The HIV/AIDS Collaboration in Thailand

Abstract This chapter describes CDC’s HIV collaboration in Thailand, which grew from an existing field epidemiology training program. Extensive commercial sex and injection drug use in the region prompted concerns for widespread HIV transmission. Early studies showed sequential “waves” of HIV infection, first in injection drug users and then in female sex workers, their male clients, and women in the general population. Men who have sex with men were shown to have been infected early but were not an initial study population. Studies examined the efficiency of sexual and drug injection-associated HIV transmission, molecular epidemiology of HIV subtypes, and viral load as a risk factor for mother-to-child transmission. Clinical trials showed efficacy of short-course zidovudine to prevent perinatal HIV transmission and lack of efficacy of Carraguard® as a female microbicide and of the AIDSVAX B/E vaccine. Generalized HIV spread in Thailand has not occurred, with HIV largely restricted to key populations.