The Kingdom of Lanna and the HIV Epidemic

largely due to the cost of penicillin, inexpensive as it is.
The shame and social stigma of HIV/AIDS have likewise had very negative impacts
on control of the disease. The same reluctance to seek treatment and testing, the same
resistance on the part of governments, schools, religious organizations, and social groups to
address sexuality, HIV prevention, and condom use have hampered HIV control efforts
worldwide.(3) In this respect, however, Thailand has been an impressive leader. While the
U.S. government continues to debate condom education programs in the schools, Thailand
began condom education, distribution, and manufacture as soon as it became clear that HIV
had arrived. The "100% condom campaign" has been a model program, and may have spared
the country an ever larger epidemic.(18)
Despite the impressive success of the Thai response to the epidemic, discrimination,
real and perceived, continues to be a problem for persons with HIV/AIDS in Thailand. This
discrimination is far-ranging, and involves not only social isolation at the individual and
community level, but discrimination in health insurance, jobs, housing, and in health care.
As the epidemic matures, and more people move from being HIV infected to being ill with
AIDS, these many forms of discrimination will have to be addressed. It will require a
significant social response to embrace and support people with HIV and AIDS in Thailand,
as it has in other countries affected by the epidemic. Even greater demands, however, will
be placed on the people of northern Thailand, which will have many more sick and dying.
people to cope with, and fewer resources.
What about what business leaders refer to as the "bottom line?" How will the HIV
epidemic affect the explosive economic growth that has been such a dramatic part of recent
Thai life? HIV is primarily a disease of young adults. As such, its greatest toll is on the
segment of the population most involved in economic growth and development; the
workforce. In addition, young adults are also the population group who have traditionally
both supported the elderly and raised the young. In the hardest hit parts of Africa the loss
of this group is already starkly evident; whole communities are dominated by grandparents
and grandchildren, elderly people who have lost their main means of support, and "AIDS
orphans" who have lost one or both parents.(3) The economic impacts of these losses are thus
multiple, and have long lasting implications. If the northern Thai epidemic were to stop
tomorrow, and no new infections were to occur, the region would still lose something like
10% of its workforce over the next decade, and would still have to support several thousands