Showing posts with label thailand. Show all posts
Showing posts with label thailand. Show all posts

Sunday, August 15, 2010

Gay men, safer sex, mini-series

[Posted by Paul Causey on MSM-Asia mailing list, 2010-08-14. Embedded Youtube video found HERE.]

Safe sex lesson wrapped in a gay drama
With its raunchy scenes and dialogue, appealing male characters and realistic local settings, the mini-series, Love Audition, is a form of entertainment that the average gay man may find hard to resist.
Enjoying watching such a straightforward depiction of their lives, they may be unaware that the programme is also indirectly educating them about safe sex.
"Our audience hasn't perceived our mini-series as a campaigning tool but a real series they can actually enjoy," said Vitaya Saeng-aroon, a producer of the series shown on the Mango TV satellite channel.
The first season centres on a bet among three friends aged in their early twenties to use condoms whenever they have sex.
Targeting viewers aged 18-24, the series is not shy about portraying the lives of young gay men - nightclubbing, "bitchy" talks, onscreen kisses and some bizarre sexual encounters.
The temptation for characters to skip condom use is high. For example, character Pom's long-term boyfriend cites "mutual trust", while Ae is tempted by an unsafe choice offered by an attractive stranger.
But they have to learn to overcome temptation and find ways to negotiate with their own desire as well as others' libido in a bid to win the bet.
"There has been so little information in the mainstream media about HIV prevention that is specifically tailored at this high-risk group," said Mr Vitaya. "The media has been so reluctant to talk about actual things in a way that both educates and engages audiences."
Feedback he has received so far convinces him that his series works.
"Viewers have enjoyed it, meaning they could have absorbed our key messages at the right moment. We aim for behavioural change," he said.
Funded by the United States Center for Disease Control and Prevention, the first season can be viewed on YouTube.
The second season, supported by the United Nations Educational, Scientific and Cultural Organisation (Unesco), will focus on drug use in the same age group.
The series is an example of an innovative way to engage young people in sex education and how to deal with sex in a safe and healthy way, its producers say.
But in a highly conservative society like Thailand, this kind of approach has rarely been adopted by parents, educators or the mainstream media.
The Public Health Ministry reports a rapid increase in new HIV cases among men who have sex with men. This group accounts for a quarter of new infections.
About half the young people in other groups also refrain from condom use.
Given these trends, health campaigners say it is time to break the taboo on sex and overhaul sex education in a truthful and non-judgmental way that adolescents will find easier to digest.
A recent survey by the Thai Health Promotion Foundation (ThaiHealth) reveals that most youngsters aged 9-11 seek answers about sex from their friends, and lack understanding about contraception or prevention of sexually transmitted diseases.
UNAids in 2008 said about 40% of young people aged 15-24 did not have accurate information about HIV.
Sirikorn, 17, said she and her school friends often talk about sex and sexual desire.
"I'm not shy when talking about it. My friends also share [intimate] details about their boyfriends," she said.
Nattaya Boonpakdee of ThaiHealth said teachers, parents and the media should start "vaccinating" the younger generation against sexual harassment, STDs and unplanned pregnancies by giving them the information they need.
This vaccination must go beyond the traditional promotion of abstinence, she said.
The mainstream media brands sex as a negative thing which shuts the door on communication with young people, who will not be so easily turned away. The entertainment industry can play a role in educating and helping audiences, she said.
Another challenge is to integrate sex education into schools.
Since young people want to know about sex, it is important for teachers to communicate in an accurate and non-judgmental fashion, said Philip Bergstrom, a reproductive and sexual health adviser to Unesco in Bangkok.
The Education Ministry has developed a curriculum and trained teachers in selected schools but needs to go further, he said.
Young people need to be prepared so they can solve problems themselves, without being told about what they should do or should not do, he said.
"Give them the information they need so they can make healthy, smart choices," he said.

Thursday, August 5, 2010

MSM care and support

Message from Family Health International, Thailand/Regional Office
Dear Colleagues,
We are pleased to share with you the final meeting report from the “Asia regional consultation on MSM care and support”. The report summarizes key policy and technical recommendations developed by participants related to each priority health sector intervention; guides the selection and prioritization of interventions for HIV treatment, care and support; and directs readers to key resources containing the best available information on the health sector response to HIV among MSM.
We are thankful to consultation participants for their excellent contributions to the meeting and draft report. We hope this report proves useful in further shaping and rolling out critical care and support services for MSM. Please contact us should you have any questions.
Warm regards.
[Posted by Paul Causey, MSM-Asia mailing list, 2010-08-04. Report available for downloading from the APCOM Resource Library, and also HERE.]

Wednesday, July 21, 2010

MSM "combination prevention" reduces HIV epidemics

Providing prevention for men who have sex with men could significantly reduce HIV infections in many countries
BY Gus Cairns (NAM)
A mathematical model developed by the Bloomberg School of Public Health at Johns Hopkins University shows that developing effective ‘combination prevention’ programmes for men who have sex with men (MSM), including both biomedical and behavioural interventions, would significantly reduce the scale of the HIV epidemic in many countries.
In areas like Latin America, where the epidemic is mainly driven by sex between men, providing comprehensive prevention to MSM could cut overall HIV prevalence by almost 50%, a pre-conference organised by the Global forum for MSM and HIV heard.
The findings, by researcher Chris Beyrer, were presented at the Be Heard! pre-conference for MSM attended by around 700 delegates.
Stephen Lewis, the former UN special envoy for HIV/AIDS in Africa, who also addressed the meeting, hailed the model as the first evidence hard enough to persuade reluctant politicians that they had to address the prevention needs of MSM in their countries.
Beyrer’s model was made possible by the increasing number of prevalence surveys of HIV in MSM from a number of countries. A literature search, combined with proactive networking with key opinion leaders, unearthed data from 138 prevalence studies of HIV in MSM from 50 different countries, covering most areas of the world with the notable exceptions of most of the Middle East and central Asia.
They reveal that, with two exceptions – Namibia and South Africa – HIV prevalence is higher in MSM than in the general population. In lower- and middle-income countries taken as a whole, MSM are 19 times more likely to have HIV than the general population, and 44 times more in developed countries.
Beyrer identified four different kinds of epidemic based on the proportions of MSM and injecting drug users (IDUs) in the population.
‘Scenario 1’ countries have epidemics mainly restricted to MSM; these are mainly in Latin America with a few outliers like Ghana.
‘Scenario 2’ comprises countries where HIV in IDUs predominated: Russia and eastern Europe.  Here, recent data show that HIV prevalence in MSM is three to seven times that of the general population, though only a quarter of that in IDUs.
‘Scenario 3’ were the countries with generalised epidemics in Africa, though, even here, MSM in countries like Malawi and Kenya have two to three times the HIV prevalence of the general population.
In ‘scenario 4’ countries, most of them in Asia but including outliers like Senegal and Egypt, the one middle-eastern country with data, there is a complex mix of transmission between heterosexuals, IDUs and MSM.
Based on these data, Beyrer devised a model of the MSM epidemic in each scenario that included what could be fed in about STI prevalence, number of sex partners, condom use and – importantly – antiretroviral provision to people with HIV.
He fed in what would happen if a programme of ‘combination prevention’ including both HIV treatment and outreach and community-based behavioural programmes were made available to MSM. He then computed what would happen to the annual number of new HIV infections, not just in MSM but in the whole population, in four selected countries: Peru, Ukraine, Kenya and Thailand.
He also computed what would happen if the status quo persisted and what would happen if all current prevention support – including ARV treatment – was removed. The model lasted from 2007, on which year figures were based, to 2014.
In Peru, providing comprehensive prevention programmes for MSM would make a dramatic difference, with new cases falling from 15,000 in 2007 to 8000 in 2014, compared with an increase to 26,000 if the status quo was maintained. In Thailand the annual number of new cases, currently 33,000, would fall to 20,000.
Comprehensive prevention would make less difference in Kenya, where it would only take 3000 or so infections away from an expected 85,000 new cases in 2014, and in Ukraine, where it would only make a difference of about 1500 from an expected total of 35,500 new cases in 2014.
In Ukraine, however, there is a significant overlap between the MSM and IDU populations, and adding in comprehensive harm-reduction programmes would lead to a 40% drop in new cases to 22,000.
Beyrer ended his presentation on a very personal note, making a plea for comprehensive prevention for MSM by showing a slide of a lover who had died in 1990. “Enough with young men needlessly dying,” was his closing remark.
[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-20]

