The context and impact of HIV and AIDS in Chiang Rai, Thailand: A study of youth and young adults

This study examines the geographic variation in the incidence of HIV/AIDS in Chiang Rai, one of the northern districts of Thailand with a very high rate of HIV infection and AIDS. A related goal of this study is to understand the socioeconomic impact of the disease. First, spatial analysis is used to estimate the effects of local determinants on the incidence of HIV and AIDS. Second, standardized questionnaire surveys of patients are conducted to understand the individual context of the disease. Finally, in-depth qualitative interviews are used to examine the socioeconomic impact of the disease at the individual level. Results show that localities with a relatively high percentage of households engaged as laborers, localities close to municipal areas, and those with a high concentration of commercial sex workers are significantly correlated with high incidence rates. Places close to municipal areas are typically more urbanized, with diverse income groups and businesses in their vicinity. These areas have higher levels of risk factors compared to places that are remote. The interview-based analysis shows that HIV/AIDS patients, from diverse education and income backgrounds and different levels of comfort with disclosure and disease intensity, have shown equally diverse levels of suffering and coping strategies. Their response is not only dictated by the intensity of the disease but by their own acceptance of their disease status, an understanding of the disease and treatment options, their fear of stigma, and the reaction of family, friends, partners, and health workers.