Prostitution and Aids in Thailand: Sexual Consumption in a Time of Crisis


Russell W. Belk (1994) ,"Prostitution and Aids in Thailand: Sexual Consumption in a Time of Crisis", in AP - Asia Pacific Advances in Consumer Research Volume 1, eds. Joseph A. Cote and Siew Meng Leong, Provo, UT : Association for Consumer Research, Pages: 288-290.

Asia Pacific Advances in Consumer Research Volume 1, 1994      Pages 288-290


Russell W. Belk, University of Utah

AIDS has reached crisis proportions in Thailand. Due largely to sex tourism, this crisis poses a growing threat not only to Thailand, but to other parts of Asia and other parts of the world. The three paper presenters spent two weeks in Northern Thailand conducting participant observation and depth interviews in an effort to better understand the nature of the AIDS crisis in Thailand and the effectiveness of AIDS awareness and prevention programs. These three papers present the initial results of our research. Together, the three papers develop an understanding of the Thai cultural context in which prostitution exists, the attitudes and AIDS risk-taking behaviors of foreign sex tourists, and the values, attitudes, and AIDS risk-taking behaviors of Thai students. The focus of each paper is on developing a sufficiently deep and culturally sensitive understanding of the problem for a meaningful discussion of AIDS prevention and future prospects in Thailand.

At the present time as many as 600,000 Thais are infected with AIDS and it is predicted that by the year 2000 as much as ten percent of Thailand's 57 million people may have contracted the virus (Barnathan, Stier, and Einhorn 1993). Because Thailand for decades has been a key center of sex tourism, the problem extends beyond its borders. Such tourism is a key factor in the prediction that there will be 45 million cases of AIDS in Southeast Asia by the year 2000, pushing it well ahead of Africa for the dubious title of AIDS capital of the globe (Hoelzgen 1993). The epidemic threatens the economic vitality of the region as young workers and executives alike begin to contract the disease. At a human level AIDS in Thailand is a tragedy linked to other tragedies including the poverty that leads to both voluntary and involuntary prostitution (as parents literally sell their children into sexual servitude) and the lack of education that hinders knowledge of AIDS and its prevention.

Although prostitution may involve an immoral exploitation of human beings (Hirschman 1991; Truong 1990), and sex slavery certainly does so (Aisbett and Malan 1993; Hornblower 1993; Sherrill 1993), the patronage of prostitutes is plausibly the oldest form of consumer behavior. Nevertheless, prostitution has been studied to a very limited degree by consumer researchers (+stergaard 1993). Consumer research into AIDS prevention is only slightly more extensive (e.g., Cooper-Martin and Stevens 1990; Gould 1990; Middlestadt 1993). The focus of this session is first on understanding the role of prostitution consumption in the spread of AIDS in Thailand and second on implications for AIDS prevention strategies. Toward this end, the three presenters conducted participant observation and depth interviews in Thailand during June of 1993. We focused our research in Chiang Mai, the largest city in the heaviest area of AIDS infection in Thailand. The majority of our interviews were with English-speaking Thai university students, although we also interviewed foreign tourists, prostitutes and other sex industry workers, government officials working in AIDS control, medical personnel working with AIDS diagnosis, women's resource center officers, and a journalist in Bangkok studying prostitution and AIDS. We also conducted participant observation in brothels, pick-up bars, "massage parlors" providing prostitution services, and at a restaurant adjacent to a major prostitution district in Chiang Mai. A sociology graduate student doing work in a local brothel was both a key informant and a liaison facilitating our research. The papers presented in this session are the results of our analysis to date of fieldnotes, interview transcripts, and secondary materials.

In Thailand patronage of prostitutes by men is a well-entrenched cultural pattern (Mulder 1992; Sickel 1991; Tangwisuttijit 1989). Nevertheless, the Thai government has until recently been reluctant to admit the rampant spread of AIDS for fear of frightening away potential tourists (Supapueng 1991/92). While some government efforts have been initiated in educating Thai people about the spread of HIV and in reducing prostitution (illegal in Thailand since 1960), these efforts have had little impact. One reason is the grinding poverty of much of Northern Thailand, where many prostitutes (both voluntary and involuntary) come from and where the rate of AIDS is the highest in Thailand. Another reason for the growth of AIDS in Thailand is the great power imbalance between men and women generally and between male customers and female prostitutes specifically (Hantrakul 1992; Tantiwiramanond and Pandey 1991). Even among the independent (rather than sexually indentured) prostitutes of open brothels, there is virtually no right or ability to insist that a customer wear a condom. Lack of open communication about AIDS is another problem. It is not uncommon for men diagnosed HIV positive to withhold this information from their wives and to continue to have sex with them. As a result, the number of cases of AIDS among housewives is rapidly growing in Thailand. Similarly, it is not unusual for prostitutes diagnosed as HIV positive to go back to work, only infrequently heeding the admonition of medical authorities to insist upon the use of condoms. One study found that in June, 1992, approximately one in four female prostitutes in Thailand was HIV positive (Sittitrai 1992). Another study found that over half of single urban Thai males and one-third of married urban Thai males had hired prostitutes during the past year (Sittitrai, et al, 1992). Overall, nearly 40 percent of the urban men in the study reported unprotected sex outside of a monogamous relationship during this period.