Tuesday, July 20, 2010

Reaching MSM through the Internet

Internet proving a key way to reach men who have sex with men in Africa, Asia and beyond
Roger Pebody
In the last few years, the scale of the HIV epidemic amongst men who have sex with men in Africa, Asia and Latin America has become clearer. There is now a body of data on HIV prevalence and on risk behaviours, but attention is now shifting to the inadequate amount of prevention work that is carried out with men who have sex with men in many countries.
In advance of the main AIDS 2010 conference in Vienna, activists and researchers gathered for Be Heard!, which turned out to be the largest pre-conference meeting organised by the Global Forum on MSM & HIV yet. The sessions covered a wide range of issues, especially human rights, but several workshop speakers highlighted how the internet has become central to their work with men who have sex with men.
For example, Yves Yomb from Alternatives-Cameroun explained how  – in a context where homosexuality is penalised, blackmail and police harassment are common, the media are homophobic and funding for work with men who have sex with men is limited (MSM do not figure in Cameroon’s national strategic plan for HIV) – his organisation needed to be creative in finding ways to support men who have sex with men.
The internet is commonly used by men who have sex with men in Cameroon to find sexual partners. Moreover, the net is a relatively safe space where sexuality can be addressed in a frank and honest way. Peer educators surf the most popular websites used for sexual networking, where they befriend and inform men about HIV and other issues which men ask about. As access to condoms and lubricant can be difficult, men met online may be invited to come to the organisation’s centre to get supplies. They may then also find out about the other healthcare services and support groups that Alternatives-Cameroun provides.
Tudor Kovacs of PSI Romania similarly explained how he used a sexual networking site to build a support network of HIV-positive men who have sex with men (an extremely marginalised and, until then, invisible group in Romania). He searched GayRomeo for Romanian profile names which included key words such as +ve or HIV. There were only six, and these men were sent a short private message inviting them to form a group (“a safe corner” to chat and be themselves). Those who joined could invite others in too, and the group slowly grew in this way. The agenda for online discussion and the rules for interaction were developed by the group members themselves, with Kovacs primarily acting to mediate and defuse conflicts.
Although the group began as being online only and with all members’ anonymity protected by pseudonyms, many group members later took up an invitation to participate in weekend meetings. These were described as an “overwhelming experience”, with excellent peer support given. Moreover, group members decided themselves to switch to a system where email addresses were visible. Kovacs suggested that one aspect of the group’s success was that the group was presented as a way of getting to know more people, rather than providing support.
In another example where face-to-face activities intersect with online work, Nada Chaiyajit and Christopher Walsh explained their work with Mplus in Chiang Mai, Thailand. The organisation works with various groups including men selling sex, transgender people and younger men who have sex with men. It lets their existing contacts know that staff will be present on various social networking sites and MSN Messenger at specific times, where they are available to interact and answer questions. This multiplies the opportunities for the group to support their clients and extends the relationship with them.
Mplus has also developed short animated videos covering health issues and legal rights. They can be used as an information referral during online work, but are also loaded onto mobile phones or MP3 players, to be used during outreach at parks, public toilets, go-go bars and brothels. The videos often act as a catalyst for further discussion and questions from the client. Another advantage of the format is that the animated videos have been relatively simple to translate into other languages used by clients (a majority of the men selling sex are migrants).
Moreover, the videos were developed with a lot of user involvement and close attention to local understandings of health and sexuality. As with the projects in Cameroun and Romania, this online outreach work relies on having peer educators with a good understanding of local subcultures and the social environment.
Working on a different scale, Stuart Koe explained how he is incorporating health work into www.fridae.com (a large gay dating and lifestyle site in southeast Asia and China).
He suggested that it was essential for HIV prevention to happen online as, for many men, this is their primary means of meeting sexual partners. In the context of negative social attitudes, the web allows anonymity and confidentiality. Stuart believes that health promoters should not try to create new web platforms, but should work with the commercial websites which are already popular and widely used. Moreover, within social networking sites, micro-communities formed around specific subcultures or sexual interests naturally form, and can be reached with targeted prevention work.
He believes that too many online health activities at present are modified versions of traditional health interventions, and do not take advantage of the potential of the web. He gave as examples static “brochure websites” and outreach work in chatrooms, which he considers too labour-intensive to scale up.
Some of the health work that Fridae has done includes an interactive quiz testing knowledge of sexual risks, an online community for men with HIV, the world’s second-largest sex survey of men who have sex with men and a low-cost service providing condom and lubricant deliveries.
They have also adapted the dating and sexual networking functions of the site so that if someone wishes to declare themselves HIV-negative in their profile, they have to supply the date of their last test. If the test was more than a year ago, their status will appear as 'not tested recently'. If it was within the last year, their status will appear as 'negative at last test'. Then a year on from the test date, Fridae will email the man to remind him to test again and give details of local clinics.
[Posted by Paul Causey, MSM-Asia mailing list, 2010-07-19]

