A hotline counselling service educates the public on HIV/Aids while helping those infected

Story by KORAKOT SURIYA-ARPORN & Photo by YINGYONG UN-ANONGRAK

WhenThailand detected its first Aids victim in 1984, few Thais had a clue about it. And 25 years later, with more than one million people suffering from HIV/Aids, few still have a clue about it.

Apart from the fear of deep social stigma, people have a lot of misunderstandings about the disease and little awareness on self protection. And that is the challenge for the hotline service Aids Access Foundation.

Set up in 1991, the hotline service is part of Aids Access's advocacy campaigns to provide accurate information about the disease and and instil public empathy for people with HIV/Aids. Its activities are funded by the Public Health Ministry, international organisations and local donations.

Due to the stigma, most patients hide their sickness and do not know where to turn to, said Aids Access Director Nimit Tienudom.

"What the patients most need is a chance to talk with someone who is willing to listen to them," he said. "Through the hotline service, we can reach out to them and guide them toward a way out, not just letting them helplessly drift and figure it out on their own."

The phone counselling service keeps the callers anonymous and their information confidential, which makes the callers feel secure and able to talk freely. This secrecy principle is extremely important since the callers' lives could be jeopardised, said Nimit.

The hotline service is not exclusive to people with HIV/Aids, he added. It is open to everyone seeking information and help for their relatives and loved ones.

According to the Disease Control Department, Public Health Ministry, about one million Thais have become HIV positive in the past 20 years, with about 560,000 of them dying of Aids. New infections last year were around 14,000. One-third are young women and housewives who get infected by their partners through unprotected sex. One-fourth of the newly infected are men who had unprotected same sex. Again, the main culprit is "unprotected" sex.

Much of the problem stems from a lack of understanding about the disease and possible preventions, said Kamondhej Sowanna, home-care service officer and hotline staff member.

Inadequate information and misunderstanding often result in risky behaviours among the youth who do not realise the importance of safe sex until it is too late.

Lack of state support for effective campaigns for safe sex is also to blame. The state budget has been reduced by half over the years, and has not been used to promote condom use among youths, he added.

According to the World Health Organization, less than five per cent of adolescents are being reached with adequate HIV/Aids prevention services in Thailand. Moreover, around 85 per cent of Thai youths have no awareness of the disease, even though most are at risk of becoming new cases themselves.

Reflecting lack of accurate information, many people wrongly believe that Aids can be transmitted through mosquito bites. The hotline staff, said Kamondej, receives hundreds of callers asking this same question.

Instead of dismissing misinformed callers, the staff urges the callers to think about the real risk - sex without condoms.

"Most callers fail to realise that some of their behaviours are potentially an HIV threat. They believe Aids will happen to only those who regularly enjoy the night-life. In fact, the culprit is unsafe sex, which more often than not happens in a relationship when one fully trusts the partner," he added.

It is no surprise, therefore, that the newly infected are mostly young females who had unprotected sex. According to the World Bank Social Monitor on Youth, over 40 per cent of deaths among young females aged 15 to 29 in 2004 was caused by HIV/Aids, which remains the main cause of death for young females. At its core is gender inequality, which makes girls reluctant to ask their partners for condom use, fearful of appearing sexually experienced.

New female Aids patients keep going up in numbers. In Thailand, it previously was a six-to-one ratio of men and women patients. Now it's two-to-one, commented the Aids Access director.

Whether in the past or now, what the hotline staff need are not only facts about Aids, but psychological savvy to handle tough calls; many are suicidal when they call.

"The staff needs to detect and understand the emotional state of every caller and tactfully talk to them," he said, pointing out the importance of staff training.

The staff, all volunteers from various backgrounds, work in two shifts - 10am to 3pm, and 3pm to 8pm - with six counsellors per shift. All have training in counselling techniques, correct knowledge on the facts about HIV/Aids, and most importantly, are never judgemental.

Aids Access Foundation now has about 30 volunteers. Unfixed schedules, however, still cause a shortage of staff during some time slots. The foundation recently held a workshop to attract more volunteers.

"Come join us. This is something we can all chip in to help stop Aids from spreading further," said Nimit.

"We need to understand HIV/Aids correctly. We need to be more open about sex and make sex education more widespread. If that happens, we will see less Aids threats," he added.