1. Commentary Thailand national guidelines for implementing HIV prevention among men who have sex with men and transgender populations As of March 2013 Frits van Griensven, PhD, MPH Thai Red Cross AIDS Research Center and HIVNAT Bangkok, Thailand Division of Preventive Medicine and Public Health University of California at San Francisco, San Francisco, CA, USA

2. Commentary These guidelines have come a long way:  30 years after the first AIDS cases in Thailand were identified in MSM  20 years after the HIV epidemic peaked in heterosexuals  10 years after the first cross-sectional assessment showed a 17.3% HIV prevalence among MSM in Bangkok  8 years after similar high HIV prevalence was found among transgender women in Bangkok, Phuket and Chiang Mai

3. Commentary What happened in the preceding 8 years? Thailand went through some difficult political times and instability  Social order campaign, war on drugs, human rights accusations military coup, frequent change of government  Social divisions of society along colored lines  Flooding of most of the agricultural and economic heart of the  In the mean time scaled up its National Access to ART Program, now providing 60-70% of its citizens with publicly funded ART  Consuming 80% of the AIDS budget

4. Commentary  Extremely pleased to see that the National Government of Thailand, and the Ministry of Public Health are now officially recognizing and embracing the HIV epidemic among its MSM and TG population, as theirs, and is acting on it  Aligns it strategy with the rest of the world to Zero HIV infections, Zero discrimination an d Zero AIDS deaths  This is a significant step and very strong signal that the National government is now committed to control this epidemic and takes leadership in doing so

5. Commentary Practical, hands-on, with examples and instructions for those working in the field Elements: 1.Community assessment 2.Enabling environments for HIV prevention and care 1.Building understanding of sexual diversity 2.Strengthening community 3.Establishing enabling policies 3.Human capacity development 4.Monitoring and evaluation But it could use a bit more hand and feet in the data we have to target and focus our efforts

6. 5 2 1 3 4 FIEBIG IIIIIIIV V EIA & NAAT Old window period (90 days) Ultra sensitive NAAT 6 Stages Prevention Clinical New window period (50 days) Acute and early HIV infection: A window period of preventive opportunity

9. Commentary Practical, hands-on, with examples and instructions for those working in the field Elements: 1.Community assessment 2.Enabling environments for HIV prevention and care 1.Building understanding of sexual diversity 2.Strengthening community 3.Establishing enabling policies 3.Human capacity development 4.Monitoring and evaluation This is a first step and we eagerly waiting for the next steps forward to follow

13. Bangkok, number and % of MSM tested, linked, retained and virally suppressed MSM, men who have sex with men; DX, diagnosis; ART, antiretroviral treatment; VL, HIV RNA viral load