Thursday, July 1, 2010

Expanding HIV epidemics among MSM

Beyrer C, Baral SD, Walker D, Wirtz AL, Johns B, Sifakis F. The Expanding Epidemics of HIV Type 1 Among Men Who Have Sex With Men in Low- and Middle-Income Countries: Diversity and Consistency. Epidemiol Rev. 2010 Jun 23. [Epub ahead of print] PubMed PMID: 20573756.
Abstract
Men who have sex with men (MSM) have borne a disproportionate burden of human immunodeficiency virus (HIV) infection and remain a markedly underresourced population globally. To better describe HIV epidemics among MSM in low- and middle-income countries, the authors conducted a systematic review of published and unpublished literature available after January 1, 2000 (2000-2009). A total of 133 HIV prevalence studies from 50 countries met the search criteria. Data were used to develop an algorithmic approach to categorize these epidemics.
The authors found that the HIV epidemic in low- and middle-income countries may be described using the following 4 scenarios:
1) settings where MSM are the predominant contributor to HIV cases;
2) settings where HIV transmission among MSM occurs in the context of epidemics driven by injection drug users;
3) settings where HIV transmission among MSM occurs in the context of well-established HIV transmission among heterosexuals; and
4) settings where both sexual and parenteral modes contribute significantly to HIV transmission.
The authors focused on Peru, Ukraine, Kenya, and Thailand to describe the diversity across and similarities between proposed epidemic scenarios. This scenario-based categorization of HIV epidemics among MSM may assist public health agencies and civil societies to develop and implement better-targeted HIV prevention programs and interventions.
[Posted by Paul Causey, MSM-Asia mailing list, 2010-06-30. With file attachment, download HERE.]

Wednesday, November 26, 2008

Get tested, live longer: fashion statement

[Excerpt of posting by Nicholas Snow, msm-asia, 19 November 2008.]


Global Ambassador for HIV/AIDS Awareness Nicholas Snow to Make Major Fashion Statement at Bangkok International Fashion Week

Launching the "Get Tested, Live Longer" HIV/AIDS Awareness Campaign

New public awareness campaign proclaims, "The absolute latest fashion is to know your HIV status." In his role as a credentialed journalist covering Bangkok International Fashion Week as he does twice yearly, NotesFromThailand.com publisher Nicholas Snow is making a major fashion statement from the grandstands and between catwalk shows, mingling with people who have known him or of him for years, with the debut of his new t-shirt design marking the launch of the "Get Tested, Live Longer" HIV/AIDS Awareness Campaign. Beginning with the first day of BIFW (Nov. 20, 2008) Snow is wearing his design on a black T-shirt.

Snow believes it is particularly poignant to launch the "Get Tested, Live Longer" campaign at one of Asia's leading fashion events presented by an industry chocked full of gay and bisexual men, as well as the men and women who love them. Collectively, the industry has a powerful influence on culture as a whole, so the ripple effect of such a statement could be enormous. In addition, Snow's project has been inspired by the Thai fashion industry, in particular by a recent t-shirt the local fashion guild designed to promote safer sex. Snow is coming out as an HIV positive person in the midst of this crowd to be of service to all of them.

The graphic message begins with "You now know you know someone who is HIV Positive." Snow is making such a dramatic statement because of the invisibility of openly-HIV positive people in Asia and the need for people to know that they know people who are, in fact, HIV positive. This serves the two-fold purpose of getting people to take HIV seriously enough to learn their HIV status, and to challenge the social and cultural stigmas facing people living with HIV/AIDS. Unfortunately, the majority of people in Asia who are HIV positive first learn of their status when they become ill. A person who learns their HIV positive status early after infection has the ability to then monitor with their health care providers CD-4 (T-cells) and viral load counts so they may begin a regime of medications when indicated, thereby dramatically increasing their chances of living a much longer, much healthier life.

Snow also believes that anyone concerned enough about their HIV status to seek out a test who subsequently learns they are in fact HIV negative can be educated and counseled as part of the process of empowering them to remain HIV negative. After decades of adhering to safer sex practices, Snow became HIV positive in August of 2007 because he failed to use a condom, not for good reasons, but for "human reasons" he says, including the fact that he was depressed and seeking comfort in sex; was with a partner who stated and believed he was HIV negative; had a false sense of security about remaining negative since he had been negative for so long as a sexually active adult; and finally, was unaware that the rate of HIV infection among men who have sex with men in Bangkok exceeds 30%.

Monday, November 24, 2008

The Pink Toilet

[Referred from a post by Grace Poore, ap-rainbow, 11 November 2008.]

Asia: The Tale of the Pink Toilet: Transgender Rights in Thailand
Date: November 3, 2008


In 2007, sexual rights activists in Thailand came together as a coalition to demand that their rights be included in the new constitution being drafted by the Constitution Drafting Assembly. Their demands included the rights to non-discrimination, same-sex marriage, and inheritance rights for same-sex couples, as well as the right of gay men and transgender individuals to seek and receive legal redress for rape. The International Gay and Lesbian Human Rights Commission wrote to the Thai National Assembly (parliament) in support of our Thai colleagues and urged Assembly members to recognize sexual diversity and sexual rights in Thailand. Unfortunately, despite the strong backing of Thailand’s Human Rights Commission, the vote on the proposal to include these rights in the new constitution was narrowly defeated in the National Assembly. Eventually, the political upheavals in Thailand altogether delayed the adoption of the new constitution. For Thai activists the fact that the parliamentary debate on the new constitution was nationally televised is worth celebrating since, for the first time, issues related to sexual orientation and gender identity received a level of serious scrutiny.

Within this context, IGLHRC was interested in examining the implications of designating separate toilets for katoey college and high school students in Thailand. The term, katoey is used broadly for transgender identified people, transsexuals, cross-dressers, or effeminate men in Thai society. In 2004, a private vocational college in Chiang Mai, Thailand offered its katoey population of 15 students the option of using separate toilet facilities. In 2008, a public high school set up a separate toilet for katoey students. What do these gestures signal for Thailand’s katoeys who are considered inferior even as they are acknowledged in Thai society?

Thai gay activist and newspaper columnist, Paisarn Likhitpreechakul provides this report and analysis for IGLHRC.

[Read the rest of the article HERE.]

Tuesday, November 11, 2008

Announcement: Diversity celebration in Bangkok

[Posted by Hua Boonyapisomparn, msm-asia, 11 November 2008.]

