CONDOM CULTURE

PROGRAM
Thailand

Megan Dalrymple, Katie M. den Dulk, Caitlin A. Martinez, Andrea R.

Moreno, Tuyet Nguyen, Tiffannie N. Snyder, & Nora M. Vue
California State University, Stanislaus

The Human Immunodeficiency Virus (HIV)

epidemic in Thailand:
Thailand

has the second highest HIV

prevalence in the continent of Asia and
there were over 500,000 existing cases of
HIV in 2005

Due to the high prevalence and

transmission in the country, prospective
reduction initiatives have been set out in

Condom Culture

 Analyze the prevalence of HIV in

Thailand and the prospective decline of
transmission with the correct use of
condoms.
Decrease the HIV transmission rate in
Thailand by:

Education regarding the correct use condoms

Teaching the benefits of using condoms
Offering availability & accessibility of
condoms

PROPOSAL

 Target population those who are at high

risk for developing HIV in Thailand:

Sex workers
Intravenous drug users
Youth
Homosexual men

Decreasing the transmission rate in the

high-risk population will in turn decrease
the transmission rate in low-risk groups

PROPOSAL

Proposed

solutions include

Developing the sexual health curriculum

in high schools
Implementing a mass media project
about the HIV transmission risk
Increasing the availability and
accessibility of condoms

PLAN

Condom

Culture will increase correct condom

use in those who participate in our program
by 35% in Thailand
98% of participants in the program will know
how to use the condoms correctly at the end
of our teaching.
By the end of the second year of our program,
60% of participants will report that they have
used condoms correctly with each sexual
encounter.
There will be a 30% decrease in HIV
transmission in the Thailand population in 10
years.

OUTCOMES

Thailand

has second highest HIV

prevalence rate in Asia

There

are multiple causes of this epidemic

Traditional
What

views vs. new age views

happens when these views collide?

BACKGROUND

Certain

populations are especially vulnerable,

including sex workers, homosexual men, and
intravenous drug users

Sexual

bridging increases the risk of

developing HIV in the general, lower-risk
population

Illegality

and lack of regulation of sex work

prevents some sex workers from seeking out
both means to prevent HIV as well as
treatment

BACKGROUND

The

government in Thailand has already teamed up

with NGOs in an effort to lower HIV transmission
Thai Women and AIDS Taskforce is a recently
established program
Efforts have resulted in reaching Millennium
Development Goal 6, which aims to decrease the
spread of HIV by 2015
Effective interventions include promoting the use of
condoms and education on HIV transmission and
prevention
These efforts have proven to be effective because
although there were over 500,000 existing cases of
HIV in 2005, only 3% were new cases
Because of the proven effectiveness, our program
focuses on similar strategies of promoting the
correct use of condoms and educating program
participants about HIV transmission

BACKGROUND

What

do studies show about Thailand?

Thailand has the second highest HIV prevalence in

Asia
Male sex workers have the highest transmission rate
Thai women are expected culturally to be reserved
regarding sexuality
Thai men are culturally expected to be experienced
regarding sexuality
It is generally considered a rite of passage that Thai
men visit prostitutes for sexual experience
Female and male sex workers are high risk groups
Female and male sex workers increase risk to low
risk groups

LITERATURE REVIEW

 Successful

evidence-based programs for

decreasing the HIV transmission include these
interventions:

Correct

use of male and female condoms

Making condoms more pleasurable
Education
Targeting women in the HIV/AIDS awareness
Lubricant use and availability amongst male sex workers
HIV testing and counseling
Street outreach programs
Improved screening of blood products and organs for
donation
Needle and syringe programs
Antiretroviral therapy

LITERATURE REVIEW

The

Primary Goal:

Condom Culture program will contribute to

decreasing HIV transmission rates by 30% within
10 years in Thailand by promoting correct condom
use
Three

Objectives:

1. The program will help increase the correct use of

condoms by 35% in targeted high-risk groups
including sex workers, intravenous drug users,
youth, and homosexual men in Thailand within 10
years
2. 98% of participants in the program will know how
to use condoms correctly
3. By the end of the second year, 60% of
participants will report that they have used
condoms correctly with each sexual encounter

GOALS & OBJECTIVES

First

Objective: Increase the correct use of

condoms by 35% in targeted high-risk groups,
including sex workers, intravenous drug users,
youth, and homosexual men, in Thailand within
10 years:
1. Develop the sexual health curriculum in high schools
with free condom incentives using different teaching
styles to engage the students
2. Select and train a program coordinator, along with
other staff members, for the high school sexual
health education
3. Implement a high-risk outreach program, including
education on the benefits of condom use, offering
emotional and financial support, and free condoms
for the duration of the Program

GOALS & OBJECTIVES

Second

Objective: 98% of participants in

the program will know how to use
condoms correctly:
1. Implement a mass media project, with the
support of the government, regarding the HIV
transmission risk with every unprotected
sexual encounter
2. Select a coordinator to manage
implementation of the mass media campaign

GOALS & OBJECTIVES

Third

Objective: By the end of the second

year, 60% of participants will report that
they have used condoms correctly with
each sexual encounter:
1. Focus on the availability and accessibility of
different types of condoms with reduced
prices at various vendors, including grocery
stores, cosmetic stores, and shopping malls
2. Provide free condoms during Condom Month
for completing a Condom Awareness survey
3. Select a coordinator to organize partnerships
between condom companies and potential
businesses

GOALS & OBJECTIVES

To

obtain all three objectives:

The program will first establish headquarters in

major cities and select program coordinators.
All divisions of the program will be fully
implemented within one year of the start of the
program.

