| Abstract: |
The purpose of this dissertation is to explore the historical, socio-cultural, and economic context of sexual behaviour and sexual networking in Ghiang Mai, Thailand, and specifically how these factors put women at risk for HIV. To address the potential for risk, several areas will be investigated including men and women's perspectives on sexual behaviour, their acceptance of pre-marital and extra-marital sex with commercial sex workers, and perception of risk for HIV. By 1995, it was estimated that approximately 2% of all sexually active adults in the country were infected with HIV (Koetsawang and Auamkul 1997). The HIV epidemic in Thailand has been described as a succession of waves with the first wave sweeping through the drug injecting population, the second wave consisting of the commercial sex workers, with the third wave currently acting as the gateway to the general population through the clients of commercial sex workers (Ungphakorn 1993). These clients can potentially infect their girlfriends and wives, the fourth wave of the epidemic. Epidemiological studies in northern Thailand have confirmed the explosive nature of the epidemic among commercial sex workers with seroprevalence rates as high as 40% (Celentano 1994). Thailand is in the midst of a social transition and undergoing economic turbulence. This study will demonstrate that Western influence as well as the response to the AIDS epidemic has resulted in changes in sexual behaviour and gender role expectations. The retention of old traditions, such as commercial sex work visitations coupled with an increasing acceptance of pre-marital sex is fuelling the AIDS epidemic. Paradoxically, the emergence of HIV in Thailand has made individuals re-evaluate previously held socio-cultural axioms involving pre-marital and extra-marital sex with commercial sex workers. Semi-structured ethnographic interviews, key informant interviews, focus group discussion, participant observation, educational material from public health campaigns, and archival data have been collected to contribute to the understanding of the epidemic in Chiang Mai. A model of transmission is proposed based on data analysis. Additionally, recommendations for future AIDS prevention programming and research are offered.
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