Dear Friends,

Thailand Queer Network would like to invite you to join the celebration of Thailand's first National Human Rights Day for Sexual Diversity. The event will be held between 9am-5pm on Saturday November 29, 2008 at Lido cinema, Siam Square, Bangkok.

Our theme for this year is "Towards a Clear Sky". The program will include colorful performances to celebrate sexual diversity; lively discussions on the titles law for transgenders, same-sex marriage and LGBTI youth; talk show by the infamous Day Freeman; seminar on LGBTI rights in Thailand; and screening of award-winning Thai Queer Short Films. The full-day event will culminate in the first Rainbow Umbrella March, from Lido to the Bangkok Art and Cultural Center between 4pm-5pm. (Rainbow umbrellas will be provided.)

All proceeding will be in Thai. However, non-Thai speakers are more than welcome to join the Rainbow Umbrella March. We hope to see hundreds of you there!

For more information, contact Paisarn at 66-81-634 3450 or email asiantrekker@yahoo.com and Sitthiphan (Hua) huab2007@gmail.com.

[MSWord document of program can be downloaded HERE.]

Rising HIV among MSM in Thai's "tourist centers"

[Posted by Frits van Griensven, msm-asia, 06 November 2008.]

THAILAND: "Alarm over Rising HIV Infection Among Gay Men"
The Nation (Thailand) (10.31.08)

HIV infections among gay men in Thailand have been rising in recent years, especially in tourist centers like Bangkok, Chiang Mai, and Phuket, health officials said recently. The news was delivered at an Oct. 30th conference about prevention lessons learned from a project targeting men who have sex with men (MSM).

In Bangkok, a survey found HIV prevalence among MSM increased from 17 percent in 2003 to 30 percent in 2007. In Chiang Mai, prevalence increased from 15.3 percent in 2005 to 16.9 percent last year. In Phuket, prevalence leapt from 5.5 percent in 2005 to 20 percent in 2007.

Male sex workers are a high-risk group due to unsafe sex behaviors and lack of HIV prevention awareness, said Dr. Somchai Chakrabhand, director-general of Thailand's department for disease control. "Most of them have anal sex with their partners without using a condom and lubricant," he said. "This could cause deep damage to the anal tissue and easy transmission of HIV."

In recent years, official campaigns targeting condom use among MSM have been discontinued, Somchai acknowledged.

In Chiang Mai, MSM often delay presenting to a general clinic or hospital for STD treatment, fearing others will learn about their symptoms, said Manoon Jaikueankaew, a health official. There is little government or financial support at the local level for MSM. "A one-stop service is really needed to provide information and health care to them," Manoon said. "This is the only way for them to protect themselves from HIV."

The best means of preventing HIV among MSM is providing free condoms and lubricant and raising awareness about health checks to diagnose HIV early, said Chatwut Wangwon, a member of a joint Thai Public Health Ministry and US CDC program. Infected MSM tend to be students, working age, single, and at least 27 percent are bisexual, Chatwut said.

Krathoey and Lanna

[Referred from posting by Paul, msm-asia, 02 November 2008.]

Ladyboys and Good Sons: Contemporary Mediums and Gender Identity in Northern Thai Trance Dance

Lanna (Northern Thai) culture is largely Animist in origin. Belief systems and rituals that go back many centuries and refer to humans’ relationship with and dependence on spirits of the dead are found in various forms throughout the region. Chief among these is the Chiang Mai region, including the cities and surrounding areas of Chiang Mai, Lamphun, and Lampang. Each year in the late Spring and early Summer months leading up to the Buddhist Lent, dozens of trance dance ceremonies take place that pay homage to royal, working class, and hero spirits within family, clan, and social lineages.

Like the majority of Thai culture, Lanna mediumship was traditionally a matriarchal practice, dominated by familial and clan females. However, with social strictures loosening in the middle to late 20th-century Thailand, fewer females have chosen to fulfill their traditional roles or, consequently, become mediums as well, opting instead for more modern vocational roles. Additionally, homosexuality, especially among men, has become generally accepted in mainstream Thai society, opening up their involvement in mediumship. Krathoey, or "ladyboys" as they are generally referred to in English, are gay males of all ages who typically engage in cross-dressing and transvestism.

The Lanna medium population that participates in annual trance dance ceremonies now contains a high percentage of elderly females and young males, the latter of which are primarily gay. While being gay is never a simple and easy social issue, despite greater social acceptance, mediums also have a tenuous relationship within their roles with the mainstream Thai population, many of whom consider mediumship as at best, mysterious and odd, and at worst, a deviant and false religion. Being a male and/or gay medium thus represents a nexus of competing social tensions that are simultaneously resolving themselves via the very nature of their masculine and feminine status.

This paper and audio-visual presentation begins an examination of this nexus and many of the socio-cultural-historical factors that contribute to it through the social-interactive lens of Lanna trance dance rituals, which are generally loud, day-long spectacles that take place in homes and small gathering areas. The presentation content is largely based on fieldwork and interviews conducted by the author in Summer 2008 in Northern Thailand with generous funding from a University of California Pacific Rim Research Program mini-grant.

Michael Sakamoto is currently an MFA student in dance/choreography in the UCLA Department of World Arts and Cultures. He has been performing worldwide since 1992, and has lectured or done guest performances at the California Institute of the Arts, Chiang Mai University (Thailand), the Los Angeles City Cultural Affairs Department, Arizona State University, UC Irvine, and UC Riverside, among others.

Monday, October 27, 2008

Lady-boys in school

[Referred on a posting by Jan Wijngaarden, msm-asia, 27 October 2008]

Thailand's lady-boys are in a class of their own, at last

By David McNeill in Bangkok
Tuesday, 21 October 2008

Lithe, peach-skinned and demure, Arttasit is the kind of woman who would turn heads on any college campus, except that he is not a woman; not yet.

The 21-year-old catering student attends class in Thailand's Suan Dusit University wearing makeup and a body-hugging female uniform. After four years of hormone treatment, he is preparing for a full sex change. "My goal in life is to become accepted as a woman," he explains.

There are about 100 transgender undergraduates at this college in central Bangkok, which offers the so-called "lady-boys" a unique educational refuge from homophobia and discrimination. Students are allowed to flaunt the campus dress code, which demands men wear trousers. Every year, dozens of the students enter a university beauty contest that has become famous for supplying entrants to Thailand's Miss Tiffany Universe, an annual pageant for transsexuals broadcast live across the country. Lady-boys work as teachers in some university departments and are even sent out on school recruitment drives.

"I'm happy here," says Wittaya Jannoi, a 21-year-old marketing student who hopes to change his gender after he leaves. "We can be ourselves because we don't have to hide. My mother said, 'Graduate first, then you can do what you want'." Like many transgender students, he learnt about the university through the beauty pageant. "I couldn't wait to come here."

