.
In the early 1990s, selling condoms was highly controversial in Vietnam. For so long, condoms had been distributed to each household throughout the country for free for family planning use only. Condoms were not used for promoting safe sex. It was extremely difficult to convince the media to advertise condoms, very hard to convince the government that it was possible to generate revenue from selling condoms. People found it embarrassing to buy condoms in shops or drugs stores.
Vào đầu những năm 1990, tiếp thị xã hội bao cao su là một vấn đề gây nhiều tranh cãi ở Việt Nam. Trong một thời gian dài, bao cao su được phát miễn phí phục vụ mục đích kế hoạch hóa gia đình. Bao cao su chưa được đề cập như một biện pháp về tình dục an toàn. Thuyết phục giới truyền thông quảng cáo bao cao su là cực kỳ khó khăn, và việc thuyết phục chính phủ rằng có thể bán bao cao su trợ giá cũng là điều rất khó. Ai cũng cảm thấy ngượng và lúng túng khi mua bao cao su tại hiệu thuốc.
Cũng có ở Tiếng Việt
Doing something useful for my country, Vietnam, always makes me happy. And I’ve tried to get this feeling through my work in developing the transport infrastructure network in Vietnam for over 10 years. Vietnam has come a long way, but there are still many related challenges ahead to make such development sustainable.
I still recall a conversation with a Bank’s specialist on HIV/AIDS a few years ago. We were discussing about the people who have recently availed of the Voluntary Counseling and Testing centers in the Mekong Delta region for HIV tests. She pointed out that they were mostly wives of construction workers employed in infrastructure projects. Sometime later I visited the construction sites and talked to the workers and their managers about the subject. I felt so worried, as their understanding on HIV/ AIDS was quite limited and wondered what could be done to protect this group of people from such a deadly disease?
|Photo from Aktionsbündnis gegen Aids through a Creative Commons license|
It was Christmas dinner two years ago, in 2010, among my gay friends. I just came back from an expat assignment in the US, and was greatly enjoying the uniquely Filipino way of celebrating the cheery season. Towards the end of that dinner, one of my close friends came up to me saying he wanted to speak with me in private.
The two of us went outside the restaurant, and in a dark corner of the parking lot he told me he wanted me to be among the first to know. Early that month, he had himself tested for HIV, and found out he was positive. I was so shocked that no words came out of my mouth, I remember just giving him the tightest hug I could, my mind blank, my heart racing, not knowing what to say or do next. He was my first close friend who came out to me as HIV-positive.
In Malaysia, over half of all HIV infections are transmitted through sharing contaminated needles and syringes. To combat the spread of the epidemic, the government in 2006 spearheaded 'harm reduction' interventions (pdf) which included a program where people who inject drugs are provided unused needles and syringes in exchange for used injecting equipment. Those who are addicted to opioids such as heroin, the most commonly used illicit substance in Malaysia, can also enroll in rehabilitation for synthetic opioid replacement therapy. Synthetic opioids, taken orally, help stabilize the opioid cravings of patients, thus enabling them to work. The move to introduce harm reduction in Malaysia revealed something that caught people by surprise—many of the fishermen from port city on the east coast of peninsular Malaysia use drugs.