Project rationale

Epidemiological and behavioral data in Thailand indicates that men who have sex with men (MSM) remain one of the most vulnerable populations for HIV infection with 62% of new infections over the next five years estimated to be among MSM and 1/3 of all new infections to be in Bangkok. Saunas enterprises are one of the most important and effective points for targeting at-risk behaviours among MSM in Bangkok because they are venues where men meet other men and frequently engage in non-transactional sexual behaviours. They represent efficient and cost-effective opportunities to reach at-risk MSM through a workforce which can be trained to deliver peer education and support as well as to maintain and promote HIV prevention and management standards in their workplace.

HIV/AIDS is a workplace issue for saunas not simply staff are known to be MSM but also because these workplaces can play a vital role in limiting the spread and effects of the epidemic. In recent years attention to HIV vulnerabilities in Thailand has seen community approaches strengthened and local NGOs have given valuable assistance by providing guidance on how to tailor programs. Despite these best efforts, effective enterprise-based HIV programs in saunas are non-existent and the industry risks becoming a hotbed for new infections among MSM.

Project strategies

The International Labour Organization with guidance from Recommendation 200 Concerning HIV/AIDS and the World of Work supported Bangkok sauna owners and managers through local peer-based organizations to develop an enterprise-based model for HIV prevention and management in saunas workplace. Key strategies were:

• Development of a positive policy environment for HIV work at saunas
• HIV/AIDS education and training for staff of saunas to protect themselves and reach out to MSM customers in the workplace
• Develop new infrastructure and distribution of condoms and lubricant within saunas

Key partners

• Owners and managers of Bangkok sauna venues
• Local peer-based organizations Bangkok Rainbow Organization (BRO) and Rainbow Sky Association (RSAT)
• Bangkok Municipal Authority (BMA)
• Ministry of Public Health (MOPH), Thailand
• Department of Labour Protection and Welfare (DLPW), Thailand
• Asia-Pacific Coalition on Male Sexual Health (APCOM)
• United Nations Development Program Thailand (UNDP), Thailand
• United Nations Educational, Scientific, and Cultural Organization (UNESCO), Thailand
• Joint United Nations Program on HIV/AIDS (UNAIDS), Thailand

Achievements to date

• Assessment and improved knowledge and understanding of HIV prevention and management needs in the Bangkok sauna industry;
• New infrastructure developed for distributing condoms and water-based lubricant in line with international standards for sauna venues;
• Training package on HIV prevention and management for Bangkok sauna staff to protect themselves, reach out to customers, and uphold workplace minimum standards;
• Guidelines on minimum HIV prevention and management standards for the Thai sauna industry with accompanying workplace policy tool;
• 6 pilot sites in venues established to implement the new enterprise-based model;
• 16 sauna venues recruited to adopt staff training package;
• New partnerships for prevention identified and a network of sauna enterprises mobilized through consultation with operators of 19 venues from the total 31 enterprises operating in Bangkok;
• Capacity building of local peer-based organizations to support workplace programs in saunas;
• Technical support to government in developing policy for a licensing model for the sauna industry;
• Improved enabling environment for work in Bangkok saunas.

For further information please contact:

Richard S. Howard
Senior specialist on HIV and AIDS
International Labour Organization
10th Floor United Nations Building
Rajdamnern Nok Avenue
Bangkok, Thailand 10200
Tel: +662 288 1765
Email