Explosive spread and effective control of human immunodeficiency virus in northernmost Thailand: the epidemic in Chiang Rai province, 1988-99

The human immunodeficiency virus type 1 (HIV-1) epidemic began in Asia later than most in other regions but then spread very rapidly. Upper northern Thailand was severely affected, with among the highest infection rates in Asia. The first 12 years of the HIV epidemic in Chiang Rai, Thailand’s northernmost province are described. HIV infection was not reported in Chiang Rai until 1988 but, within a few years more than half of the brothel-based female sex workers and one in six of 21-year-old male Royal Thai Army conscripts from the province were HIV infected. Infection rates in Chiang Rai have since declined following an aggressive prevention campaign, but the number of AIDS cases continues to mount, along with profound demographic, social and economic effects.