Bureaucrats in Thailand's Ministry of Culture say the Suan Dusit experiment encourages confused youngsters to recklessly experiment. But Pacharee Suankaew, vice-president for student affairs, says: "Our view is that everybody is equal: boy, girl or lady-boy. We try to accept them and not look down on them."

Also known as "the third sex", Thailand's lady-boys have campaigned for years for equal rights and seek, among other things, separate bathrooms and passports that record their unique gender. Despite the discrimination, the country is famed for its acceptance of transsexuals, with a booming sex-change industry that attracts people from across the world.

Transgender students started coming to Suan Dusit about a decade ago, attracted to courses in catering and marketing. The numbers climbed after the start of the beauty contest. Ms Suankaew says they can study everything on offer, except education. "We can't have them teaching kindergarten children and they accept that." In return, she says, the students must be ladylike. "We tell them, 'If you want to be a woman, act like one'." Some staff are resisting. "Some professors tell us we are not human beings and we should grow up," says Arttasit. "They're usually older women with thick glasses."

Wednesday, October 1, 2008

"Action Equals Life" launches

[Posted by Nicholas Snow on msm-asia Google Group, 01 October 2008]

ActionEqualsLife.com Web Site Open / Bangkok Press Conference October 8th

FOR IMMEDIATE RELEASE

Nicholas Snow, founder of ActionEqualsLife.com, is revealing that he became HIV positive in August of 2007, and holding a press conference to call attention to key issues such as the need for HIV testing and early intervention, the need for increased adherence to safer sex practices, and the rates of HIV infection among various communities in Asia and other parts of the world.

Snow is also using the press conference to spotlight passionate individuals involved in the fight against HIV/AIDS.

Appearing on the panel, among others, will be Narumol Sriyanond, Ph.D., and Tim G. Zajaros Jr., founder and co-founder respectively of Building for Life, a non-profit social activism group, currently producing a feature-length documentary about HIV/AIDS.

Dr. Narumol is also the director of Thai Women: Challenging AIDS, a passionate 10 minute short documentary film by Narumol Sriyanond, Ph.D., that interweaves personal stories of Northern Thai women with HIV/AIDS, who use their creative and spiritual strength to challenge the societal stigma of the disease.

About ActionEqualsLife.com

According to Snow, "ActionEqualsLife.com is my personal globally-focused community service project, and a focal point of my life moving forward."

ActionEqualsLife.com is devoted to creating HIV/AIDS awareness; to supporting the creation of lesbian, gay, bisexual, transgendered and queer (LGBTQ) civil rights worldwide; and to being a champion of human rights for all.

This community—blogs, groups, profiles, events calendar, photos and more—is being built by its members, people with a passion to change the planet. While the primary language of the community will be English, members may create blogs and forums in multiple languages.

The Action Equals Life Press Conference will take place Wednesday, October 8th, at the Foreign Correspondents' Club of Thailand, beginning promptly at 10:00 a.m. (registration 9:30 a.m.).

For more information, email Nicholas Snow.

Announcement: technical officer at FHI

[Posted by Celine Daly on msm-asia Google Group, 29 September 2008]

Family Health International (FHI) is a U.S. based non-profit international public health organization dedicated to improving the health of populations in more than 70 countries worldwide through research, education and prevention services in family health. Our work includes public health HIV/AIDS prevention and care and clinical research on infectious diseases in 10 Asia/Pacific Countries including Thailand. The Asia/Pacific Regional Office (APRO) of FHI is seeking highly qualified and experienced individuals to join its team, based in Bangkok.

VACANCY
Technical Officer, Male Sexual Health (MSH)

The Technical Officer will provide technical assistant to FHI’s country and regional programs in Asia Pacific region in the area of male sexual health and ensure that FHI’s Men Who Have Sex With Men (MSM) outreach and service provision programs are technically sound and of high quality.

Duties and Responsibilities:

  • Provides program and technical assistance to MSM projects in FHI country programs in the Asia Pacific region.
  • Liaises and networks with international donors and senior level Ministry of Health and other government representatives in developing and implementing MSH programs or influencing of such programs.
  • Ensures that high quality of HIV communications interventions and research in FHI programs are of international standard and quality of developing and implementing appropriate mechanisms to ensure quality of the interventions in collaboration with program staff and implementing partners.
  • Collaborates with other APRO and FHI/USA technical staff in the development and implementation of guidelines, tools and recommendations related to HIV strategic behavioral among MSM
  • Supports country offices through capacity building of FHI and other implementing agency staff who work in the area of male sexual health.

Qualifications:

  • Thai National
  • Master’s degree or equivalent in public health or related field
  • At least 5 years of relevant experience in and working with NGOs, international and/or donor organizations in HIV/AIDS
  • Has knowledge of HIV/AIDS, reproductive health, public health, or research health programs in developing countries
  • Excellent written and spoken English

We offer a competitive compensation package.

Kindly send your resume and cover letter via email to: Human Resources Department at HR@fhibkk.org. We shall consider only applications via email address and only shortlisted candidates will be notified.

Closing date for application is October 15, 2008.

Thursday, September 18, 2008

MSM life skills camp by Fasiroong

[From an attachment to posting by Rob Sutherland on msm-asia Google Group, 18 September 2008]

To: Ms Prateep Ungsongtham Hata
Secretary General, Duang Prateep Foundation

Date: 17 September 2008

Subject: 28th MSM Life Skills Camp; HIV Prevention Skills and other life skill, 6-7 September 2008, 'Rim Korb Fah Camp' in Samuth Prakarn province.

I am writing in reference to the abovementioned workshop which I attended at the invitation of staff at the Rainbow Sky Association of Thailand (Fasiroong). I was wishing to convey my congratulations and support to the Duang Prateep Foundation for its funding of this initiative.

This workshop is a positive example of best practice HIV community education and development for young men who have sex with men (MSM), executed under the broad framework of ‘life skills’. The precise type of program that should qualify for scale up in national responses. I would like to share three key insights from my involvement with the workshop:

HIV skills and knowledge development

The workshop delivers accurate, culturally appropriate and practical HIV knowledge and skills to participants in a manner which is understanding of the context that HIV has in the lives of many MSM. Examining the barriers and facilitating factors to the practice of consistent safe sex in a method that is engaging, effective and undeniably real. One activity in particular ‘Fluid Changing’ is a highly innovative way of demonstrating how quickly, efficiently and covertly HIV can spread through MSM sexual networks. The outcome of such activities is an acutely increased awareness around HIV risk and sexual responsibilities. Practical advice on how to act upon this awareness is succinctly provided, including where to access condoms and lubricant, MSM friendly VCT services and other forms of support.

