Arresting HIV in Soi Cowboy

As neon lights bounced off the mirrors in a club on Bangkok's Soi Cowboy strip, a gaggle of dancers were enthralled by a performance on stage. A young community worker, Chamrong Phaengnongyang, was wedged between four dancing poles, and had his crowd laughing hard at a wickedly funny lesson about safe sex and HIV prevention.

Chamrong blew up a condom and applied baby oil to demonstrate what happens when the wrong lubricant is used. Pop! The condom broke and the audience got the message – only use water-based lubricants. And always, always use a condom.

Chamrong, deputy director of the Swing organization, explained that about 1,000 women aged 18-25 work in the Soi Cowboy precinct. Swing is encouraging them to use condoms, get tested for HIV and encourage their peers to do the same. Swing also takes its messages to transgender and male sex workers in other districts of Bangkok. Many of the sex workers have migrated from rural provinces or neighboring countries such as Cambodia, and their knowledge of sexually transmitted diseases is often scarce.

Swing encourages testing at its own premises at three monthly intervals. It also leans on peer leaders within the clubs to push the messages of safe sex and awareness. Last year, four percent of the women tested were HIV positive. For male sex workers, it was 15 percent. In these instances, a network of care and support swings into action. Counselling and ARV treatment is provided in quick measure.

In public health parlance, organizations such as Swing are part of community systems strengthening. Thailand is transitioning away from Global Fund investment, and one challenge is to keep such groups funded and active. While governments can provide condoms and medication, they also need charismatic community workers who can connect on a human level. Like Chamrong.