Of all Asian countries, Thailand has been the first and one of the hardest hit by the HIV-1 pandemic. A national surveillance system was implemented in 1989 to monitor the spread of the epidemic to the general population: in 1994, the prevalence of HIV infection in pregnant women presenting at the antenatal clinics was exceeding 10% in highly impacted regions such as Phayao located in the Northern part of the country. With the nation-wide prevention campaigns, the prevalence rates in pregnant women dropped significantly. Since June 2006, the prevalence rate of HIV-1 among pregnant women was less than 1% nationwide, with the highest rates found in the Central and Eastern provinces of the country. Despite this outstanding progress, many infants in Thailand are still born to an HIV infected mother and are at risk of acquiring HIV/AIDS.
Thailand has an estimated 570,000 people currently living with HIV. With the expansion of access to treatments through the national program (NAPHA), in 2009, over 197,000 persons receive antiretroviral treatments under the universal coverage system. Approximately 50,000 receive treatment from other programs.
Though pediatric HIV infection has dramatically decreased in Thailand due to the implementation of the national PMTCT program derived from the PHPT's research studies, there is a need to optimize interventions and to maintain the lowest possible rate of mother to child HIV transmission whilst eliminating the risk of developing resistance mutations to antiretroviral drugs in the mothers in order to maintain their future treatment options under the Thai universal coverage system.
Furthermore, as the number of persons receiving antiretroviral treatments will continue to increase, the national treatment guidelines will need to take into account the latest research studies on how to best treat these patients within resource limited settings.
The knowledge, technology and experience gained through PHPT studies and training on the prevention and treatment strategies in Thailand is also critical for neighboring countries and other countries heavily hit by the AIDS epidemic. The Thai-PHPT experience is being transferred through a Franco-Thai-Lao Training program for physicians, laboratory technicians and nurses, the “Esther” Program, and through the Mekong Regional HIV trainings conducted with collaborating partners at Chiang Mai University Faculty of Associated Medical Sciences.