Thailand: Outrage over U=U messaging: An example of pervasive stigma and discrimination in 2020

By Tanat Chinbunchorn, MD, Reshmie Ramautarsing, MD, PhD

In January 2019, a Thai influencer, who is open on social media about living with HIV, his sex work, and use of stimulant drugs, offered to teach the public how to have safe bareback sex, using U=U as a back-up theory. He posted the offer on Twitter and Facebook, but did not receive much interest. More than a year later, in February 2020, this particular post was shared on Facebook by a student nurse with an angry caption, calling the influencer several names. The influencer then responded that he would take a legal action against her, which sparked a large public outrage with hundreds of thousands of profiles on Facebook and Twitter condemning him, and accusing him of being a public threat. Self-proclaimed "HIV-experts" without any demonstrable HIV experience, began blaming the influencer for spreading lies, and for instigating fear of HIV-transmission in the Thai community. This outcry took social media by storm, and the U=U message kindled national-level interest and scrutiny.

In response, several television interviews took place with a renowned HIV doctor - Dr. Nittaya Phanuphak, and a highly experienced HIV professor - Professor Praphan Phanuphak, both from the same organization, both with decades of experience in clinical HIV care, and HIV related research and advocacy. Dr. Nittaya Phanuphak endorsed the U=U message during her interviews, and carefully explained the science behind it. She mentioned that for people living with HIV and with undetectable viral load, it is safe to stop using condoms if the reason for condoms use was preventing HIV transmission, stressing that although condoms still play a role in prevention of other sexually transmitted diseases, it is everyone's own right to decide whether or not to continue using condoms for this purpose. Doctors should not blame their clients for deciding one way or the other, but rather educate them so that clients are equipped with the knowledge to make an informed decision. She also explained that although condoms are an effective HIV prevention option, in the real world it would be impossible for everyone to use condoms consistently due to a variety of personal or occupational reasons. She then thanked the influencer for bringing up U=U to discuss in a wider public.

Professor Praphan Phanuphak was also invited for a televised interview to discuss the legitimacy of the message, together with the influencer and an HIV advocate. Instead of condemning the influencer as the audiences would like to see, Professor Praphan Phanuphak and the HIV advocate endorsed U=U. Read more via Prevention