In order to understand such patterns and accordingly to gain insight into what might be effective AIDS prevention strategies, we undertook this pilot study of prostitute patronage and AIDS knowledge and behaviors. Together the three papers attempt to present a culturally contextualized understanding of these attitudes and behaviors, concentrating primarily on heterosexual men. The paper by Groves historically situates the present sex industry in Thailand and focuses particularly on the "farang," foreign tourists to Thailand who purchase prostitution services. This includes military, group sex tours, and independent tourists. The contributing role of the U.S. government in building the infrastructure of prostitution during the Vietnam war is noted, along with its residual impact on current foreign sex tourism in Thailand. The paper by +stergaard focuses on the Thai cultural patterns and values that have institutionalized patronage of prostitutes by Thai men. He raises the ethical issue of whether intervention to change strongly entrenched cultural beliefs and behaviors is justified by the AIDS crisis in Thailand. Finally, the paper by Belk uses interviews with Thai university students to better understand these students' exposure to the risk of HIV infection and their knowledge and use of preventative measures. Based on these results we make recommendations for reducing AIDS risks in this group, with separate segmented strategies aimed toward homosexual men, heterosexual men, and women.





Ronald Groves, Edith Cowan University


Northern Thailand is currently witnessing one of the world's most rapid increases in the spread of the AIDS virus. The inherent danger, particularly for potential tourists, has been well documented. In most instances, the sex industry has been singled out as the major contributing cause of the dilemma. Undoubtedly, part of the problem can be attributed to "Rest and Relaxation" programs for American armed forces during the Vietnam conflict, and more recently, organized sex tours. This paper suggests, however, that the underlying causes originate in ancient religious and cultural practices within Thai society. It is these influences which have led to the patriarchal attitudes and double standards which maintain women as second class citizens. Western males have taken advantage of the situation through both misunderstanding and selfishness. This paper outlines the historical and cultural factors which have determined current attitudes and discusses a number of ways in which Thai society is beginning to challenge both these attitudes and the moral standards which threaten the survival of their society.



Per +stergaard, Odense University


During the last several years there have been major information campaigns in Thailand about the dissemination of AIDS. However, these campaigns don't seem to have had a significant impact on the number of new AIDS victims. One explanation is that prostitution in Thailand is a fundamental part of the culture. Thai men consider consumption of prostitution services as a part of the general consumption. Prostitution itself is also a legitimate part of the culture. It is not unusual to watch a husband drop his wife of in front of the brothel on his way to work and then pick her up again on the way home at five p.m.. A distinct difference from Western cultures is that it is not a taboo to talk about one's personal consumption of prostitution services.

The fight against AIDS must be combined with a fundamental change of behavior and attitude in the entire culture. This could include trying to change the sexual behavior and attitude into more Westernized norms and values-e.g., giving up the claim for a virgin bride and the acceptance of pre-marital sex. This would result in a decrease of young men's demand for prostitution services and therefore hopefully reduce the development of this kind of consumption pattern. Such a change in the young Thai's sexual behavior would be a major change in the entire Thai culture. The big question is then: Is it acceptable to change the old and rich Thai culture? Would such a change create much more trouble than AIDS? There is no clear answer to this. The paper assesses the costs and benefits of such changes from the perspective of Thai culture.



Russell W. Belk, University of Utah


Despite the Thai government's decreasing denial of Thailand's AIDS epidemic (it's former policy for fear of hurting tourism) and its recent occasional enforcement of anti-prostitution laws, changes in the infrastructure of prostitution in Thailand are unlikely. While some reduction of AIDS among foreign tourists is occurring, the rate of HIV infection is increasing rapidly among Thai patrons of prostitutes. Based on depth interviews with Thai University Students in the region of Thailand most heavily infected with AIDS (the north, in the city of Chiang Mai), this study assesses the state of knowledge of AIDS, knowledge of and attitudes toward prevention of HIV infection, sexual attitudes, and AIDS risk-taking behaviors among this vulnerable population. Both males and females and both heterosexual and homosexual students were interviewed over a two week period during the summer of 1993. Several contributing problems are detected that put this population at high risk.

One such problem is the tradition of kun kroo, in which young boys are initiated sexually by being taken to a brothel to find a "first teacher." This practice typically occurs in the early teenage years and is repeated as a rite of passage among "freshies"Cfirst year university students. Young Thai men also continue to go in groups to patronize prostitutes, sometimes as often as once a week or even more frequently (prices at the low end were typically US $0.50 during 1993). A second contributory problem is the prevalent male belief that sex with a condom is unsatisfying and the prostitute's substantial lack of power to insist on safe sex. This disempowered position persists among both male and female prostitutes and among both the indentured "sex slaves" of "closed brothels" and the independent prostitutes of "open brothels." These problems are exacerbated by a relative openness to homosexuality (codified by transsexual "katois") and a relative lack of openness toward heterosexual premarital sex for males. And a fourth problem is the adaptive rather than controlling tenets of Theravada Buddhism. Because of beliefs that some Westerners would pejoratively characterize as fatalism, there is little willingness to change behaviors that put Thai students at risk, as well as less desire to be tested for HIV among those exposed to such risk. While knowledge of AIDS is often, but not always, good and improving, the belief that such events are outside of the individual's control often resulted in behaviors that were little changed by this knowledge. In light of these findings and trends that may be emerging in Thai student behaviors, recommendations are made for more successful campaigns to change behaviors among this population.


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Russell W. Belk, University of Utah


AP - Asia Pacific Advances in Consumer Research Volume 1 | 1994

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