FORMER MODEL OF SUCCESS, THAILAND'S AIDS EFFORT FALTERS, U.N. REPORTS

BANGKOK, July 8 - Thailand's AIDS program, widely promoted as the
world's most successful in preventing the disease, is in serious
danger of unraveling, the United Nations said in a report issued here
on Thursday.

The United Nations called the report "a frank assessment" of
Thailand's situation and said that the report should sound an alarm
and spur discussion of the issue at the 15th International AIDS
Conference, which opens here on Sunday. The meeting is expected to
draw at least 15,000 scientists, health workers, political leaders and
advocates. Health officials have long praised Thailand for preventing
millions from becoming infected with H.I.V., the virus that causes
AIDS, by acting decisively early in the epidemic.

Strong support from top political leaders to provide educational
programs and adequate public financing and to promote condom use as
part of protected sex helped reduce the number of new infections to
about 20,000 in 2003, down from a peak of 143,000 in 1991.

That was "an achievement unrivaled by any other country," J. K. Robert
England, of the United Nations Development Program, said at a news
conference here.

But Thailand has let its guard down, the United Nations said, allowing
a new phase of the epidemic to become "a frightening reality."
Prevention has lapsed, and the incidence of H.I.V. is on the rise
among young people, fishermen, construction workers and other migrant
workers, drug users and gay men.

Half of the new infections are occurring among men and their wives or
girlfriends.

"Thailand may be in for a nasty surprise" from a resurgence of the
epidemic that does not yet show up in national statistics, said Hakan
Bjoerkman, the deputy resident representative of the United Nations
Development Program in Thailand.

The Thai government has cut its AIDS prevention budget by nearly
two-thirds since 1997. Now adequate prevention services are reaching
fewer than 5 percent of teenagers and adults too young to remember the
heyday of the AIDS epidemic, Mr. Bjoerkman said. He also said that
condom use was falling among young, sexually active Thais because they
considered AIDS a disease of the past and had little or no perception
of the risk of H.I.V. Public awareness campaigns have all but faded
from view.

"Thailand is in a danger zone, threatened by a new wave of the
epidemic, and if Thailand's success turns into failure, the world will
lose a guiding light and that will have great implications for the
global response to H.I.V.," Mr. Bjoerkman said. "Time is not on our
side."

The report is being posted on a United Nations Development Program Web
site (www.undp.or.th). The agency said it hoped that all countries
would use the report as a reference to learn from what Thailand did
right and what went wrong.

About 1.5 percent of adult Thais are infected with H.I.V., down from
2.5 percent in the mid-1990's. But since 2000, the prevalence of
H.I.V. among pregnant women has doubled to 2 percent in southern
Thailand, and has exceeded 3.5 percent in two provinces.

Since AIDS was first recognized in the United States in 1981, more
than 400,000 Thais have died of the disease, 53,000 of them last year.

The United Nations and leading Thai authorities on AIDS urged Thailand
to put AIDS back on the political radar screen. The authorities also
urged Thailand to consider revising its prevention messages because
some old approaches may no longer work among a new generation.

Young Thai women appear more likely to engage in extramarital sex than
earlier generations. Yet studies have found that only 20 percent of
sexually active young Thais and 15 percent of young gay men report
using condoms consistently.

From 1994 to 2003, H.I.V. prevalence has dropped to 7 percent to 12
percent from 30 percent. Condom use among brothel-based sex workers
has dropped to 50 percent in some locations from 96 percent at the
height of the education program in the mid-1990's.

Stigma and discrimination remain major problems. About 40 percent of
infected people report breaches of confidentiality in the health
system and 25 percent say they have been harassed.

Although nearly all young Thais know that H.I.V. can be transmitted by
unprotected sex, 20 percent also believe they can become infected by
hugging or kissing an infected person. "Condoms need to be available
everywhere," said Mechai Viravaidaya, a leader in Thai AIDS
prevention. In a new approach, he said, Bangkok now has the first
A.T.M. in the world that can simultaneously dispense condoms with cash.

Dr. Werasit Sittitra, a Thai who works for the United Nations AIDS
program in Geneva, recalled what he said a young woman told him as she
was dying of AIDS early in the epidemic, "Adults did not do enough to
protect me."

On Thursday, he urged Thailand to better protect its young.