Northern Thailand's ethnic minority HIV awareness: Challenges & realities high for HIV-risk communities with limited access to services

Objective: The aim was to determine unique HIV information gaps of ethnic minorities experiencing limited-to-no health care access in Northern Thailand. Background: Qualitative data from Thailand's Project Accept were used to determine health information needs of Northern Thailand's ethnic minorities. These communities experience high HIV prevalence, often participate in high-risk behaviors (sex & drug trades) due to limited economic opportunities, and usually experience no access to healthcare services. Methods: Qualitative research methods (open and focused coding, theme development, memoing and integrative-memoing, conceptual framework construction) were applied to semi-structured in-depth interview transcripts. Sample (n=36) included: Chinese, Pakistani, Thai-Yai, Black & Red Lahu, Lisu, Hmong, Akha, Karen, Zam and Kon-Muang. Results: HIV information gaps were widespread among ethnic minorities and included: lack of accurate HIV transmission routes awareness, beliefs HIV transmits via touch, breath, food, being near/sharing food or items with persons living with HIV (PLHIV) (resulting in stigma toward PLHIV). Lack of condom-use awareness was common. HIV treatment information gaps were also common and perceptions included: forest herbs, chicken bile, bitter gourd and an injection/tablet to prevent or cure HIV. Others believed no HIV treatment yet exists (and would be unavailable to ethnic minorities if needed). Conclusion: Northern Thailand's ethnic minorities experience high HIV prevalence due to lack of HIV awareness, high HIV-risk behaviors and limited access to care. Most cannot be reached via traditional health education messages due to language/literacy barriers. Clear, culturally and linguistically appropriate health education messages should be targeted to these high-risk groups to improve HIV understanding.