IMPACT OF THAILAND HIV-CONTROL PROGRAM AS INDICATED BY THE DECLINE OFSEXUALLY-TRANSMITTED DISEASES

The Thai government began an HIV-control programme in 1989. The progra mme had the following parts: the government bought and distributed suf ficient condoms to protect much of the commercial sex in the country; sanctions were brought against commercial sex establishments where con doms were not used consistently; and a media campaign bluntly advised men to use condoms with prostitutes. Between 1989 and 1993 the use of condoms in commercial sex in Thailand increased from 14 to 94%, accord ing to surveys of prostitutes, and the number of cases of the five maj or sexually transmitted diseases declined by 79% in men. We estimate t hat sex acts with prostitutes where there was a risk of HIV transmissi on declined from about 2.6% in June, 1989, to about 1.6% in June, 1993 . If condom use in commercial sex stays high, future cohorts of young men and women may experience lower HIV incidence rates than those of t he recent past. However, although condom use is high, there are many m ore infected prostitutes than before and many infected men who will pa ss HIV to their wives.