Addressing broader issues of vulnerability

Addressing HIV under the broad framework of ‘Life Skills’ for MSM is consistent with best practice HIV programming for this population. It generates an interest from a broad array of MSM who may not be interested in attending a workshop that is narrowly focused on HIV. This is particularly so for younger MSM who may not perceive HIV as a key priority in their life. A high proportion of the participants were indeed young sexually active MSM, a key priority population as outlined in the Report on the Commission of AIDS in Asia, 2008.

Perhaps more importantly however it addresses the associated risk factors and vulnerabilities that place MSM at greater risk of HIV infection. The curriculum covers issues of sexuality and self acceptance, developing sexual negotiation skills and sensitizing participants to people living with HIV (PLH) thereby reducing discrimination and stigma. All this is woven effectively throughout the curriculum to give a strong sense of community and enhanced confidence, empowering participants to make healthier and more informed decisions.

Peer leadership development

The workshop offers the opportunity of participants to become peer leaders themselves and play a role in the development and implementation of future workshops. This is a unique opportunity that capitalizes on the skills, knowledge and motivation that participants gain and is a key ingredient in the success of this model. It also adheres to the principles of true peer education, as participants become facilitators and facilitators become mentors to new participants. The peer facilitators are not only highly skilled in their role but are also clearly respected. What develops is a strong network of volunteers and young MSM peer leaders whom have a sense of ownership over the workshop, ensuring that many will stay engaged and thereby supporting sustainability of the program.

Given the ongoing and alarmingly high rates of HIV among MSM in Bangkok (30.7%, 2008); this is a timely and invaluable program. Again I congratulate the Foundation on supporting such an innovative program and hope that it can grow and expand in the future.

Yours sincerely,

Rob Sutherland
Capacity Development Officer
UNAIDS Regional Support Team, Asia and Pacific

Thursday, August 7, 2008

HIV and MSM in Thailand

High HIV incidence among young Thai men who have sex with men
By Roger Peabody, NAM.

The first ever study of the incidence of new HIV infections among men who have sex with men in Thailand has shown that each year 5% acquire HIV, reported Wipas Wimonsate from the Thai Ministry of Public Health at the International AIDS Conference in Mexico City on August 4th. The men recruited to this study will continue to be followed for three years, and the data from the study will help the planning of HIV prevention in this group.

Thailand is often seen as a lesson in early and effective HIV control. However, efforts have largely concentrated on commercial sex workers and their clients as well as injecting drug users. The ongoing spread of HIV among men who have sex with men (MSM) had been largely ignored until a much overdue study of Bangkok MSM in 2003 found an HIV prevalence of 17%.

Although there has been an increase in HIV prevention activities in the past few years, when the prevalence study was repeated in 2005 and 2007, the figure had jumped to 28% and then to 31%. Given that prevalence was high in men under the age of 22 (who had been sexually active for a brief period), this suggested that incidence must be very high. Moreover four-in-five of those infected with HIV in 2005 were unaware of their infection.

In the current study, a cohort of 1,292 Bangkok MSM was recruited, who will be followed at four monthly intervals over a three year period. Recruitment began in April 2006, and was completed by January 2008. Participants are all Thai nationals, male at birth, resident in the Bangkok area, aged 18 or over, and have had anal or oral sex with a man in the six months before recruitment. Participants were recruited from the sexual health clinic where follow up visits were conducted, through a web site, from a range of bars, saunas and parks used by MSM, and through community organisations.

Men recruited were relatively young (73% aged 29 and under), and were frequently born outside of Bangkok (64%). A majority were employed, well educated and identified as homosexual or gay.

In this sample, 23% of men were HIV-positive at baseline. Although 48% of the cohort had previously tested for HIV, none of those with HIV had been previously aware of their infection.

In July 2008, follow-up data were available covering 985 person years of participation in the cohort study. A total of 54 men had sero-converted to HIV, which corresponds to an annual HIV incidence of 5.5%.

The mean age for those acquiring HIV was 24 (range 18-42).

Risk factors for HIV infection

Further information was provided on those who had HIV at baseline. Wipas Wimonsate described the risk factors for HIV infection as being similar to those found in other settings. In multivariate analysis, they included being aged 30 or over (compared to men 21 and under, odds ratio (OR) 2.32). Men without university/tertiary education were more likely to have HIV (OR 1.72), but on the other hand, infection was more likely in those who were employed (OR 1.70).

Unsurprisingly, men who usually had receptive anal sex were more likely to have HIV (OR 1.71), as were men with HSV-2 (OR 3.89) and rectal gonorrhoea (OR 2.54). Moreover, men who had used the recreational drug poppers in the past four months were more likely to be positive (OR 2.29).

Men who had never tested for HIV before were more likely to have HIV (OR 1.60). However men who frequently worried about getting HIV in the future were also more likely to have their fears confirmed (OR 1.96).

There was also information on sexually transmitted infections at baseline. Prevalence was high: 44% of men had hepatitis B, 20% had genital herpes (HSV-2), 4% had syphilis, 9% had chlamydia, and 6% had gonorrhoea.

Reference

Wimonsate W et al. Successful start of a preparatory HIV cohort study among men who have sex with men (MSM) in Bangkok, Thailand: preliminary baseline, follow-up and HIV incidence data. XVII International AIDS Conference, Mexico City, August 4 2008. Abstract MOAC0105.

Tuesday, August 5, 2008

Gay bar crackdown in Pattaya

Pattaya mayor cracks down on illegal gay bars and teen druggies
Pattaya Daily News, 26 July 2008

The Mayor of Pattaya, Mr.Itthipol Khun-pluem, intent on cracking down on illegal operations and under-age sex in one of Pattaya's most popular gay venues, Sunee Plaza, South Pattaya, on July 26, 2008, co-operated with police to mobilize in strength and thoroughly search the area. They were especially concerned to eradicate the prolific gangs of teenagers who sell sexual services, amongst whom there is a high illegal drug usage.

At 00.30 AM, on July 26, Pol.Col.Nopadol Wongnom, Pattaya Superintendent, organized a 70-man squad of regular and volunteer police to raid Sunee Plaza, where many foreigners go to find willing young boys. The squad checked 50 gay beer bars, pubs and go-go bars on the lookout for business licence lawbreakers, overly-explicit sex shows and staff under 20 years old. However, no premises were found to be breaking the law on any of these three counts.

