Syphillis and Other STIs on The Rise Especially in Bangkok

[PeterRS]

Adding to the recent thread on gonorrhoea inoculations soon to be available in the UK, in Thailand we have also to be aware that the rate of STIs is rising alarmingly. According to date from the HealthDeliver Clinic website, three key take-aways from their research -

- Thailand experiences a rise in STI rates, particularly syphillis and gonorrhoea, with alarming inplications for youth health.

- Drug use and casual sex culture contribute significantly to risky behaviors and decreased condom use among young individuals.

- Gonorrhoea is increasingly antibiotic-resistant, posing a serious public health threat that could lead to untreatable infections.

More significantly, under the heading Alarming Statistics on STI Rates in Bangkok, the Report writes - 

"In recent years, Thailand has witnessed a shocking spike in the rise in STDs, with syphilis cases jumping from 11 to 18.6 per 100,000 people between 2018 and 2022. These alarming statistics reveal a troubling rise in sexually transmitted infections, particularly among youth . . . As syphilis rates soar, gonorrhoea emerges as a growing concern that can no longer be overlooked. This STI, particularly affecting our youth, is becoming increasingly resistant to antibiotics, raising alarms among health professionals. With rising STI rates in Thailand, gonorrhoea’s potential to develop into an untreatable health crisis looms large. It's vital for you to understand the risks of transmission from one sexual partner to another."

The Report is particularly concerned with Thailand's youth -

"The rise in sexually transmitted infections among youth can be traced back to multiple factors. Casual sex and dating app culture often lead to risky behaviors [aligned with] the decrease in condom use which has contributed to the rising HIV prevalence in Thailand."

This forum has frequently expressed concern at the apparent lack of condom use in most of the saunas outside the centre of the city, but till now that has been focussed more on the spread of HIV. With other STIs rising in importance, the government's seemingly increasing lack of urgency in introducing more detailed sex education in schools and colleges is especially worrying. 

https://www.healthdeliver.asia/blog/thailand-and-bangkok-rise-in-sexually-transmitted-infections-crisis-among-young

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[Moses]

3 hours ago, PeterRS said:

Adding to the recent thread on gonorrhoea inoculations soon to be available in the UK

With high probability that will lead to increasing of cases of gonorrhea, since that vaccine has efficacy only 38%. But inoculated will think they are 100% protected and their behavior will be even more risky.

I asked ChatGPT to calculate a probabilistic model of behavior, it came up with the idea that the vaccine will increase the number of cases due to riskier behavior of the population. So, that vaccination is pure populistic and (maybe) stimulated by bribe decision.

 

[Riobard]

Just so readers here know, that Chat GPT garbage posted above is not remotely sane or scientific, and contradicts the sophisticated analytical Bayesian modeling upon which the NHS is rolling out the gonorrhea vaccine for already established MSM attending for testing minimally, whose baseline risk factors are already high.

These models stratify expected absolute decrease in cases according to subpopulations ranging from all males to those with multiple partners and historically screened, many diagnosed. They consider behavioural variables as well as the expected case incidence over time that would occur based on doing nothing, the increased trajectory to date being a major factor in introducing intervention with limited randomized control research data.

Simply put, since condom uptake is already low and exposure risk via partner quantity high, the vaccine is a substitute, albeit limited in eradication potential, for condom protection among those targeted for implementation. Obviously, the baselines aren’t already consistent condom use that will lapse or low numbers of partners that will escalate. Moreover, treatment availability has been a key factor in risk behavioural trends. A false sense of security regarding vaccine prophylaxis wouldn’t be expected to impact the breadth of risk that already manifests according to counting on after-the-fact infection management. Why would guys, the same cohort with access to vaccine as well as treatment for breakthrough infection get tested without this expectation? At this point the narrative is two disease mitigation approaches, one with roughly flu vaccine efficacy in a lower efficacy year and the other fraught with growing antimicrobial resistance. 

There is plenty of logical academic reading available in the public domain on this subject that is not sourced from the Dunning-Kruger afflicted. If you care to think it through rationally rather than manipulate the facts.

[PeterRS]

Condom use - or the inceasing lack of it over the last dozen and more years - has become a topic occasionally covered by this Board. If I read posts correctly, the general view seems to be that all sex has risks, but with relatively more recent medications like PrEP and treatments for early detection of some other STIs like syphillis, the need for condom protection is now far less. But there are other STIs out there and, as discussed in this thread, gonorrhoea is one which now has to be taken much more seriously.

I remember the pre-HIV days when we all took risks and maybe some of us caught the occasional STI which was relatively easily treated. Then came HIV-AIDS which quite literally put the fear of death into us. I may have reduced my sexual activity but certainly did not stop it. I just made sure that I had a constant supply of condoms and lube both at home and on my frequent travels. I knew there were some countries I visited where gay sex was pretty much a taboo subject. I would have felt more than awful had I knowingly or otherwise infected a young guy realising he would die as a result. Even when AZT and the anti-retrovirals became more common, I was never without a condom and that has remained pretty much the case even today. With a young partner in Thailand and, with his knowledge not being sexually inactive when travelling, his health and the simple desire not to pass on any STI I might otherwise have picked up I believe this is being sensible.

I know others do not agree. I know too that the lack of condom use, especially among Thailand's younger generations, is especially worrying. I hear of saunas outside the centre of Bangkok where condoms are rarely if ever used. To those of us who lived in the later 20th century, this always seems odd, given that it is the popularity of condom use that has brought the birth rate down from nearly 6 per family in the late 1960s to under two today. (One reason why we now see so few Thais in the gogo bars when you never saw non-Thais on their stages even 30 years ago). Condoms are in common use in Thailand. Yet the government seems to do nothing to get this mesage across to the nation's youngsters. It is desperately sad.