Rapid assessment and response: The context of HIV/AIDS and adolescents in Bangkok

Background: HIV/AIDS is still a major health problem throughout the world, including Thailand. As HIV/AIDS becomes endemic, it is critical to find ways in which to effectively fight this disease locally. In Thailand, social and economic conditions are rapidly changing, creating the sorts of unstable conditions that make adolescents vulnerable to HIV/AIDS infection. A better understanding of unique risk behaviors, attitudes, and values and HIV/AIDS prevention and care needs is critical for providing HIV/AIDS services to adolescents. Purpose: The purposes of this study were to utilize the World Health Organization's Rapid assessment and Response (RAR) method of assessing HIV/AIDS risk-taking behaviors among adolescents in Bangkok Metropolitan Areas and to evaluate whether knowledge gained from rapid assessment assisted response to identified local needs and facilitated development of appropriate HIV/AIDS prevention interventions to reduce HIV/AIDS risk among adolescents in Thailand. Method: The study was designed in partnership with a community working group (CWG) consisting of local community leaders, public health and social services providers as well as key members of local communities. Participants consisted of adolescent between 12-22 years and adults 23 years and up in Bangkok Thailand. A trained field team conducted behavioral and environmental mapping, site observations, focus groups (N=24), in-depth interviews with adolescents (N=9), health and social service providers (N=2), and community leaders (N=6), and street intercept surveys (N=100). Results: Findings revealed that adolescents in Bangkok are at high risk of early unprotected sex. Among adolescent risk behaviors observed, unsafe sex, substance abuse, selling drugs in the communities, and sex exchanges (for drugs, money, etc.) were identified. Findings also pointed to strong links between alcohol consumption and unprotected sexual encounters. Due to a lack of HIV/AIDS knowledge among adolescent, the communities had expressed a need for school-based or community-based prevention programs. The results were presented to the CWG to develop targeted action plans. Recommendation based on these findings will be addressed. Conclusion: RAR appears to be an effective assessment tool to develop population-specific HIV/AIDS prevention interventions. The findings of this study provide information that could enable local health providers and policy makers responding to HIV/AIDS situation. This can help reduce the spread of HIV/AIDS among young people in Thailand.