Police volunteers, nevertheless, did manage to detain over 100 rent-boys who were soliciting in the plaza. Of these, six were under 15, 40 were using Yah Bah (amphetamines) and four were illegal Burmese immigrants. All the offenders were detained at Pattaya police station.

Pol.Col.Nopadol Wongnom, Pattaya Superintendent, stated that because Pattaya is a prominent international tourist city, with millions of Thai and foreign visitors annually, it has long been a favourite venue of criminals, sex tourists and paedophiles. As a result, Pattaya's new mayor, Mr. Itthipol Khun-pluem and Pattaya Police have decided it is high time that illicit activities were eradicated and a good reputation be created for the city.

Consequently, police have started a surveillance campaign and crack-down on non-compliant entertainment owners and sexual abusers. The authorities are particularly concerned about the large number of young boys, mainly from up-country and largely uneducated; many of whom have no legal guardians, forcing social services to send them to rehabilitation centres. However, because of the demand for their sexual service and the easy money available, the teenagers escape from the rehabilitation centres to return to Sunee Plaza to ply their trade. The problem is exacerbated by the fact that many teenagers use their immoral earnings to buy drugs to share among their friends.

Mr. Itthipol Khun-pluem stated that he was relatively satisfied with the level of arrests and optimistic about the ongoing combined attempts to eradicate crime and give Pattaya a good name.

Thursday, July 24, 2008

Male sex work in Chiang Mai

The Other Side of the Coin: Male Prostitution in Chiang Mai
Chiang Mai Citylife Vol. 15 No. 10 October 2006

The room was on the 14th floor of an expensive apartment block, facing on to a balcony suspended far above the miasma of the city centre. A gleaming combination of shiny black granite, polished teak wood and windows, it wasvisible before we reached it - the light shining through the open door andbouncing off the stark white walls of the corridor, was accompanied by the sing-song buzz of engaged voices.

It was a delightfully hedonistic affair: generously heaped platters ofsnacks laid out on sparkling surfaces, a perennial flow of fine wine and cocktails, and two luscious, attentive barmen clad only in jeans and their six-packs. One of them - dark, tall and muscled - caught my eye as I walked in and stared at me intently with a practiced gaze until I looked away."Love the eye candy. Are they straight?" I asked our host, Pete, a littlelater. "Oh yes, absolutely", he answered emphatically. "There are so many women coming to my party that I thought I'd do something for the girls tonight."

A few hours and a substantial number of drinks later, things had begun toturn pleasantly pear-shaped. Tongues and ties were loosening as the horizon flashed with the approach of a tropical storm and glances at the naked torsos behind the bar were no longer quite as furtive. The boy who had greeted me at the door swaggered up to our balcony table, dispensing Cosmopolitan refills from a leftover songkran bazooka. It was then that I really noticed his companion for the first time, standing quietly behind the bar. Aung had a strong, refined beauty - square jaw, full mouth, alabaster skin. When I began speaking to him later that night he commented on the traditional patung I was wearing and pulled a laminated photograph out of his wallet. His father, mother and grandmother, he told me, both women wearing sarongs similar to mine. "I haven't seen them in four years."

"If your friend wants to take him home she's perfectly welcome," I was surprised at Pete's message when it was relayed to me. At that moment I realised the power of the human ability to repress what we know to be true. In the recesses of my consciousness I had known all along that Aung was for sale, but as a virgin to the sex trade, I was having some trouble getting my head around it.

Over the next four months I became close friends with Aung and the complexities of his story became clearer to me. Like more than half of Chiang Mai's male sex workers, he was of Shan (Thai Yai) origin. A shared border between Shan State in Burma and Chiang Mai makes our Northern Province one of the most accessible areas to Thai Yai men seeking work outside Burma. Aung was 19 years old when he arrived in Chiang Mai via the Taichilek-Mae Sai border, four years previously. His Shan father and Chinese mother were farmers and money was always in short supply during his childhood. "Burma is not like Thailand," he told me on one occasion. "In Burma, the government doesn't help you if you can't afford to go to school. My parents were poor and couldn't help me either, so I left school five years early."

When Aung was 6 years old, three of his four siblings - two brothers and asister - died suddenly, leaving behind a devastated family. "When I turned 17 I left home to look for work," he says. I went everywhere in Burma to find a job that would give me good money, but I couldn't find one, so I came to Chiang Mai," Aung said during one interview. "My parents cried when I left, but it was the only way I could earn money to help them. When I got toThailand I didn't know anybody, I didn't know where I was going, I didn't understand the language. Thai is similar to Shan so I have mastered it, and now I am studying to improve my English."

Aung's first job in Chiang Mai was in a restaurant kitchen, working seven days a week from 8 a.m. till midnight, for a salary of 2,000 baht a month. When his Thai improved he moved on, taking a day job at a restaurant and working evenings as a barman in Chiang Mai's Night Bazaar. It was here that he was approached by his first customer, a Singaporean woman who offered hima thousand baht to spend the night with her. "I was excited," he responded when I asked him how he had felt. "At the bar I earned just 4,000 baht a month. What could I do? I needed to send my father and mother money to build a new house." It was not long before Aung extended his services to men, though he told me he restricted these encounters to a few times a month("otherwise I don't have the power") and by the time I met him he was completely immersed in the sex trade - working days at a massage parlour and nights at one of Chiang Mai's most popular go-go clubs. With the money he earned there he was in the last stages of paying off his parents' new house.

My first visit to his bar shook me up, literally. There is nothing subtle about the city's go-go bars - though I never saw full sex performed onstage, the shows are explicit and are followed by a brief parade in which all 'waiters' strut their stuff. My hands were trembling when I left that first night, but it was not so much the naked bodies on stage that upset me as the sight of Aung's name placard emblazoning his tie. It was that small detail that made me acutely aware that he, too, was the potential object of a simple monetary transaction. But as I became familiar with the scene, the violence of my initial reaction soon subsided to subtle discomfort. I didn't mind going to visit Aung at his bar anymore - I felt comfortable as long as he was there and I enjoyed talking to some of the boys I met, who were friendly and polite. There was even something strangely thrilling about a world in which society's conventions did not apply - a cultural underbelly governed entirely by the human desire for money and sex - and I realised how easy it would be to become entirely de-sensitised to the environment.

"It's not difficult to understand how young boys from poor families get drawn into selling sex", says Pad Thepsai, drop-in manager of Mplus, a non-profit organisation that provides health and information services to men who have sex with men (MSM) - homosexuals, transgender people and male sex workers. "Many boys come here from their villages in the hope of being able to send money back home to their families. Some of them are hill tribe, others are from Isaan and many are from Burma, where people are treated like animals - especially the ethnic minorities like the Shan or Karen."

