Population Council | Asia

ASIA
Thailand

The Population Council's research agenda in Thailand includes projects to improve the quality of reproductive health services and to address the AIDS pandemic.

Reproductive health
The Council has been working with researchers at Chulalongkorn Hospital, Siriraj Hospital, Ramathibodi Hospital, and Maternal and Child Hospital in Nakhorn Sawan, and in a clinical study of the mifepristone-misoprostol medical abortion regime for inducing abortion in cases where the procedure is legal.

HIV/AIDS prevention and care
Though HIV/AIDS was late in coming to the region, there was a significant nationwide epidemic documented in Cambodia by 1999. Thailand (particularly northern Thailand) was initially one of the places hardest hit by the AIDS epidemic in Asia, but HIV incidence declined dramatically in response to the Thai government's 100 percent condom use program.

The Population Council's Horizons Program for Global Operations Research on HIV/AIDS/STI Prevention and Care conducted several operations research projects in the country. The mostly recently completed studies include:

A project to promote the evaluation and accreditation of workplace AIDS programs in conjunction with the Thai Business Coalition on AIDS.
A collaboration with the Program for Appropriate Technology in Health (PATH) to develop standards for the community-level case management of infection in Lampang, Thailand, a province with a high prevalence of HIV and AIDS.
The introduction and evaluation of a HIV/AIDS school-based "life skills" curriculum for vocational students.
A situation analysis of a Ministry of Public Health project to expand antiretroviral therapy for persons living with AIDS.

The Council is currently engaged in an operations research study in northern Thailand in which the intervention is aimed at increasing adherence and reducing drop-out levels for persons with AIDS who have started antiretroviral therapy.

Microbicide development
In Chiang Rai, a town in northern Thailand, the Council joined forces with the Thailand Ministry of Public Health–U.S. Centers for Disease Control and Prevention (CDC) Collaboration to conduct research related to microbicide development.

Population Council researchers have been working for nearly two decades to create effective microbicides—products designed to substantially reduce sexual transmission of HIV. If proven effective, such products will offer a powerful new prevention tool in the fight against AIDS. Carraguard®, a gel made from carrageenan, was the first microbicide candidate developed by the Population Council. The Council conducted two expanded safety and acceptability trials of Carraguard gel in South Africa and Thailand.

A total of 165 HIV-negative, nonpregnant, generally healthy women were enrolled in the Thailand study. Participants were randomized to groups using Carraguard gel or its matching placebo, methyl cellulose gel, and neither participants nor staff knew which product they were receiving. Participants were instructed to insert the study gel at least three times a week (approximately every other day) and before each act of vaginal intercourse. Women returned to the clinic for monthly pelvic exams, interviews about compliance and acceptability, safer sex counseling, testing and treatment of curable sexually transmitted infections, and free condoms.

The Population Council and the Thai Ministry of Public Health–CDC Collaboration also held an expanded safety trial of Carraguard among 55 HIV-negative couples in Chiang Rai who used Carraguard or its matching placebo for six months. The trial protocol was similar to that of the main expanded safety and acceptability trials. However, this was the first time that men were also examined for safety (mostly the effect of study gel on the penile skin), and interviewed about compliance and acceptability.

Projects

Publications/Resources on Thailand