Men having sex with Men
Thank you so much for the information that you have provided on this post! It has been a tremendous help to me, as I am struggling to figure out how I will manage my medications once I move to Thailand. I tried to message you privately, but as a newbie, I don't have 10 posts yet.
Thanks again for taking the time to answer questions.
I'm a newbie here (on the forum and in Thailand), also recently had to leave another Asian country due to my status, also would like to thank everyone who has contributed to this thread. At the moment I'm not working but considering going back to teaching or starting a business here.
I'm not sure if this is too much to ask but was wondering if anyone has personal recommendations for Bangkok:
- hiv specialist doctors
- health insurance
- farang support groups (to share information)
Due to the HIV screening for "insurance purposes," it is clear that a person with HIV cannot teach in a government school. However, is it possible to refuse the insurance altogether, thereby bypassing the HIV test? Also, what are the alternatives to public schools? Do the big language schools require an HIV test? Private language schools?
I am undetectable and very healthy otherwise. Like many of you, I would love to spend a year or so in Thailand teaching English and immersing myself into the culture. However, after much research I have found that my options are limited due to my condition. I would need at least 40,000 BHT/month to live in Bangkok, and I doubt it is possible to earn that amount privately. I do have a BA and a recently acquired TEFL certification, but lack experience overseas. I realize that these factors put me at a serious competitive disadvantage.
Any information and advice will be greatly appreciated.
scv91 There is no requirement for HIV screening for insurance purposes. It is a lie. That said it might have been done by one school here or there. Certainly it is not a requirement. Ignore the request. Choose another school.
HIV tests are private and should remain so. Anyplace requiring you to give a blood sample isn't respecting workers and should be avoided in any case.
MP.. The best hiv doctors in the country are afflilated with Chulalongkorn University and Mihadol University and work at the goverment hospitals of those universities. Many also have work part-time at Bumrungrad Hospital. That said, every district hospital in Thailand has been charged with having and hiv program as part of the universal health care scheme.
That scheme has readily availiable gpo-vir, gpo-vir Z, and combivir, efervanese, TDF and 3TC. These drugs and combinations thereof from goverment hospitals would run less than 3000baht a month. Ltv/r a generic protese inhibitor is the usual second line regiment and even with that would probably be under 6000 baht month. Brand names get priceyer.
I have heard that the thai red cross std clinic in bangkok near Chula Hospital has a foreigners group once a month (vaguely recall something said about 3 Sat each month but contact them directly).Welcome to The Thai Red Cross Society.
If you get to Pattaya, Dr. Phillip has a HEARTT2000 NGO which he works with the Doctor at Chonburi hospital (who has done numerous clinical trials). www.heartt2000.org
From the THAI RED CROSS SITE:
Medical Services Anonymous Clinic
The Thai Red Cross AIDS Research Center set up the Anonymous Clinic on July 4, 1991. It is the first clinic in Thailand not required to report HIV-infected patients to the government. The clinic gives knowledge and advice about AIDS and offers anonymous testing. Patients are not asked for their names or addresses; instead, each patient is assigned an identification number.
The services presently offered include: 1. Knowledge and advice about AIDS
hepatitis B, syphilis and blood group testing. Test results are treated as confidential, and patients need not give their names or addresses.
2. Anonymous testing of CD4 cells
for HIV+ patients to determine antibody levels.
3. HIV viral load testing
Knowledge and advice about veneral diseases, and veneral disease testing and treatment.
How to collect a blood sample for HIV viral load testing
Collect seven millilitres of blood in an EDTA-treated tube (to prevent it from clotting), and have the tube sent to the Anonymous Clinic as soon as possible within six hours. In case it is not possible to have it sent within six hours, isolate the plasma from the blood by churning it at a speed of 1500 rounds per minute. Place the plasma in a box of ice at -20 degree Celsius and send it to the Clinic within 24 hours. The b-DNA method is used in HIV viral load testing.
4. Hepatitis B viral load testing.
How to collect a blood sample for Hepatitis B viral load testing
Collect five millilitres of blood in an EDTA-treated, non-heparin tube (to prevent it from clotting), and have the tube sent to the Anonymous Clinic as soon as possible within six hours. In case it is not possible to have it sent within six hours, isolate the plasma, or serum, from the blood by churning it at a speed of 1500 rounds per minute. Place it in a box of ice at -20 degree Celsius and send it to the Clinic within 24 hours. The PCR method is used in HBV viral load testing.
