HIV is a leading cause of death for people under the age of 50 in Thailand. Of those with HIV in Asia and the Pacific, 9% live in Thailand. In 2019, about 470,000 people were living with HIV in Thailand. Sex workers, men who have sex with men, transgender individuals and people who inject drugs are most affected by the epidemic. Thailand has made progress in combating the disease, especially in regard to mother-to-child transmissions, which the country eliminated. However, HIV stigma is a factor both preventing people from seeking treatment and causing discrimination in healthcare. The stigma surrounding HIV can also lead to mental health issues such as depression.
HIV stigma includes negative attitudes and judgments toward people living with HIV. Discrimination can occur when a healthcare professional refuses to provide services for people living with HIV. It can also occur when someone receives a lack of social support due to being HIV positive. The stigma and discrimination resulting from living with HIV can lead to internalized stigma. This stigma is when people living with HIV develop a negative self-image impacting their mental health. As a result, higher rates of loneliness and depression have been reported among people living with HIV.
HIV Research in Thailand
The National Institute of Nursing Research conducted a study in Thailand in 2007 which revealed information about the impact of HIV-related stigma on mental health. The researchers interviewed people living with HIV in northern and northeastern Thailand to collect data. Data was collected by measuring stigma on a scale of “Internalized Shame” and “Perceived Stigma.” They concluded that there is an association between depression and internalized shame, as well as between depression and perceived stigma.
Additionally, the study’s conclusion included strategies to improve the mental health of people living with HIV through treatment programs. The researchers emphasized the importance of boosting self-esteem and creating a sense of belonging to a community. Doing this would combat the effects of isolation often felt as a result of stigma. Furthermore, addressing HIV stigma in Thailand in addition to providing social support could positively impact the overall health of people with HIV.
Responses to the Impact of HIV on Mental Health
TREAT Asia (Therapeutics Research, Education and AIDS Training in Asia) is an organization working toward increasing access to psychiatric care. It also works toward improving mental health services for those living with HIV in Thailand. The organization is conducting a study on depression and anxiety among Thai adolescents with HIV. By evaluating participants, the study team aims to improve the health of Thai adolescents living with HIV. It does this through developing a better understanding of how to address mental health in the treatment process.
Service Workers in Groups (SWING), a Thai organization, provides HIV services and supports sex workers. COVID-19 left about 145,000 sex workers in Thailand without an income source. As a result, they are in greater need of support to cover basic necessities such as food and housing. Barriers preventing access to HIV treatment have only strengthened due to the coronavirus crisis. Sex workers are at a disadvantage in terms of social protection. SWING has made efforts to confront the new challenges due to COVID-19. It continues to provide HIV healthcare, including mental health services, for sex workers amid the pandemic
By 2030, the Ministry of Public Health of Thailand plans to reduce HIV discrimination in healthcare settings by 90%. While Thailand has enacted policies and laws to protect people living with HIV, they continue to endure the negative effects of HIV stigma. This prevents them from receiving efficient treatment. Greater efforts and more research are necessary to break the cycle of mental health issues created by HIV stigma to improve the quality of life for those living with HIV in Thailand.
– Zoë Nichols