Niyada Kiatying-Angsulee

HIV AND AIDS, STIGMA AND AIDS SUPPORT GROUPS: PERSPECTIVES FROM WOMEN LIVING WITH HIV AND AIDS IN CENTRAL THAILAND

In this paper, community attitudes toward women living with HIV and AIDS at the present time from the perspectives of women in Thailand are examined. We also look at strategies women use in order to deal with any stigma and discrimination that they may feel or experience in the community. The paper is based on our larger study of the experiences of women living with HIV and AIDS and their participation in clinical trials. In late 2007 and early 2008 we carried out a number of in-depth interviews with women living with HIV and AIDS in central Thailand. We find that women living with HIV and AIDS still deal with stigma and discrimination in their everyday life. However, from the womens narratives, we also find more positive attitudes from local communities. Some women deal with stigma and discrimination by joining and participating in HIV and AIDS support groups that have emerged in response to the AIDS epidemic in Thailand. We argue that women are not passive victims, but that they act in their own agencies to counteract any negativity they might encounter.

Living Positively: The Experiences of Thai Women Living With HIV/AIDS in Central Thailand

Living with an incurable illness such as HIV/AIDS is a stressful experience. However, many HIV-positive individuals are able to maintain their emotional well-being. This begs the question of what strategies these individuals employ to allow them to do so. In this article, we examine how Thai women living with HIV/AIDS learned about their health status, what feelings they had, and how they dealt with the illness. In-depth interviews were conducted with 26 women in central Thailand. The women adopted several strategies to deal with their HIV status, including taking care of themselves, accepting their own faith, disclosing their HIV status to family, and joining AIDS support groups. These strategies can be situated within the “living positively” discourse, which helped to create a sense of optimism to combat the HIV epidemic among the women. Additionally, the acceptance of their HIV status played an essential role in the meaning-making process because it assisted the women in sustaining the equilibrium of their emotional well-being.

High rates of midazolam injection among drug users in Bangkok, Thailand

BackgroundReports from Thailand suggest that a growing number of people who inject drugs (IDU) are now injecting midazolam, a legal benzodiazepine with potent amnestic and ventilatory depressant effects. We therefore sought to examine midazolam injection among a community-recruited sample of Thai IDU.MethodsWe examined the prevalence and correlates of midazolam injection among 252 IDU participating in the Mitsampan Community Research Project, Bangkok, using multivariate logistic regression. We also examined the use of midazolam in combination with other drugs.Results252 IDU participated in this study, including 66 (26.2%) women. In total, 170 (67.5%) participants reported ever having injected midazolam, and 144 (57.1%) reported daily midazolam injection in the past six months. In multivariate analyses, a history of midazolam injection was independently associated with using drugs in combination (adjusted odds ratio [AOR] = 5.86; 95% confidence interval [CI]: 2.96-11.60), younger age (AOR = 0.43; 95%CI: 0.22-0.83), having a history of methadone treatment (AOR = 3.12, 95%CI: 1.55-6.90), and binge drug use (AOR = 2.25, 95%CI: 1.09-4.63). The drugs most commonly used in combination with midazolam were heroin (72.3%) and yaba (methamphetamine) (30.5%).ConclusionWe observed a high rate of midazolam injection among Thai IDU. Midazolam injection was strongly associated with polysubstance use and binge drug use, and was most commonly used in combination with both opiates and methamphetamines. Our findings suggest that midazolam injection has become increasingly common within Thailand. Evidence-based approaches for reducing harms associated with midazolam injection are needed.

Local Discourse on Antiretrovirals and the Lived Experience of Women Living With HIV/AIDS in Thailand

Antiretrovirals (ARVs) have been seen as life-saving for HIV-positive people. However, ARVs have a darker side. Since 2000, many HIV-positive people in Thailand have received ARV treatments, but the understanding of ARVs and practices of medication-taking among HIV-positive women have not received much attention. We discuss local discourses employed by HIV-positive women and health work by these individuals in their attempts to adhere to ARVs restrictions. The local discourse of ARVs was ya tan rok AIDS “medications that could resist HIV/AIDS.” ARVs provided hope for the women. Although the women were affected by the side effects of ARVs, they continued to take their medication to be able to live longer and perform their duties as mothers and carers. They were more concerned about the practice of medication-taking. Understanding why these women were adherent to their ARVs offers insights into the social impact of these ARVs on their lives.

