Thailand Finds Education Lowers HIV Spread Among Soldiers

An aggressive government campaign in Thailand to increase condom use and discourage visits to prostitutes has achieved dramatic reductions in Thai soldiers’ rates of infection with the human immunodeficiency virus, which causes AIDS, and other sexually transmitted diseases, according to a new study.

The findings appear to provide evidence that a program of education and “social marketing” can reduce risky sexual behavior and slow the AIDS epidemic.

In 1991, the Thai government inaugurated its 100% Condom Program, combining education, free condom distribution and enforcement of condom use in brothels.

Researchers from Johns Hopkins University School of Hygiene and Public Health, Thailand’s Chiang Mai University and the Royal Thai Army Medical Corps tracked sexual behavior and infection rates in 4,086 military recruits, comparing a group conscripted in 1991 with one conscripted in 1993. The men were interviewed and tested at six-month intervals over two years.

The frequency of HIV infection decreased fivefold and the frequency of STDs fell tenfold.

Soldiers drafted in 1993 were less likely to report having visited a brothel than those conscripted in 1991. And they were more likely to have used condoms. Only 2.5% of 1993 conscripts reported inconsistent condom use during brothel visits, compared with 14%.

“The rapid decrease in [infection rates] that followed the reduction in high-risk behavior is unprecedented for a general population of young adults,” writes David D. Celentano of Johns Hopkins and his coauthors in the journal AIDS.