The issue of male prostitution, he explains, is closely tied to the problems faced by Burmese refugees who come to Thailand looking for a better life. "Because most are illegal immigrants, they are often exploited. Many start out working in the construction industry and are paid only a portion of their salaries because the companies they work for know that, without ID cards, they can do nothing about it. And to get ID cards they need cash. They speak to other boys who are already working in the bars, making good money and this is the way they start. Everybody wants more money, a better life. Education is the best way - but not all sex workers have access to education. Most of them start selling sex when they are very young and have no idea what they are getting into. They get lost in this world, they don't understand the impact of the work they are doing - they don't have anybody to tell them."

Mplus provides the north's only free MSM clinic, as well as a drop-in centre and information resource centre dealing with MSM issues and education. The organisation also does outreach work with male sex workers and youths, providing information and distributing free condoms with the aim of curbing the spread of STDs. While the incidence of AIDS and other STDs is lower in Thailand than in some other parts of Asia, a 2005 study revealed that approximately 11.4% of male sex workers in Chiang Mai are HIV positive.

Like all thriving industries, Chiang Mai's male sex trade is a well-organised web of working spaces, systems and protocol. "There are so many places where sex is sold," says Thepsai. "Mplus works all over Chiang Mai - in gay bars, cabarets, saunas, spas, massage parlours, cruising parks, stadiums - even one public toilet." There are approximately 36 gay meeting points in Chiang Mai, he tells me, many of which are frequented by male sex workers - some as employees of the bars, others as freelancers.

The fact that much of the city's male sex trade is concentrated in gay-friendly venues does not mean that all visitors and/or paying customersare gay men - or even men, for that matter. Several of the boys I met at the bars said they sold sex to all kinds and during my visits to the clubs I was offered sex by both heterosexual and homosexual workers who said they sold sex across the gender barrier. Aung puts the division of customers at his go-go club around 80% gay men to 20% women. "But there are also others that come to the bars - bisexual men, or married men that are mostly straight but like something different. And twice I have been with couples who wanted me to have sex with both of them."

The go-go bars are overseen by one or more mama-san - a management individual or team that provides the channels of communication needed for transactions in the bars to be smoothly conducted, including the payment of a 'bar fine ' should customers wish to take a boy home. Fluent Thai and a reasonable command of English are pre-requisites for this position in ChiangMai: 'captains' - as one told me he preferred to be called - often need to negotiate on behalf of Shan, Burmese, Isaan and hill tribe sex workers who aren't proficient in the languages of their clients. "Not all the boys go with customers and not all of them will sell full sex," says Ae, who has worked as a captain in both Bangkok and Chiang Mai, "but for most its easy money. A good mama-san knows exactly what each of his boys will do - whether they sell full intercourse or oral sex or only hand jobs. He finds out from the customers what kind of boy they like and what services they are looking for and helps to make a good match."

Aung tells me that he usually requests between 1,000 and 5,000 baht from customers for full intercourse, 10,000 baht if they appear to have the money to spend. "Most Thai customers will only pay 1,000 baht, sometimes 2,000baht, but farang will often pay more, so I ask for more." While some boys working the go-go scene prefer not to go home with customers, Aung tells me that almost all will do so for 1,000 baht or more. "But not all customers come to the bars to buy sex," he adds. "Some just come for the show or to talk to the boys and then go home."

Monthian Promlatthisorn, Mplus project manager, estimates that male sex workers in Chiang Mai can make between 15,000 and 40,000 a month, a financial bracket far beyond the average earning potential of most student-aged Thais, and one that many Burmese refugees may never have dared to dream of. Quite simply, the money can't be beaten. "Approximately 95% of sex workers in gay bars are heterosexual," says Promlatthisorn. "They don't want to have intercourse with other men, but sex is the bridge to the money they want." I asked Aung at one of our meetings how he felt when he was servicing male customers. "I don't feel," he replied. "It's work…I just close my eyes and do my job." During this conversation he was calm and composed, even detached, but at another interview a few months later he became visibly upset. "None of us who work at the bar likes to do it. We are all there for the money. I don't work for me - I work for my mother and father." "The issue of prostitution in Thailand - both male and female - can't really be separated from the country's cultural framework," says Tey, an eloquent Thai man who spent time studying and living in Germany and the United States. "In Western countries individuals can be independent from their families, while here there is an enormous degree of dependence on the fact that children will take care of their parents. If you look at it in the light of these expectations it's easy to see why the sex industry here is so successful. It is part of Thailand's cultural fabric. And people looking in from the outside need to understand that if you break down this system you not only break individuals, but whole families."

At the Night Bazaar one evening I talk to Tua, a bar owner. The area around this popular night market is worked by boys playing pool, massaging or drinking with customers. Things work slightly differently here than at the go-go bars - though sex is just as easily available for purchase, not everybody sells it and those that do work on a freelance basis. "Many of these boys first come here selling flowers," says Tua. "They earn hardly anything in a day, and when they are offered 500 baht to give some guy a hand-job, they see it as easy money. Some of them start working in the sex trade as young as 10 or 11."

It is at the Night Bazaar that I meet Zach, a gentle, soft spoken Canadian who has twice taken boys home from this bar strip. After many months of exploring the sex trade from the perspectives of its purveyors, my conversation with him offers insight into another angle of the issue - that of those supplying the industry's demand. "These boys provide a service," he says, "which they are willing to sell and others are willing to buy. They can always say no if they don't want to go home with a customer - the choice is there."

Two other paying customers I speak to have a very similar outlook on the situation. At the same bar a few nights later, Belgian Gerry introduces me to his 20-year old 'boyfriend'. "He likes girls," says Gerry, "but that's not a problem for me. He comes with me at night, but he does his own thing during the day, because we both need our freedom. It's a good arrangement - a relationship that works."

Dave, 45, is a regular visitor to the gay bars and massage parlours of his adopted home. "I don't go to bed feeling guilty at night," he tells me. "The way I see it, every relationship is a contract. These boys come here from the villages looking for money - so they get what they want and I get what I want, which is no-strings-attached sex."

On the last night I see Aung at the go-go bar, he shows me an Mplus card declaring him HIV negative and tells me he has decided to stop selling sex."It's not good," he tells me, "I don't want to do it anymore." "Some things are more important than money", I say to him. "Your health is more important, your happiness is more important." "My life is more important," he agrees. But I am not surprised when three weeks later he relocates to a bar at the night market. For a while he continues to tell me he is no longer involved in the sex trade and only works as a barman, but later admits that he still services customers occasionally. He wants to open a small shop oneday, he says, and hasn't saved up enough money yet.

by Cindy Tilney