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Why has the Thai HIV epidemic in men who have sex with men been so silent?

Celentano, David D

doi: 10.1097/01.aids.0000189567.72353.8a

Department of Epidemiology, Infectious Diseases Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Received 18 July, 2005

Accepted 21 July, 2005

Dr Thanprasertsuk and his colleagues from the Royal Thai Ministry of Public Health (MOPH) and the Thailand-based US Centers for Disease Control and Prevention took issue [1] with my challenging statements regarding why there has been so much silence in the face of a mounting HIV epidemic among men who have sex with men (MSM) in Thailand [2] in response to their outstanding recent article [3]. The task of the editorial writer is often to point out that which others do not wish to state. As a guest researcher in Thailand for the past 15 years, I must say that I understand this ‘official’ response to my concerns, but to paraphrase the Bard ‘Methinks that they doth profess too much’. To state that the MOPH conducted the 2003 assessment in response to the changing epidemiology is perhaps a little too ‘politically correct’, as it was nearly two decades in coming and was the first definitive study of the HIV situation among MSM in Thailand. It is clear that the landscape in Thailand is changing; witness the emergence of the Rainbow Sky Association of Thailand, and that the response to the HIV prevention needs of MSM are now actively being addressed. However, we need far more than surveillance and descriptive epidemiological studies to provide assistance for this vulnerable population adequately. It is time for action, and with a developing community base emerging, let us hope to read in the not too distant future of the success of the MOPH in responding to this epidemic with a similar outcome to the response to the heterosexual epidemic that has been so widely acclaimed.

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1. Thanparsertsuk S, Sirivongrangson P, Ungchusak K, Jommaroeng R, Siriprapasiri T, Phanuphak P, et al. The invisibility of the HIV epidemic among men who have sex with men in Bangkok, Thailand. AIDS 2005; 19: in press.
2. Celentano DD. Undocumented epidemics of HIV infection continue to persist in the twenty-first century. AIDS 2005; 19:527–528.
3. van Griensven F, Thanprasertsuk S, Jommaroeng R, Mansergh G, Naorat S, Jenkins RA, et al. Evidence of a previously undocumented epidemic of HIV infection among men who have sex with men in Bangkok, Thailand. AIDS 2005; 19:521–526.
© 2005 Lippincott Williams & Wilkins, Inc.