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The
major overseas response of the U.S. DoD to the global
HIV threat to military forces was the establishment
of the Department of Retrovirology at AFRIMS in 1991.
The mission of this department focus on the evaluation
of vaccines for prevention of infection. HIV is a sexually-transmitted
or bloodborne infection which has emerged and become
pandemic during the latter decades of the 20th century.
The impact of HIV/AIDS on the young adult populations
of many countries is becoming a
Representation
of human immunodeficiency virus - the causative agent
of AIDS.
destabilizing
factor in nations worldwide. Thus, HIV is both a lethal
infectious risk for individual military members and
a significant economic and political issue on the international
level.
Beginning in 1989 the Royal Thai Army (RTA) began HIV-1
screening of new recruits. HIV prevalence data generated
from this screening program provide an unparalleled
window on the HIV epidemic in Thailand. In the late
1980s there was an alarming increase in the prevalence
of HIV throughout Thailand, most
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notably
in the Northern region. This dramatic increase continued,
peaking in 1992-1993. Since that time there has been
an equally dramatic decline. There is little doubt that
this dramatic decline mirrors the development and implementation
of Thailand's extensive nation-wide HIV intervention
program. Thailand's tremendously successful respond
to the HIV epidemic is a model of what can be accomplished
by a government, public health infrastructure and pupulation
willing to face and address the difficult issues surrounding
HIV intervention and control in a concerted, national
effort. This same spirit of cooperation and willingness
to address HIV control issues, in addition to a highly
developed public health infrastructure, makes Thailand
an ideal area to continue the development of HIV prevention
strategies including the evaluation of potential vaccines
in the world-wide fight to control the HIV/AIDS pandemic.
In 1995-96, a phase I/II trial of a subtype B (the most
prevalent strain in North America) vaccine candidate
was conducted in Thailand. In 1997-99, the world's first
phase I/II trial of a non-subtype B HIV vaccine designed
for a specific regional epidemic was carried out. Evaluations
of "prime-boost" vaccine combinations will
be initiated in 1999-2000. Other efforts include the
characterization of potential cohorts for participation
in a phase III efficacy trial, epidemiological and virologic
surveillance of the regional HIV epidemic, investigations
of the natural history of HIV in potential vaccine populations,
and study of the interaction between HIV and endemic
tropical infectious diseases.
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