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  • Title: "100 percent" condom use seeks to slow HIV spread.
    Author: Rojanapitayakorn W.
    Journal: Netw Res Triangle Park N C; 1993 May; 13(4):30, 32. PubMed ID: 12344875.
    Abstract:
    AIDS is one of Thailand's most important health problems and the sex entertainment industry is the most important factor for its heterosexual transmission. Many Thai men go to these establishments on a regular basis, with almost 100% of male sexually transmitted disease (STD) patients reporting that they contracted the infection(s) from sex workers. Information, education, and communication programs were first employed to encourage greater condom use and other HIV preventive changes in sexual behavior. While many sex workers reported the desire for their clients to use condoms, some clients refused and workers were ultimately pressured into complying with the wishes of clients to engage in unprotected sex. In response, public health officials, police, and representatives of local government met with the owners of commercial sex establishments in the Ratchaburi province south of Bangkok in 1989. Owners were provided with information on AIDS and encouraged to withhold sex services from clients who refuse to use condoms. Establishments would be monitored, penalized, and potentially shut down for failure to comply with the "100 percent" program. Monitoring approaches include asking clients in STD clinics where they last had sex with a prostitute; sending volunteers to test compliance; observing STD infection rates among sex workers receiving routine examinations at local clinics; and monitoring the number of condoms provided per establishment. The success of this program prompted its extension to other provinces and ultimate nationwide expansion in 1991 as called for by the National AIDS Committee. By July 1992, the program had been implemented in all 73 provinces. A marked increase in condom use has been observed in the establishments, with some levels reaching 90% last summer. Moreover, the incidence of STDs has decreased steadily from 6.5 infections/1000 population to 2.1/1000 over the period 1989-92. It is, however, still too early to say whether the program has helped reduce the transmission of HIV.
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