New chapter in tackling antimicrobial resistance in Thailand

Nithima Sumpradit and colleagues describe the experience of Thailand in developing its national strategic plan on antimicrobial resistance and highlight the need for sustained political commitment and multisectoral collaboration

AIDS Support Groups and Women Living with HIV/AIDS in Central Thailand

In this chapter, we examine community attitudes toward women living with HIV/AIDS in Thailand. We also look at strategies employed by women in order to deal with any stigma and discrimination that they may feel or experience in the community. The chapter is based on our larger study of the experiences of women living with HIV/AIDS and their participation in clinical trials in Thailand. We carried out a number of in-depth interviews with women living with HIV/AIDS in central Thailand. We find that women living with HIV/AIDS still deal with stigma and discrimination in their everyday life. However, from the women’s narratives, we also find more positive attitudes from local communities. Women deal with stigma and discrimination by joining and participating in HIV/AIDS support groups that have emerged in response to the AIDS epidemic in Thailand. We argue that women are not passive victims but that they act in their own agencies to counteract any negativity they might encounter.

Participating in HIV Clinical Trials: Reasons and Experiences Among Women Living With HIV in Thailand

The authors discuss the experiences of participating in HIV trials and their ethical concerns among Thai women living with HIV/AIDS. In-depth interviews and participant observations were conducted with 26 Thai women. Due to their vulnerability and poverty, HIV trials were particularly attractive to these women. Reasons included personal protection from infection, personal gains (free medication, medical care, and information about the development of future clinical trials), and social altruism. The attempts of the women to stay healthy and live longer by participating in clinical trials can be seen as health-promoting behavior. Participation in clinical trials helped to create a sense of optimism to combat the HIV epidemic. The participation also assisted the women to sustain the equilibrium of their emotional well-being. These findings can be valuable for the design and conduct of future HIV clinical trials and the provision of sensitive HIV care for women who are the vulnerable members of society.

Women, motherhood, and living positively : the lived experience of Thai women living with HIV/AIDS

Living with an incurable illness such as HIV/AIDS is a stressful experience. However, many HIV-positive individuals are able to maintain their emotional well-being. This begs the question of what strategies these individuals employ to allow them to do so. In this chapter, we examine how Thai women who are mothers and living with HIV/AIDS dealt with the illness. In-depth interviews were conducted with 26 women in central Thailand. The women adopted several strategies to deal with their HIV status including taking care of own self, accepting one’s own faith, disclosing their HIV status to family, and joining AIDS support groups. These strategies can be situated within the “living positively” discourse which helps to create a sense of optimism to combat the HIV epidemic among the women. Additionally, the acceptance of their HIV status plays an essential role in the meaning-making process because it assists the women to sustain the equilibrium of their emotional well-being.

Identifying Safety Indicators of New Drug Safety Monitoring Programme (SMP) in Thailand

The Safety Monitoring Programme (SMP), Thailands new drug safety monitoring system, aims to perform new drug safety profiles for the country. There have been an increasing number of new drugs in Thailand, and only a few studies have explored this particular issue. This study was a part of a situational analysis of the new drug Safety Monitoring Programme in Thailand. The objective was to identify safety indicators of the SMP system through the structure, process, and outcome model. A three-round modified Delphi method, including semistructured interviews, mailed questionnaire, telephone recall, and in-person contact, was used. Forty-five persons, representing various stakeholders dealing with the SMP, were asked by telephone or in-person contact to join the expert panel. Thirteen individuals declined to participate, resulting in a panel of 32 experts. Seventy-one indicators were identified in the first round, 40 indicators in the second, and 36 indicators in the final round, and then the indicators were regrouped by similar concepts into 19 safety indicators. The assessment of the SMP through the 19 core safety indicators will be used to assess elements in the SMP system. These indicators should be further developed and continuously used and improved.

Impact of COX-2 Inhibitors in Thai Orthopaedic Outpatients

Prescribing of cyclo‐oxygenase ‐2 inhibitors (coxibs) has had an economic impact on patients and overall healthcare costs in Thailand.