1. Anonymous AIDS, viral hepatitis B, syphilis, and blood group testing is available on
weekdays from 12:00 a.m. - 7:00 p.m. and on Saturdays from 9:00 - 12:00 a.m. The clinic is closed on Sundays and official holidays.
Regular Immediate Results 1. AIDS 80 baht 200 baht 2. Viral Hepatitis B 70 baht 200 baht 3. Syphilis 50 baht 60 baht 4. Blood Group 20 baht
2. CD 4 cell counting is available
on Fridays from 8:30 - 11:00 a.m. only. The fee is 400 baht.
3. HIV viral load testing is available during office hours.
The fee is 3,000 baht.
4. HBV viral load testing is available duringoffice hours.
The fee is 2,500 baht.
Thai Red Cross Anonymous Clinic
1871 Rama 4 Road Bangkok 10330
Phone: (662) 2256 - 4109
Fax: (662) 254 - 7577
MP. No health private health insurance company will cover your pre-existing conditions and hiv is specifically excluded in any case on all private policies. The only program that would cover you for HIV would be the Social Security System, which would require you to work for a Government School as private schools were specifically excluded from the program. Some non-school private employers may also have social security insurance. I would say that you not really bring it up except casually in an interview and don't dwell on it.
If you want to challenge the world's most powerful factions, you're going to get attacked in all sorts of ways. That's the nature - the essence - of power: it is capable of exacting a cost for defying it.--Glenn Greenwald
This doctor at Bumrungrad has been given good recommendations and was trained in the US:
Dr. Asda Vibhagool.
I had to give blood and urine to get a work permit. No mention of HIV test though.
I am interested in having a check done at the red cross but I read that they scan your passport???? Is that true?
The whole process took about 2 hours which involved filling out a form, letting them scan my passport (so it’s not annonymous although they say it is), going for pre-test counselling by a doctor, drawing blood, and then meeting the doctor again for the result.
More info from the Anonymous Clinic:
Thailand's Official MSM website / Thai Red Cross AIDS Research Centre
It is possible for outside patients to purchase medications from the Anonymous Clinic of the Thai Red Cross AIDS Research Centre. However, it will be necessary to have a doctor’s prescription with the doctor’s signature or authorized signature. You will also need to provide the doctor’s full name, his/her affiliation (hospital/clinic name), address and contact information. Your health and wellbeing are important to us. Therefore, it is important for us to know that you have access to assistance and care in the event that you experience any side effects of the medication.
The Thai Red Cross AIDS Research Centre’s dispensary offers a choice of two regimens. Regimen A consists of “original source” medications, while Regimen B consists of one original source and one generic brand. The monthly cost of the medications by regimen is as follows:
Regimen A (original source)
Truvada (IBS: Germany) cost = 2,100 THB per month
EFV (MSD: Australia) cost = 810 THB per month
Total cost per month = 2,910 THB (approx. US$ 92.00)
Regimen A (India + original source)
Ricovir-EM (India) = 1,020 THB per month
EFV (MSD: Australia) cost = 810 THB per month
Total cost per month = THB 1,830 THB (approx. US$ 58.00)
Medications are usually dispensed in 3-month allotments but it is possible for you to get a 6-month supply.
When you arrive at the Thai Red Cross AIDS Research Centre, you will need to register at the Anonymous Clinic. You may then go directly to the dispensary, which is located just above the registration area, and present the prescription order and doctor’s contact information. The dispensary pharmacists will give you an invoice for the medications. Once you have paid the cashier for the medications, take the receipt back to the dispensary to pick up your medications.
Adam’s Love Team (Gregory Carl)
These are the first line medications used in the US and developed countries. They make up the single pill prescription called Atripla. That pill costs about $2000 a month in the USA so considerably cheaper here in Thailand and hopefully this will assure all that top line treatment is available an a cost that a teacher's salary could afford.
Now get tested if you have been putting it off. If positive, then start medication when you are ready to take these pills everyday for the rest of what should be your very long life.
