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Sex in the Village:
Culture, Religion and HIV/AIDS
in Thailand

Chapter 1

Strategizing Against AIDS in Thailand

This sample passage is from pages 9 to 12 of the book. References, footnotes and illustrative material cited below are available in the printed book:
The Localization of HIV/AIDS in Thailand

Thailand, in collaboration with WHO, UNAIDS, and other UN agencies, has adopted guidelines to work on HIV/AIDS prevention and surveillance for funding and support. Thus, we can say that Thailand has been the recipient of global HIV/AIDS prevention. Thailand has been using biomedical interventions, such as promoting condoms, blood screening, treatment of STIs, etc; behavioral change interventions, such as voluntary counseling and testing, and school-based interventions; structural interventions such as the 100% condom use program; community-based approaches, such as the Buddhist and the Christian approach to HIV/AIDS prevention; and multi-sectoral approaches which integrate all of the above-mentioned approaches at different scales of operation.

As will be explained in Chapter 2, although Thailand has been passing many phases of HIV prevention, there has never been an effective assessment of the religious approaches to HIV prevention. This book explores and assesses the two most common approaches: the Buddhist and the Christian approaches which combine the biomedical approach and the behavior change intervention with religious beliefs. The Buddhist approach has been carried out in about 50 temples across the country. The Christian approach, with its headquarters in Chiang Mai, is covering operations in the northern part of Thailand.

My research project was designed to investigate perspectives on prevention concepts and methods as displayed at the grassroots level in Thailand, and to study what impedes or facilitates the prevention process.

I started this research in 2005 in Chiang Rai, Thailand. The research aimed at studying the globalization-localization process of HIV/AIDS prevention notions from the Western or the developed world down to the village level. The ABC (Abstinence or delay sexual debut, Be faithful or reduce the number of partners, and Condom use where one is unwilling or unable to practice A or B) strategy and the safer sex and dialogue approaches, unofficially called CNN (Condom, Negotiation and sterile Needles) to prevent HIV/AIDS were studied. I interviewed 160 Thai Buddhist and 102 Protestant villagers using questionnaires with closed and open-ended questions administered in a face-to-face situation. The Buddhist respondents, who came from Tonnam6 village in Tonpa sub-district, were systematic randomly selected from the whole village of 1,274 people. The Protestant respondents, who came from Lamthan village in Lamnao sub-district, were all the villagers living in the village at the time of research. In addition, I conducted 29 in-depth interviews with key informants in both villages. The data collection took place from 1 September 2005 to 10 January 2006, and during a two-week follow-up visit in April 2007. I was also given access to the library of the Department of Disease Control at the Ministry of Public Health in Nonthaburi, and interviewed the Chair of the National AIDS Committee in Bangkok. Some interviews were semi-structured, some unstructured.

The distribution of global HIV/AIDS prevention policies via the national level to the local village level are summarized in the flow chart shown on Table 2.

Chiang Rai province is part of the so-called Lan Na region (the upper northern part of Thailand which includes Chiang Mai, Chiang Rai, Lampang, Lamphun, Phayao, Phrae and Nan provinces). Lan Na used to be an independent kingdom until 1899, when it was annexed to Thailand. It had its own globalization periods, which were parallel to those of Thailand.

Thai Culture is another key concept in this study. The dynamic interaction of the socio-economic context with patriarchy (and female subordination) and the patriarchal Buddhist worldview amidst phases of historical globalization processes has resulted in cultural change. The understanding of Thai sexuality as a cultural product informs the HIV/AIDS studies. The Buddhist worldview as another cultural product is responsible for the local interpretation of the global HIV/AIDS concept rooted in a Protestant worldview.

To further illustrate Table 2, HIV/AIDS prevention concepts and policies from the elites of global organizations (such as the UN agencies) are being transferred to the Thai government as local elites in the world system. The ABC program and the strengthening of Buddhist leadership in shaping moral values and adhering to the Buddhist Five Precepts and HIV/AIDS prevention in a community-based approach promoted by UNDP and UNICEF are being transferred to the Sangha (the Thai Buddhist body) through the Sangha Metta Project in Chiang Mai and the Monks against AIDS network in Chiang Rai. At the same time safer sex concepts, condom promotion and biomedical interventions are being transferred from UN agencies to the Thai government through the Ministry of Public Health. The Thai government supervises the Sangha via the office of National Buddhism (2010). How the Thai government has exercised control over the Sangha during the globalization period is explained in Chapter 3.

The Protestant institutions that collaborate under the Ecumenical Advocacy alliances such as Presbyterian USA, the World Council of Churches (WCC), the World Alliance of Reformed Churches (WARC), DanChurchAid, the Christian Conference of Asia (CCA), etc. (Ecumenical Advocacy Alliance 2010) also transfer messages on life-skills education (including sex education), Protestant morality and HIV/AIDS holistic preventive approach.

The line of localization can be divided into:

1) The localization of messages from the Sangha level and the flow of the messages to the Monks against AIDS network in Chiang Rai which influences the localization of the messages and practices as transmitted by the abbot of the Tonnam Buddhist Temple. Finally the messages are transferred to the Tonnam Buddhist villagers.

2) The localization of messages from the Church of Christ in Thailand and the flow of the messages to the Christian AIDS Ministry in Chiang Mai which influences the localization of the messages as transmitted by the pastor of Lamthan Christ Church in Chiang Rai. Finally the messages are transferred to the Lamthan Protestant villagers.

The text which preceded this passage is available at:
HIV/AIDS as a Manifestation of Unequal Development

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