GOALS & OBJECTIVES

Sex

education of high school students

Enacted in 20% of the schools at the end of the

year
Education based on teaching 10 core concepts

Outreach program
Target high risk group
Free male and female condoms with
lubricants
Educational classes for safer sex methods

TECHNICAL APPROACH

Mass

Media Campaign

Message reaches 25% of general public at the

end of year

Condom Month

Condom Awareness Survey

Availability

and affordability of condoms

Spot inspections
Vendor advertising
Venders sales and inventory records

TECHNICAL APPROACH

Talking

about sex is taboo

Media Campaign floods airways, streets, and

mainstream culture with information about
sexually transmitted diseases, HIV, correct
condom use
Encourage use of condoms as being pleasurable
Forming

connections

Government officials and community leaders

No

funding

Government, schools, businesses

STAKEHOLDERS

TECHNICAL APPROACH

Monitoring Goals:

Questionnaires regarding
knowledge
and condom use will be given before
educating clients and after teaching t
monitor change in attitude & knowledge
Prevalence and transmission rates will be gathered from
local health departments and the CDC

Evaluating Programs:

Program coordinators meet on a monthly basis

Monitor and Evaluation Lead meets headquarter leaders to
discuss surveys, results, and program effectiveness
Continuous and frequent monitoring of these programs is
crucial in providing data that can be used to modify and
maintain efficiency of the program and to achieve goals

MONITORING & EVALUATION

Programs

(School
Education and High Risk,
Mass Media, and
Condom Availability):

Will have their own

coordinator who will report
to the Monitor & Evaluator
on a monthly basis

Recruitment:
Required to pass an assessment test after
training with 80% and if needed additional
training and a passing rate of 85% for second
assessment. Staff will be evaluated every six
months.

MONITORING & EVALUATION

School

and High Risk Outreach

Staff will pass an assessment test of 80% and if

needed, additional training
Participants will be given surveys to evaluate how
they feel about the program and its effectiveness
Mass

media

Individuals who participates will be asked in a

survey where they have heard of the Condom
Culture Program
Condom

Availability

Participating vendors will be asked to monitor

the amount of condoms in-stock and how
many
condoms are sold monthly

MONITORING & EVALUATION

Strategies

group

that worked best for our

Meeting in person
Facebook message board
Dividing up work
Equal participation from all team
members

STUDENT RECOMMENDATIONS

Challenges

faced during the

developmental process
Facebook message board
Logic model
Dividing up tasks
SMART goals and objectives

STUDENT RECOMMENDATIONS

Lessons

learned

Start earlier
Unique experience seeing all that goes in
to starting up a program

STUDENT RECOMMENDATIONS

Crosby, R. (2013). State of condom use in HIV prevention science and practice. Current HIV/AIDS
Reports, 10(1), 59-64. doi:10.1007/s11904-012-0143-7
Energy Saving Trust. (2014). How to monitor and evaluate your community project. Retrieved from
http://www.energysavingtrust.org.uk/Communities/Support-and-guidance/How-to-guides/How-tomonitor-and-evaluate-your-community-project
Park, L. S., Siraprapasiri, T., Peerapatanapokin, W., Manne, J., Niccolai, L., & Kunanusont, C.
(2010). HIV transmission rates in Thailand: Evidence of HIV prevention and transmission decline.
Journal of Acquired Immune Deficiency Syndromes, 54(4); 430-436. Retrieved from
http://130.17.174.102/illiad/illiad.dll?Action=10&Form=75&Value=117530
Pattanaphesaj, J., & Teerawattananon, Y. (2010). Reviewing the evidence on effectiveness and
cost-effectiveness of HIV prevention strategies in Thailand. BMC Public Health, 10(1), 401.
Retrieved from http://www.biomedcentral.com/1471-2458/10/401
Rotheram-Borus, M., Ingram, B., Swendeman, D., & Flannery, D. (2009). Common principles
embedded in effective adolescent HIV prevention programs. AIDS & Behavior, 13(3), 387-398.
doi:10.1007/s10461-009-9531-4
Tan, J.Y., Huedo-Medina, T.B., Warren, M.R., Carey, M.P., Johnson, B.T. (2012). A meta-analysis of
the efficacy of HIV/AIDS prevention interventions in Asia, 1995-2009. Social Science & Medicine,
75, 676-687. doi:10.1016/j.socscimed.2011.08.038
The Presidents Emergency Plan for Aids Relief. (2013). Next Generation Indicators Reference
Guide. [Data file]. Retrieved from http://www.pepfar.gov/documents/organization/206097.pdf
Thianthai, C. (2004). Gender and class differences in young people's sexuality and HIV/AIDS risktaking behaviours in Thailand. Culture, Health & Sexuality, 6(3), 189-203.
doi:10.1080/1369105031000156379
Wirtz, A. L., Pretorius, C., Beyrer, C., Baral, S., Decker, M. R., Sherman, S. G., . . . Kerrigan, D.
(2014). Epidemic impacts of a community empowerment intervention for HIV prevention among
female sex workers in generalized and concentrated epidemics. Plos ONE, 9(2), 1-11.
doi:10.1371/journal.pone.0088047

REFERENCES