Generic name/ Strength
Lamivudine 150 mg (3TC)
360.00 (60 tab)
Lamivudine 300 mg (3TC)
360.00 (30 tab)
Efavirenze 600 mg (EFV)
810.00 (30 tab)
Zidovudine 100 mg (AZT)
450.00 (100 tab)
Tenofovir 300 mg (TDF)
1,350.00 (30 tab)
Stavudine 30 mg (d4T)
240.00 (60 tab)
Nevirapine 200 mg (NVP)
540.00 (60 tab)
Lopinavir/Ritronavir 133.3/33.3 (LPV/r)
5,400.00 (180 tab)
Lopinavir/Ritronavir 100/25 (LPV/r)
1,440.00 (60 tab)
Didanosine 250 mg (ddI)
2,430.00 (30 tab)
Didanosine 400 mg (ddI)
3,750.00 (30 tab)
Abacavir 300 mg (ABC)
8,520.00 (60 tab)
Ritonavir 100 mg (RTV)
3,024.00 (84 tab)
Darunavir 300 mg (DRV)
12,000.00 (120 tab)
Darunavir 600 mg (DRV)
12,000.00 (60 tab)
Atazanavir 200 mg (ATV)
9,750.00 (60 tab)
Atazanavir 300 mg (ATV)
8,640.00 (30 tab)
Saquinavir 500 mg (SQV)
9,600.00 (120 tab)
AZT 300 mg+3TC 150 mg
930.00 (60 tab)
3TC 150 mg+NVP 200 mg+d4T 30 mg
750.00 (60 tab)
3TC 150 mg+NVP 200 mg+AZT 250 mg
870.00 (60 tab)
TDF 300 mg+FTC 200 mg
2,100.00 (30 tab)
Etraverine 100 mg
10,200.00 (120 tab)
Tenofovir 300 (Generic)
810.00 (30 tab)
16,680.00 (60 tab)
TDF 300 mg+FTC 200 mg (Generic)
1,020.00 (30 tab)
My guess it that these medication prices would be fairly standard at all the government HIV clinics. It is my understanding that all provincial hospitals can provide care now locally that would be Chonburi Hospital. This would be the price if paying yourself and not relying universal health to pay which tends to want to put people on the GPO-vir 2 a day tablets (both because its cheaper) and to test for the patients adherence to medical treatment. Why pay 20000 baht a month on drugs if the patient decides not to take them. If you are on a very limited budget then start on the Gpo-vir Z250 as the Gpo-vir S uses d4t which caused limp pain, and facial wasting. The TDF+3TC+EVF generic at $58 a month would be a better option. If a woman and planning children then Keletra+Combivir is the usual first line treatment and is quite a bit more expensive at $200 a month.
The generic drugs come from a large reputable Indian pharmaceutical company that is approved by The Clinton Foundation and the WTO so its not a 'counterfeit' it's the generic version of the drug.
If you are a Teacher, I would recommend that you do not get drugs in your home community if up country, it might be career ending. (Gossip mill).
Of note the Universal Health Scheme is reported to be preparing to change the guidelines from beginning treatment at CD counts of less then 350 in stead of 250. My advice is test and treat without regard to CD count. Earlier intervention is preferred by most providers in high resource countries.
Update: according to several sources, Atripla is available in Bangkok's Thai Red Cross-NAT for 2640 baht for 1 month supply. This one a day pill should simplify treatment and adherence issues.
One person decribed the process for him............
"You both must have a prescription from a regular Thai hospital for atripla etc and then have it filled at the red cross clinic. Their current price is 2.500 baht per 1 month's supply. You can get a yearly script if you ask for one and collect a maximum of 2 months meds from the clinic per prescription every 2 months. You cannot get meds for 2 people with one prescription; you'll need 2 separate ones. You both also need to register at the clinic in person, (if indeed there are 2 of you). They don't ask for your name, only your initials.
Blood work at the clinic is very reasonable. cd4 results in 24 hrs, vl results in 7 days. these results can be e- mailed to you if requested.
By the way, the consultation fee at the regular hospital is around 1500 baht per patient. If your condition is stable you only need to see an ID doc twice a year.
To recap. If you're working outside Bangkok, on your day off go to a hospital, get a years prescription, get 2 months supply at the clinic and return home. You can do this in about 4 hours. Not bad eh? Time for a cold one and some somtam before you get back on the bus...!"
Update: These medications are available (but pricey non-generics) at Thai Red Cross Clinic according to reports:
Etraverine 200 mg Intelence Price 10,200.00 (120 tab)
Raltegravir 400 ISENTRESS Price 16,680.00 (60 tab)