"Teens are a new risk group," says task force member Sureerat Treemanka. They are sexually active but do not know how to protect themselves from HIV infection, she says.

The social trend towards "free sex" has not been accompanied by education about "responsible sex", Sureerat said. "The problem is that their attitudes about sex could lead to risky behaviour."

Phra Alongkot of Wat Phrabaht Namphu, a temple in Lopburi where Aids patients are left to die, has also noticed a change. "The patients are younger and younger," he said.

As many as 700,000 Thais are living with HIV/Aids, but most do not know they are infected, experts say.

Sureerat, who has worked on Aids issues for more than a decade, estimates that only about 200,000 know.

About half have access to Aids medicines, which include drugs to prevent opportunistic infections, drugs to treat physical and mental discomfort and the anti-retroviral medicines that prevent HIV from destroying the immune system and block transmission from a pregnant mother to her foetus.

Overall, the system for helping people living with HIV/Aids has significantly improved due to the universal healthcare system, Sureerat said.

"Once you find you have HIV/Aids, you can go to your hospital under the Bt30 system and have the right to get proper medical treatment," she said.

"That's good news, but the bad news is not many hospitals will provide you with what you are entitled to."

Many hospitals are worried they will not get paid for treating HIV/Aids patients, she says. "It's a management problem during a transition period of the system's implementation that is expected to improve within two years."

Sureerat identifies the hurdle as an unclear agreement between the Public Health Ministry's Aids office, which used to oversee treatment, and the Office of Universal Healthcare Coverage, which does so now. The problem of transferring responsibility to the new office is political as well as practical, she said.

"That's why many hospitals are still reluctant to provide proper services to HIV/Aids patients," she said.

The most recent UNAids report placed Thailand among the countries that had made significant progress in controlling the spread of HIV infection, but Sureerat said as many as 30,000 Thais were infected each year, most of them teens.

The situation in Thailand may sound as if it is improving when compared to that in other countries, but Aids is still a crisis here, and the epidemic has become more complex, she said.

"Our problem is how to deal with people who are living with HIV/Aids. Around 80 per cent of them are living and working normally," Sureerat said.

Charin Khonman, an official at Wat Phrabaht Namphu, estimates that three of every 10 Thais living with HIV/Aids keep it a secret while only one in 10 get proper medical treatment.

Those working at the temple in Lopburi as well as Sureerat agree that more needs to be done to prevent infections.

Abbot Phra Alongkot said he was trying his best to educate the public, especially teens, about Aids.

What is needed, however, is a new kind of education, an Aids-awareness programme run by youths for youths, Sureerat said.

UNAids says the spread of HIV/Aids appears to be slowing worldwide and some regions are reporting progress in bringing the epidemic under control, but other countries are failing to reach key targets for prevention and treatment.

At the end of last year, there were an estimated 38.6 million people worldwide infected with HIV, including about 4.1 million who were infected last year.

The number of people who died from Aids-related illnesses fell to 2.8 million people last year from 3.1 million in 2003, UNAids said.

Sureerat said Thai society would remain vulnerable to Aids until it accepted that the most important requirement for sex was that it be safe.

"We may be successful on some levels in Thailand, but the main problem remains bias and attitudes towards Aids and its major cause, sex.

"As long as we are hypocritical enough to say sex is acceptable only within marriage and try to push everyone into that single type of sexual relationship, Aids will remain with us," she said.

"We need to accept various kinds of sexual relationships, including those outside marriage, but they must be safe," Sureerat said.

Kamol Sukin

The Nation